How To Treat Paw Knuckling In Dogs

There are many ways a dog can present with lameness. It may be a slight limp, having an unbalanced gait, or paw knuckling. Paw knuckling in dogs is uncomfortable, and it is distressing for owners to see their pups struggle to move easily.

It is vital to understand what paw knuckling is and what causes it to find a method to help your dog and treat the condition. 

Paw knuckling can occur in the hind or forelegs. The dog’s foot bends so that the dog walks on the top of its toes. Treatment varies according to the underlying cause. Splints, proprioceptive devices, pain management, nutritional correction, surgery, and physical therapy help treat paw knuckling.  

Most people are understandably disturbed when they see their beloved pup paw knuckling. They want to know if the problem can be fixed and how quickly that can happen. Paw knuckling is a complex symptom that arises from underlying conditions.

What Is Paw Knuckling?

Dogs walk on their toes. This is known as digitigrade mobility. When something goes wrong, the toes may fold over so that the dog walks on the top of the toes. The top, furry skin part of the toes is in contact with the ground instead of the pads. You can see some more pictures of paw knuckling here.

Paw knuckling is a symptom of underlying conditions. It is not a diagnosis but points to another problem that needs investigation. Any time you see paw knuckling, you should consult a veterinarian as soon as possible. 

Paw knuckling can indicate serious diseases that need prompt attention. It is also uncomfortable and painful for the dog as walking in this position causes severe trauma to the foot. 

What Are Causes Of Paw Knuckling?

Paw knuckling typically occurs when the proprioceptive feedback from the feet and legs is interrupted. Proprioception refers to the ability to position and orient the body in space. It is how we can stand upright, kick a ball, etc. It is vital for correct and precise movements. 

The same proprioception skills are necessary for dogs. If the dog is unaware of the position of his foot, he may not know it is placed incorrectly and will not know how to correct the positioning. 

Proprioceptive problems are almost always the result of neurological damage or disease. The break in the proprioception feedback may be at the level of the peripheral nerves, or it may be from the central nervous system.   

1. Spinal Trauma

Spinal trauma can occur from a fall from a height, a blow to the spine, or even the dog falling awkwardly during play. Motor vehicle accidents may cause spinal trauma even if the the dog is just clipped by the vehicle. 

The resulting blow can damage the nerves that provide feedback at the level of the spinal cord. The damage may be temporary, and the nerves will recover once the bruising has dissipated. It may also be permanent, and the dog may have paw knuckling as a lifelong mobility challenge.    

2. Spinal Stroke

Dogs have thick cartilage discs between their vertebra that protect the spine from concussive forces. Sometimes a disc ruptures, or a piece of the disc breaks off. The cartilage piece obstructs blood flow to part of the spine. This occurrence is known as a spinal stroke or Fibrocartilaginous Embolism (FCE). 

The obstructed blood flow prevents oxygen from reaching areas of the spinal nerves, which results in damage. The dogs may show various symptoms, from paw knuckling to paralysis. 

3. Intervertebral Disc Disease

The cartilage discs between the vertebra may rupture and collapse into the spinal cord. Alternatively, the disc may degenerate and bulge outwards, causing pressure on the spine. These conditions are both known as intervertebral disc disease. 

The site of the lesion influences the symptoms that are seen. If the lesion occurs in the neck (cervical) region, the dog may show paw knuckling and other lameness or paralysis in the fore and hind limbs. If the lesion occurs lower down the spine, paw knuckling and other symptoms are seen in the hind legs.

4. Wobbler’s Syndrome

Wobbler’s Syndrome is another spinal condition that can result in paw knuckling. It is more common in big breed dogs and occurs due to narrowing of the spinal canal.

5. Tumors Can Cause Paw Knuckling

Tumors in the dog’s brain or spinal cord can result in lameness, including paw knuckling. The exact presentation will depend on the sit of the tumor. 

6. Degenerative Myelopathy

Degenerative myelopathy is a neurological disease that results in progressive paralysis. The paralysis is usually seen in first one hind leg but quickly progresses to include the other back leg. Paw knuckling is a common symptom.

