The brachial plexus is a grouping of nerves that provide motor and sensory innervation to the front legs. The nerves of the brachial plexus can become injured from a traumatic event, and injuries can range from mild to severe. An animal with a brachial plexus injury will usually have some level of paralysis and loss of sensation of the affected front leg, and they may drag the leg or hold the leg up. Difficulty weight bearing is a common sign of brachial plexus injury. The severity of the injury will dictate how much recovery will happen. A completely lacerated nerve will not recover, but a nerve that is stretched or partially damaged may regenerate. Nerves may regenerate at a rate of 1mm per day, so recovery is typically slow.
An animal with a brachial plexus injury will typically have some level of muscle paralysis and loss of sensation of the affected front leg, and they may drag the leg or hold the leg up. Absence of deep pain is often an indicator of poor prognosis for return to function. They often have trouble weight bearing through the affected limb, but they may be able to bend through some of the joints of the front leg.
Rehabilitation for brachial plexus injuries first focuses on preventing muscle contracture, decreasing pain, decreasing inflammation, maintaining range of motion, and protecting the limb from wounds. We then work to regain function in the limb. Depending on the extent of damage, nerves can have the ability to regenerate. By promoting weight bearing and stimulating nerves via electrostimulation, laser, and hands-on techniques, we can help facilitate this healing process. Orthotics can also be used to help maintain some function and help a pet weight bear on the leg again.
It is important to keep in mind that we may not see recovery if the damage is severe, and sometimes amputation is the best choice in the long run. In addition, dogs can have abnormal nerve sensation and pain related to a brachial plexus injury. When nerves regenerate it can lead to a tingly feeling, and sometimes dogs will chew at their limbs as this occurs. So ensuring dogs are not able to chew at their limbs is very important to prevent wounds and infections. We also recommend using an orthotic, bootie, sock, or sleeve to help protect the limb from dragging.
Overall, we have helped many patients reach full recovery who have acquired a brachial plexus injury. For the few whose nerves were completely lacerated and didn’t recover, we helped them with supportive devices to continue a healthy and happy life.
