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Conservative Management Instead of TPLO – Hudson

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.

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52 Responses to Conservative Management Instead of TPLO – Hudson

  1. Jana Rade March 8, 2011 at 7:24 pm #

    Conservative management can be successful as long as you manage to control your dog’s movement and avoid mishaps.

    (((hugs))) to Hudson

  2. David Welshans March 11, 2011 at 6:51 am #

    Thank you for your comment. We have the following elements of CM in place at this time: Diet (weight reduction, fish oil, chondroitin/glucosamine, Yucca extract), an A-TraC brace on his right leg (tolerates it very well) and generally very restricted activity (no stairs, short leashed walks, no running).

  3. Melissa March 13, 2011 at 4:13 pm #

    I have a 1.5 year old Purebred Rottweiler that is in need of TPLO (from what my vet tells me). I have been doing some research on some natural ways to hopefully avoid surgery if at all possible or at least relieve the pain and get his mobility back. So far I have found a few things that have increased his mobility and reduced his limping and swelling drastically. I have been giving him Elk Velvet Antler powder(www.naturespremium.com, Fish Oil and Liquid Joint care (www.springmeadowsnaturalpetfood.com)daily. I ran out of the supplements for a few days and he started running around on three legs, which tells me this stuff works as long as it’s part of his daily diet. Research the products on the websites I provided. Hopefully they will help you as well as they’ve helped me.It’s worth a try :)

    All the best to you and Hudson!!!!!

  4. Renee March 15, 2011 at 7:54 pm #

    My lab mix has just undergone TPLO on one knee that she ruptured the ligament and tore the miniscus. We already know her other knee has similar problems. She is only 5 and 2 weeks into it her recovery has been great. However, I can’t even imagine going through what you and your dog have been through. I’m not sure I would put her through this at 9-10 years old. She’s our best friend and I don’t EVER want to see her suffer like this again. That said–she put weight on the leg the day after surgery–is mentally ready to swim and chase squirrels. It will be a VERY tough 6-10 weeks from here on. She will have to be non-weight bearing on the other knee for me to consider putting her through this again. I wish you ALL the best for your very best best friend in the world. I’ve spent many nights on the floor w/our girl. Slobbers and kisses

  5. David Welshans March 16, 2011 at 5:54 am #

    Melissa, thanks for suggestions…we are investigating. Best wishes to Renee’s lab for a healthly recovery. These are all very tough decisions we are making and try and feel good about them as you are all doing it with the best information and thought you can do.
    The brace is allowing Hudson to place weight on his injured leg. Walks are still short, but his interest is improving. His weight has not reduced, though we have not been on diet long. We have reduced his dry meal by 1/3 cup per feeding and replaced with green beans…trying to keep him full, but still reduce the calories.

  6. Kristin March 19, 2011 at 12:55 am #

    Don’t forget about physical rehabilitation, more specifically, hydrotherapy. Check in your area for a canine rehab center or veterinarian that has a pool or underwater treadmill. This would be done after the brace comes off, and will help build up muscle where there has been atrophy. I am a Certified Vet Tech and have seen great results with the A-Trac Brace, and am currently working in canine rehabilitation in Washington State. I have no doubt that Hudson can recover well as you have all your bases covered!

    • David Welshans March 19, 2011 at 5:30 pm #

      Kristin, I am putting Hudson in the brace 1st thing in the morning and keeping him in it all day. When finished his last brief walk of the night and when he is just ready to lay down in his bed, I take it off. He does not move during the night with the exception of sometimes rolling over on his other side. Is this appropriate? I have not seen any binding of the brace when he is laying down with it on. Also, how secure/tight should the Caudal straps be? I am using the thumb/forefinger grip as advised. Maybe the better question is do you error on being looser or tighter (I realize this is subjective and I am not trying to use the brace to make the leg rigid or immobile)? Finally, even if he wants to walk more, should the walks be kept very short at this time? I have a tendency to let him be the judge and willing to let him go longer if he is willing…should I stop that? Sorry to lean on your expertise, but I don’t want to mess up. Thank you for your time.

    • Jana Rade March 19, 2011 at 8:50 pm #

      Definitely. Physical rehabilitation is so important. Lots of that can be done at home, having a rehab center is a bonus.

  7. Kristin March 20, 2011 at 9:58 am #

    Hi David! If he is truly just laying there sleeping and not running around during the night, then giving him a break overnight should be fine. As for how tight to secure the straps, the more stable the better without creating rub sores. As for the length of walks, generally if you leave it up to them, they will go until it bothers them (and for some, that doesn’t even stop them!). It is better to keep on a timed schedule and add a minute every other day. More frequent, shorter walks are always better, we are trying to build muscle steadily without any set-backs if possible. I will finally add, I know you are worried that you’ll mess something up, but I have seen this brace work in even the worst conditions. We had a fearful heeler mix with bilateral torn crutiates that the owners had a hard time even getting the brace on the dog, let alone adjusting it, it stayed on 24/7 and the his knees did great! You are so concientious, Hudson is very lucky to be in your care!

