Our 3 1/2 year old yellow lab has had hind lameness after exercise for several months now. We tried rest and anti inflammatory meds for 3 weeks with no results, so finally had her examined and x-rayed.

She was diagnosed with a torn CCL, with some arthritis in her affected knee. It was a very difficult decision to make whether to operate or do conservative management. I spent nights crying about the consequences of both, and finally decided on the TPLO.

She was operated on 2 days ago and we brought her home yesterday. I was amazed that she was doing so well with some slight weight bearing on the affected leg, but was shocked at the swelling and bruising that resulted after the TPLO surgery. She is eating, drinking, peeing and pooping, and we hope that she remains infection free on her road to recovery. I am still on the fence with regards to my choice, but we shall soon see. Lots of friends have had success with TPLO surgeries on their dogs so I hope to have the same results.

Our dog was also part of a clinical trial involving CCL injury and TPLO surgery. She will be followed closely post op with regards to her gait, weight and hydro therapy.

TPLO Ligament Surgery – Taylor is a post from: Dog Knee Injury

The standard rehabilitation procedure for Tightrope repair is a bit different than TTA and TPLO, due to the less invasive nature of the procedure.  When dogs return home from Tightrope repair, owners are instructed to allow their dog to utilize the leg as they wish.  For some dogs this means they will start putting weight on it the next day, and for other dogs it could be 2-4 weeks before they feel comfortable bearing weight on the surgical leg.  Keeping your dog still while in the house, and keeping leashed walking to a minimum (bathroom breaks only) is critical during the first few weeks home no matter what procedure you choose, and exercise/movement restriction is advised for the first 8 post operative weeks.

At 4 weeks post op, most veterinarians will instruct owners to begin introducing their dog back to walks, particularly walking uphill in an attempt to rebuild loss muscle mass.  It is a good idea to start out by taking a few short walks every day, gradually working up to longer and less frequent walks.  This will prevent strain on the knee joint, which can hinder the healing process.  Post operative exercises need to be controlled, leashed walks, as any running, jumping, or roughhousing during the first 8 weeks can be detrimental to the stability of the knee and recovery process.

Upon his arrival home, your dog will need to take a number of medications for pain, inflammation, infection prevention, and possibly sedation.  If your buddy is not a willing pill taker, it is a good idea to try to get them into the habit of taking a small snack such as a piece of cheese, peanut butter, or a hot dog slice after their meals.  Each dog is different with regard to how long they need to be on a particular pain, inflammation, antibiotic, and sedation regimen, but usually the antibiotics are taken over 10 days, with the pain/inflammation/sedation used on an as needed basis.

As a general rule, just pay close attention to your dog and be sure to tailor their recovery to their particular needs.  There is no such thing as having a post operative dog rest too long, but there is always the risk of damage to the repair if your dog tries to do too much, too soon.  Tightrope CCL, like other traditional repair methods (lateral suture, extracapsular imbrication), is simply a way to stabilize the joint while scar tissue is being formed, it is not a replacement ligament.

Tightrope CCL Surgery Recovery is a post from: Dog Knee Injury

Following a CCL repair surgery or during the Conservative Management process, your dog is likely to experience a significant amount of pain related to the injury to their knee ligament. For surgical pain or injuries that your pet my be dealing with, there are some holistic alternatives which are extremely effective in dogs.

• Acupuncture – Acupuncture has been shown to both relieve pain and relax your pet, helping him or her cope with stress better.
• White Willow Bark – White willow bark is an herbal remedy that can take the edge off minor pain, but should NOT be used on cats.
• Arnica – Arnica is a homeopathic remedy that can be powerful for post-surgical pain, or pain from injuries. For severe pain a typical dose of arnica is the 1M or 10M potency, but for exact dosages and directions, please consult your holistic veterinarian. Arnica is applied topically, so you will need to take precautions to ensure your dog does not remove the arnica from their skin.
• Calendula Officianlis – Herbal or homeopathic gels containing calendula officianalis are wonderful for putting on incisions. They help with pain, itching, and irritation; many humans use them on their own surgical incisions with much success, and the relief is often immediate and unmistakable. Dogs tend to leave their incisions alone much more readily when they are treated with calendula.
• Fish Oil – Fish Oils containing Omega-3 Fatty Acids can be very helpful in reducing inflammation in dogs. One daily dose of 1000 mg is sufficient to aid any discomfort related to inflammatory processes, including arthritis.
• Yucca – Yucca can be helpful for dogs with inflammation and arthritis. Yucca root can be found in a tincture that can be placed in your dog’s food, and it should be used daily for maximum effectiveness.

