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783.e2 Phalangeal Disorders

injection of the area with platelet-rich of bone lysis, and always submit amputated
digits for histopathologic evaluation.
plasma or triamcinolone; surgical excision • Digits are best amputated at the metacarpo/
VetBooks.ir • Collateral injuries: bandage for 3-4 weeks; metatarsophalangeal joint (unless only claw
of fragments if lameness persists.
removal is needed). Simultaneous removal
surgical repair indicated for performance dogs
• Acute flexor tendon injuries: suture tendons
or reattach avulsed insertions, then splint for of two digits (even if those digits are 3 and
4 or 2 and 5) is tolerated well by most dogs.
4 weeks with the paw in a slightly flexed
position. Chronic, degenerative injuries Technician Tips
seldom respond to this treatment but are When radiographing digits, spread the toes by
usually not painful. Fusion podoplasty has attaching gauze to the claws of digits 2 and 5.
been successful in treating refractory cases. Use the gauze to pull these digits medially and
• Pyogranulomatous infection: treat with laterally on the dorsopalmar/plantar view and
antibiotics/antifungal drugs, but full resolu- to angle them (medial digit more dorsal and
tion may not be achievable; amputation of lateral digit more palmar/plantar) on the lateral
affected digit may be necessary. view so that each digit can be seen without
• Neoplasia: amputate at the metacarpo/meta- superimposition.
tarsophalangeal joint (provide chemotherapy
if indicated; consultation with an oncologist SUGGESTED READINGS
is advised). Eaton-Wells RD: Injuries of the digits and pads.
• Digital pad corns: excise or core out the In Bloomberg MS, et al, editors: Canine sports
hyperkeratotic mass, then bandage for 3 medicine and surgery, Philadelphia, 1998, Saunders,
weeks. Flattening the corn with a Dremel pp 165-173.
drill and then treating with topical vitamin Tomlinson J: Digital injuries and their treatment.
E ointment may be helpful. Recurrence is In Proceedings of the North American Veterinary
PHALANGEAL DISORDERS Radiograph of a dog Conference: Small Animals and Exotics, vol 29.
with digital squamous cell carcinoma. Note lysis of common. Removal of P3 and the distal con- Gainesville, FL: 2015, NAVC, pp 1141-1143.
the third phalanx (arrow). dyles of P2 combined with pad repositioning
has been successful in a small number of ADDITIONAL SUGGESTED
cases.
• Bacterial/fungal culture (by fine-needle READINGS
aspiration or biopsy) of infected digits PROGNOSIS & OUTCOME Guillard MJ, et al: Corns in dogs; signalment, possible
• The most common digital tumors are malig- aetiology and response to surgical treatment. J Small
Anim Pract 51:162-168, 2010.
nant, and thoracic radiographs and lymph • Most phalangeal fractures and isolated col- Kaufman KL, et al: Short- and long-term outcomes
node aspiration (at least) are appropriate, lateral injuries heal with treatment. after digit amputation in dogs: 33 cases (1999-
especially in cats because the digital tumor • Flexor tendon injuries: prognosis good for 2011). J Am Vet Med Assoc 242:1249-1254, 2013.
may be secondary to a lung tumor. acute and guarded for chronic injuries; Wobeser BK, et al: Diagnoses and clinical outcomes
fortunately, chronic ruptures seldom cause associated with surgically amputated canine digits
TREATMENT lameness. submitted to multiple veterinary diagnostic labo-
• Pyogranulomatous infections with osteo- ratories. Vet Pathol 44:355-361, 2007.
Treatment Overview myelitis often fail to fully respond to
Treatment goals are to reduce or eliminate pain, antimicrobial treatment. RELATED CLIENT EDUCATION
slow or reverse the underlying problem, and • Digital SCCs metastasize in about 10%-29% SHEETS
enable the patient to return to normal ambula- of cases.
tion as quickly and completely as possible. • Digital melanomas metastasize about 50% Consent to Perform Fine-Needle Aspiration
of the time. of Masses
Acute and Chronic Treatment • Median survival time for cats with lung-digit Consent to Perform Radiography
• Phalangeal fractures: bandage the paw for tumors is 1.5 months.
4-6 weeks (adjacent digits serve as splints). • Digital pad corns recur in ≈50% of cases. AUTHOR & EDITOR: Kathleen Linn, DVM, MS, DACVS
Affected digits may be taped to adjacent
normal ones, but monitor for swelling if PEARLS & CONSIDERATIONS
this is done. Radiographic healing often lags
behind clinical union. Articular fractures Comments
are best treated surgically, as are some shaft • The most common (nontraumatic) cause of
fractures in performance dogs. swollen digits in dogs is malignant neoplasia:
• Symptomatic sesamoid abnormalities: look carefully on radiographs for evidence
decreased activity for 6 weeks; consider

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