  8. mary March 23, 2011 at 8:19 am #

    Hi, i was in the same boat as you a few months back with my lab rolly he is 7ish. Started limping – had the x rays vet said dysplasia and arthritis present in hips – however he probably had this for years (all along) the cause of the limp was the cruciate damage and arthritis in left knee he recommended TTA left it a few mnth as was not entirely convinced .. Gave every supplement under the sun (missing link, gluco/chondrotin etc etc) it was ok but was still lame and just didnt improve to the point where it was acceptable to not give him ano operation. My dog hasnt had 2 x hip replacements , mind you so i can understand why you are holding back, rolly has been out a day now and yes i spent last night sleeping on the floor just hoping its gonna be worth it. He is younger than your boy though and still has the mentality of a hooligan as much as i would take a ‘conservative approach’ realistically he is bonkers and still has his paws into everything . Your vet sounds ‘full on’ why ano earth would you operate on a completely healthy knee – money makin….

  9. Jana Rade March 23, 2011 at 10:24 am #

    Conservative management can work. We opted for surgery also though. We felt that Jasmine was young and we wanted a sure-fire solution. Well, as sure-fire as they come.

  10. Marsha March 23, 2011 at 2:42 pm #

    i’m having a major problem, after two vets recomended my 15 month old bichon/shihtzu mix have knee surgery…i fell apart i have Multiple Sclerosis, any stress sets it off…
    i’ve been trying to find someone to take her get her the surgery and keep her as their pet, she’s papered, potty trained (but i keep pads on the floor because MY MOBILITY.
    She’s spayed, chipped and needs someone to care for her like i can’t. the vet said she’d still have pain but she’s on ramadyl. I know one should do all to take care of a pet, but when the health of said individual comes into play everything changes, i’d be willing to help with the cost of the surgery, say $500.00 or so.

    • Jana Rade March 26, 2011 at 9:17 pm #

      Hi Marsha, sorry you’re having a hard time.

      I can try to help by posting your story in my blog if you’d like, let me know.

      I do doubt that the surgery would cost $500 though, the cheapest is extracapsular repair and that comes to $1500 or so at the least.

      • Marsha March 27, 2011 at 1:01 pm #

        Hi, thank you for your post, the vet showed me the xrays, she had already developed displacia in both hips, the bone density was very thin, i put her to sleep, just goes to show that mix breeds don’t always work..Father was Bichon (LG) Mother Shihtzu very small, she was 15 months..
        after 10,000 for knees and hips she’d have still been in pain..

    • Shirley July 24, 2011 at 7:45 am #

      Marsha,

      I hope everything has worked out for you. CM does work – especially for a dog the size of yours. We have a Lhasa Apso who is around 9kg – he is pretty big for this type of dog. Gizmo ruptured his right cruciate ligament in April and we treated it conservatively. He then ruptured his left one in June and could not walk at all – and I mean at all. I had to carry him out to the garden to do his business and carry him everywhere he wanted to go. We again thought about surgery but opted against it – he is nine with arthritis already.
      It is now July 24th and what a difference. We still have to watch him to make sure he does not chase squirrals or anything but he is now walking, albiet slowly and stopping several times but walking still the same. I had him on his leash yesterday for the first time and he walked to the end of the road – I could have cried.

      If you need to do this it will work – Gizmo is proof of that.

      Take care

  11. Jaya March 23, 2011 at 5:46 pm #

    Wishing you the best with Hudson! We have a black lab, Max, who will turn 9 this year and after misdiagnoses and atrophy of his hind leg muscles, we found out he has CCL injuries to both hind legs. After a lot of debate, we just had TPLO surgery yesterday. I only hope it will be worth it for him. He’s been in so much pain post op, but he’s a real trooper. I know the key dates are ahead of us, keeping him calm, helping him realize he’s still recovering and all that. The recommendation for his other knee is the same, but I don’t think I can see him going through it again… I hope it works, but in the meantime, I’m going to try CM for his non-operated knee. God bless and good wishes!

    • Blair April 28, 2011 at 9:31 am #

      Wondering how your lab is doing. We have a 9 year old yellow lab who has a ligament injury to one hind leg. We are struggling with decision to operate or not. Our vet said if she was younger he would whole heartedly recommend it but at 9 he wan’t so sure. We are scheduled for a surgical consult next week.

      • David Welshans April 28, 2011 at 12:09 pm #

        Blair,

        Hudson has experienced steady improvement the last 3 weeks (since my last comments). Though still cautious with his injured leg, he is using it more and more (a bit stiff when 1st getting up and taking 1st steps, decreasing limp when walking). He has lost a bit more weight (diet), still using brace morning till night, limiting his walks (4 to 5 per day) to about 5 minutes each. He does now have free reign when inside the house…1st floor only. I have been applying a Thermalon Moist Heating pad on his leg at night when he goes to bed. I believe this injury was pretty severe (2nd occurrence as he “got over” his lameness 2 years ago without us really helping him), so we are learning to take things slower/easier (i.e., keeping the walks short, absolutely no running/jumping/stairways) and he is responding much better. You have a tough decision to make and I am sure you will chose correctly. It has been stated by others with more experience than I, but CM may prove sufficient for your pet’s recovery or, at a minimum, a good prelude to surgery. I am encouraged by Hudson’s improvement to continue the CM approach.

  12. David Welshans March 24, 2011 at 9:16 am #

    Hudson has a couple of weeks under his belt with our CM regiment. Top 2 items that I think are benefitting the most at this point: Use of the brace during all hours except nighttime sleeping; no stress environment (no more stairs, no jumping in/out car, always on leash when outside, very short walks…I was letting him go too far initially). The 3rd will be weight loss once it is accomplished, but we have lost ~1 lbs. in several weeks, so it will be awhile. His attitude is great so I consider that a good sign. He does carry weight on injured leg, though a limp is still apparent and varies. To those who underwent surgery, I would still consider a brace if your research and vet think it beneficial. I think it is helping my dog significantly. The A-TraC is more complex than it appears (meaning it provides a great deal of support, but not very hard to install once you get things set up) and I am lucky Hudson tolerates it very well. When he has moments of feeling his old self and sorts of wants to run at something, I believe the brace can provide some backup. I wonder what they think of all this new stuff going on with them?

