Cowboy – Ectrodactyly, Bilateral Congenital Front Limb Deformities


Written by: Christina Biren-Fetz

Midwestern University College of Veterinary Medicine, Class of 2018

Patient Name: Cowboy

Signalment: 15-month-old, neutered male, German Shepherd Mix

Clinical Problems:

  • Ectrodactyly, bilateral congenital front limb deformities involving carpal joints and toes, with the left being shorter than the right due conformation
  • Diffuse muscle atrophy – most notably in the shoulders, thighs, and paraspinal muscles
  • Significant changes in posture as a result of limb deformities
  • Osteochondritis dissecans (OCD) present in both shoulders
  • Bilateral hip dysplasia
  • Moderate myofascial back pain

Rehabilitation Goals:

  • Strengthen hip, thigh, and core muscles
  • Improve flexibility and quality of movement
  • Reduce compensatory issues related to congenital limb deformities
  • Increase quality of life
  • Investigate orthotic options for front limbs

Modalities used in Rehabilitation Program

  • Homework Exercises:
    • Cookie side bends
    • Cookie stretches
    • Paw shakes
    • Proper sit
    • Proper down
  • Therapeutic Exercises:
    • Cavalettis
    • Figure 8’s
    • Proper sit
    • Proper down
    • Paw shakes
  • Underwater Treadmill


Cowboy initially presented to Pawsitive Steps Rehabilitation & Therapy for Pets for possible rehabilitation options in regards to his bilateral congenital limb deformities. Cowboy was born with a condition known as ectrodactyly, which is a condition where there is a division along the longitudinal axis of the paw (separations between the metacarpal bones). In addition, he has bilateral hip dysplasia and OCD in both shoulders. He recently underwent arthroscopic procedures to remove the OCD lesions. Due to his front limb conformation, he stands with a kyphotic (arched) back and a tucked pelvis, and he places more weight on his right front limb than the left. There is some concern that this compensation will result in further orthopedic issues in the future, and Cowboy’s owners are interested in pursuing orthotic options to improve pain and quality of life.


Cowboy’s rehabilitation sessions have been focused on strengthening his muscles, improving his flexibility, enhancing the quality of his movements. He has improved through various homework exercises and therapeutic exercises during his rehab sessions. Cold laser therapy and Pulsed Electromagnetic Field (PEMF) treatments have been avoided, as Cowboy is still a young dog and it is important not to interfere with his natural growth. Cowboy was recently casted for his first orthotic device on the left front limb, and is currently awaiting it’s arrival. If successful, he can then be casted for an orthotic on the right front limb. Hopefully these devices can support Cowboy’s carpi and paws and therefore reduce compensatory issues that arise as a result of his limb deformities.


Cowboy has his own Facebook page, in case you might like to follow him:

Cowboy was featured as our March 2019 Pet of the Month!  Check him out at this link:

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