I have a rescue Basset Hound/Golden Retriever mix who is almost 4 years old. He is a very mellow, chill couch potato that does have spurts of energy and playfulness, unlike our constantly crazy Yellow Lab. About 7 months ago, they were playing in the yard and he must have somehow hurt himself because after napping for a couple hours he wouldn’t put his left rear leg down. He even moaned every once in a while in pain. We called our vet that night (not a surgeon), and he said he was pretty sure it was his CCL and that we can have him evaluated first thing in the morning. However, in the morning he was able to walk on his leg just fine and no moaning or lameness since – so I was reluctant to even take him to the vet. The vet explained the drawer test to us, and then performed it on our baby (who let out the most heartbreaking squeals of pain I have ever heard).

I was a little miffed by the way our vet recommended TPLO. We wanted to do our homework, so we saw an orthopedic surgeon who said he only partially tore his ACL and he recommended TTA surgery, but suggested we first try glucosamine/MSM/chondroitin pills along with strict rest for 8 weeks. We combined that with another antioxidant with glucosamine in a powder form. We were relieved that he suggested this first, as the TTA/TPLO are scary to me. He seemed to recover beautifully, he is a mostly chill dog so he didn’t much mind strict rest! He had no obvious limp and seemed to bear weight pretty evenly for months so we started to slowly introduce some exercise about 2 months ago. At the same time, we decided to switch to cheaper glusocamine pills and he remained to be doing great. We let him off the leash, take him for long walks, and he hasn’t had any signs of pain or lameness.

However, as of 2 weeks ago, he seems to be regressing. I took him for a walk, and wouldn’t even use his leg after a couple of hours. So we went back to strict rest and he was fine to put weight on it again the very next morning, just like at Day One over 7 months ago. Although he is using his leg, he does slightly favor his good leg and are concerned that the rest and glucosamine just isn’t enough for him, but I am praying that switching back to the other pills will do the trick.

Let me tell you, I love the hell out of my dogs, and have done more research and called more vets (holistic, surgeons, etc) than you’d ever imagine. We are trying to figure out what the next step should be. No matter what, we are going back to the other pills and they arrive tomorrow. We are also putting him on a diet dog food, he could lose a couple pounds. I have started massaging and icing his knee. I’m also doing a little physical therapy on him at home using a really helpful youtube video I found. Maybe a brace would help him?

We were so saddened by his setback that we are revisiting the possibility of surgery, as much as we don’t want him to go through that. But I am afraid of arthritis – some say NOT doing surgery causes it, some say surgery causes it. We don’t know what the best thing is for our dog and we want to do the right thing and make an educated decision. The TPLO/TTA seems so invasive, and aren’t sure if it’s worth the risk/cost. Or if since he is generally lazy the conventional surgery would be better for him. Maybe the Tightrope would be better, but I have researched and there are many failed cases of those as well as the other types of surgeries. Any advice or general direction would be greatly appreciated! Thank you in advance for your time!

We are trying to figure out what the next step should be, as surgery is something we are considering but we don’t know what the best thing is for our dog and we want to do the right thing and make an educated decision. The TPLO seems so invasive, and aren’t sure if it’s worth the cost or if since he is generally lazy the conventional surgery would be better for him. Any advice or general direction would be greatly appreciated! Thank you in advance for your time!

A Conservative Management Experience – Pudge is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Looking for more information on experiences using canine chiropractic, laser therapy and nutrition to help your dog heal form a CCL knee ligament tear or rupture? Keep reading to see how Pepe is progressing using Conservative Management.

I’ve also put him on a raw food diet to ensure that he’s getting the best possible nutrition.

He’s a laid back boy so it’s not too hard to keep his activity at a minimum. I’ve been picking him up to get on the bed, but after reading some of these posts maybe I should not let him go up and down the stairs. I’m also looking at chiropractic and acupuncture as complementary treatments.

I spoke with the Dr. in my office today, and he is going to use a chiropractic instrument (activator) to adjust his spine, and also a cold laser on the knee. This is one of my huge benefits of working where I do! Complementary and alternative medicine is hopefully going to be beneficial for Pepe.

June

Pepe is doing okay… Still not using the leg but does touch his foot down quite a bit.

Two weeks ago Pepe was treated with the activator by going three times down his spine. It’s spring loaded, and as he goes through each vertebrae, he can tell where there are energy blockages by Pepe’s movements after each. Then when he repeats he can tell if those spots “clear”. He had his 2nd treatment last week, and then well wait 2 weeks for the next.