  13. Kimberly March 24, 2011 at 9:02 pm #

    Our 90lb Airedale underwent TPLO surgery just over two years ago. He was 7 at the time. Now he’s 9, will be 10 this year and has injured the opposite stifle. It happened 2 weeks ago tommorow. Took him to the vet and the drawer test confirmed that he’d ruptured the CCL. Scooby’s gait changed after his TPLO. It wasn’t a limp but there was definititely a change in how he walked. We were OK with that since apparently the surgery had been successful. The days after his surgery two years ago were sadder that I can put in words. I remember him laying on his bed crying from the pain. The pain killers seemed to do very little for him. We were extremely diligent with his post op precautions. He swam (against his decision) in our neighbors pool for several week and we were very guarded about the weightbearing.
    Anyway, fast forward to March 24th 2011. Scooby is injured and it’s such a difficult decision. Do we put him through that invasive and painful surgery again or do we try the conservative management?! As of right now I’m leading towards the latter but I think my husband is thinking another TPLO.
    We have no children and it’s just as well. I couldn’t handle the guilt. I am sitting here now looking at my beautiful dog shift around as if he can’t get comfortable. He’s on his new memory foam bed which I think he likes but he can’t seem to settle. I have this horrible feeling that I shouldn’t have taken him upstairs today. The cleaners were coming and we always take both pups upstairs. Scooby can be cantankarous (where is spell check???). He bit a pest exterminator, luckily not severely but he did break the guys skin and caused a pretty dark bruise about the size of a half dollar. Anyway, that’s a different story. So, after I got home from work I went up to get the pups out of jail (they’re used to having run of the house). As usual I had the sling to try and reduce the weightbearing off his back legs but with gravity working against us it was extremely difficult and I am in so much fear that I shouldn’t have done it. Hence, the burden of guilt!! I would like to keep an eye on this blog and follow Hunter’s progress. Please keep up the posts and share your triumphs, and dare I say, errors in judgement. No more stairs for Scooby, even with his weak 5’2″ human mother attempting to hold his back legs up while preventing herself from going headfirst down them. I’ve just given Scooby another Tramadol. My plan was to start the Rimadyl on Saturday, only 1 pill. I’ve read that NSAIDS can inhibit recovery because the physiological mechanisms that come into play after an injury are supressed by the anti inflammatory properties of the drug. I can’t let my boy be in pain though so we’ll play that by ear. I have never blogged before. Haven’t felt the need to. But, I think that possibly I’ll be able to get some comfort and advice from other humans owned by their dogs. That being said, I definitely recommend a “sling type device” to aid in keeping the weightbearing to the minimum. The memory foam bed (though spendy) I think was a good investment. I just bought a pen type thing from Amazon. It should arrive on Saturday. We’ve sequestered him to his crate while at work for the past 2 weeks. Although I think he likes his crate it doesn’t give him room to stretch out. The exercise pen will give him enough room to stretch yet limit him from overdoing it. I’ve also ordered some fish oil for pups. My other dog (a Welshie) has terrible allergies so hopefully that’ll help her too, along with her already expensive regime!! So, please keep up the posts. It’d be great to take this CM route with someone else. Thanks much.
    PS where is the spell check?? please eckscuuze all spelin erors :o )

  14. Megan Gallup March 25, 2011 at 11:07 am #

    My 5 year old rottweiler Daisy has hurt her right rear leg. She refuses to walk on it 90% of the time. If she HAS to then she will put a bit of weight on it. We took her to vet yesterday and the vet said it could be the cruciate because she felt grinding in the knee. And it’s only been about a month since she hurt her leg so an x-ray wouldn’t show any arthritis yet. She recommended that we get surgery on it. and that we put her on Rimadyl or another pain medication I can’t remember the name of. My mom has tried to wrap Daizy’s leg with a regular human wrap. Also we have a 1 year old Doberman who is constantly jumping on her and tryin to play with her while she’s in this pain. I want to help her because she is still quite young, yet I don’t exactly have the money. I could barely pay for the meds…. I’m not sure whether to do the surgery when I can get the money or try and get a brace for now? and see how she does? Also, she is a bit overweight and I’m going to change her food to a diet food.. and keep giving her the pain medication. I just need some advice. I’m only 19 and I have no idea what’s best for her.

  15. David Welshans March 25, 2011 at 1:31 pm #

    While my experience is very limited, one of the benefits of a CM approach is it buys you time. Removing stressful situations (no access to stairs, walk only on leash) will have to be done anyway if you chose a surgical remedy; using a brace made for the dog can help with or without surgery; getting weight under control will have to be done either way…and so forth (use of supplements, bedding, etc.). Guess I mean to say the CM regiment can be the only means to a recovery, or it can be an integral part of the process if surgery in involved…at least that is my take. Regardless, this healing process takes time. The literature on the brace we use for Hudson says about 10 to 12 weeks for initial therapy, then possible additional use of brace depending on situation. Our large animal vet says 6 months minimum on healing due to very little blood flow in the area around the ligaments. Bottom line, this is not a quick process. Also, I believe owners need to manage their expectations…my dog will not be running/jumping and catching a Frisbee again (though he never did a good job of it anyway :) ). But I hope he can get back to working outside with me all day on our acreage. I have been told TPLO will make your dog like new…I really do not know…but that is not my personal goal for my dog. No problem if that is the goal you have, but again I think CM principles are good to start with right away and continue with regardless of your long term approach. And they will give you some time to do learn more and make a better decision. All the best to Scooby and Daisy.

