knuckling over HOD growth problems

The term Developmental Orthopedic Disease represents a variety of conditions that occur in young developing canines. Usually this is a problem that occurs in large and giant breeds, but I have seen cases in smaller dogs as well. I will list the conditions in the order in which I have seen them occur in young puppies.

Knuckling Over
HOD - Hypertrophic Osteodystrophy
OCD - Osteochondritis Dissecans
Pano - Panosteoitis

Knuckling over is the first condition normally seen and I will focus this paper on this particular problem. The other conditions listed a different set of problems - all usually nutritionally base and if caught early enough can be corrected with a comprehensive feeding program.

Knuckling over is first noticed in the area of front leg on a puppy, or the growth plate (wrist or carpal) area. The term coined by professional breeders for this condition is knuckling over, and it describes a condition where the front end assembly of the dog, the weight bearing part of the body, is unable to support the whole body weight of the puppy, due to a lack of integrity in the muscle, tendon and ligaments. It is my opinion this condition is not genetic - it is due to uneven growth pattern between the bone and tissue/muscle of the puppy and it is cause by dietary imbalances and/or missing micro-minerals and/or minerals that are not available to the body - difficult to assimilate.

The condition of " knuckling over", can be very extreme, almost as if the legs are made of some malleable material - like rubber! Early knuckling over - under 8 weeks of age, is not a problem and very common because the large and giant breeds grow quickly during the early stages of development.

Once a puppy reaches 8 weeks of age they need to be separated from the litter during meal time, so you can keep track of the amount of food being consumed and it is during this period that we start to see the beginnings of extreme knuckling over. I have noted this problem has 4 stages in terms of degrees, and I am happy to report, if owners contact me early enough and put them on the Blackwatch Puppy Feed Program, and in some cases do wrapping and supports, we can turn them around very quickly - 2 days - 2 weeks depending on the age and length of time they have been this way.

One critical key to the correction of this problem is the use of Eagle Natural or Eagle Large/Breed Puppy food both 23% protein and 12% fat - 360 calories per cup which is moderate. I have tried to use other foods when Eagle was not available and we had no luck. I can't get this problem corrected quickly on any other food. It is the balance of moderate protein/fats/carbs making it a moderate calorie diet and fed in proper amounts it works. The big secret to a quick turn around time is the macro minerals in Eagle products are easily assimilated by the body, and the inclusion of microminerals, which are often omitted in most foods, makes this food the ideal composition to "even out" the growth patterns between the muscle and bone. Add to that mix a good joint support supplement that contains MSM- nutritional sulfur and we can correct this problem in short order.

Breeders often think growth issues are cause by too high a protein in a diet and that is not the case at all and research shows us this is not true. It is true that high protein diets are also high fat diets and therefore they are high calorie diets and difficult for owners to manage the a months fed. But the real issue with growth problems is the relationship between the protein/fat/carbs in a diet, the calories per cup and the quality and availability of the macro and micro minerals in a food. When you do not have this equation in a diet, it causes uneven growth patterns between muscles, ligaments, tendons and bones. They are all developing at different rates - the end results are severe knuckling over and this grotesque deformation, which can be permanent if not taken care of in the early stages. This does not only effect the carpal/wrist area, but can also the shoulder area (see below photos).

Before change of diet to Blackwatch Puppy Feed Program and wrapping with vet wrap.

Left: 11 days later she can support her own body weight. Warps are checked every 2 days.
Right: at 5 Months - her legs show no sign of developmental orthopedic disease.

Knuckling Over

Level 1

Puppy on the right, shows the inside leg as an example of the beginning of the early knuckling over we see at 5 - 7 weeks of age. This is not at all unusual and often corrects itself as the dog matures to 8 - 9 weeks of age, provided they are on the right diet. There will be some vacillating back and forth during the time of vaccines and ear cropping, the stress of all of this and the fast growth they go through all contribute to the problem. If by 8 - 9 weeks this condition has gotten worse, you need to contact me and let's discuss options.

Level 2

On Left: 8 weeks

On Right: 9 weeks after being wrapped and a change in diet, this dog is able to support his own weight.

Level 3

8 weeks on left , then with wrapping and a change in diet and it is corrected at 9 weeks

Level 4

On left is at 9 weeks and unable to stand and support his own weight. With a spoon splint, wrapped and change of diet you can see in 3 days this dog's leg can be straightened out. Only in extreme cases do we have to brace the whole foot, in this case the dogs toes were curled and deformed, so we needed to straighten them out so he could support his weight.

This is an image of the spoon splint that was put on behind the dog's leg in order to straighten it out. The photo on the right is 3 days later, and the dog's leg is straight.