Pepe is also getting the cold laser, but it really works best if you can treat every day for multiple sessions.

I can definitely see a difference in Pepe’s demeanor after the adjustments. He just looks perkier and the way he holds his ears just look like he’s happy and normal!

I still have him on 2 Gotu Kola Complex (MediHerb) tabs per day, as well as 2 Boswellia Complex tabs per day. Additionally, I am feeding him raw “meatballs” from Nature’s Variety and break the herbal tablets in half and stuff them in chunks of the meat. I also sprinkle his food with 1/2 t of Canine Musculoskeletal Support (Standard Process) each day as well.

Our Dr. has seen quite a few dogs completely recover and stabilize the joint on their own, but it’s a slow process. I’m still convinced that with the alternative treatments avoiding surgery may be possible.

4 Months

Alternative Treatment for CCL Injury – Pepe is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Hello Everyone,

But sadly, against my better judgement, I let her rip when we were out, because she has such a high prey drive, it was the only way to rid her of some of her restlessness. She is supposed to be Chow/Border Collie, which explains the high prey drive! So last week, at the park as so many times before, ZOOM, man she’s gone chasing a squirrel up a tree.

She came out of the bush, with her left rear leg, just gimpy, limpy along. Not until later at the house that night did I notice the extent of her injury. I freaked, cause I knew this was not good. The injury occurred on (I believe) Sunday, and by Monday we were off to the vets.

Long story short, she has blown her ACL and I am devastated. Moving along to a few weeks later, after getting her on Deramaxx for the pain, I wind up at the Idaho Humane Society. I had a visit with the executive director of the center, who is an orthopedic surgeon. We did the exam, had x-rays taken for the first time, and much to my despair, not only is her left leg shot, her right is even worse!

Much to my horror, she also has hip dysplasia in both hips with arthritis and arthritis in both legs also. So in trying to decide to do surgery or CM, after reading about all of you guys that have taken that road I figured, what the hell…. I can not do surgery on legs, hips, and God knows what else! I was so bummed, I am so worried about my girl.

It is horrid to see my wild child, become crippled. (tears, and more tears) So as it stands, right now I too am having to just try to keep her comfortable and out of pain. I restrict her movements, am trying to get a little weight off her (she’s 48 lbs or so) and I have her Rimadyl and Tramadol also. Doc. said to give her 2000mg. of MSM and Glucosomine, which is good to know cause I only was going to give her 1000 of each. That for about 2 months, (2000mg) while she is trying to recover.

This is a difficult thing to watch, but thank goodness I will be home with her not having to work (unemployment!). I can assist and watch over her! I am an old lady myself, but have no children, so you know how neurotic us pet owners can be with “our kids!” So, keep writing guys, this is very helpful – I don’t feel so alone and sad, knowing others out there are struggling with the same problems! Thank you all, and I will keep you guys informed, as we travel this very bumpy road of destiny!!

Appreciatively,
Eilen Baldwin
Star, ID.

Healing a CCL Tear Without Surgery – Jasmond Baldwin is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Hudson, a Lab mix, came into my life in April 2002 as a rescue from a local shelter. He was discovered abandoned at a car wash and he has never been alone again. Hudson is just a dude who loves his Daddy and Mommy and we adore him. I would sell all my possessions and live in a box if that is what it took to care for him. Judging from other posters to this site, my feelings are no different than others regarding their pets. But I have made some mistakes along the way.

At approximately 4 year of age, he showed significant hesitation in his normal activities. Short version is – We discovered serious hip dysplasia, had full hip replacement on both sides, and he had a full and healthy recovery.

About 2 years ago, he came up limping on right rear leg. Testing indicated hips were fine, but knee was suspect. Admittedly we were upset being hit with a $1300 bill to find out what was done earlier (hip replacement) was ok and now you can spend more finding out what is wrong. As we contemplated making an appointment with recommended doctor for evaluation of knee, Hudson stopped limping, so we postponed evaluation and life went on.

About 3 weeks ago he started limping again. Not fully off the right leg, but favors it when getting up and during initial walk. He did (and still does) stand on it to pee (about 30% of time, uses left leg the remainder). We started him on fish oil (twice daily) as an anti-inflammatory. I poorly thought this was just a flash-back to earlier and keeping him inside more and not chasing/playing with his buddies would suffice.