  16. Dearra March 31, 2011 at 7:05 pm #

    Hi, everyone. I found this site while double checking the fish oil dosage for my dog. After reading all your stories, I felt I should share my experience with my 20-lb mutt’s (Mazzy) ccl injury. I created my own “CM” program a few months ago after doing some research about joint supplements. Until today, I had no idea that what I’ve been doing for my dog is really CM, and that there are web sites like this one that outline it so well. But at the point I was researching, my dog’s injury had not just occurred. The injury was almost 10 months old.

    Mazzy was injured in a fight with a dog that came into our yard. She isn’t accustomed to dogs really fighting, so I doubt she was prepared when the dog got her by the back leg and actually pulled it out from under her and hurt her. She started limping immediately afterward. I waited a few days to take her to the vet, thinking she was probably just sore. Since she didn’t improve, I took her in.

    Unlike David’s vet experience, my vet (like David’s local vet) is generally conservative about treatment and unnecessary expenses. He diagnosed the ccl injury using the “drawer” test and generally observing/examining my dog. My vet doesn’t like to do x-rays unless he feels it is really needed, because he thinks the cost of the x-ray is usually not justified. In this case, he was sure about the diagnosis and did not want me to have to pay for further tests. (I love my vet for things like this.)

    My vet informed me about the expense and complications of surgery. Then he recommended we give Mazzy a cortisone shot, limit her activity, and if she did not improve after 2 or 3 months, then we would move to the next step of putting her under a mild anesthesia (sp?) so he could fully determine the extent of the injury by examining her knee without her hurting or tensing up. The final step was to decide if surgery was the right thing for Mazzy. The vet also told me that it would be about 6 months to a year before there would be danger of arthritis setting in, so we had time to really decide the best course of action.

    The cortisone was great…for a while. and sure enough, the injury started showing its signs again. Because I lost my job durng this time, I had absolutely no money – literally, none. So going in for the full exam was out of the question, and surgery was not even a remote consideration. I just couldn’t pay for ANY of it. Mazzy was limping, but not seeming to be in pain, and I had some time before I had to worry about permanent damage. So I kept her activities pretty restricted most of the time and would give her 1/2 an aspirin if she overexerted herself and was in pain.

    Over the next 6 months, she pretty much stopped limping unless she had a day of running at the park, etc. Then I would give her the aspirin for a day or two and she would seem fine again. But because she would limp after exertion (and for a day or so afterward), I knew the injury was not fully healed. So I decided to start her on glucosimine/chondroitin/ msm supplements and fish oil.

    After about 4 months on the supplements and fish oil (about 14 months after the injury), Mazzy is doing great! She can run and swim at the park without any major limping at all. When we get home from an outing, I give her the next dose of supplements immediately to offset any possible inflammation. We haven’t had any “next day limping” or loss of mobility from exertion in months. And Mazzy has also been aspirin free for over 3 months! Really, the improvement is amazing.

    If supplements and rest can help Mazzy recover so well from an injury that occurred last year, then I think the conservative management techniques described here should prove very effective when administered early and consistently. Even though I realize CM won’t work for every dog, I think giving it a real try is the best thing you can do. It’s true: you really don’t have much to lose by giving your dog the chance to heal without surgery. And there is a very real possibility that it will work. Especially if you do it the right way (like David).

  17. Dearra March 31, 2011 at 7:15 pm #

    FYI: the supplements I’ve been using are called “Nutri-Vet Hip & Joint Plus.” I ordered them from drugstore.com for a lot less than I would have paid at a pet store.

    I’m sure there are better ones out there, but these are working great so far.

  18. David Welshans April 7, 2011 at 8:59 am #

    We have a full month of CM under our belt with Hudson. Of course I wish he was up and walking around like “normal” but that is not the case yet. Some days better than others; mostly he is still light on his injured leg when he gets up, does apply weight on it while taking short walks (though it is taking more encouragement to get him to go on his walks…I am worried about this), appetite still pretty good. Developed an ear infection (being treated by vet) that may be a factor in his reduced desire to exercise. We have him in brace from start of day to bedtime…still tolerates it well (not chewing or pulling at it), but seems happy when it is removed at bedtime. Wish I understood the extent of his injury more and what else I could do productively to help him. It is truly awful to see your pet in distress.

  19. Lynne April 12, 2011 at 12:19 pm #

    Hi There,
    Thank you for this post it has given be real inspiration. My 4 1/2 year old male dog ‘Buckley’ (20 kilo) has been recently diagnosed with cruciates disease on both his knees. However, on reading this post, his condition doesnt appear to be as unfortunate as other dogs. The Vet has recommend he has TPLO on both his legs, however after further research im not convinced i want to go through the heartache of this intrusive surgery if other conventional methods may prove successful. The frustrating thing for me is that he loves his walks, is full of energy – i can walk him for a whole hour and there are no lameness etc. Then a few hours in the evening I notice a slight stiffness and he takes his time going up the stairs. I keep asking myself , is he really needing this surgery right away or should I try the conservative method.

