TL;DR: Knuckling is a neurological symptom where a dog walks on the tops of their paws, requiring a veterinary evaluation within 24 hours or immediate emergency care if the dog cannot stand.
What does it mean if my dog is knuckling over?
- Knuckling over occurs when a dog drags or tucks their paws, walking on the tops of the feet rather than the pads.
- This is typically not an orthopedic issue with the paw itself, but a neurological symptom.
- It indicates that "proprioception"—the dog's subconscious ability to know where their limbs are in space—is impaired.
- This usually points to a communication breakdown between the brain, spinal cord, and the nerves in the legs.
Is it an emergency if my dog starts knuckling?
- The urgency level for knuckling is Medium, requiring a veterinary evaluation as soon as possible, ideally within 24 hours.
- The urgency increases to High if the knuckling is accompanied by a total inability to stand or sudden paralysis.
- You should visit an emergency clinic immediately if your dog shows signs of intense pain, such as shaking or vocalizing.
How can a photo or video of my dog knuckling help the veterinarian?
- Capture a short video of your dog attempting to walk, as neurological symptoms can fluctuate.
- A video allows the vet to observe the specific gait and identify which legs are affected, even if adrenaline masks the symptoms at the clinic.
- This visual evidence is vital for an accurate triage and diagnostic plan.
Clinical Context (Merck Veterinary Manual)
When a dog presents with knuckling over, the affected animal stands with the digit knuckled over onto the dorsal surface of the pastern and fetlock. The hock may appear overextended. In mild cases, the fetlock may knuckle over intermittently during ambulation, but this can also occur with heel pain. In severe cases, the dorsal surface of the hoof may be dragged along the ground, and sensation to the dorsum of the fetlock is often decreased. Reflex testing may demonstrate absent hock flexion, while stifle and hip flexion remain normal, which differs from cases involving the ischiatic nerve. Peroneal nerve damage, due to its superficial location over the lateral femoral condyle and fibula head, can be caused by external trauma or pressure from recumbency. Most cases resolve naturally.
Chapter: Neurology
Source: The Merck Veterinary Manual, 11th Edition (Page 1090)