6
Physical Therapy After CCL Repair
Each veterinarian seems to have their own theories regarding how soon physical therapy should be started after ccl surgery and what techniques work best. Other veterinary surgeons will write off physical therapy all together, preferring for the dog to remain quiet for the first 6-8 weeks after the repair, gradually returning to exercise. While it is always best to go along with the instructions of your vet, I do want to point out that studies done by the American College of Veterinary Surgeons have shown that dogs beginning rehabilitative therapy within 48 hours of the procedure tend to heal faster and have greater range of motion than dogs without any physical therapy.
Swimming is an excellent non-weight bearing activity, but only after the incision site itself has had time to heal. All therapies should always be cleared through your veterinary surgeon, prior to their implementation. If you have access to a pool and a dog that loves to swim, this can be a great way to help them regain lost muscle mass while working on ROM exercises in a zero resistance environment (decreasing the likelihood of injury).
Some owners have also chosen to go a more holistic route with their dog’s post operative therapy, seeking out the assistance of a professional skilled in acupuncture. The use of animal acupuncture, and similarly acupressure, in a dog recovering from ccl repair surgery may help alleviate post op discomfort, which can help your dog to heal more quickly from surgery. A growing number of veterinary clinics are now integrating western techniques such as acupuncture and massage into their practices, with many offering these services on site. Acupuncture and acupressure can be used in conjunction with ROM exercises and hydrotherapy under the supervision of your veterinarian.
The long term prognosis for animals undergoing surgical CCL repair is good, with clinical reports of improvement in 85-90% of the cases. Unfortunately, degenerative joint disease or osteoarthritis progresses regardless of treatment. Long term outcome includes a decrease in activity over time, an increasing level of disability, an adverse response to cold weather, and stiffness after inactivity related to progressive degenerative joint. Weight loss, an exercise regime of daily moderate activity, and the use of joint supporting supplements like glucosamine and chondroitin can help to improve these adverse clinical symptoms.
June 7th, 2008 at 8:10 am
Thanks for the comment! Our dog had CCL repair just over a year ago now, and she is doing great. She’s dropped 1/3 of her body weight (per the vets request) and acts like a puppy again and she’s almost 7. The surgery worked great, though it was tough for the first few months.
November 18th, 2008 at 10:12 am
Hi there. My 4 year, 4 month old German Shepherd just had her CCL surgery 5 days ago. What is the best advice anyone can give me. We are just coming in to winter and the weather is already below freezing. She loves to just sit outside. Will the cold affect her inscision and her leg? What is recommended? I appreciate any shared stories I can read. thank you.
December 25th, 2008 at 12:53 pm
After the surgery its better that U keep the dog warm & inside.Maybe cover him with a blanket.
The cold may cause more stiffness Or infection being outside.
Its very important that he rests for 1-2 months so the bone heals………
Follow the docs advice.
Also,make sure he doesn’t run Or slip after the Surgery Or he may damage the knee.
Please let him rest & follow instructions strictly.
Hope he recovers soon.
Thanks.
December 29th, 2008 at 8:13 am
My 7 year old Border Collie tore her CCL mid-November. Our vet suggested waiting a couple of weeks before surgery and sugery was performed on December 3rd. We left her in the care of the vet for 1 week so that he could check to make sure all had gone well.
After a week, we borught her home and did as instructed: kennel with bed (memory foam), no excessive movement, carrying her in and out of the house (2 steps), lifting her into and out of the car for vet visits, etc. Unfotunately, the vet removed the bandages that she had been wearing even though we protested. I left alone in her kennel for 1 hour, she removed the bandage that he had applied and chewed out the stitches. Back to the vet and he used staples to close the wound and more bandages plus halo collar.
Since she has a large neck and small head, the halo collar was meaningless. Regardless of how it was attached, she could remove it. Every night for 10 days she would remove the bandages and staples. Everyday we would go back to the vet to have more staples to close the wound.
We used a muzzle but everytime she was left unattended for even the shortest period of time she would remove the bandages and remove the staples. In several cases, this only took 15 minutes.
While leash walking her 2 weeks after her surgery, she tore the CCL on her good leg. Now we have to wait until the first leg heals before surgery on her other leg.
We had no idea that a torn CCL could be so exhaustive. For those considering CCL surgery for your dog, please be forwarned. It is a long, long and trying recovery. Good luck and God bless our dogs!
January 28th, 2009 at 6:17 pm
Our Golden had Extracapsular suture technique done 8 days ago. She’s still holding her leg up pretty high and is not using it at all to walk or balance. When can I expect her to begin to use the leg? Is canine Physical Therapy worth the time, drive and money? Any suggestions? Follow up appointment is 6 days out.
January 29th, 2009 at 7:18 am
Hello!! Just read everyones comments, the therapy is key to the surgery, your buddy will be grateful.
