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3. Radius Curvus – Treatment
First of all I have to underline I am not a vet nor a medical doctor. What I describe here is based on the knowledge I gained through the Internet, through consulting a number of vets, and of course through my “own” experience.
I think it is important to explain what can cause Radius Curvus. In most cases the predisposition is inborn – it is a genetic fault – or in other words, dogs inherit a suit of genes which makes them predisposed to develop Radius Curvus. From my research on the Internet I conclude, that the great majority of the cases of Radius Curvus has genetic bases. There is a whole group of factors which can cause the syndrome and make your dog develop Radius Curvus. We can divide these factors into 4 groups:
1) Genetic influences 2) Environmental influences 3) Nutritional influences 4) Mechanical influences - injuries
You can read more about it at the following www service:
http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2005&PID=10975&O=Generic
Anyway, as a multifactor disease it is treated as genetically conditioned one. Unfortunately, the total lack of cooperation from the breeders’ side in finding the reason for Tarat’s condition forces us to believe it is strictly genetic, also evoked by too rich diet and maybe some infection – but we are only guessing here. It is not so easy to see it at a puppy. Especially, that they are very lively and running all the time. However, the picture taken by Alma Oakley-Abrahams just a day before we bought Tarat shows, that his legs looked twisted before we got him (unfortunately I only got this picture later, when Tarat was with us and I started to be worried with his legs):
So, the breeder had to see it, and most likely ignored it thinking it was a growing phase. If you look closely at this picture you will see that not only the paws are twisted to the sides, but what is most important here – the elbows are kept very closely to the body and the long bones of the front legs are not straight and the front legs make a V shape. This is not the best picture, obviously Alma was not even thinking to look closely at the legs. But for the vets I talked to this picture together with the further development of Tarat’s condition was a clear sign the problem was already there some time before we bought the puppy.
The treatment
As to the treatment of the syndrome, you can read a bit about it in the links I provided before and here:
http://www.shilohgtf.com/Premature%20Closure%20Ulna.htm
http://www.asecvets.com/pdf/dimsurg/DimSurg1103.pdf
We decided to go for the corrective osteotomy. In most cases this surgery should be done between the 16-20th week of puppy’s life, so that the process of healing would take place during the fast growing phase. The operation meant cutting a gap in both Ulna bones. Normally, to stop the bones from healing to fast, vets use some fat from the body of the puppy to block the both ends of the gap. Then, the bones will not start healing before the fat gets absorbed. In Tarat case – as you can imagine – finding any fat on this puppy was mission impossible. Therefore, his Ulnas were cut more – above 1,5cm in each leg. It is important to make the process of rehabilitation as slow as possible. The later the Ulnas would close – the better and the bigger chances we would not have to repeat the surgery.
The dog after this surgery is basically able to walk “normally” within days. The Radius bones take over and the dog is standing on his front feet quite firmly. We have to remember though, that both legs are only 50% efficient. It makes them rater fragile and easy to injure.
The retaining cartilage at the end of Ulna can not be healed by giving Calcium as many uneducated breeders think:
“From a variety of studies it became clear that nutrition has a major impact on skeletal development. Food with a high calcium content has proven in field studies (Slater et al, 1992, Kallfelz & Dzanis, 1989) as well as in standardised laboratory circumstances (Hazewinkel et al, 1985, Schoenmakers et al 2000) that high mineral intake will cause disturbances in endochondral ossification. This makes the skeleton more vulnerable to mechanical influences like over weight as well as to OCD lesions. More recently, it became clear that vitamin D intake increased to a level that it will not lead to hypervitaminosis D (with calcification of soft tissues), will also disturb endochondral ossification by direct influence and not by increasing intestinal calcium absorption (Tryfonidou et al, 2002). High food intake and thereby excessive calcium and vitamin D intake does also lead to osteochondrosis (Lavelle 1989, Hedhammar et al, 1974). High calcium or high vitamin D intake will cause retained cartilage in growth plates and thus a disturbance of growth in length of the fast growing growth plates, in particular of the distal ulna and distal radius. Disturbance of growth in length may lead to radius curvus syndrome or short radius syndrome, respectively. Elbow incongruity in case of radius curvus syndrome may coincide with UAP, whereas incongruity with a shortened radius may coincide with FCP.” From: http://www.vin.com/proceedings/Proceedings.plx?CID=WSAVA2005&PID=10975&O=Generic
The Radius Curvus Syndrom is not evident when you look at dogs with your eyes - I mean if you can see it with your eyes, then it is too late to treat it with gaping the Ulnas. In more advanced stages, when the dog is not growing any more the treatment is more complicated and requires a corrective osteotomy of the Radius bones – we had to do it later, with Tarat’s left leg due to the complications and a fracture of the left Radius – more about it in “Complication” sections. Thanks to the great expertise of the vets I consulted I was able to avoid the worst situation when the Radius would curve too much and the elbow would be totally destroyed. The ribs of Tarat were perfectly well. Tarat was getting the right amount of Calcium with the higher ratio of phosphor as his metabolic system was also wrong and he did always have a wrong Ca/P ratio no matter what we fed him with. Basically, this was a weak and not a healthy puppy. I kept him and I was doing all I could to heal him.
There is no doubt Tarat has a Radius Curvus Syndrom. One could argue with us about the way we chose to treat the problem – but I guess for this I would expect someone to have some experience with dogs with this Syndrome. We chose what we thought was the best in our total situation after analyzing all the factors and over 5 weeks of observing the puppy.
As an owner I had to take the decision whether we should risk and wait for the Radius to destroy the elbows or whether we should operate. We chose the second way. In my opinion the best for Tarat.... But to be honest - the best would be if we never had to make these choices. I hope nobody else will ever have to go through it.
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