    Lynne

    • Denise McCarthy March 18, 2012 at 12:26 pm #

      Hi all,

      I am happy I found this site! My girl a 9 yo Lab was chasing a ball when we noticed the limp. Our vet practically coerced us into surgery which we refused for only one reason. We were both out of work and although I have been raising therapy and service dogs forever thirty years, have never run into this problem before. We have always been able to somehow come up with the money for our vet bills when employed. Our vet made us feel like we don’t care about our dog even though she is pour furry chile We have no children of our own. I cried and cried over what I could do. We have been using the conservative approach. We ordered “Tear Repair” a homeopathic remedy with really good review. We have not gotten it yet but have given her tamarol. As a lab owner/breeder I would never give a dog rimadyl as have seen too many dead dogs from it. but I am also going to get her some chrondrotin /glucosimine. In the meantime we have tried to keep her on mostly bed rest which is really hard since she is a registered therapy dog and goes everywhere with us.
      she doesn’t understand the restrictions but know its for her well being. She is doing better for sure a little at a time. its been about three weeks and our vet did the drawer test too and told us it was a complete tear and within three months would tear the other from the stress of putting wt on. it.that seemed a little drastic to me. for all those who are feeling guilty go to tiggerpoz.com and read full article on the surgery not being necessary…

  20. Lefty's Mom April 15, 2011 at 4:57 am #

    Last night at the emergency hospital, I was told my boy would need knee surgery. The cost is one thing, but I’m not sure if I want to put him through surgery. Lefty is a 7yr Spitz/Aussie mix. He appears normal other than the fact that he cannot use his hind end. He just drags it. We have an appt to follow up with our vet this morning.
    My head is still sppinning and I am still trying to degest all that I have been told. This is terrifying and I am at such a loss. I love my boy more than words can discribe and I am filled with mixed emotions. I just bought my first house and am also raising a teenager. Yes the cost is a factor exspecially when your told this could be up to $8000.00. I will find the money somehow, hes my baby.
    Has anyone had a ‘friend’ that as been at this point and recovered without surgery? It will be a huge ordeal for Lefty if I decide to go with the surgery. (alot of travel, drs., stress on my boy)He has already been taking Glucosemean, Cod Liver Oil, and Prednizone (hes allergic to dog food).

  21. Delphine May 11, 2011 at 7:38 pm #

    Lefty’s Mom

    I was told also that my dog needed TPLO surgery. So I’m asking the same question. I’m trying to avoid the surgery.

    My dog (Dalmatian/Pitt Bull) was diagonised with a rupture ligament and a candidate for TPLO. The Vet said he had pain, but during the examine he didn’t make a noise or move. He was sedated for the x-rays. My question is, how do you detect that the dog is in pain? He’s a very active dog and chases anything that runs. I’ve tried to keep him still by keeping a close eye on him outside. He limps, but sometimes he
    stands on all four legs. Last year he injured the same leg, but recovered after 2 months of restriction and confinement to the backyard and house. This injury, I took him to the Vet. The Vet determined after a 10 minute conversation with me and looking at the limp, that TPLO was necessary. I appreciate any comments and support for “Conservative Management” approach.

  22. David Welshans May 18, 2011 at 6:26 pm #

    We are now a bit past 2 months with our CM plan in place and all is going well. The last 3 weeks Hudson has had good movement and use of his injured leg. We are still using the brace daily and same diet, short walks, no stairs, etc. So far so good.

  23. Jana Rade May 18, 2011 at 6:42 pm #

    Way to go, good to hear!

  24. Kimberly May 18, 2011 at 7:31 pm #

    Hi all,
    I posted for the first time about 9 weeks ago. Our 9 year old 100# Airedale Scooby ruptured his hind right stifle. We debated about the TPLO. He had the opposite done two years ago.
    Well, I want to offer any readers some hope. The conservative management is going well with our boy. We bought a hind quarters “sling” and kept him only partial/toe touch weight bearing for about 5 weeks. We would also not allow him on any surface that could induce a slip (tile in our case!). He was supervised at ALL TIMES. He was not allowed upstairs or on the furniture. He was crated when he wasn’t being supervised. We added Nutripet Jip and Joint Plus (glucosamine, MSM, chondroitin, hyaluronnic acid)
    buy at: http://www.wildblueyonderthestore.com
    At week 5 we started taking him for short, leashed walks around the block. We also bought him a pet tent so he graduated from the crate to the exercise pen. I am very reluctant to say that he’s doing very well since it’s still early days yet. Six months is the duration of this particular CM program. But, he’s happy, wagging, eating a lot, enjoying life in general. We exchanged a cup of his evening kibble for frozen vegetables and halved his morning meal. He’s lost at least 6 #’s by now which is good since he was slightly overweight. Anyway, I wish all of you dog parents the very best. I hope you can all avoid the surgery. Not only is it costly but it’s painful for the pup as well as the parents. The rehab is difficult and laborious……
    Like I said, it’s not done and dusted yet but it appears that we’re doing well so far. Good luck all!

  25. Susan W June 21, 2011 at 12:11 pm #

    I wish you well with Hudson. My Gizmo (11 years old/ 55 lbs) had TPLO in Dec. 2010 on one leg. The surgeon made it sound so urgent, I went ahead and agreed. I wish I had done some research first. The pain he went through was unbelievable and I felt so helpless and guilty for rushing into the surgery.