Starting this week it appeared to be getting worse. So we took him in (I notice folks do not mention vet or clinic names, so I won’t…but will if asked). He had x-rays taken (and they asked if they could do routine blood work for kidney/liver function to gauge general health…I said ok). During our wait a nurse/technician showed us x-rays of horrible knee joints and told TPLO was the only way to go. It will fix our dog…this was before any evaluation!

Surgeon was delayed for some reason, so nurse/technician brought us Hudson’s x-rays. I am not a vet, but they looked nothing like what we had been shown. Realize you cannot tell a ligament tear/rupture from an x-ray, but you can measure bone misalignment, get some feeling for buildup of scar tissue, arthritis, etc. She started back-peddling a bit and said she was not that experienced (earlier she boasted of her 10+ years assisting this surgeon) and doctor was better at seeing the problems.

Regardless, doctor showed up. After a brief introduction (5th time at this hospital, 1st time with this fellow) he brushed by my wife and myself, stooped down to dog and pulled his leg. Hudson yelped and ran for the corner. Doctor said Hudson had torn ligaments in right leg (as indicated by the dog’s pain) and needed TPLO surgery right away. He also said we needed to do the left side also as typically during the recovery the stress generated on the non-repaired knee will cause it to fail. It was best to do both at same time…$4200 a piece (less ~$1200 discount for doing both at same time) and he had opening in his schedule for Thursday (this was a Tuesday). I started to remember the blood work being done…they already thought this was a go without any discussion/consultation? Reason for so quick was ligament was most likely not fully ruptured so meniscus was likely intact, so it needed to be done ASAP to prevent more damage. We gathered Hudson who fortunately could still walk; I took him to our car while my wife paid our bill ($398.10 for 2 x-rays, general blood work and our consultation).

Hard to drive when you are crying like a baby (I’m 58). Lots of stuff on my mind, but on the productive side I knew we needed much more information.

That brings me to this site (and similar ones) where experiences are shared. After reading many of your contributors stories and experiences, we contacted our regular vet (he is mostly a large animal fellow who takes care of our horses but has always been honest with us and we have known him for years…and right now I needed a professional I could trust) and relayed our experience. He stated the surgeon at the hospital had already contacted him (our local vet was the referral for the hip dysplasia diagnosis) and told him the dog had a ruptured CCL in right leg and damage in the left. The dog was tough (how do you know this…because Hudson only yelped and did not bite him when he pulled his leg?) and could take both TPLO procedures at once. Our local vet did not say (and my wife asked directly) this surgeon tried to convince him to convince us, just wanted him to know the facts before we talked to him.

Anyway, our local large animal vet reviewed the x-rays and blood work (results fine), watched Hudson walk, gave a careful exam to both Hudson’s legs and felt (while he was not certain as the dog really tensed up and this stiffens the muscles making checking play in the joint difficult to detect) that he would not initiate the TPLO process (or any other surgical remedy) at this time. He also stated he would not do any surgical process simultaneously-risk was too high, animal may just quit due to the pain/rehabilitation stress). Our local vet was not certain the status of the ligaments. He did place a call to a radiographer and discuss passive options to determine ligament condition (CT scan was not viable; MRI was, but at a cost of $1500 to $2500). He felt the conservative management approach we learned from this site and told him about was a good one to try for at least 60 days. He felt nothing was to be lost and much to gain. It would give us some time to obtain even further information.

So we are on day 1 of our CM venture. Food is changing (we have historically believed you should take a few days to fully change from current food) to a weight management recipe (he is at least 10 lbs. overweight), Hudson remains on 2 tablets daily of Fish Oil capsules, we have started him on twice daily Chondroitin/Glucosamine tablets (SAM’s version) (pulverized), I have ordered the Yucca Oil Extract (another anti-inflammatory), we have spoken several times to Dr. Spatt and ordered the A- TraC Dynamic Brace (hopefully get middle of next week), Hudson is under house arrest (as my Mom call’s it)…minimal walking on leash only!. I will now be sleeping downstairs…no steps…we have put up barricade to stairs.

I am not a person of strong faith but I am praying daily for my dog to recover. This experience has placed his mortality in the forefront of my mind and I truly cannot imagine his not being my best friend forever.

