Cinder's Journey: Recovering From Metacarpal Fractures, Weeks 8-13
You can catch up on the previous 8 weeks here.
PSA ***there are some "graphic" images in the second section so skip that one if wounds make you squeamish***
Man alive. A lot happened and also nothing happened. It felt a bit like we were stuck inside some weird episode of The Twilight Zone. Between weeks 8-10, it was pretty much business as usual. We kept C as quiet and as occupied as possible and tried not to stare at the calendar (a watched pot doesn't boil, right?) while we counted down the days until her week 10 visit. Spoiler alert: it's really hard to entertain a border collie after making them sit still for several months.
Week 10 Radiographs
These were the "moment of truth" rads for us. After receiving a corrected timeline of 10-12 weeks before splint removal, we were looking forward to this visit more than any other one. If her bones looked amazing, we could move on to phase 2 aka the "bulky padded bandage" that would allow her to flex her carpus without adding too much extra stress to her very wasted leg and fragile bones. The results were mixed. Happily, the ortho felt that the bones looked really good (yay!) and even mentioned that, depending on how the bones felt during palpation, we could make the transition in 2 weeks.
10 weeks of bone healing!
We took this as good news! However, because of Cinder's overly active nature, our vet made the decision to keep her in the splint until her 14 week appointment, at which point the ortho had recommended we perform another set of radiographs. This happy prognosis was further complicated by the appearance of some nasty pressure sores.
It took 10 weeks but Cinder ended up with the dreaded "pressure sores" from being in the splint. I was honestly kind of surprised that these had not happened earlier in the process and give major props to her care team for keeping her sore-free for nearly 3 months! Unfortunately, in true alignment with Cinder's "go big or go home" approach to life, the sores were pretty nasty. The main culprits were an inflamed dew claw (which resolved itself with diligent cleaning and care from our vet team after a couple of weeks) and a nasty pressure point at the slight "V" where her displaced 5th metacarpal was resting against her splint (I felt it, it was cool). This point was the main area of concern.
I do not have a photo of the main sore from the 3/15 appointment or from 3/22 but you get idea:
Left to Right: 3/19, 3/26, 4/2
The results of these sores were that we needed to come in to the vet very regularly to make sure nothing got worse and Cinder was started on a round of clavacillin to ward off infection. So, in other words, we went from a casual appointment every 10-12 days to appointments every 3-4 days for a couple of weeks. IT WAS ROUGH. Not just because it was an added stress for everyone but also because the effects of frequent sedation became a massive issue for me and my "this is my child, do not mess with her" approach to everything. After taking 45 minutes to recover from sedation after her 3rd visit in a week, I had a frank conversation with the care team about my feelings and we were able to resolve the issue in the following visit (get yourself a vet you can have honest conversations with, y'all! It makes a world of difference!!).
Poor little monster went from having us practically force-feed her meals so she wouldn't turn into skeletor to begging us to eat. But, she went from 40lbs to nearly 47lbs (!!!) in the early part of her healing journey. If the only positive thing we get out of this is that she'll be eager for mealtime for the rest of her life, I'll consider it a win. Anyway, because of her reduced diet, she's slowly been losing weight (yay!) but is always ready for whatever meal is up next. So! I started messing around with making her meal time more engaging. I like to change it up and we'll rotate between simple set-ups like putting her kibble in a muffin tin and covering all of the holes with balls and toys to more elaborate meals like stuffing 1/2 a bell pepper with a bunch of tasty things and freezing it. That's one of her favorite actually and bell peppers (the red ones in particular) are high in antioxidants! Tasty options to add include: pumpkin, yogurt, peanut butter, blueberries, gravy from her wet food... the list goes on. I just make sure to reduce the kibble calories to make up for the addition of the other things (peanut butter in particular is pretty rich). This has made for a good alternative because she "throws" her stuffed kongs across the floor and we can't really let her chase things around right now ....
Finding a Physical Therapist
Yeah, okay, dog PT may seem like a very "Portland thing to do" but Cinder isn't the kind of dog who will be willing to just make a partial recovery. Since Andy and I are both dedicated proponents for physical therapy (as well as chiro, massage, and acupuncture!), signing our athlete dog up for PT just made sense. The issue was.... most of the clinics I called weren't a good match for a number of reasons:
They were modality-based. I believe in modalities, like laser, tape, graston, etc, as needed but I don't believe that they should be the main focus of a rehabilitation plan. My PT is exercise-based and I am a firm advocate for this kind of rehab. I want to do the work and Cinder, well, she's the same. I also wanted someone who was willing to give us a "couch to 5K plan" or whatever so we weren't just floundering around in the dark between visits.
They wouldn't allow us to accompany Cinder at her appointments. COVID made this into quite the complication. Given that C has some anxiety when it comes to being "forced" to do things she doesn't want to (another reason why Cooperative Care training has been a game-changer), the idea of dumping her off with a random stranger felt like a recipe for disaster. We needed to be able to make sure she was 100% comfortable before leaving her alone in a rehabilitation environment.
Many of them wanted to schedule a 2-hour "evaluation" appointment, which mostly included an assessment of her ROM and didn't involve any real treatment time. Some of these "initial appointments" were cost prohibitive at $300-400 and would mostly be used to determine if Cinder would be a good fit for their program (aka, is she aggressive? is she okay being handled unaccompanied by a parent).
They were booked out until mid-June!! Since C was slated to have her splint removed by mid-April, this wasn't a great option.
Finally, after countless emails (seriously, I emailed everyone), and out of the goodness of their hearts, Healing Arts Animal Care sent us a recommendation. They did not need to do that and I will be forever grateful for them. To paraphrase what they told me, "I hope some of these places might be able to help Cinder sooner than we could!" *cue happy tears*
I will share more about the PT we chose in a later post!
A second note on cost and a first note on keeping your expectations low (if not non-existent):
I literally do not know what people do without pet insurance when something like this happens. I won't even share the amount of money we've spent throughout these many months (and we have many more to go!) and although I would not have done anything any differently, I am beyond grateful that we are only responsible for covering 30% of the cost of everything.
The timeline is forever-changing. We were originally given a timeline of 6-8 weeks. Then it changed to 10-12 weeks. At the time of my writing this, we are now 14+ weeks in and the thought of taking Cinder for even a walk around the block feels so far away. You have to learn to go with the flow or you'll end up crying almost every time you have a vet appointment (which is what I do).