    He was finally doing better but on May 15th he ruptured the other knee. I took him to his vet (not the surgeon) and he agreed the CCL was ruptured. When I told him I would like to consider CM, he was all for it.

    David, I’m doing everything you are doing and Gizmo seems to healing. It’s baby steps but it is progress. The only thing I might recommend for you is a sling for the back legs.

    I went to the local pet store but the slings were too flimsy for my big guy. Like Hudson, he is a few (actually 10) pounds overweight. I ordered a gingerlead online at gingerlead .com It was about $55.00 It has really helped. It allows me to control how much weight he puts on that leg, control him when he goes outside, and I can even go up stairs with it. I use it when I take him out or when I need to go from room to room with him.

    I am not a spokesperson for the company. It is just a really great product, especially for larger breed dogs like ours. I will keep you and Hudson in my thoughts. Susan

    • Barry August 7, 2011 at 4:15 pm #

      The GingerLead dog support and rehabilitation harness is available at http://www.gingerlead.com. It’s a soft, padded belly sling with a handle and leash which is ideal for recovery from knee or hip surgery.

  26. David Welshans July 3, 2011 at 5:54 pm #

    Hello all…we are about at 3 months (since injury) and all is going very well. Believe this was the right decision for Hudson. I am so thankful finding this site and the information from all. We are in the rehabilitation phase now. Taking longer walks (he is up to about 1 mile daily) including grade changes, continuing diet and still using brace during daytime. He now goes upstairs (I use a sling mostly to slow him down as opposed to giving him much support)…trying to be careful as the progress is wonderful and I do not want any setbacks but also giving him much more freedom. Thanks again for all the ideas and support. David

    • Cindy Allen November 15, 2011 at 5:50 am #

      Hi David, Your sweet pup, Hudson, looks so much like my Bentley, and I have just read your postings about conservative management as Bentley has a torn knee ligament. From all that I am reading here from you and others, I think CM is the smart way to go. I will buy Bentley a gingerlead because that makes sense. Like you, I have been sleeping on the couch for a week now because Bentley is not supposed to climb stairs. I only let him outside to void, which makes us both sad because we have always enjoyed our daily 3-mile walks.

      I plan to use much of the advice here. Bentley is overweight and I will do my best to help him lose some of it. The few times I have put him on diet dog food, however, his skin has become so dry, that he scratches and scratches. Anyone else have this problem?

      I guess my main question is about supplements. I put Bentley on glucosamine, but I have read here of other things others are using. David, what specifically has worked for Hudson, including dosages?

      I cannot tell you how thrilled I am to have found this informative site.

  27. Jana Rade July 3, 2011 at 7:12 pm #

    Hi David, so happy for Hudson! Great to hear he’s doing so well. And great job on your part!

  28. jill August 24, 2011 at 11:12 pm #

    I did all this…except for knee braces that I really wish I would have looked for online sooner. I have a lab and always assumed it was the hip. Then 5 years ago she was diagnosed with the ACL tear and surgery suggested. I went the alternative treatment route because of the pain and money involved in major surgery. She was 9 at the time. Now she is 14 and the natural treatments are not working anymore. The medications and herbs have started to upset her stomach and are getting harder to give. She is still full of energy and only has problems with her tummy when given too many pills at once or antibiotics. So, her only problem is the knee because without that there would be no need for the supplements. It has progressed and gotten worse…but now she is old enough I don’t know if she would recover. I WISH I would have done the surgery. Only the posts that say the surgery didn’t last and repeats were necessary lessen my guilt.

    • Lucy September 17, 2011 at 2:12 am #

      Jill, your dog has had 5 healthy years thru conservative management. At 14, you would now expet to see some decline and desintegration of the joint. That would be true of her difficulty tolerating pain meds ahd herbal remedies as well. I’d heard about, and used parsley for my Cocker Spaniel as he got older to help soothe his stomach. Perhaps it can help your dog as well.

  29. Bridgett September 13, 2011 at 6:38 am #

    Hi Everyone,
    Your stories have been very helpful to me in understanding options out there for knee injuries. I found out yesterday that my 4 year old dalmatian/lab mix has Bilateral torn ACL’s (both knees). Of course the vet said that Kiko would need two separate TPLO surgeries on both knees. Kiko loves to enjoy the outdoors but she limps after exercising or if she has been laying too long. I purchased an orthopedic pet bed for her last week. If we choose surgery, it is going to cost $6k. With a baby on the way, the stress and cost of surgery is a lot for us right now. However, I want, like any other parent, what is best for my dog. While reading these stories and the amount of pain that the dog undergoes after surgery, I am hesitant to put her through this. I would like to think that CM, Rimadyl, glucosamine, and other supplements could help her get better. The vet said that both of her knees were “shot” and if left untreated with surgery, arthritis would set in so badly that she wouldn’t be able to walk later. The sling sounds like a great idea if you have ONE injured knee but can it help if BOTH knees are ruptured? I would use the brace along with CM for as long as it takes if it will work. If anyone can offer any suggestions with two injured knees, I am all ears for suggestions. Good luck with all of your pooches recoveries. Bridgett

    • jamie April 7, 2012 at 1:53 pm #

      HI BRIDGETE I,M SO SORRY TO HEAR ABOUT “KIKO,S” INJURIES.
      YOUR STORY SOUNDS IDENTICAL TO MY 4 YEAR OLD AM. STAFF, “NICK,SI” STORY.
      I AM SO UPSET AND CONFUSED, THE MORE I READ THE MORE CONFUSED I BECOME.
      BECAUSE YOUR STORY IS SO SIMILAR TO OUR,S, I WAS WONDERING WHAT YOU DECIDED TO DO AND IF IT WORKED OR DID NOT WORK?
      I HOPE ” KIKO” IS DOING FINE AND WOULD REALLY APPRECIATE ANY INPUT THAT CAN HELP ME DECIDE WHAT THE RIGHT THING TO DO FOR MY NICKI IS?

