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Heather L. Troyer, DVM, DABVP, CVA, CVPP, The Oradell Animal Hospital, Paramus, New Jersey
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This study evaluated standing weight in patients that had previously undergone thoracic limb or pelvic limb amputation. The evaluators used a commercial stance analyzer. As compared with standard force plates, which are used in other methods to evaluate gait kinetics, stance analyzers require less skill for collecting data, use less space, and are less costly.
Two groups of dogs were evaluated. One group comprised dogs with thoracic limb amputation (n = 10), and the other group comprised dogs with pelvic limb amputation (n = 10). Five trials of stance data were collected for each dog and compared with established normal, nonamputated values.
Dogs with thoracic limb amputation and dogs with pelvic limb amputation had the largest increase in weight bearing in the contralateral thoracic limb. The study suggested that a careful preoperative orthopedic and neurologic evaluation of the limbs is necessary and that long-term emphasis on preservation of the contralateral thoracic limb would be useful.
Multimodal adjunctive techniques1 could help preserve joint and limb health in amputees. Analgesic and restorative therapies may include NSAIDs, extra-label adjunctive analgesics, physical rehabilitation, acupuncture, cold laser therapy, weight maintenance, stem cells or platelet-rich plasma, and/or emerging drug therapies.1-3 Understanding these new modalities and the biomechanics of an amputee may help practitioners make more informed clinical decisions, in the same way that knowing which digits are primarily weight bearing can help when discussing prognosis about foot trauma or surgery with an owner.
Key pearls to put into practice:
If venous drug administration is needed in an amputee, clinicians should consider not using the contralateral thoracic limb.
If a pelvic limb amputee has orthopedic disease in the ipsilateral thoracic limb, both thoracic limbs should be assessed and treated to preserve the contralateral (primary weight-bearing) thoracic limb.
Clients should be educated about the importance of maintaining lean body weight, preserving joint health, and encouraging exercise for amputee patients that are comfortable and able. Also, assistance devices should be discussed, and patients should be referred for orthotics when necessary.
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