PROM or Passive range of motion exercises are an important part of canine physical therapy following a cranial cruciate ligament (CCL) injury. PROM exercises are useful whether your dog has undergone surgery such as a TTA, TPLO, traditional repair, etc. or if you’ve chosen to do Conservative Management. The goal of PROMs are to increase the movement and flexibility within the joint by stretching the tendons and muscles in a careful, controlled manner.

Dr. James St. Clair of TopDog Health and Rehabilitation demonstrates how to perform Passive Range of Motion Exercises, and explains their importance with regard to maintaining range of motion within the dog knee joint.

Passive Range of Motion Exercises – Video is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

It is estimated that there are over 15.5 million dogs suffering from arthritis right now – many of whom are silently suffering.

Arthritis is defined as inflammation in the joint, and it may be accompanied by pain, discomfort and/or stiffness. There are 5 general areas which are most succeptible to arthritic change: hips, knees, elbows, shoulders and spine.

In the case of arthritis related to cranial cruciate ligament (CCL) injury, the onset of arthritis is linked to the traumatic injury of the knee joint.

Dogs do not exhibit signs of pain in the same way we do by crying, whimpering or complaining. You will need to pay close attention to the habits of your pet to try and determine whether arthritis is an issue.

Arthritis in Dogs – What to Look For:

• Slowing Down
• Sleeping More & Sleeping Longer
• Standing with Back Legs Closer Together
• Wide Front Leg Stance
• Running with Hind Legs Together aka “Bunny Hopping”
• Joint Licking
• Slow to Rise
• Walking Less than Normal with Frequency and Distance
• Avoiding Jumping or Stairs
• Stiffness
• Limping
• Muscle Atrophy

How to Diagnose Canine Arthritis:

Dr. James suggests if at all possible, you need to have x-rays taken to accurately diagnose arthritis, particularly, the exact point of origination for the arthritic change.

The video above was created by veterinarian, Dr. James St. Clair of TopDog Health and Rehabilitation. Dr. James created his GlycanAid-HA joint support formula as a result of working with many patients and owners coming into his rehab center with a plethora of different supplements. In 2007 he began working with one of the leading experts in the world of veterinary supplements and developed joint health supplement formulas packed with ingredients that he knew worked, and were something he wanted to offer his patients.

Basics of Ligament Injury and Arthritis – Video is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Case study on Beefcake – A 12 1/2 year old dog with a difficult time walking; unable to run.

Video courtesy of Dr. James St. Clair of TopDog Health and Rehabilitation, the creator of GlycanAid-HA.

Beefcake Case Study for GlycanAid-HA – Video is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Dr. James St. Clair of TopDog Health and Rehabilitation discusses the benefits of using moist heat to help your dog heal from a cruciate ligament injury.

The use of moist heat can help increase healing and decrease pain.

Moist Heat Therapy – Video is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Dr. James St. Clair of TopDog Health and Rehabilitation explains the importance of post operative icing within the first 72 hours following ACL repair surgery. Icing will help constrict the blood vessels and prevent inflammatory agents from entering the knee joint. The use of ice can also help relieve pain and make your pet more comfortable.

Icing Options Following Dog ACL Surgery:

• Ice Pack (Standard) – Do not conform to body
• Gel Pack (Gel) – Great choice, conforms to body and stays cold
• Frozen Bag of Peas – Good backup, just does not stay cold very long
• Therapy Wrap – Hot and Cold therapy wrap, easily conforms to body

How to Ice Your Dog

Dogs can be very sensitive and may react. If your dog reacts to the coldness of the ice, go ahead and place a towel over the area you plan to ice in order to prepare them.

Ideally you’ll want to place the ice source so that it wraps around your dog’s injured knee – this is where having a gel ice pack therapy wrap can come in handy.

Post Operative Icing – Video is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

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

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

I created this website to be all about the experience.  The experiences we go through as owners of dogs with knee ligament injuries, and the experiences our dogs go through as a result of tearing their CCL.  As a result of my experience I have been through both a Traditional Repair surgery and successful round of Conservative Management.  The best advice I can offer to anyone considering Conservative Management with their dog is this – listen to your dog.

Many veterinarians, for one reason or another, are quick to jump the gun on surgery.  Surgery is not the “quick fix” many people tout it to be.  The surgical procedure and recovery process are long, painful, difficult and financially taxing for many dogs and their owners.  Don’t feel pressured to have your dog go under the knife if you want to first try CM.  You are not doing your dog any injustice by giving them the chance to heal on their own.  The option for surgery is always there if you need it, but if you’re willing to give an alternative approach to healing a dog ACL tear a try, CM can be a successful route.

Overview of My Conservative Management Dog ACL Plan:

1. Weight Management – Our first step in getting our American Bulldog’s weight down was to begin cutting out treats and snacks.  I started making my own dog treats using a simple recipe with peanut butter as the main ingredient.  Making the treats myself allowed me to make smaller sized treats, which I began gradually feeding less of.  We also made the transition to a higher quality food, and once he was adjusted to the food we cut his portion size down by 1/3, continuing to feed him twice per day.  With less weight on the injured leg it will give your dog a better shot at recovery.
2. Inflammation – When Tucker first started showing signs of lameness in this injured leg we began giving him Rimadyl.  Knowing we did not want to keep him on a NSAID for a long period of time, we immediately began looking for a more holistic option for inflammatory control.  Along with the Rimadyl we started giving Omege 3 Fish Oil – one, 1000 mg capsule, twice per day.  After 1 month of the Rimadyl I transitioned to Yucca Intensive, and give 9-10 drops diluted in food twice per day.
3. Joint Support - A number of veterinary studies have shown that Glucosamine and Chondrointin supplements are good to support joint health in any dog.  Many people believe different brands of supplements show different results, so plan on experimenting with a number of different brands to see what works best for your dog.  Ask around at your veterinarian’s office or pet food store to see if they have any samples for you to try as you’re finding which product works best.
4. Rest – This is often easier said then done, but it is extremely important to make sure your dog stays in a confined area without distraction. Carpeted areas are best if at all possible.  Try to avoid steps, steep hills, jumping, running, rough play or anything that may create a jerking motion in the leg such as jumping up into a car or into a pool.
5. Prevent Boredom – Get creative with ways to entertain your dog while they are taking it easy and recovering.  Toys such as frozen kongs filled with peanut butter or bully sticks are a good way to help them alleviate boredom.
6. Exercise – Keep exercise to a minimum, but take care to avoid muscle atrophy.  Controlled, leash walking a few times per day is a good way to make sure your dog maintains range of motion without further injuring the knee.  These short periods of exercise may also encourage the growth of scar tissue in the area of the injured ligament.  This scar tissue will serve to stabilize the joint as your dog goes along the healing process.
7. Listen to Your Dog - Keep close tabs on your best friend throughout this process.  They’ll let you know how they are feeling.  Go at their pace, and if you don’t see any noticeable improvement in their lameness in a few weeks it’s time to re-evaluate CM.

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