Dog Bracing Made Simple

Canine intervertebral disc disease or IVDD is a condition where the disc material between two vertebral levels deteriorates and extrudes into the vertebral canal, compressing the spinal cord. The result is a varying degree of neurological deficit, affecting the dog’s ability to walk, perceive sensation, or have bladder and bowel control. The current recommendation for dogs with IVDD is to undergo surgical intervention as soon as possible following the occurrence of symptoms. However, for many owners and their dogs, surgical intervention is just not an option. If this is the case, what can be done for these dogs? Understanding intervertebral disc disease Intervertebral discs sit between the vertebrae throughout the length of the spine. While we like to think of intervertebral discs as separate from one another, in reality they are very connected – we should consider them as part of one structure. The disc is made up of an outer ring, the annulus fibrosus, and an inner portion, known as the nucleus pulposus. The nucleus pulposus is gelatinous and has a very high water content. When Things Go Wrong If the disc degenerates, the annulus fibrosus becomes hard and brittle, making it prone to rupture, while the nucleus pulposus becomes calcified and solid. In the event of a disc herniation, the annulus fibrosus can remain intact but change its shape and protrude into the spinal cord. Alternatively, the annulus fibrosus can rupture, causing the nucleus pulposus to escape into the spinal cord. In both cases the spinal cord becomes compressed. Categorizing Disc Disease IVDD is usually categorized into one of two categories. Acute Hansen Type 1 extrusion In this condition, the annulus fibrosus ruptures and the nucleus pulposus escapes into the spinal cord, causing compression of the spinal cord and neurological deficits in the patient. This usually occurs in chondrodystrophic breeds between 3 and 7 years of age, with the signs of dysfunction progressing over the course of a few days. These dogs are usually in great pain. Chronic Hansen Type 2 protrusion In this condition, the annulus fibrosis remains intact, but loses its shape and starts to bulge into the vertebral canal. This often occurs on more than one spinal level, and it can be very difficult to determine which spinal level is responsible for the neurological symptoms in the patient. This condition usually occurs in older, large breed dogs with slowly progressing neurological signs. Often these patients are affected with other conditions, such as arthritis. Discerning deep pain The presence or absence of deep pain sensation in IVDD patients creates a large divide in how we think about these patients’ treatment, and their prognosis for recovery. Patients who have deep pain sensation intact have a good prognosis for a return to function. Patients who do not have deep pain sensation have a poorer or guarded prognosis for recovery. This seems to be true whether surgery is performed. Treatment For dogs that lose their ability to walk, surgery is currently the recommended treatment route. In this article, we will not be discussing surgical treatment, but rather medical management. Learn more about the different surgical techniques and whether surgical intervention is the best option for your animal by speaking to your vet. Medical management Medical management usually includes a combination of cage rest, pain control, bladder management and rehabilitation or physiotherapy. Rest This can be the most challenging component of medical management. Rest aims to improve the condition in a few ways: • preventing further extrusion of the disc material into the vertebral canal; • allowing the body time to resorb the disc material within the spinal canal; • protecting the dog from further injury because of neurological deficits and a inability to walk. There are many different recommendations for the duration of rest and how strict rest needs to be. Dr Paul Freeman recommends at least one week of strict cage rest, followed by three weeks of exercise restriction and cage rest when necessary. We can help make rest easier with a few enrichment activities and modifications to the environment to ensure that the dog receives mental stimulation and social interaction, remaining part of the daily activities of the household. Pain Control A multi-modal approach to pain control is highly recommended. The pain needs to be managed as quickly and efficiently as possible. Many veterinarians will prescribe a combination of opioids, NSAIDs, and gabapentin – please discuss pain control with your treating veterinarian. Rehabilitation and Physiotherapy The primary goal of physiotherapy is to help the patient regain function as quickly as possible. We also want to facilitate the best possible quality of functional motion. There are a few ways in which we might work towards these goals. Rehabilitation of Neurological Conditions The rehabilitation of neurological conditions focuses on helping the patient to regain function. During the initial phases of rest, a rehab therapist can help both the owner and the patient negotiate the challenge of confinement with advice on the following areas: • Mental games that help build postural awareness and stability • Advice on incorporating the patient into activities of the household safely• Massage and gentle traction techniques that may be performed with the patient daily to reduce pain and encourage healing• Gait retraining that can be performed daily to help maintain the muscle and sensory stimulation from the affected areas without stressing the spine• Fitment of supportive devices such as harnesses, back braces, carts, etc., depending on the needs of the client and the patient. As the patient begins to heal and regain function, the rehab therapist will continue to aid in optimizing function in a variety of ways. A Rehab therapist plays an essential supportive role as they help to overcome the individual challenges faced by the owner and the patient throughout the stages of progression and healing. The Use of a Back Brace for IVDD The use of a back brace for dogs with IVDD may be indicated in a few different instances. A back brace is protective, helping to stabilize the spine and reduce movement through the back, making it ideal to use during the phases of rest when we want to prevent any further damage to the intervertebral discs. As dogs with IVDD start to regain function, they can be very ataxic, with large anduncontrolled movements of their limbs and back occurring throughout movement. Using a back brace during walking can help stabilise the body, preventing uncontrolled ataxic movement that can be damaging to the spine and the soft tissues of the back and limbs. When the dog practices walking in a straight and stable fashion, we also strengthen those neurological pathways, establishing them as the norm. In other words, the more the dog practises with correct posture, the more it will become second nature. Walking with incorrect posture will have the opposite effect, establishing damaging movements as the norm. Chronic type 2 IVDD, especially, can benefit from the use of a back brace during periods of activity. The back brace is also something that can be used during strenuous exercise once the dog has recovered function, or in the event of a recurrence of IVDD in the future.  