I am open to any ideas to assist in this process. That includes experiences with a surgical remedy, though at 9 years old and having been through 2 hip replacements (although it truly went fine and he was given a better quality of life to date) I currently cannot imagine putting him through a similar or more invasive process again at this time in his life.

Thank you for your time.

Conservative Management Instead of TPLO – Hudson is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Help!  My dog is limping – Could it be a torn ligament?

This guide is a good starting place for anyone looking for more information on dog knee problems, specifically cruciate ligament injury in dogs.  This article will give an overview of dog knee injuries covering everything from symptoms to recovery.

What is a Cruciate Ligament Injury?

An injury to the CCL (also known as the cranial cruciate ligament and sometimes called the ACL) can cause lameness in dogs, and is one of the most common causes of rear leg lameness. The function of the cruciate ligament in dogs is to stop the femur (large bone at the top of the leg, above knee) and tibia (smaller bone at bottom of leg, below knee) from rubbing against one another. When the cranial cruciate ligament is torn or ruptured the leg loses stability because these bones are now free to move back and forth on top of one another, causing friction, inflammation, possible meniscal injury and eventually arthritis.

During activities with a healthy dog ACL ligament there will be tension on the ligament, preventing the femur from pressing into the tibia, creating a sliding motion for fluid movement. If your dog is walking or running with a cruciate ligament tear there will be no tension on the CCL, allowing the bones to unnaturally move together, causing pain, lameness and an aversion to using the leg. The best way to think of this would be to envision the ligament like a rubber band, but instead of holding the bones together, the rubber band is in place to prevent the bones from coming into contact. When the rubber band is snapped, there is no longer a gliding joint in the knee and there is contact between the bones.

Acute vs. Chronic Causes of Cruciate Ligament Injury

Acute injury is generally associated with trauma. If the CCL (also referred to as ACL because of it’s similar function to the human ACL) is injured acutely it will most often be due to improper rotation of the knee and hyper extension. This can occur in many different ways such as a dog taking a misstep off a curb, stepping into a divot, jumping or becoming stuck, using a jerking motion to free him/herself.

Chronic injury of the canine ACL is generally associated with disease, age related degenerative changes of the ligament, excess weight (obesity) and conformation of the knee joint (certain large breed dogs are more prone to these types of injuries due to the way their back legs are formed). In the case of chronic injury of the cruciate ligament, there is very little that can be done to prevent the injury from taking place.

Size Matters

Small and large dogs fair differently with the same type of ACL injury. Studies have shown that dogs weighing less than about 25 pounds can experience a full recovery from ligament damage without surgery. This is not true in dogs above the 25 pound threshold. While dogs over 25 pounds may appear to be improving with conservative methods, these larger dogs rarely return to their full function without any issue. This is not to say that there has never been a case of a medium to large sized dog recovering from a torn CCL with only conservative management, but does demonstrate that smaller dogs have an easier time fully recovering using the conservative approaches.

Symtoms of a torn, ruptured or injured CCL will vary from dog to dog, and depending on whether the injury was acute or chronic in nature. Some dogs with a fully torn cruciate may only exhibit mild lameness, while others with a tear may not bear any weight on the leg at all. This again varies based on the type of dog, their size and whether other structures within the knee (particularly the meniscus) were also damaged. Below are some of the most common symptoms associated with a dog knee ligament injury.

Symptoms of a Dog ACL Tear:

1. Decreased range of motion.
2. Hind leg extended straight when sitting down (this is known as the sit sign).
3. Crackling noise of bones rubbing against each other – the medical term for this is Crepitus.
4. Dog exhibits signs of pain when knee (stifle) joint is touched.
5. Exercise intolerance.
6. Limited range of motion or mobility.
7. Stiffness, limping or unwillingness to use the leg after exercise.
8. Knee joint is swollen and/or hot to the touch.
9. Thick, tight, hard and/or firm feel to knee.
10. When standing will only place weight on the toe instead of using entire foot (called toe-touching). An early sign of toe-touching is to only have weight on one side of the body when standing.

There are other conditions with symptoms similar to a dog ACL injury such as: arthritis, knee sprain, meniscal injury, hip dysplasia, patellar fracture, patellar luxation, myelopathies, lyme disease and others. Please schedule an appointment with your vet if your dog shows any of the CCL tear symptoms listed above.

What if my dog’s CCL is never repaired?