Sometimes, as in level 4 problems, we need to splint the whole foot because the dog's toes are curled under and can not support the weight of the dog. This problem can effect any large/giant breeds - it can happen to smaller breeds as well.

Left are examples of the bracing of this dogs legs and feet. After 12 days in a brace (checked every 2-3 days) and a change to Blackwatch Feed Program ,this problem is corrected to the point the animal can now support his own weight on his feet.

In order to correct level 3 and level 4 of knuckling over, it is mandatory to change the dogs diet, control the amount of food consumed and allow free exercise.

It may also be necessary to wrap the shoulder area with vetwrap, as well as the growth plate or wrist area on the dog.

How To Wrap For Wrist and Leg Support

In younger dogs, often the pastern area only, needs to be supported with vet wrap, as seen on the left example. In older dogs - up to 7 months, the whole leg may have to be supported with vet wrap. It can't be too tight (feet swell) and it must be changed every other day on older dogs, to check for open sores. This can't get wet!!! or you will end up with sores- so make sure it is covered with plastic if it is raining outside and they have to go out. Seek your Vet's assistance.

How To Wrap For Shoulder Support

Splints -

There are a couple of different types of splints, the plastic spoon splint which you see above in the photos, then there is the light weight aluminum splint that is lined with foam. This one is obviously easier to cut to the length you want to use. Make sure that it is straight and the cut edge is covered with tape so it does not cut the dog's leg.

Do NOT splint the elbow, make sure it is below the elbow so the dog can have free range of motion with the front end of the dog. You just want a channel to support the bone. Wrap with vet wrap and do not wrap feet so the dog can walk properly. This splint must be kept dry and make sure it is taken off and checked every 2 days, so there are no sores that develop under it. Make sure the leg is dry, before wrapping and a layer of cotton is laid down on the leg before resting it in the splint. Your vet needs to be consulted when doing this splinting and wrapping.

What Causes This Extreme Knuckling Over?

Knuckling over is caused by the following:

1) a combination of two different types or brands of dog foods - feeding (50/50)
2) the brand or type of food has been changed several times (3-4) times
3) the addition of vitamins/minerals to a diet
4) human foods in amounts enough to disrupt the calcium/phosphorus balance
5) too many calories vs the amount of free exercise they get on a daily bases
6) using a food that has minerals that are not very available to the body - crude forms
7) diets lacking vital microminerals or trace minerals
8) feeding too much of a good food
9) any or all of the above.

In order to solve the problem, I must get a history of the feeding schedule used on a puppy in order to pinpoint the exact problem. I know I can only fix it by another food change to Eagle Natural Pack or Eagle Large/Giant Breed formula.

I can't get this problem corrected on other foods. These dogs grow so fast, even a slight adjustment in foods, supplements or amounts can throw their system into a tizzy. This is a problem of rate of growth being out of sync between the bones, muscles, ligament and tendons of the shoulder and wrist/carpal area.

When I asked my friend Pat Hastings about this her comment was, "I believe the problem is a combination of muscle, tendon and ligaments. There is not enough integrity of the tissues to hold the joint in proper alignment. One piece that is weak adds added stress to the rest and it works like a domino effect. " 1.

When the owner or breeder starts to see this happening in a puppy (level 1) , they panic. Instead of starting off the puppy on a holistic brand of dog food and monitoring the amounts, they "monkey around" with the diet, changing foods, adding this and that, listening to too many suggestions online, their friends and the vet. Breeders are the worst at doing this and therefore they are often the ones that wait too long to contact me for help, because they are embarrassed. But we need to address this issue immediately so as not to have life long damage. Many dogs with early developmental problems have gone on to finish their championships and live long happy lives, once on a comprehensive feeding program. Those who have not end up with permanent damage as adults (see below).

Getting Help

If you ask for my assistance need all the info you can provide on current diet and photos - front on and side. These photos become the property of GreatDaneLady and Blackwatch Nutritional Consulting and can be used at my website, seminars, lectures and books to help others from experiencing the same thing with their puppies..

I will crop to photos so they are unidentifiable, change the names to protect the kennel and breeder, but use the photos to educate others about this problem. I do not charge a fee to assist in these matters. The best compensation anyone can have is to learn from these images.

If you have contacted me for help, you may be interested in first reading some other related articles at this website.

Getting Help For HOD - FILL OUT FORM FOR ASSISTANCE

Send the info requested on the form and send me photos in JPG format. I need front and side joints, laying down and standing. Email to me at GrDaneLady@aol.com -- KNUCKLING OVER in the subject line.