February 7th, 2009 at 11:26 am
Hello. Our almost 2 year old lab just had ccl repair surgery. I would NOT recommend this. SHe is miserable. We have three other dogs and she hates begining in the crate when they are outside. She weights 65lbs and I have to carry her back legs in a sling per the vets request which is very hard. I have to do this for the next 6 weeks!!! She also has a halo collar on that she cannot keep from hitting the sides of the crate with. I had NO IDEA what we were walking into with this surgery. I wish we had just kept her on glucosamine tablets to help with the arthritis (sp?) and let the leg out. This looks like torture to her.I am so overwhelled with her care and the long road to recovery we were told 6 month after she had the surgery. This is awful.
February 23rd, 2009 at 9:30 am
Katy,
Don’t be discouraged. We had the right CCL on our 45-lb mutt done two years ago and two weeks ago the other one blew out so we have just started the surgery, recovery and rehab all over again. He came home on the 10th day with stitches removed and no E-collar, and promptly started chewing at the wound. I cleaned up an old E-collar from the garage and put that on him for a few more days to protect the incision.
I would definitely recommend to anyone that you board your dog at the vet for at least a week post-surgery, if not two. The first time we did two full weeks and this time ten days, but I wish we had left him the two full weeks again. This is important especially if you have other pets and you want to be sure he remains calm.
If I remember correctly, it was a good six weeks of very limited activity with some therapy (the “dancing” and also the “bicycle” movement with the leg). Then at the 3-month point he was allowed to go faster but still we had to avoid any forceful springing starts or jumps. At six months it was almost normal but it was not till about nine months that he really seemed to be close to 100% normal again.
Now he’s 12 yrs old and I expect recovery to be slower this time. He’s very active for his age and we do have other pets that want to engage him in play. He also has keen hearing and he rises very quickly to check out any stray noise he hears. It is hard to keep him in slow-motion!
The bottom line is that it will be a slow and careful recovery and rehab BUT it will be worth it, especially considering that your dog is so young. I guess because she is a larger dog you are having to assist his movement with the sling.
Do be aware that 35 to 50% of dogs who have torn one will eventually tear the other, so be careful. But even then, it can still happen due to some genetic tendencies regarding the ligaments themselves.
March 2nd, 2009 at 3:31 pm
Our 4 year old Sheppherd/Rotti cross had his second knee done about 10 weeks ago, the first 2 years ago. Unfortunately, after 8 weeks he got out of our gated yard for only 90 seconds and came back hopping on three legs! Then a few days ago, even though he was on a leash he jump onto a high step… he just appeared up there. Now he’s walking on 3 legs again or putting very little weight on it. It’s so frustrating and I feel so sad for him. My husband has now taken him to the vet who has suggested limited walking yet again and hopefully he hasn’t re torn the ligament. Not sure if we can get it done again! ALthough, he’s so young would his quality of life be better having it done for the second time? I don’t know.
Anyway, the moral to the story is, keep your dog on a tight leash and really restrict their exercise for a good 3 months. Swimming wil be great once the weather warms up but they do feel better and think they can run or jump…but they can’t, don’t let them.
April 10th, 2009 at 10:56 am
My 8 year old lab mix had the wire CCL repair on her right knee a month ago. So far, so good, but as lot of people on this site have mentioned, this kind of surgery involves a lot of post care. My mom and I have split her care which has been a big help. If you can make the time, I really think the physical therapy can be done at home as opposed to a professional facility which I hear can get really expensive.
This is how her care has progressed and hopefully my diary will help others here:
Vet provided a Fentanyl patch for pain directly after the surgery which made initial pain management a lot easier on my end.
I fed her 4 small meals a day at first to evenly stagger her antibiotic and Vetprofen dosages.
She wanted to chew on her incision so I ended up getting this type of cone (http://www.allfourpaws.com) and it was great compared to those giant plastic ones.
First two weeks she was kept in a cage most of the time. Only went out for bathroom breaks. Iced the joint followed by range of motion exercises twice a day.
In the 2-4 week range she’s been kept in the house to restrict her movement but no longer needs the cage or cone. Stopped icing and started hot compresses (hot wet rag wrapped around the knee) followed by the ROM exercises twice a day.
She wants to put some weight on the leg now, unlike prior to surgery, and the knee doesn’t seem to be too stiff.
One problem is because of her decreased exercise, she’s been gaining too much weight so I’ve had to cut back her food.
The other big problem is her boredom! She was getting listless alternating with anxious energy after being cooped up so much. Been trying to take her out into the yard to sniff/dig gopher holes and rub her back on the grass. No real walking just yet though.
This weekend I plan on starting her with some real exercise. Just 15 min up and down the street slowly on a leash and some time in the pool.
Her thigh muscle is in pretty skinny from disuse and I’m hoping the workout will eventually help regain her muscle mass.
The vet suggested after 2 months to get her to walk on uneven surfaces like deep pillows, big gravel, and stairs to help get her balance back as well.
I have to admit she’s been pretty miserable at times, especially with that cone around her face. But so far it seems to have been the right decision, seeing her want to stand on her leg again. I went into this never expecting her to fully recover to her old self but to the point where she can run to some extent again. I was also concern over the increased stress from scrambling around on 3 legs may prove to been too much for the remaining good joints and she’d end up with other problems.
I’ll follow with another update as she progresses.
Good luck to everyone out there!