Does the Custom Orthotic Casting Process Intimidate You? If you really think about it, the impression process isn't much different than wrapping a bandage.  We find vet nurses excel at the process in the CE courses we teach! Check out a video of our CE course at the bottom of this blog. Old-School Casts....Don't Make Me Cringe! Many Doctors are hesitant to work with Orthotics because of the Casting/Impression process. Mention the word “cast” and Doctors envision an old-fashioned plaster cast that is removed with a saw. This material was fine in its day but today is not needed for the Impression process. The fiberglass impression material currently used is easier to work with and does not require a saw for removal.   Creating a dog’s custom knee, ankle or wrist brace is a breeze. Hero Braces has tried to simplify the process to make successful impressions a breeze. As easy as wrapping a bandage. Creating the Impression for a custom brace is an easy task.  As practitioners, bandages are something we use daily. The light tension and 50% overlap used in creating a bandage are the same when creating an Impression. Patients can lie in lateral recumbency and staff use is the same. Sedation is rarely needed. The fiberglass material used in the Impression is thin and cuts easily once it cures. I don’t have time. We all worry about the time it takes to get tasks done. The Impression process can take as little as 15 mins. Many practices have qualified Veterinary Nurses that place bandages for their Doctors every day.  The Casting/Impression can be turned over to them as well, freeing up the Doctor to diagnose and prescribe Hero Braces as treatment for issues such as Cranial Cruciate Ligament Rupture, Hyperextension of the Carpus and Achilles Tendon Injuries. We’ve got the tools you need. Our impression kit comes with everything you need to complete the process and we are here to help. Stockinette to cover and protect the limb Fiberglass tape to create the impression A guarded blade knife to cut the Casting/Impression tape A grooved strip to place under the Casting/Impression tape to guard the limb and act as a cutting guide Online and in person labs to demonstrate and practice the process Anything new can be intimidating. The Casting/Impression uses similar techniques to wrapping a bandage and is learned quickly by you and your staff. Let us help you help more pets. Call Hero Braces for a Casting/Impression kit today. We teach casting at the University of Tennessee Canine Rehab Certificate Course. Below is a video of us teaching the casting process. Watch it to feel confident about casting.  It really is just a version of bandaging!  

Zoey's liver condition made ACL surgery too risky. Read how a custom Hero Brace provided the non-surgical stability she needed to run, play, and recover fully.

