What is an orthosis?
An orthosis, also known as a brace, is a medical device designed to improve movement by supporting a weak limb, improving normal joint function, or protecting a limb. A brace can be rigid, semi-rigid, or flexible, depending on what is needed.
There are many situations in which your veterinarian or veterinary rehabilitation therapist may recommend your dog wear a brace, and the type depends on your dog’s condition. Conditions that can benefit from braces include carpal hypertension, abnormal side-to-side movements of the carpus (carpal valgus/varus), medial shoulder instability, Achilles tendon rupture, and cranial cruciate ligament disease.
Can braces cause problems?
Although braces can be useful, complications can occur.
- A poor-fitting brace can result in pressure sores if it is too tight, or chafing if it is too loose.
- With a hinged brace, if the hinge of the brace doesn’t match the normal hinge point of the joint, it can impair normal motion instead of improving it.
How can I ensure a brace fits my dog correctly?
To ensure a brace fits your dog correctly, you must work closely with a veterinary rehabilitation therapist experienced in orthotic device-fitting or with a certified orthotist/prosthetist recommended by your veterinarian.
For soft/flexible braces, they will obtain measurements at the correct anatomic points as recommended by the brace manufacturer. For rigid or semi-rigid braces, they will create a cast mold of your dog’s leg following the specific instructions of the brace manufacturer. Usually, casting bandage is placed over a thin bandage or other material placed to protect your dog’s leg from the casting material. The cast is allowed to cure/dry, then removed using a cast saw or scissors, depending on the type of casting material used. Your dog may need some degree of sedation for this process. The brace manufacturer will use this cast of your dog’s leg to create a custom fitted brace.
Regardless of the type of brace used, the orthotist or veterinary rehabilitation therapist will need to see your dog again for the first “fitting” of their brace to ensure proper fit and to teach you how to apply it properly.
As your dog gains or loses muscle, the brace may need to be re-fitted, so be sure to watch for any signs of skin changes and report them to your dog’s veterinary rehabilitation therapist or orthotist right away.
Will my dog accept the brace?
This is something that nobody can answer for sure, but you can do things to help your dog accept a new brace. Initially, have your dog wear their brace for 30–60 minutes, three to five times throughout the day. Recommendations on how long to wear the brace and how frequently may be provided by the brace manufacturer.
The first few times your dog wears their brace, they may try to shake it off, exaggerate their step (high-step) or, rarely, vocalize or refuse to walk. You may need to start even more slowly – placing the brace, praising your dog, and immediately removing it. Monitor their skin every time you put on or remove the brace. If there are no problems, you can gradually increase the time your dog spends in the brace by about 25% every 3–4 days.
"Make sure you supervise your dog any time they try something new with their brace on (e.g., walking up or down stairs)."
Make sure you supervise your dog any time they try something new with their brace on (e.g., walking up or down stairs). Watch for fatigue or soreness – a dog that finds they can move better in a brace may overdo their exercise initially!
Your orthotist or veterinary rehabilitation therapist may recommend another assessment, about a week after your dog starts wearing their brace, to re-evaluate their gait while wearing the brace, to ensure the fit is still good and there are no skin changes, and to ensure you have no concerns.
How canI help my dogs brace to last as long as possible?
Avoid getting the brace wet, where possible, unless the manufacturer says it is safe to get wet. Water can damage or degrade brace materials and a wet brace can also cause skin irritation. Try to keep your dog from lying against a hard or abrasive surface like concrete with the brace – this can damage the material.
Remove the brace when your dog is resting inside. Except in certain situations, braces are generally meant to be worn while a dog is walking or playing.
Is a brace as good as surgery for a dog with a cranial cruciate ligament (CCL) tear?
While a properly designed and fitted stifle (knee) brace can limit some of the abnormal motion associated with a CCL tear and improve your dog’s lameness, studies have shown that braces are not as good as surgery at this time. Furthermore, a meniscal tear is a common and painful complication of CCL injury and requires surgery to repair.
A brace combined with rehabilitation may help support those dogs that aren’t good candidates for surgical stabilization of the stifle; however, more studies are needed to evaluate the full effect of the brace.