There is nothing holistic about suffering or pain, and if your dog is in real distress, you may want to explore other pharmaceutical options for pain management; this is especially true in the case of dogs that develop chronic pain post-operatively due to arthritis. Many of the holistic techniques mentioned above can go hand in hand with conventional veterinary medical treatments. For example, if your dog has arthritis or similar conditions, acupuncture can be powerfully effective in combination with allopathic medications, and the drug Adequan actually rebuilds cartilage and lubricates and cushions your pet’s joints. Let the NSAID handle the pain, but continue using alternatives to help heal and support the body.

We all want to do what is best for our pets, and making sure they are comfortable throughout the surgical process is important in their overall recovery. Be sure to attentively listen to your dog’s needs and be open to pursuing other avenues with regard to pain management to assure the best outcome for your dog.

If you’re interested in learning more about holistic, naturopathic and alternative veterinary treatment for dogs, there are a handful of excellent books out there written by homeopathic veterinarians. Below are a few of the guides I’ve found helpful when looking to treat my dog using natural methods like homeopathic medicine, naturopathy, chiropractic and accupuncture.

If you want information on buying natural supplements or homeopathic treatments for dogs, please visit our – Homeopathic, Alternative and Natural Medicine Guide (click on text for link)

Holistic Alternatives to Pain Management in Dogs is a post from: Dog Knee Injury

Many veterinarians will try to pressure owners into immediately proceeding with surgical intervention to repair a dog’s damaged cranial cruciate ligament (CCL) by saying early intervention will decrease the likelihood of arthritic changes to the knee. There is some truth to this – restriction of the knee joint after injury does help to minimize the progression of arthritic tissue in a dog with a CCL injury, but the necessary amount of restriction can be reached with conservative techniques as well as surgery. Restricting your dog’s activity following a cruciate ligament injury is your best defense against arthritis, and no owner should ever be made to feel as though surgery is their only option.

The truth is, all dogs that sustain a cruciate ligament tear or rupture are at an increased risk for arthritis, no matter at what point surgery (if ever) is undertaken. There is no evidence that dogs who recover using Conservative Management (CM), and dogs who recover with surgery show any differences in the development of future arthritic problems. Proper restriction during recovery and avoiding high-risk activities after recovery, together with weight control, good nutrition, and joint-supporting supplements are what minimize the chances of future arthritic problems – not immediate surgical intervention.

Does CCL Repair Surgery Lessen Arthritis Risk? is a post from: Dog Knee Injury

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

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

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

CCL Injury in Both Back Legs is a post from: Dog Knee Injury

NSAID stands for non-steroidal anti inflammatory drugs. These medications are most often prescribed to dogs for pain, inflammation and to aid in fever reduction. NSAIDs are most commonly used for the symptomatic relief of arthritic pain in geriatric pets. Aspirin and ibuprofen are well-recognized human NSAIDs, and the Food and Drug Administration’s (FDA) Center for Veterinary Medicine (CVM) has approved specific NSAIDs for use in pets with osteoarthritis. NSAIDs work by blocking the production of prostaglandins, the body chemicals that cause inflammation, and can be highly effective for controlling discomfort in arthritic and post op pets.

The FDA considers NSAIDs to be “safe and effective when used according to the label and when pet owners are informed about common NSAID adverse reactions.” According to the American Veterinary Medical Association (AVMA), the NSAIDs are available today are much safer than they have ever been in the past and cause far fewer side effects. The FDA also notes that “duration of use makes a difference in the safety” of NSAIDs as the risk of side effects can increase the longer a pet is given an NSAID. The FDA considers approved NSAIDs to be safe and effective when used according to the label and when dog owners are informed about common NSAID adverse reactions.

What are possible adverse reactions/side effects to NSAID use?

• Change in appetite
• Vomiting
• Change in bowel movements
• Change in behavior
• Seizures
• Yellowing of gums, skin or whites of the eyes
• Change in drinking habits
• Change in urination habits
• Change in skin – redness, scabs or scratching
• Lethargy and/or depression

More serious side effects included gastro-
intestinal bleeding, ulcers, perforations, and in
rare cases, kidney and liver damage, and death.

What NSAIDs are approved for use in my dog?

