The carpus of your puppy is the lowest large joint on the front leg; it is equivalent to your wrist. A developmental deformity that can develop in this joint in puppies is known as carpal valgus. This is a deformity of the carpus joint that causes the front feet to point outward, or deviate away from the body. The condition most often becomes evident in puppies between 6 weeks and 12 weeks of age but can affect dogs up to 7 months old.
It has been established that this condition most commonly occurs in rapidly growing medium- to large-breed puppies. Some evidence suggests male puppies are more likely to be affected by the condition. Any breed may develop carpal valgus. Small studies report that Doberman pinscher and Shar-Pei puppies are more likely to develop carpal valgus.
Several causes of carpal valgus have been proposed, but not all of them have been proven. The abnormality is thought to be primarily caused by a difference in the growth rate between the bones and the tendons of the front legs. This could result from your puppy’s genetics, particularly if he has very large parents. However, the condition may also result from poor nutrition leading to poor bone development and conversely from “over-nutrition” -- some puppies are fed diets very high in energy, vitamins and minerals to encourage fast growth and tall stature, but this may contribute to uneven growth between the bones and tendons. The condition can also be caused by trauma to the leg that causes early closure of the growth plates, which are the portion of the bones essential for normal growth.
The condition is not painful, but some puppies have such deformed lower legs that they limp or show signs of abnormal gait on the front limbs. The primary symptom is an obvious deviation of the front feet outward, away from the body. The deviation will be in both legs unless it has been caused by trauma or an abnormality that affected only one leg. Carpal valgus is easily diagnosed by X-rays of the front legs that show deviation of the bones below the carpus. The X-rays are important because they exclude any other causes such as fractures or other damage to the legs.
A number of treatments have been suggested for carpal valgus, but consensus is lacking about how to address the problem. Your veterinarian can provide the most accurate and current information on treatment for the condition for your individual puppy. Initially, it was recommended that puppies have their front legs placed in splints, but this has been shown to actually worsen the condition. Current treatment recommendations include providing your puppy with surfaces that provide significant traction and providing a normal- to slightly low-energy and calorie diet. Such a diet will prevent growth that is too rapid, helping to lower your puppy's risk of developing this condition. Always consult with your veterinarian before making any diet changes for your puppy, as his energy requirements will depend on a number of factors. In rare cases, the deformity is so severe that intervention such as surgery or stabilization devices is required. The good news is that most puppies return to normal within about a month of being diagnosed with the condition and do not suffer any long-term effects.
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