Valgus deformity??? Has anyone heard of this??

[ASTPhi877]

Okay, so I've always considered the way my puppy's front paws turn out to be sooo adorable... Almost like she standing with 'pretty feet' in a slight first position. As her feet have been like this since i adopted her at six weeks (I know, WAAAAAY too young, but i got her from the pound, so there was no help for it) I've never thought anything of it. However, recently I've noticed that her 'turn out' has become much more pronounced, especially in her left leg, and I started thinking that it might be something more than just the adorable way God made her. So to Google I went. I wasn't able to find much, but I did come across the term 'valgus deformity' and I was wondering if anyone has ever heard of this or had any experience it. Should I be alarmed? Well, I am alarmed, but do I really need to be? The turn out really is rather slight... It only concerns me because the angle suddenly seems more acute. I do plan on taking her to the vet, but any info or suggestions/advice from y'all about what, if anything, this could be would be greatly appreciated!!!

[gemy]

Originally Posted by ASTPhi877

Okay, so I've always considered the way my puppy's front paws turn out to be sooo adorable... Almost like she standing with 'pretty feet' in a slight first position. As her feet have been like this since i adopted her at six weeks (I know, WAAAAAY too young, but i got her from the pound, so there was no help for it) I've never thought anything of it. However, recently I've noticed that her 'turn out' has become much more pronounced, especially in her left leg, and I started thinking that it might be something more than just the adorable way God made her. So to Google I went. I wasn't able to find much, but I did come across the term 'valgus deformity' and I was wondering if anyone has ever heard of this or had any experience it. Should I be alarmed? Well, I am alarmed, but do I really need to be? The turn out really is rather slight... It only concerns me because the angle suddenly seems more acute. I do plan on taking her to the vet, but any info or suggestions/advice from y'all about what, if anything, this could be would be greatly appreciated!!!

Valgus and varus deviation is most often referred to knee alignment. Valgus being knock kneed and Varus knees are turned out. Her feet turn out so they would be Varus deviation. But as her feet turn out her knees will become closer together giving a Valgus look to the knee.

Structurally varus deviation can originate from the "ankle" joint, or even higher at the elbow, and higher still at the shoulder angulation.

With dogs elbow dysplasia and feet turn out is closely associated. Elbow dysplasia is ddx'd by Xray.

You didn't mention how old she was? At any age it is good to get it assessed.

There are some exercises your vet can suggest once an examination is performed. These exercises are designed to strengthen the weak muscles, and to stretch out the tight muscles.

But whichever the source is of the problem, walking your dog in sand, or on gravel will help to strengthen the whole leg assembly from toes, up to shoulders. The other thing is keep the nails well trimmed, as long nails are devastating to the strength of the paw.
An all around good exercise is swimming, and with small Yorkies can even be done in a bath tub

Let us know what the vet says.

[ASTPhi877]

Thank you for the quick reply! She is only seven mos. old and has thus far resisted any of my efforts to get her to swim! She hates the water, but she'll tolerate bath time and is only just over three pounds, so that is a great suggestion.

Do you know if this is something that will worsen as she continues to grow? Is it something that will one day become problematic?

Her vet is closed until Monday, but I will give an update as soon as I know more. And again, thank you!

[YorkieRose]

How close is the hair clipped on her feet..if it is long and needs a trim, it can make the feet look like they are turning out...dog feet do not face forward like a humans anyway...

[gemy]

Originally Posted by ASTPhi877

Thank you for the quick reply! She is only seven mos. old and has thus far resisted any of my efforts to get her to swim! She hates the water, but she'll tolerate bath time and is only just over three pounds, so that is a great suggestion.

Do you know if this is something that will worsen as she continues to grow? Is it something that will one day become problematic?

Her vet is closed until Monday, but I will give an update as soon as I know more. And again, thank you!

Your very welcome;

Unfortunately it is a good chance that either the turn out will worsen (this turn out is sometimes called easty/westy) or stay the same, but with this structural anomaly more pressure is going to be born upwards through the elbow and eventually into the shoulder joint.