For years, families would celebrate tradition and travel for miles to get their annual Christmas Tree at the Clapp Christmas Tree Farm off the coast of Maine. Waiting, with tail wagging to welcome them and help each family find the perfect fir, was Kuli. Kuli is a beautiful 10 1/2 year old Black Labrador Retriever who for years has loved to run and play at the Clapp's Christmas Tree Farm, helping families pick out the perfect tree to celebrate the holidays. One December afternoon in 2008, she was out playing amid the trees when she somehow ruptured her Achilles tendon. Her owners, Kathy and John panicked. Kuli is the 3rd member of the Clapp family, and they could not stand to see their dog in pain. Their veterinarian, Dr. Greg Thibodeau recommended surgery, so they drove almost three hours through a northeastern snowstorm to Norway, ME for the procedure. Unfortunately, the surgery did not work. The surgeon, Dr. Todd Gauger of Norway Veterinary Hospital stated that there was nothing more he could do surgically to help repair Kuli's leg. The situation looked grim. Dr. Gauger had heard about something new that was being talked about in veterinary circles and thought it was worth a chance. He called Hero to request a casting kit to be sent to Dr. Thibodeau in Blue Hill. He sent the cast off and a short time later, Kuli received her ankle brace. This is the first time anyone at the veterinary clinic had ever heard of bracing for dogs, and Kuli was soon the poster child for the concept. Proper fit is paramount when determining whether a brace will help or not. If a brace does not fit properly, it will not only fail to help a dog to recover, but it can also cause more physical problems. That is why having a custom dog leg brace and a good cast is so important. When Kathy and John sent the pictures of Kuli trying on her brace for the first time, Ben from Hero was not satisfied. He made another brace for her immediately in order to guarantee the perfect fit. "We think the world of Ben," says Kathy. "The brace helped Kuli so much." Kuli was able to begin walking and playing again, even wearing out the brace's Velcro a few times during the past 5 years. She has gotten to the point where she doesn't need to wear it any more and continues swimming every day in warm weather. The Clapps are so grateful for the second chance Hero has given Kuli that they send Ben and the team a Christmas card every year to keep them up to speed with what the family is doing. It's been a joyous 10 1/2 years on the farm, but eventually all dogs get to the point when they need to slow it down just a bit. This year Kuli has decided to enjoy the season from a different perspective; underneath her very own Christmas tree with a warm blanket, twinkling lights and the comfort of the season. Enjoy your break, Kuli. You deserve it. Wherever your Holiday traditions take you this year, we hope your family pet can be with you. From our pet to yours -- Merry Christmas and Happy New Year!

When Caleb tore his CCL, his owner refused 13 weeks of crating. Read how a custom Hero Brace provided a non-surgical solution that made Caleb "happier than a pig in slop."

Even after a full ACL tear, Roxy returned to "super dog" status! Her vet recommended a Hero Brace over surgery, allowing this athletic Boxer-mix to run, jump, and play again.

Boo Boo saved his owner’s life, then his owner saved his. A severe car injury severed a tendon, but a Hero Carpal Brace helped him regain strength and mobility.

When surgery threatened Bowa’s career, his owner found a custom Hero Brace. Discover why this non-surgical solution was the perfect choice for a competitive dog's recovery.

We usually think of the long-backed Dachshunds when we think of back pain. Turns out many breeds can have back problems called IVDD. How can we best help those dogs so they can still chase, jump, and play?  WiggleLess, the dog pain relief Superstore has some ideas for you.... Their dog back brace designs come in 5 stylish designs to support your dog's back so their pain does not stop them from smiling.  

After a painful jump led to severe carpal injuries, Farley faced $6500 in surgery. Discover his inspiring non-surgical comeback with custom Hero Wrist Braces.

When four surgeries couldn't fix Jack's patellar luxation, his owner (a vet) chose a Hero Brace. Read how this custom knee brace prevented re-injury and restored his activity.