  30. Lucy September 15, 2011 at 6:53 am #

    I am happy to hear Hudson is doing well! This is quite a long read to get all the way thru, and I read ALL the stories. I’m sure there are no wrong decisions when it comes to dog knee injuries. Conservative management is certainly a highly utilized method. We seriously considered it for our then 11 year old Cocker Spaniel. Ultimately, we took our chances he would live a long and healthy life and did the traditional repair. He prooved our assertions correct and lived to be 17 years of age… all if it happy and running about to his last day.

    I have friends who did the TPLO with great success! One in particular did 1 full year of physical therapy and got back into agility. He was a lovely tailed Rottweiler rescue. He had a number of titles as I recall. Initially, yes,it is guresome and painful. But it really puts tibia in nicely with the femur. There’s no denying that.

    People have had wonderful success with TTA’s, and tightropes. When it happened to Raven, we had further technology… the TTO or triple tibial osteotomy. One cut into the tibia is the same as the TTA. That’s where the TTA stops. The TTO adds an “L” cut, just the width of the saw blade to alter the plane of where the tibia meets the femur, making it equal to the TPLO, but less invasive.. I’m certain many of you know that already. Many do not have it readily available. Dogs come home already weight bearing. It seemed the best option for Raven… and 9 weeks later, my Stetson as well. It takes a good 6 months to rebuild the muscles that were cut.

    Physical Therapy is something again not available to all. If I didn’t have PT I am one who would be looking all over and researching what I could do on my own to help the dog make a comeback. Being a nurse, I just tend to think that way.

    Would I now do the same for the Cocker? No. His size made the traditional repair all he needed. In fact he would have been just fine with conservative management. It was MANY years ago. The new stuff was unavailable, not that I would have chosen it. He was so active and samll (17 lbs) I doubt he would have benefit from the espense and time of PT.

    We and our dogs have differing life styles, Age, level of usual activity, expense, physical health of the owner, etc…. all come into play. There are only good decisions. Hudson’s is definately working! And I am glad he is loved so very, very much! Keep up the great work.

    And a big THANK YOU! to the site organizers, for giving us a place to share our fears, opinions, information, and experiences! This is GOOD! It is helpful and needed. Thank you.

    • Daisy October 1, 2011 at 3:41 am #

      We are in our 6th month of conservative management with our Rottie, we have given he all the usual supplements and regular injections of Carthrophen Vet (is not a pain killer ) We will be letting her off lead gradually over the coming months starting with a minute and slowly increasing. We have been swimming her which is great as she uses her back leg and it is helping to increase her range of movement, it is great as she can play fetch in the water without risk of re-injury.
      When we took our Rottie to the Vet, yes he wanted to operate on both legs, my worry with TPLO is that if you are altering the angle of the knee then it must effect the way the dog is walking and this must effect the spine, causing more problems, also if this op goes very wrong than the animal may have to have it’s hind leg amputated, dogs can do well without their front leg but a hind leg! Give consevative treatment a good try and you will need patience.

  31. David Welshans December 1, 2011 at 5:40 pm #

    Almost 9 months since Hudson’s injury…he is doing great. We see no limitation or impediment to his daily activities. He is the “poster child” for our local vet for folks to consider alternatives to surgery. CM may not work in all situations, but has been very successful for us.

    We continued the use of the brace up till last month…I think it was a big help.

    Have been remiss in not keeping up with comments: Cindy…The only supplements we stayed with were SynFlex (liquid gulcosamine)…1/4 oz per day (make the bottle last a month) and 2 fish oil capsules (1000 mg each) per day. Keeping him on his weight management feed (1 cup Wellness Core Reduced Fat dry food and 1 cup greeen beans) twice a day.

    Can not thank enough for this site and the information we used to facilitate his recovery via CM.

    Best of luck to all…David

  32. Lucy December 2, 2011 at 4:11 am #

    I am happy to hear the brace worked so well for you. Thanks for the update. Hudson is a special dog, I know. He is much loved.

  33. Ed K. December 8, 2011 at 10:27 am #

    David – Thats awesome!

    My dog Zep had full a cruciate tear. We used the A-TraC Dynamic Brace as well. Dr. Spatt was so helpful and by talking to him, made me feel even better going the CM route.

    I couldn’t justify the surgery and knowing it the chances of a good healing were not that great.