This, again, depends on their size, breed and a number of other factors. Some dogs without a CCL may do just fine, while others may use the ability to use their leg. One truth for any dog without a supporting knee ligament is the fact that they will be more succeptible to injuring other structures within the knee, particularly the meniscus. The role of the mensicus in the knee is to act as a cushion, and absorb shocks. Damage to the meniscus is serious and typically leads to arthritic change and lameness.

What to Expect During Your First Veterinary Visit for a Suspected CCL Injury

Consultation and Review of Symptoms

Your veterinarian will review your dog’s symptoms and time of onset.  Going through a detailed history will allow your vet to determine if conditions with similar symptoms may be ruled out at this time.

Physical Exam

Walking Gait

Your veterinarian will want to watch your dog walk and run to see how they are balancing their weight and using the affected leg.

Palpation of the Joint

Your veterinarian will touch your dog’s knee to assess the joint looking for signs of:

• Swelling or Inflammation
• Loss of Muscle Tone
• Pain or Soreness
• Range of Motion
• Popping of the Joint
• Fluid Accumulation

Drawer Sign Test

During the drawer test the veterinarian with stabilize your dog’s femur with one hand while manipulating the tibia with the other. If the tibia moves forward, known as a positive drawer because of the way the bone moves similar to a drawer being opened, the ligament is ruptured.   A negative drawer sign does not necessarily mean your canine does not have a cranial cruciate injury, and false negatives can happen if your pet is tense, if the injury is old and if there is arthritis.

Tibial Compression Exam

Another test, similar to the eliciting the drawer sign, is the tibial compression test. During this exam your veterinary physician will stabilize the dog’s femur with one hand, while flexing the ankle with the other. In dogs with a ruptured cranial cruciate ligament, the tibia will display forward motion upon flexion of the ankle joint.  Again, a negative tibial compression exam does not rule out a cruciate ligament injury, and many factors can contribute to a false negative result.

How to Test a Dog for a Knee Ligament Injury

X-Rays for CCL Injuries

Radiographs are usually taken, not to diagnose a cruciate ligament injury (soft tissue damage is not clearly visible on x-ray), but to rule out other diseases such as cancer and hip dysplasia. An xray will confirm the presence of fluid in the joint as well as arthritis, which will help to confirm the diagnosis of a cruciate ligament injury.

Ultrasound for CCL Injuries

Ultrasound may be used to positively diagnose a CCL injury. Unfortunately a minority of medical clinics are equipped to do ultrasound, and many veterinarians rely on the results of the consultation with you, physical exam and ruling out any other conditions by x-ray to make the diagnosis of a CCL injury.

My Dog Has Received a Positive Diagnosis of a CCL Injury – What Are My Treatment Options?

There are two major avenues for treating a dog knee ligament injury – conservative management or dog knee surgery.

What Is Conservative Management?

Conservative management is a non-surgical option for treating cranial cruciate ligament (CCL) injuries in dogs. Depending on the size of your dog, the severity of the injury, presence of other damage (particularly to the meniscus – remember, this is the part of the knee that acts as a shock absorber) and the duration of time since the onset CM may be a good option for your dog. As mentioned above, dogs weighing less than 25 pounds tend to have better outcomes using conservative techniques than larger dogs.

A variety of techniques can be used if you choose Conservative Management (CM) for your pet.

Conservative Management Includes:

“Standard” Conservative Management

• Rest – Your dog should remain inactive during the recovery period, abstaining from rough play, prolonged exercise or any movement that may cause any pressure or unwanted movement within the knee joint.
• Weight Control (and reduction if necessary) – One way to reduce stress on the joint is to keep your dog’s weight under control, and if possible, underweight is better during the recovery process.
• Anti Inflammatory Medications – There are a number of Holistic (ex – Yucca Root) and Prescription (ex – Rimadyl) medications available that can help to make your pet more comfortable as the knee heals.

“Optional” Conservative Management

• Dog Knee Brace – There are a variety of dog knee braces available including the orthopets canine stifle brace and atrac dynamic brace.
• Veterinary Acupuncture – Acupuncture for dogs is available, and can help to de-stress your pet as their body heals.
• Veterinary Chiropractic - A chiropractor can work with your dog to make sure your pet is free from any subluxations or other blockages.
• Physical Therapy for Dogs – Working with a certified canine physical therapist can help to ensure your dog maintains muscle tone and range of motion in the leg following their injury.

What Are The Different Types of Surgery for Dog ACL Injuries?