Not sure bracing fits into your practice? Initially a skeptic, Dr. Beck shares how her veterinary practice has grown to use bracing. 100% of my professional time is devoted to healing animals.  You could say I come by it naturally.  My father and I are both veterinarians. I took it a step further and am a certified canine rehabilitation therapist. Our private practice still believes surgery, with rehab, is the best way to treat orthopedic injuries. AND not all dogs can have surgery. My first experiences withe bracing were in 2010.  Initially, I was skeptical about bracing for cranial cruciate disease (torn ACL). After bracing many patients I have found it extremely useful when used in combination with rehabilitation therapies. I have had many cases where bracing has made a dramatic difference in a pets life. One patient tore both CCLs in the course of two years and chose to brace one leg and rest for the other (conservative management).  While both knees are now stable, the braced knee has better range of motion and less scar tissue that the knee that went unstabilized (no surgery, no brace).  I think that speaks to the biomechanics of the brace in preventing tibial thrust. I had a 150 lb. Boerboel dog tear both cruciates within 30 minutes of each other.  He had surgery on one knee and the other knee was braced. Otherwise he would not be able to walk and he was certainly to large for his mom to carry. I had a labrador retriever patient that lived on the second story apartment building with no elevator.  Bracing allowed her to use the stairs without pain, and she could still go for walks with her mom in downtown Omaha..  This treatment certainly made life easier for her mom! The Brace Honestly, I think what makes Hero Braces exceptional is their customer service. I feel like Ben, the orthotist, has a deeper understanding of the needed fit and support because he is an amputee and wears a prosthesis everyday. I have always believed that the more empathy you can have for your patients, the higher quality care you can provide them. The Hero Braces are very high quality and durable for all the wear and tear a dog can do. Dogs do very well with the application of the braces, and most owners do a great job monitoring the leg for  any changes from the brace. Michelle Beck, DVM CCRT

Facing amputation after a severe injury, Luke's owner chose hope. A custom Hero Brace completed his recovery, allowing this active dog to run and hike the mountains again.

When our furry friends undergo surgery or face injuries, the dreaded "cone of shame" is often recommended by veterinarians to prevent them from licking or biting their wounds. While the cone serves its purpose, it can be uncomfortable and distressing for dogs. Thankfully, there are alternatives available that provide comfort and healing without the discomfort of a traditional cone. In this comprehensive guide, we'll explore three innovative alternatives to the cone, each designed to promote your dog's well-being and recovery: 1. Medipaw Protective Boot: Keeping Wounds Clean and Dry The Medipaw Protective Boot is another fantastic alternative to the traditional cone, especially for dogs with foot or leg injuries or post-surgery wounds. Key Features: Waterproof and Breathable: Medipaw boots are designed to keep wounds dry while allowing airflow to promote healing. Easy to Put On: These boots are simple to put on and secure with adjustable straps, making it a breeze to keep your dog comfortable and protected. Reusable and Washable: You can wash and reuse Medipaw boots, ensuring they remain a cost-effective choice. With Medipaw Protective Boots, your dog can enjoy comfort, mobility, and wound protection, all without the discomfort of a cone. 2. DogLeggs Surgi-Sox Torso with Anti-Microbial Protection: Comfortable Recovery Wear For dogs that require specialized care following surgery or injury, DogLeggs Surgical Suit offers a tailored solution. Key Features: Tailored Fit: DogLeggs Surgi-Sox are customized for your dog's specific measurements, ensuring a perfect fit. Easy Application: Using Velcro brand fasteners, these leggings are simple to put on and remove. Comfort and Healing: The soft, breathable anti-microbial fabric provides comfort and aids in the healing process, making it an ideal choice for post-surgery recovery. DogLeggs Surgi-Sox Torso is an excellent option for dogs requiring a higher level of care, as they provide both protection from infection and support. 3. WiggleLess Dog Back Brace: Supporting Your Dog's Back and Torso First up is the WiggleLess Dog Back Brace, designed to provide support to your dog's back and torso. This product is particularly helpful for dogs recovering from spinal surgery, intervertebral disc disease (IVDD), or other back-related issues. Key Features: Support and Stability: The WiggleLess brace is carefully crafted to offer stability and support to your dog's spine, reducing the risk of further injury or strain. Comfortable Fit: The brace is designed to fit comfortably around your dog's body, allowing for easy movement and ensuring your furry companion stays happy. No More Cone: With this back brace, there's no need for the traditional cone. Your dog can move freely, eat, drink, and even go on short walks with ease. The WiggleLess Dog Back Brace is an excellent choice for dogs with back problems, as it provides gentle support while allowing them to maintain their normal activities. In conclusion, when you ask, "What can I put on my dog instead of a cone?" the answer lies in these innovative alternatives. Each product offers unique benefits, from spinal support and wound protection to customized care. Choose the one that best suits your dog's needs, and ensure a comfortable and stress-free recovery journey for your beloved pet. Say goodbye to the cone of shame and hello to a happier, healthier pup!