Problematic, umm a 50 50 chance, by that I mean clinical signs of distress. Be it limping, lifting up paws, early arthritic changes into the joint.

Now at 7 months old you have a world of time to investigate and to ameliorate the symptoms and to give your girl the best chance of a long and happy painfree life.

First things first though. Get your vet to examine your pup, see what he recommends in terms of Xrays. If the turn out is greater than 5 degrees, I might strongly recommend Xrays to see the alignment and condition of ankles, elbows, and shoulders. If she is not spayed yet, while she is under is a great time to do the Xrays. Also of course to remove any baby teeth.

There are as I mentioned a whole lot of rehab you can try, but first get some diagnostic testing.

There are also food additives that help to support joint health. Also I can give you some suggestions on how to train the legs/feet into a more proper alignment, but it will take time and dedication on your part.

[ASTPhi877]

Originally Posted by gemy

Your very welcome;

Unfortunately it is a good chance that either the turn out will worsen (this turn out is sometimes called easty/westy) or stay the same, but with this structural anomaly more pressure is going to be born upwards through the elbow and eventually into the shoulder joint.

Problematic, umm a 50 50 chance, by that I mean clinical signs of distress. Be it limping, lifting up paws, early arthritic changes into the joint.

Now at 7 months old you have a world of time to investigate and to ameliorate the symptoms and to give your girl the best chance of a long and happy painfree life.

First things first though. Get your vet to examine your pup, see what he recommends in terms of Xrays. If the turn out is greater than 5 degrees, I might strongly recommend Xrays to see the alignment and condition of ankles, elbows, and shoulders. If she is not spayed yet, while she is under is a great time to do the Xrays. Also of course to remove any baby teeth.

There are as I mentioned a whole lot of rehab you can try, but first get some diagnostic testing.

There are also food additives that help to support joint health. Also I can give you some suggestions on how to train the legs/feet into a more proper alignment, but it will take time and dedication on your part.

Well, we went to the vet yesterday, and he said he really didn't think x-rays were necessary unless I planned on having the surgery to correct. I'm not sure whether I plan on that, as I sincerely hope it never comes to it, but I went ahead and pressed for the x-rays anyway, because I'd rather not leave anything to chance with this. Lila actually had other ideas, tho, lol, and refused to hold still, the squirmy little booger! So, back again we went this morning so he could sedate her and try again. (Note: I actually had both of my girls spayed/teeth removed several months ago, at the earliest opportunity, so combining procedures wasn't an option... which was unfortunate, because I was a nervous wreck both then and today But she did fine, as I knew she would. I just picked her up, and her vet said that, yes, he did see some premature bone closure, but that he wasn't OVERLY worried about it... however, his tone seemed to imply that he was a BIT more worried than he'd been the day before... and he decided to have an orthopedic specialist in a town nearby take a look "just to be sure that no further action (aka surgery) is required.

Now, I'm not entirely sure what (if anything) the fact that he felt a specialist is necessary means, but I've decided not to worry or stress about what MIGHT happen until we know a little more. That won't do anyone any good. So the waiting game has begun... I have a week.

However, in the meantime, though he didn't mention anything in the way of exercises to train the legs, I would love to work with her on that. You have been extremely helpful, and I am up for any more suggestions/advice you can give me! The time/dedication is not a problem at all (I have a lot of free time with her, and we both love to train!), and if this will help her in the long run, then I'm ready and willing to learn!

[ASTPhi877]

Originally Posted by YorkieRose

How close is the hair clipped on her feet..if it is long and needs a trim, it can make the feet look like they are turning out...dog feet do not face forward like a humans anyway...