    Ed. K

  34. Mary Richardson February 16, 2012 at 9:06 am #

    Hi, I am isolated in my bedroom with my big dog Hank, who had tplo surgery three days ago. Hank is doing great but the first day after surgery it was a pitiful sight. Two years ago Hank injured his other leg and we tried cm for 6 weeks. After a lot of research I still didn’t know what the right thing to do was but we went ahead with the surgery. I took two weeks off from work to stay with Hank, I realize this is not an option for some, and he came back seemingly 100%. It was a long, intensive recovery. In Denver we had a big snow, I put both dogs out and 20 minutes later he wouldn’t bear weight, that was a Saturday we took him to the vet on Monday and scheduled surgery which was done the following Monday. We saw three different vets with the two surgeries and no one tried to push us into surgery. So hopefully Hank will recover from this surgery as well as he did before, he just turned 7 and is a big dog, we think Rhodesian Ridgeback/Doberman and a bit over 100 pounds. This is the most expensive ‘free’ dog I ever owned. Funny thing I was saving to buy new furniture, at 60 I’ve never owned nice furniture, then this happened to Hank and oh well.
    I had another dog, Xena, who lived to 15, who injured one hind leg during another big snow and we only did cm because she was 12, and I didn’t have the money. Xena was very arthritic and in pain but still seemed to enjoy life up to the end, she was blind, almost deaf but still one heck of a watchdog. Dogs are amazing, loyal, stoic(through the pain) and life is hard when there are so many other priorities.
    Good luck to all and may our decisions be the right ones.

    • Tarra R. February 24, 2012 at 2:30 pm #

      Thank you for your comment. I am currently struggling with a 9 year old Lab/Plott Hound mix. He averages 96lbs. He first injured his right knee three years ago, and doing CM instead of Sx. Over the past year I have started to save for the sugery. His Right Knee is in distress, while the left knee has been overcompensating, is now also, become desperate. After 3 years, finally surgery. I dont know if this is the best choice, for him, and for my husband and I. What choice do I have, I owe it to him.
      Your comment did help me to feel better about the situation, and no matter what happens to his knees, he will always be Flea, my best friend.

  35. Ed K. March 13, 2012 at 11:09 am #

    Tarra,

    Have you looked at the A-Trac brace?

    I made a post about our experience.

    http://dogkneeinjury.com/conservative-management-full-cruciate-tear/

    Good Luck!

    Ed K.

  36. Chelsea April 7, 2012 at 8:54 am #

    I have a boxer/bull mastif cross, 4 years old. Her name is Bella.
    We first noticed limping in her back left leg. It went away on its own after 3 months and she was good for about 4 months .This was in 2010.
    Then, in September 2011, she was running in the field, happily chasing geese and she began limping on her back right leg. We were told she needed TPLO surgery. The cost – 3000$. We tried conservative management for 2 months as well as giving her supplements and deramax. The CM did not work for us. On Dec 1, 2011 she had TPLO surgery on her right leg. Seeing her in so much pain and then not being able to take her for walks for 2 months was stressful for Bella and I. However, the rehab was a success and 8 weeks post surgery, we started her on short walks, and then added an extra 5 minutes to her walks every week. She was doing very well, and we started taking her to the dog park again, where she would run and play. Our old Bella was back. We were soooo relieved.

    Then, 4 days ago, I think she pulled something, or ran too hard at the park. She has been limping on her Right leg, the one she just had her TPLO surgery on. I have put her back on glucosamine choindroitin sulfate and fish oil. I am going to keep her rested for the next week and only take her on a couple of very short, 10 minute walks everyday. If she continues to limp and shows no improvement, I guess it is back to the vet for us.

    I can’t believe she is limping again on this knee after having had TPLO on it and having done so well.

    Does anyone have any similiar experiences?

    • Amanda August 15, 2012 at 9:17 am #

      I have a 3 year old 50 lb female pit bull terrier. She had the TPLO done on left knee in Jan. 2011. The sugery seemed very successfull. The only thing I notice now is that after playing or long walks, she will rest with that knee stretched out (doesn’t want to bend it). Then after about an hour, she’s back to bending it normally. I’ve never hear of a dog with a TPLO sugery begin to limp after full recovery. It could be a problem with the implant hardware. I would not hesitate to take her to the vet immediately, especially if she had fully recovered from surgery. My dog has quite a bit of scar tissue built up around the implant, but I’ve heard it’s not that uncommon to have problems with the implant hardware down the road.

      On another note, I just wanted to mention that my dog is now having some pain in her “good” knee. Not sure if the conservative approach will ever be a success with already having one TPLO done. Always know that surgery will mean your dog’s knee will never be 100% normal. I believe her surgery knee still gives her some pain and believe she is offsetting her weight onto her good knee. I have to agree that the TPLO is a brutal surgery, although in most cases successfull. My dog HATES going back to that vet’s office now where she had the surgery. She cries out in panic (not pain) whenever they touch her or pick her up to put her on their table. I don’t know if I can bring myself to put her through another TPLO. But, at this time, her “good” knee isn’t that bad. Only a little hitch in her step…so we’ll see.

      • Denise August 15, 2012 at 10:06 am #

        I am not sure where I go to reply to this but my dog had a complete tear and we chose to conservatively treat our baby girl. We got a homeopathic remedy from a website in Australia called “tear Repair” It was like a miracle along with bed rest as much as you can keep a lab down! We then let her swim and take short walks. She is 9 and a half and the vet told us without the surgery that she would injure the other knee within 6 weeks and then we would have to put her down. We were devastated and didn’t want to put her thorough the painful surgery or could we afford it!
        She had recovered completely running and jumping on the bed etc. The past week we were out running again and she had a little set back overdoing it and was limping somewhat. we started her back on the remedy and we will let her swim today a little and already see so much improvement.

        I would definitely suggest this product first when the vets try to intimidate you with the surgery ASAP! I was so happy I found it!!! Yoiu have to be diligent about giving it to them and really watch their movement so they get as much rest as possible..

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