Discover the heart behind the brace: Trina's passion for quality and family drives the precision manufacturing of every custom Hero Dog Brace. Read her story here!

Kepa tore a knee ligament, but couldn't have surgery. Read how a custom Hero Brace got this adventure dog back to hiking the Pacific Crest Trail pain-free!

The quick answer is yes. So why didn't my Veterinarian offer bracing as an option to help my dog? Many Veterinarians didn't have much success with early brace designs, which left them with a bad taste in their mouths. So much has changed over the past 15 years. Early braces were made by do-good pet parents. They all started by looking for solutions to help their limping dog. Yet, these pet parents didn't quite understand some mechanical principles to make the knee braces effective. Today, braces are made by actual orthotists (people trained in brace making) who have researched mechanics and materials that work for dogs. To better understand what has changed, let's look at dog knee braces from 3 different perspectives. 1- Fabric Vs. Plastic Braces To better answer the question, you need to have a simple understanding of what "bad motion" we are trying to limit with a brace.  In dogs, an ACL tear allows a bad motion called a cranial drawer.  This motion is the tibia slipping forward under the femur. This slipping startles your dog because its leg feels unstable. It can also be painful. Over time, slipping causes inflammation that results in arthritis in the joint. If dogs want to play... they won't really put weight on their foot unless their knee feels stable.  This is likely why they also tear the other ACL. Fabric braces were the first braces used to address this problem. The big problem is that fabric stretches. Because of this stretching, it is physically impossible to stop the slipping, so they didn't work. Also, fabric braces need some sort of harness to hold them on the leg.  The harness made it very complicated to put on.   It also limits the motion in the hip joints, so your dog cannot move very easily. Today, we use plastic that is more durable and can actually limit bad motion.   Some worry about the comfort of plastic, but I can vouch as an amputee that wearing a stable plastic device is so much more comfortable than a fabric piece that rubs back and forth.  The fabric feels like a rope burn. To replace the harness, plastic braces actually form-fit around bones so they can stay on the leg.  This allows the dog to move more fluidly. Some are tempted to start with a fabric brace until they can afford a plastic brace. Knowing how well a fabric brace works, you really are better off saving your money until you can afford the support you need. 2- Surgery Vs. Surgery Not Possible Many people cannot have surgery.  This has led people to look for other options to help their dogs. Surgeons know surgery works, so it can be hard to look at other options like bracing.  In the end, we want to help all the dogs. Surgeries like TPLO or TTA change the geometry of the bones and do not need added support from a brace. Surgeries like lateral suture or extracapsular work better with bracing. Heavier dogs can break the suture in these surgeries. Adding support from a brace is beneficial to help prevent too much pressure on the suture from failing. Dogs that cannot have surgery need some extra help until their body forms a medial buttress. (The medial buttress is the scar tissue that stabilizes the knee.) Veterinarians always like to see proof. Studies have been done by veterinarian colleges to help us know that braces do work.  If you are a big researcher, you can access those here.   If not, here's a quick synopsis.   A study done at Colorado State Veterinary School showed surgery wins out over bracing 98% to 85% for owner satisfaction.  So though not perfect, there is merit in bracing dogs that CAN NOT have surgery. University of Georgia Veterinary School did a study in a gait lab (complex measuring camera model.)  It showed the braces cause a shift in the knee motion when a dog puts its weight on the leg (when the bad motion happens).  However, it is not clear if this means that the brace stops the bad motion. The University of Louisville did a study simulating a dog's leg and a torn ACL, which showed the brace did as well as any surgery, limiting the bad motion.  And that the more rigid the joints, the better the brace did at limiting the bad motion. Most credible companies are supporting more research to validate what they have seen with thousands of successful patients. However, there will always be skeptics. Surgery is best, AND if you cannot have surgery for whatever reason, you have to figure out how you can best help your dog.   In human medicine, we do surgery AND a brace because insurance pays for both. In veterinary medicine, we generally choose surgery OR a brace. Ultimately, how you help your dog is your choice. 3- Custom-Made Braces Vs. Small, Medium, Large Fit All People who think braces don't work likely don't understand this difference. So, let me try to simplify it... If you were to tear your ACL, you would have 14 different sizes to fit your leg. Do you know how many breeds of dogs there are? The World Canine Organization recognizes 364 different breeds with a wide variety of shapes and sizes. So, how many different sizes of knee braces would you need for dogs? 14 x 364 = 5096 Okay, this is a large overstatement, but you get the picture.  Fitting dogs can be really tough with a few sizes. It is important to remember the bad motion we are trying to correct. The movement is so small that we really need a good-fitting brace to limit that cranial drawer motion.   Simply put, one size fits all is really one size fits NONE for dog knees. Ready-to-fit knee braces do not work. Custom is key to playing again! Custom just means you have to do a little bit more work upfront for the best chance for success.  The casting process is pretty simple.  Check out our casting tips to help. Ultimately, if you are here, you are trying to help your dog. We want to help you help your dog, too!