Dog Knee Surgery Options:

TPLO Surgery (tibial plateau leveling osteotomy)

This surgery adjusts the slope of the tibial plateau (preventing unwanted forward motion) by cutting and rotating the top of the tibia, and keeping it in position with a bone plate (which can be removed after healing).

TTA Surgery (tibial tuberosity advancement)

The TTA surgery also focuses on changing the angles of the bones within the knee joint. In a TTA the tibia is cut and moved forward to create stability. The new position of the bone is held into place with a bone plate (which can be removed after healing).

TTO Surgery (triple tibial osteotomy)

The TTO is a combintation of the TPLO and TTA techniques. It moves the tibial crest forward, as a TTA does, and also adjusts the tibial plateau to 90 degrees, as the TPLO does.

Tightrope Surgery

Tightrope CCL is an extra capsular technique using the lateral suture stabilization (LSS) procedure in conjunction with a material called FiberTape to provide bone to bone stabilization.

Extra Capsular Suture (traditional repair, extracapsular imbrication)

This is referred to as a traditional repair because this was once the conventional treatment for CCL tears. The extra capsular suture uses a strong leader line suture in a figure eight pattern around the knee to provide stability and keep the knee in a normal position.

Fibular Head Transposition (fibular head transfer)

The fibular head transfer surgery utilizes another ligament in the knee, the lateral collateral ligament, to take the place of the CCL. In this surgery the fibula is rotated so that the lateral collateral ligament can perform the function of the CCL.

Dog CCL Surgery Recovery

Depending on where the ligament surgery was performed, your dog may stay overnight to be monitored and receive pain medications following the procedure. TPLO surgery recovery can be different from TTA surgery recovery, so it’s important to follow the recommendations of your vet during the post operative period. Your dog’s sutures will be removed within a week or two of the procedure, and follow up appointments are typically done at 2 weeks, 4 weeks, 8 weeks and 12 weeks. Again, depending on the type of surgery done, radiographs may be done during these follow up appointments.

During the 6-14 week period following surgery it is very important to severely limit your pet’s activities. For approximately three months following dog knee ligament surgery your pet should be confined to a crate, small room or enclosed area when you are not able to be with your pet. You will probably want to make use of a dog cone collar – Elizabethan collars or Pro collars are my favorite. Make sure to post operative doggy proof your house and make sure they have no opportunity to slip, slide, jump up onto furniture, climb up stairs or engage in any activity that may damage the healing knee.

While outside you should accompany your dog for bathroom breaks, and they should always be controlled on a leash – you never know when a post operative dog may get the urge to chase a squirrel! You may increase the length of walks during the recovery period under the recommendation of your veterinarian and judging by how well your dog is recovering. I strongly recommend not letting your dog off leash at all during the first few months following surgery just to be on the safe side. Your veterinarian will most likely encourage you to have your pet use the injured limb immediately following surgery, but do not overdo it. Physical therapy during this time can also be very beneficial, and swimming is a great way to ensure your dog gets to use their leg (helping to maintain strength and muscle mass) without engaging in any activities that may be harmful to the knee.

Cruciate Ligament Injury in Dogs is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

A reader of Dog Knee Injury has graciously offered to share her dog Fargo’s story and share their experiences with Conservative Management. When Fargo’s owner first contacted me in February, 2010 she wrote:

“Our 11-year old yellow lab, Fargo, tore his ACL on February 4, 2010. I called the vet and he asked, “Did he go outside as a four-legged dog and return as a three-legged dog?” Which explained it precisely. We considered surgery, but, after days of research, I read about the extreme failure rate of surgery and it scared me. I stumbled upon a website called tiggerpoz.com that made so much sense. It recommended Conservative Management so, with great hope, we tried that for two months. He seemed much better as time went by, but then he would end up back at square one for some reason. I must confess we considered euthanasia because Fargo’s quality of life was not good. I went back to tiggerpoz’s website and found information on a fantastic knee brace from Orthopets. The info and videos on their website are amazing. So, I am ordering a stifle (knee) brace for our dog tomorrow. My vet or I will make a cast so the brace fits perfectly. I’ve been in touch with the owners themselves by email and they are very quick to get back to me and seem very caring. I cannot wait until Fargo can go for walks and go swimming again.”