Lol, I think I forgot to mention that Lila is not a Yorkie! She is my Chihuahua, and the hair on her paws is quite short I do own a Yorkie, (Lucy) who is also a rescue, and the other love of my life, which is why I am a member here. I'm so sorry for the confusion. But thank you for the suggestion and for taking the time to read and respond, as any opinion is greatly desired and appreciated

[gemy]

Originally Posted by ASTPhi877

Well, we went to the vet yesterday, and he said he really didn't think x-rays were necessary unless I planned on having the surgery to correct. I'm not sure whether I plan on that, as I sincerely hope it never comes to it, but I went ahead and pressed for the x-rays anyway, because I'd rather not leave anything to chance with this. Lila actually had other ideas, tho, lol, and refused to hold still, the squirmy little booger! So, back again we went this morning so he could sedate her and try again. (Note: I actually had both of my girls spayed/teeth removed several months ago, at the earliest opportunity, so combining procedures wasn't an option... which was unfortunate, because I was a nervous wreck both then and today But she did fine, as I knew she would. I just picked her up, and her vet said that, yes, he did see some premature bone closure, but that he wasn't OVERLY worried about it... however, his tone seemed to imply that he was a BIT more worried than he'd been the day before... and he decided to have an orthopedic specialist in a town nearby take a look "just to be sure that no further action (aka surgery) is required.

Now, I'm not entirely sure what (if anything) the fact that he felt a specialist is necessary means, but I've decided not to worry or stress about what MIGHT happen until we know a little more. That won't do anyone any good. So the waiting game has begun... I have a week.

However, in the meantime, though he didn't mention anything in the way of exercises to train the legs, I would love to work with her on that. You have been extremely helpful, and I am up for any more suggestions/advice you can give me! The time/dedication is not a problem at all (I have a lot of free time with her, and we both love to train!), and if this will help her in the long run, then I'm ready and willing to learn!

So the good news is an orthopaedic surgeon is going to evaluate the xrays. Maybe the vet thinks it's too premature yet to suggest exercises until such time as the Xray is evaluated. Or as in my experience, vets don't have a huge rehabilitation experience, and/or maybe interest in that field. Historically speaking most rehab has been after surgery, and this has probably only matured/developed over the past 10 years or so. Truly there is a paucity of expertise at the general vet level.

Now in terms of the ortho; if the vet doesn't offer a written evaluation from the ortho, ask for one. Ask for one, even if the ortho wants to see you and your dog. Have them fax you over his professional opinion on this Xray.

This will give you time to do some research on his findings, prior to meeting him/her if he does want to see your dog.

IMO surgery is a very last option for almost anything muscular and a lot that is structural. So let's cross that bridge if a recommendation comes through, well actually a surgeon won't recommend to the vet surgery off the bat, they will probably want to see the pup first.

Premature bone closure, might be premature bone closure, or might be structural anomalies, or even very very early arthritic changes on the articulating surfaces of the joint(s). that is why you have an expert evaluate the Xray.

What I would like to know vs a vs the ankle joint, is there boney fusion in either the medial or lateral aspect of the ankle? Imagine if you would for a moment, a very very small space present between the articulating surfaces of in this instance the bones of the lower leg and the bones of the foot. The space is there to enable the joint to bend forward and back, to bend to the inside and the outside. This is important to know because it will help to delineate the limit of how far physical reconditioning can correct the "problem". Which is not the same as saying physical conditioning shouldn't be done!

The exercise descriptions are long and rather involved, so I will post some starting points tonight in another message, and more to come tomorrow, as I have more time.

[gemy]

Okay here is the easiest first thing:

Weight Control: Is critical when joints are compromised. And with this deviation at the minimum the ankle joint is compromised anatomically speaking. Now your pup is still a pup at 7mths old, so proper nutrition and good food is very important. You don't want to put your pup on a "diet". A little bit of a rounded belly is fine, but the loin should have a very good tuck up and the ribs should be easily felt underneath a gentle pressure from your fingers.

Learning the structure of your pup : Your eyes and your hands here are what you use. Watch how your girl stands and walks and runs first. You can even video her if you have a video camera. Watch how your girl does downward dog, how are the front paws oriented? Watch how she sits. For example; does she put her two front legs together with a turn out of both paws, or just one paw, or one paw more than the other? The same for standing, walking, and running.
Now for the feeling part, and your pup will just love this!. With a gentle touch, from the tips of the paws feel/palpate up each leg, she can be sitting on your lap, or on a grooming table, whatever feels most comfortable for you. Feel for the configuration of the bones, and compare right to left. Don't over analyze, trust what you feel with your fingertips. Learn all the bumps, and thicknessess, and just about each little bone in her paws and ankles all the way up to her knees.