7. Central Nervous System Conditions Can Cause Paw Knuckling

Diseases and conditions that impact the central nervous system (the brain) can result in diminished proprioception and paralysis, seen as paw knuckling. There are a wide variety of CNS problems that can include strokes, hydrocephalus, and other rare disorders. 

Conditions of the central nervous system are sometimes treatable, but they are seldom cured. Veterinary management is always needed. Strokes may show a period of spontaneous recovery within the first six weeks as the blood drains from affected areas and swelling reduces. It is essential to do as much rehabilitation as possible during these first six weeks to maximize the recovery. 

8. Mechanical Causes Of Paw Knuckling

Not all causes of paw knuckling are neurological. In some instances, damage to tendons, ligaments, and muscles can result in paw knuckling. Severe lacerations and tears can make it impossible for the dog to correct the position as the mechanical ability to move the foot is interrupted.

Veterinary intervention usually includes surgery and can have excellent results in correcting paw knuckling from traumatic damage.

Puppies with poor nutrition present with foot and leg deformities known as carpal flexural deformity. The bones, ligaments, and muscles are too weak to sustain the dog’s weight and motion. The legs may bow out, the paws knuckle over, and sometimes the puppy cannot stay upright and ends up crawling. 

The good news is that carpal flexural deformity can be rapidly corrected with good nutrition and rehabilitation. 

Arthritis affects older dogs and may, in severe cases, cause paw knuckling. The deformities of the joint due to arthritis inhibit normal mobility, making the joint stiff and difficult to straighten.

How To Treat Paw Knuckling In Dogs

Paw knuckling must first be treated by addressing the underlying condition. There are various methods of assisting dogs that have paw knuckling. 

1. Devices To Improve Proprioception And Grip

One of the difficulties a dog with paw knuckling faces is the effort to place the foot flat on the floor. 

Toe grips are rubber caps that fit onto the dog’s nails and increase the traction on the floor. The dog feels more secure and moves better. The added sensory input from the rubber improves proprioception in some dogs. 

Proprioception socks such as the No-knuckling training sock provide support, and the pressure improves proprioception. K-taping works on a similar principle but generally needs to be applied by a trained professional. 

2. Physical Therapy

Physical therapy is critically important for dogs with paw knuckling. The physical therapist will aim to strengthen muscles and ligaments that support the joints. Hydrotherapy is invaluable for dogs with carpal flexural deformity. 

The physical therapist may include laser therapy to reduce scar tissue and loosen contractures. Custom-made braces can be fitted to the dog. These are manufactured by veterinary orthotists working with physical therapists and veterinarians.  

Physical therapy can achieve some impressive results with neurological damage. It is well worth exploring this option to keep your dog comfortable and functional. 

3. Nutritional Correction And Supplementation

Correct nutrition and supplements are essential in treating dogs with carpal flexural deformities. Supplements such as intensive vitamin B can be useful in neurological conditions.

4. Pain Management In Paw Knuckling

It is crucial to keep dogs comfortable and pain-free. The veterinarian may prescribe non-steroidal anti-inflammatories and other analgesics.

Corticosteroids effectively reduce inflammation and lessen pain, especially in neurological conditions. 

Helping A Dog Suffering From Paw Knuckling

Changing floor surfaces in the house can help a dog with paw knuckling. Textured carpet or tiles can aid the dog in maintaining traction and give additional feedback to the dog on how his foot is positioned. 

Dogs that cannot correct the position of their paws will need to have protection for the skin on top of the toes. If the dog spends time on concrete or other hard surfaces, these can be covered with artificial turf, which is soft and easy to clean.  

Bandages and dog boots can help protect the skin on the foot from trauma. Ensure that the dog has a warm bed, as the cold can worsen aches and pains accompanying paw knuckling. Raised beds are useful for dogs that have mobility issues. It is easier to lie down and get up, and the bed is generally warmer.

A good diet and health supplements that keep the dog at an appropriate weight without compromising nutrition can increase the dog’s quality of life. 

Verdict on Paw Knuckling In Dogs

Paw knuckling can be treated with the help of a veterinarian, physical therapist, orthotist, and nutritionist. Surgical corrections can be beneficial.

Devices to improve traction and proprioception aid dogs with permanent paw knuckling.