Fargo has since been fitted for his Orthopets brace, and received it on 4/23. His owner has reported that he seems to be doing well with the brace, and the pictures below are of Fargo wearing the brace. I was unsure how the brace managed to stay up without being strapped to the dog in any way, but Fargo’s owner said that the brace stays up because of the velcro straps above the hock and around the knee – there are also auxillary straps on the thigh.

Dog Knee Brace from Orthopets is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Not surprisingly, surgery is almost always advocated by surgeons . It is likely that surgery does help reduce the amount of arthritis that occurs, but in a long term study of cruciate ligament surgery in dogs in Australia, about 50% still had detectable arthritis in surgically repaired joints and about 10% of dogs were persistently lame despite attempts to surgically stabilize the joint. Tibial plateau leveling osteotomy (TPLO) has become the top choice for surgical CCL repair among many orthopedic veterinarians, and it can be done in both large and small dogs. Supporters of TPLO will say its good choice for the situation in which there is a bilateral cruciate rupture since it seems to be a strong repair procedure, but there are many instances where dogs have done equally as well with either TTA or a traditional repair.

One benefit of doing a traditional extracapsular repair, in addition to saving a few thousand dollars, is that you still have other options for repair if for some reason the traditional repair fails. If you are choosing surgery for a dog with a double CCL rupture, make sure to research each procedure carefully before blindly going along with a procedure you know nothing about. TPLO, TTA and traditional repairs are all very different procedures, and each carry their own set of risks vs. rewards. The best way to find out what is right for your pet is to do as much research as you can and find a veterinarian that is willing to discuss your many options for surgical intervention.

If surgery absolutely isn’t an option, there is a very good chance that in a few weeks, to a few months, you will find that your dog is doing OK without any type of surgical intervention -especially if you can manage the weight loss. There are a number of great resources both on this website and the web with instructions on how to succeed with CM.

CCL Injury in Both Back Legs is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Surgery is not always an option for some animals.  There are risks from anesthesia, and allergies to which some dogs are particularly sensitive.  The financial burden of a surgical procedure can be great, and is not always an option for even the most caring owner.

What happens if my dog’s cranial cruciate tear is not repaired? Will my dog’s knee heal on its own?

A ruptured or torn CCL will decrease stability within the stifle (knee) joint. Your dog will begin to produce wear between the bones and meniscal cartilage, becoming abnormal, the joint will begin to develop degenerative changes. Eventually bone spurs known as osteophytes develop and chronic pain and loss of joint motion result. The osteophytes are evident as soon as 1 to 3 weeks after the rupture in some patients, with others showing no osteophyte development after years of living with the condition. The development of osteophytes, and degenerative changes in general, typically is related to the size of the dog, i.e. it is more difficult for a large breed dog to bear extra weight on an injured joint, whereas a lighter dog has an easier time with weight displacement.

It is normal for dogs, of all sized, to show signs of improvement within several weeks of the time of the acute injury. During this time the dog may appear to get better, but it is unlikely that your pet will become permanently normal. There was a study done on a group of dogs for 6 monts after cruciate rupture. At the end of 6 months, 85% of the dogs under 30 pounds had regained near normal or improved function, whereas only about 20% of dogs over 30 lbs had regained near normal funciton. Both groups of dogs required at least 4 months of exercise restriction and anti-inflammatory medication use, also known as conservative management, before maximum improvement was shown.

Remember, any degenerative changes, such as osteophyte development and arthritis, that have taken place after your dog’s CCL injury will not be healed by surgery. These changes are permanent, and while they can be arrested by surgery, they can not be reversed.

What Happens if a CCL Rupture is Not Repaired? is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

1. Weight management
2. Exercise moderation/rest
3. Using anti-inflammatory medications

Maintaining your dog’s body weight at normal, or slightly below normal, levels will reduce the load placed on the injured joint, and may help to improve its function. This will allow your canine to strengthen the joint without adding any additional strain, adding stability and range of motion. Restriction of activity for at least 6-8 weeks after injury is a key part of successful CM. After about 2 months of little to no exercise you may begin reintroducing your pet to weight-bearing activities such as short walks, making sure to avoid any extremes in activity. Controlled walks and exercise will help to maintain and strengthen muscle mass while avoiding re-injury; owners need to be careful to limit their dog’s play during this time as there is an elevated risk of injuring the other leg while the originally affected leg heals. The use of anti-inflammatory medications during this time will help to limit painful episodes and encourage healing.

Conservative Management in Cranial Cruciate Injuries is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information