Why does biomechanics matter? Read how analyzing canine movement allows Hero Braces to provide superior support, preventing trauma and restoring full mobility.

After a traumatic experience with anesthesia, Chloe's owner was hesitant about ACL surgery. Find out how a custom Hero Brace saved this Lab from the operating table.

Your dog has been shaking his head a lot lately, and then suddenly, you see something disturbing: His ear flap has swelled up. Aural hematomas are also known as ear hematomas or even blood blisters. An aural hematoma usually forms from trauma to a dog’s ear — often from head shaking — that causes a blood vessel or vessels to break and bleed into the area between skin and cartilage that make up the ear. Aural hematomas are often a result of an underlying issue like allergies, ear infections, or something in the ear canal like a tick, mites, or a grass lawn. These will cause a dog’s ears to feel itchy or uncomfortable, leading to shaking and scratching at his head and ears — and resulting in ear trauma. Effective treatment involves treating the hematoma while also treating the underlying condition. Conditions Leading to Ear Hematoma Environmental and food allergies can both lead to a lot of itching and discomfort in pets. There are many potential triggers for both kinds of allergies — from chicken and corn in food to pollen, grass, and mold in the environment. Allergies in themselves can take some investigation to figure out, but elimination diets and allergy testing may be a good place to start if these are suspected. An ear infection is another condition that may cause a dog to shake his head excessively. They are painful and uncomfortable. When ear infections are chronic, there may be underlying conditions — including allergies and hormonal imbalances like hypothyroidism, for example. So if your dog is getting a lot of ear infections, it’s important to figure out the root cause. Dogs who spend a lot of time outdoors may end up with something in their ear — like a tick or grass awn. As you can imagine, this is highly uncomfortable for a dog and will cause him to shake his head. Fortunately, once the foreign body, like a tick, is removed from your dog’s ear, the problem should rectify itself on its own. If you have a younger dog with itchy ears, he may have ear mites. Some signs of these tiny parasites include head shaking, scratching ears, ears that droop when they’re usually upright, smelly ears, and a dark, coffee-ground-like discharge. Puppies and young dogs are more prone to get ear mites than adult dogs. Of course, there are other reasons why a dog might shake his head enough to cause an ear hematoma, like a bug bite, so it’s important to keep a watchful eye if you notice any excessive shaking by your dog. Aural Hematoma Treatment There are a few ways an ear hematoma is treated. Surgery is one common treatment and involves draining the hematoma and suturing the ear flap while the dog is under sedation. A vet may also choose to use a syringe to aspirate the fluids out of a dog’s ear flap or place a drain to remove the blood until it heals and bandages the head and ear. Holistic remedies may include homeopathy, topical applications of yarrow oil and/or witch hazel, and compression wraps. The Surgi-Sox Aural Compression Bandage is an alternative for head and ear bandaging. It helps prevent damage to the ear during head shaking. It can also reduce head shaking and help keep ear medications inside the ear to treat underlying ear conditions. A compression wrap may help a hematoma from getting worse or keep a new one from forming. An ear hematoma may actually heal on its own over time. However, it can result in scar tissue and deformation known as “cauliflower ear,” which can block the ear canal. It’s best to consult a vet to develop the best plan to treat your dog’s ear hematoma, which should also include addressing any underlying conditions. Prevention Ideally, a dog never gets an ear hematoma in the first place. If you start to notice your dog shaking his head or scratching at his ears excessively, take note and act quickly before it turns into something worse. Check his ears for foreign objects and make sure he’s not hurting himself. If it continues, start looking into possible causes, including allergies, infections, and ear mites, and schedule a veterinary visit.