A Velpeau sling is a method of holding the wrist (carpus), elbow and shoulder joints in flexion preventing the animal from putting any weight on the forelimb. The use of a Velpeau sling is limited to cases that have minor scapula or humeral fractures that should heal if the limb can be kept still, or cases that need a prolonged period of immobilization such as a reduced shoulder luxation.
Velpeau slings are more commonly used in dogs than cats since the former tolerate this restrictive bandage much better.
Your vet will decide if a Velpeau sling is the appropriate way to manage your dog's problem following a physical examination and radiographs of the shoulder region of the forelimb.
A sling is not appropriate in cases of severe scapular and humeral injuries, particularly fractures involving the joint. Slings are less than ideal if other limbs are also injured.
The sling is best applied with the patient awake, supported in a standing position. If your pet is in pain or is fractious the bandage can be applied while the animal is under general anesthesia.
Chest x-rays can be useful, whether anesthesia is required or not, since the primary injury is close to the thorax and concomitant chest trauma is common.
Cotton padding will encircle the paw and carpus in a position of moderate flexion. Padding is placed in the armpit region (axilla) and the wrap continued to include the elbow and shoulder, pinning the limb to the side of the torso and encircling the other side of the body. Padding is ideally placed behind the limb on the opposite leg, but if your pet is excitable or fractious, padding will wrap behind and in front of the opposite limb, to prevent your pet from stepping out of the sling as soon as it is complete.
Cotton padding is covered with gauze, and then this layer is covered in elastic tape or Vetrap®. A small window is cut into the outer surface of the bandage down where the toes should be and the padding squeezed out of the way to allow visualization of the toes.
The toes should be checked daily for swelling, heat/cold and pain. The sling will need to stay clean and dry. This may mean assisting your pet to get around on three legs, in order to avoid falling, and not going outside in the rain or lying down in wet grass.
Where the bandage wraps around the opposite forelimb will be an area prone to skin abrasions and sores. Pay daily attention to this area and contact your vet if problems occur.
The sling may need to stay in place for several weeks. If your pet seems to be excessively bothered by the bandage it may be because the padding is constricting the paw or interfering with local blood supply. Constant chewing or licking at the sling together with crying or restless behavior would merit removal and/or replacement of the sling.
Dependent on the original injury, your pet may receive a follow-up x-ray to ensure that sling removal is appropriate. Do not be surprised to find the affected leg covered in sweaty dusty fur, muscle mass to have wasted from disuse and your pet being unable or unwilling to put weight on the leg. All these changes should be reversible within a short time.
A Velpeau sling is not commonly used in veterinary medicine mainly because the indications for its use are rare. For example, many scapula fractures will heal with just cage rest alone, and most trauma that results in a broken humerus is sufficient to require surgical fixation.
Careful fencing of your pet and appropriate use of a leash will minimize the risk of the type of trauma, such as falling from a height or being hit by a car, that might result in an injury requiring a Velpeau sling.