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Surgery vs. Conservative Management – Sophie

surgery vs. conservative managementThree months ago in February, my Scottie Terrier, Sophie, tore her CCL. She is 22.5 lbs and 7 years old. She had x-rays and saw two different vets, one being an orthopedic who recommend the band surgery. He manipulated it and said it was completely torn (not sure if he can really tell?) Anyway, I made the mistake of not restricting her from activity (I also live in a 3-story) and 3 months later, I decided it was not any better and then I went and consulted with another orthopedic (he recommended a TTA). After scheduling her surgery, I continued to be very scared and nervous to say the least about her having surgery. So I cancelled it after much reading and research. I’m still not sure if I made the right decision.

So it’s been a week now and I have started restricting her, with limited walking, and no running, jumping, or stairs. I am still trying to find out if I should do water therapy with her (wading and swimming) and the proper way to do it with her. I made her wade in the water yesterday and then I felt awful because it was hurting her the rest of the day and she started hopping back around. I would appreciate any suggestions out there and have I made the right decision in not doing surgery? Will my baby heal? Thanks so much.

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10 Responses to Surgery vs. Conservative Management – Sophie

  1. Candace Jones April 28, 2016 at 2:50 pm #

    kaylies mom here- from my research your dog is in the weight range that can do well with non surgical conservative treatment ,but I learned it takes many weeks and months for her leg to form its own scar tissue around and in the joint to stabilize the bones so they do not rub against each other – which is what causes pain. a custom brace- I used Animal Ortho Care will stabilize her knee in the way needed while her body is trying to heal the injury as best it can- I suggest you look into a brace along with restricted activity for a few months and also research passive exercises you can do with her leg-Good luck to you both,kaylies mom

    • Michelle May 2, 2016 at 7:42 am #

      Thank you so much for your response!

  2. Neil Embleton April 29, 2016 at 11:57 am #

    Hi,
    I read about your troubles with Sophie and i thought I would see if I can help. The decision to proceed surgically can be a daunting one. Especially given the conflicting information available. I think in her weight range conservative management is an option. However, it has been a number of months since her injury. If she has not begun to respond at this point, it is unlikely she will do so. Braces can be used, unfortunately they can’t stay on continuously and provide little to no rotational stability. Ultimately, I think this case will become surgical. Options will include LFS (band procedure), geometry modifying procedures (TPLO, or TTA), or the less invasive Simitri Stable in Stride ( see link to New emerging treatments). Simitri would be my first choice and LFS my second. Full disclosure I invented the simitri procedure.
    Hope that helps.
    Dr. Neil Embleton

    • Michelle May 2, 2016 at 7:50 am #

      Thank you very much for your response. I will look up the simitri procedure, not familiar with that one. While giving it more time to possibly heal, could you please recommend what rehab I should do and in what time frame. How long should I do slow lease walking/how many times a day and what kind of water therapy should I do with her and should I start that now or when? Do I let her swim or wade? Thanks again, Michelle

      • Dr. NEil May 2, 2016 at 11:49 am #

        Hi Michelle,
        That you would need to discuss with your veterinarian. They would be much more familiar with the case and would be better able to make appropriate suggestions

  3. Carine April 29, 2016 at 12:14 pm #

    Where can one get the Simitri procedure done? Is this widely available?

    • Dr. Neil May 2, 2016 at 11:50 am #

      Hi Michelle,
      That you would need to discuss with your veterinarian. They would be much more familiar with the case and would be better able to make appropriate suggestions

    • Dr. Neil May 2, 2016 at 11:52 am #

      Hi Carine,
      The implant is available world wide and then preoperative planning, step by step surgical instructions and the surgical procedure video are all available to any veterinarian on line. Have your clinic contact New Generation Devices ( ngdvet.com) for assistance.

  4. Judy May 16, 2016 at 7:10 pm #

    My pooch Brako has torn his Acl yesterday. I was at the vet and he suggested surgery that he is not able to do. I will have to find a specialist in this country. Brako is an American Stafforshire (Pit)He weighs about 55-60 I am guessing. My dilemma is I live in Costa Rica and would like to know if the surgery is necessary with his weight. I am completely stumped and the vets here although great are just not the same.

  5. Candace Jones May 18, 2016 at 2:33 am #

    Sorry to hear your dog has injured himself–My 10 yo dog Kaylie did the same in February-our story is on here-She is 63 pounds and unable to have surgery because she is immunosuppressed on meds due to Lupus that make her highly susceptible to infection.
    I went the route of a custom made brace thru Animal Ortho Care in Chantilly ,Virginia, restricted activity, weight loss, carrying harness to help keep weight off her hind end, pain med–and glucosamine .chondroitin and time.-lots of time- Has been 3 months and she is pretty comfortable- and bearing weight on her leg.The body does try to stabilize the joint by building fibrous scar tissue over time.
    You do not say how old Brako is? I would suggest you restrict his activity to not further damage the knee and consult with an orthopedist for him- ? maybe in San Jose?? and read all you can about this injury and the various treatments–the rehab after surgery is long but some dogs are very good candidates for a procedure-once you have all the facts you will be able to make the best choice for Brako–Good luck and keep us [posted on his progress—Candace and Kaylie

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