Now you want to see a gravity free idea of your girl's structure. You need to do this in front of a mirror. With one hand directly under the jawbone and the other hand between her rear legs at her rump, lift your pup directly up. You can coo and cuddle her, until you feel her relax. Then look in the mirror and see the alignment of her front legs, rear legs, topline etc. Do the front legs hang straight down from the shoulder? Do the front paws turn out? How much? What is the spacing between the front legs, the rear legs?

While not foolproof, this should give you a good idea of her natural non weight bearing boney structure. But the more relaxed the pup is, the better idea you will have.

Make all of this easy and fun for you both. There is no pressure here, there is only learning your darling pups body.

Taking pictures of your pup at the beginning and prior to any exercise regime is a great idea; for you can see changes when they happen.

[gemy]

Part two

Nutritional Supplements: Glucosamine and Chondrotin are two supplements that are thought to support bone health. Cosequin is one trade name, Biologic Vet, Dr.Maggies etc. This is quite a popular supplement, and can be found in many pet food stores. There are some threads on here about the different supplements used by other Yorkie owners. I think a search should pull up those threads, and you'll have lots of happy reading.

Exercises:

Standing: Sounds crazy but standing still in correct alignment actually does strengthen the leg muscles. Here what I would suggest is to place her either up on the grooming table or the kitchen table with her feet on a non slip surface.

Getting Ready for the Exercise
Have tiny treats (lots) available to you. You can use small cheerios, or teeny pieces of carrots, or peas, or some mixture thereof.
Have a small box of kleenex handy, it's height should be such that it easily goes underneath her body, and will be placed just ahead of her back paws.
Have another small box of kleenex handy which will eventually be placed just to the outside of the front paw she loves to turn out. Or you could use some pieces of wood that are 2-3 inches high instead.
The purpose of these tools is to discourage the movement of her feet from the alignment you will place them in.

Now you are ready to begin: 1. Lift your pup up in the hold I described earlier.
2. Place your pup on the table 3. Adjust back paws so that the hock joint stands at 90 degrees. This means the toes are behind the hips. Place the feet about hip width apart.
4. Now for the more difficult front leg adjustment. You adjust the paw placement by adjusting at the shoulder joint, and not at the ankle. Gently tip your dog sideways so that the paw to be adjusted is non weight bearing, with two fingers or so, place fingers at the top of the shoulder just where it adjoins the chest. Now turn the shoulder/leg assembly inwards. Place paw down. Look to see if the paw is now turned forward. Repeat as needed. Note: for the first month or so, you might not get a perfectly front alignment.

Slip box of kleenex just ahead of back paws, and other box just to the outside of the front paw you adjusted.

Give the commands Stand and Stay. Treat in the beginning every few seconds. You can keep your hands on her, and if she moves say no, adjust her back to the good stance.

Initially work for 30 seconds at a time. After finishing your exercise have a good romp with your girl.

Eventually build up so that your pup will stand stay for 5 minutes.

Like any exercise/trick, this takes patience and perserverance on your part.


BATHTUB WALKING:

Preparation: Treats a few Can be combined with your weekly baths. Or if she loves toy a water okay toy as a reward.

Purchase some plastic mats for the tub, that are ribbed or nubbed. Remember what I said about walking on gravel; how it strengthens the paw/leg assembly? Run these mats the length of your tub.

Optional: Add epsom salts to the bath water.

Have plastic lead and harness (it will get wet), this will be for the early days, when you are training just what you want her to do in the water.

The water in the tub should come up above the elbow but be very clear of the belly or shoulder. Here the water is going to act as a resistance to the forward motion of the legs, with the ribbed or nubbed mats will help to strengthen her legs/paws.

Leash up your pup, place at one end of the tub, and give a command like - Let's go, or Let's walk, etc. walk with her to the end. Turn around and walk back.

Reward for obedience, if she tries to climb out of tub, get some plastic trays or cutting boards and place high up on the side of the bath tub.

Try for 5 minutes timing.

Then give your baby a bath and lots of massage and hugs.

Such a good girl she is