What is Angular Limb Deformity(ALD)

What is Angular Limb Deformity(ALD)

Angular Limb Deformity (ALD) is a condition where a dogs legs develop abnormally, causing them to bend or twist at unnatural angles. This condition is usually because of trauma to a growing bone, abnormal growth plate development or more commonly genetic predisposition. At Northwest Referrals we have certainly seen a rise in cases of ALD, more commonly seen in Dachshunds, Bulldogs, Shih Tzus and Bassett Hounds. Due to this predisposition, there is not a lot that can be done surrounding prevention; however, we can correct this issue with surgery.

Signs and Symptoms

Angular Limb Deformities can manifest in many ways. Some of the signs and symptoms include, but are not limited to:

-             Limb deviation: this is visible bowing or twisting of the legs, often affecting the thoracic limbs eg. anterbrachium

-             Limping or lameness: Dogs may favour one leg or struggle to walk properly

-             Pain or Discomfort: Some dogs show signs of pain, especially when moving or being touched

-             Abnormal Gait: An unusual way of walking, such as stiff or unbalanced gait

-             Joint swelling: Affected joints may appear swollen or inflamed

-             Uneven weight distribution: Dogs may put more weight on one leg, leading to secondary issues like joint strain or pawinterdigital cysts.

When to do something about it

If your pet is showing any of the clinical signs above, you should seek veterinary advise as soon as possible.Some of these signs may not become symptomatic immediately, but over time can cause other, degenerative diseases such as arthritis and chronic joint pain which can be challenging to treat. If you are a client or a vet who seeks for a referral for a patient with suspect ALD please see “How to Refer a Case” below.

How to Refer a Case

To refer, the client; be you the case vet or client, follow a simple link on our website. This easy to use, 1page form includes all the initial information required to book to refer a patient to our care. The client will receive a response within 4 hours of booking. For regular users, many veterinary hospitals prefer to use ourWhatsApp service, where a dedicated account manager will oversee all bookings and communications via this platform. We have a transparent pricing system, with most procedures done at a fixed price. Please see our website for more information.

Case Study ALD

Teddy is a 6 year old shih-tzu who frequently visited the veterinary hospital with chronic, interdigital cysts due to abnormal weight bearing. Our Dermatologist referred this patient to ourOrthopaedic Veterinary Surgeon Dr Adam Kluczny Cert AVP PgC SAS MRCVS after suspecting that this patient may have ALD.

Preparation

After a consultation with DrAdam, Teddy was scheduled for a CT scan of the forelimbs to confirm his diagnosis of Angular Limb Deformity (ALD). Using our in-house CT scanner and a bone optimising protocol, we not only diagnose ALD but also generate highly detailed images to assist in surgical planning. These scans are sent to Bill Oxley at Vet 3D, who creates custom 3D surgical guides to aid our surgeon in the operating theatre.

Once Teddy’s ALD diagnosis was confirmed, we ordered the 3D guides and scheduled his surgery. As with any procedure, surgery carries risks which we take very seriously. To ensure safety, we offer pre-anaesthetic blood profiles before sedation, assessing vital organ function and identifying any potential complications. Possible risks include adverse drug reactions, organ strain, hypothermia and delayed recovery.Rest assured, all patients are continually monitored throughout general anaesthetic and in recovery by our highly trained, clinical nursing team. These concerns are thoroughly discussed with the referring vet and informed, signed consent is always obtained before proceeding.

The Surgery

Once all the preparations had been made, Dr Adam Kluczny performed a Angular Limb Correctional Surgery on the left anterbrachium. Using a craniomedial approach and osteotomy guides, Dr Adam was able to correct the limb conformation to a more natural stance, improving patient gait and relieving pain from unnatural posture. This surgery took around 2 hours to conclude, and Teddy was monitored continuously from our highly qualified team of registered nurses.

Aftercare

After the procedure, patientTeddy stayed at the hospital overnight. This allowed the clinical team could oversee his recovery and keep him rested. During this time, the patient is closely monitored whilst we reduce and replace pain medication to a suitable, at home use drug that can be administered at home. Some patients require more time for this; however, most are fit for discharge the following day.

Discharge

Once discharged, patients who have received ALD surgery will be under controlled exercise regime for an initial 6 weeks, however as this is patient specific, sometimes that time can be extended after assessment. In the initial few days post-op, the patient will have a dressing on the leg to protect the wound and reduce swelling.

Each case is different, but we aim to have the patient up and about within 12 weeks of surgery. After this 12 week we can sign off the patient and refer to your primary care vet.

We are always available to assist with any post-operative concerns. Clients can call us directly or reach out viaPetsApp, which connects them straight to our clinical team. Through PetsApp, clients can also send photos for assessment, and we can share updates and images when pets are under our care. This ensures clear communication and peace of mind throughout the recovery process.

Potential Complications

As with any surgery there are risks of post operative complications. We are on hand to help if you suspect any problems postoperative, and post operative instructions are given to help avoid them. Some of the complications that can be found in ALD surgery include:

-             Infection: Surgical sites can become infected, requiring antibiotics and wound care

-             Swelling & Inflammation: Some post op swelling is normal, but excessive draining might be a sign of infection or seroma formation.

-             Delayed Bone Healing: Bone heals faster in younger patients and longer in older dogs with systemic diseases.

-             Implant failure: plates, screws or external fixators may shift or break, requiring revision surgery.

-             Lameness or Stiffness: some dogs experience temporary mobility issues as they adjust to their new corrected alignment, this can be prevented with a correct preoperative planning

-             Joint Pain or Arthritis: If arthritis was already present, it may persist or worsen post-surgery

-             Nerve Damage: although unlikely, nerve injury can lead to temporary or permanent neurological deficits in the limb.

Conclusion
At Northwest Referrals we offer diagnosis and treatment of Angular LimbDeformity (ALD) using in house advanced imaging and 3D-guided surgical techniques. Our streamlined referral process, dedicated clinical support and commitment to patient safety ensure the best possible outcomes.

Surgical risks are carefully managed with pre-anaesthetic assessments and post-operative care is prioritised through direct client communication via phone and PetsApp. White ALD surgery is highly effective, complications such as infection, delayed healing or implant issues can occur, emphasising the need for strict post-op care.

For dogs requiring limb correction, a minimum or 12-week recovery is needed with strict exercise regime restriction plan. With expert care and comprehensive follow-up, we aim to restore mobility, reduce pain and improve the overall quality of life for our patients.

Frequently asked questions:

1.       Will my dog need both legs doing and can you do it at the same time?

In a lot of cases of ALD, both limbs require surgery. If this is the case, we would not do these at the same. It is case dependent but a time scale of 12 week minimum would be required in-between surgeries to allow proper bone healing.

2.       If both of my pets’ limbs need doing will there be a discount?

As we are one of the cheapest in the UK, we do not offer a discount for this due to the time taken for surgical planning  

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