• Etogesic (etodolac)
• Rimadyl (carprofen)
• Metacam (meloxicam)
• Zubrin (tepoxalin)
• Deramaxx (deracoxib)
• Previcox (firocoxib)
• Novox (generic carprofen)

Safety of Anti Inflammatory Medications, NSAIDs is a post from: Dog Knee Injury

Age is also a risk factor for CCL injury, and there are two types of CCL onset related to a dog’s age when the injury occurs. Chronic onset, degeneration over time with subsequent rupture (usually from aging), occurs in 80% of cases and occurs in dogs 5 to 8 years old. Acute onset, a tear caused by injury, is most common in dogs under 4 years old. Young dogs of large breeds are more susceptible to rupture than young dogs of small breeds. Older dogs are also at greater risk for CCL tears if they already have arthritis and/or have decreasing musculature, especially surrounding the knee joints.

To sum it up, there is no way you can protect your dog from a CCL injury, but there are risk factors which make dogs more likely to sustain a serious cranial cruciate ligament tear or rupture. Large and giant breed dogs do more commonly sustain CCL injury, but this is usually compounded with other risk factors, which are mentioned below.

Risk Factors in Dogs for CCL Damage:

• Age
• Arthritis
• Previous injury to knee joint
• Overweight
• Large or giant breed
• Poor musculature, especially surrounding the joints
• Structural abnormalities – luxated patella, etc.

Are CCL Injuries More Common in Certain Dog Breeds? is a post from: Dog Knee Injury

Whether or not your dog has surgery to temporarily stabilize the joint after ligament rupture, long term joint health is best assured by careful restriction during a slow return to normal activity over a period of at least several months, and by avoiding unnecessary surgical removal of all or part of the meniscus. People are sometimes told that their dog’s meniscus is damaged and that the meniscus cannot heal on its own therefore surgery is always required for meniscal injury. This is not true. In fact, there are two basic methods used by the body to repair meniscal damage:

1) Extrinsic - When meniscal tear occurs, a fibrin clot forms within its margins. This fibrin clot contains factors that act as agents for reparative cells to migrate and develop. Further inflammatory response and angiogenesis result in healing of the lesion in about 10 weeks in the dog. It may take months or even years for the scar tissue to change into fibrocartilage, resembling that of the meniscus. Differences between the newly formed fibrocartilage and mature fibrocartilage are recognizable and include increased cellularity and, at times, increased vascularity in the repair tissue.

2) Intrinsic - The cells within the meniscus itself have an inherent capability to generate a healing response. The cells of the meniscus are assisted by the fibrin clot, which not only acts as a scaffold, but also provides stimuli to promote healing.

Why should I be wary of a veterinary surgeon removing my dog’s mensicus during ccl repair surgery?

Eventually the more observant doctors woke up to the fact that the menisci were important joint components, and in recent years the more enlightened surgeons have become less aggressive in removing all or part of the meniscus. But there are still many vet surgeons who cut far too much of a meniscus away. Some of these guys just can’t stop themselves from getting in there and excising something. Their approach is often, “When In Doubt, Cut It Out” and is a rule of thumb often used in canine stifle surgery. They won’t usually tell clients that of course. The history of surgery in general is filled with examples like this of too-aggressive surgical intervention. Never be too trusting of a surgeon. They became surgeons to cut; not to tell you no cutting is needed.

Source:

About the Dog Meniscus – http://home.earthlink.net/~tiggerpoz/id16.html

Does My Dog Need a Meniscus? is a post from: Dog Knee Injury

The osteotomy will take 6 to 8 weeks to heal, during which time your pet will need to be kept relatively quiet and only allowed outside on a leash. Your dog will most likely start to feel that they are completely healed within a week of the TTA, but it is important to not let them to do too much too soon as they risk damage, not only to the implant, but a CCL tear in the opposite knee. Many veterinarians will advise pet owners to keep their dogs sedated during this recovery process to assure they remain quiet and only go outdoors to relieve themselves.

All dogs with CCL injuries will go on to develop some level of arthritis. It is a good idea to have your dog’s knees x-rayed during your yearly veterinary visits to examine the presence of arthritis and determine what type of treatment plan would be best for your pet to make them the most comfortable.

TTA Repair Postop Recovery is a post from: Dog Knee Injury

For the next two weeks (which is the duration of time the bandage will remain on if you dog was fitted with one) your dog will not be putting much weight on the injured limb. They may hold the leg up if they do not have the modified Robert Jones bandage in place, while others will exhibit some toe-touching behavior. After the sutures are removed, at about the 2 week mark, you veterinarian will determine the course of therapy for your dog to proceed with. In many cases your vet will recommend exercise restriction until 4 to 8 weeks, at which point short, 2 to 5 minute walks, can be reintroduced to your pet.

After 4 to 6 months your dog will be able to return to normal activities without any restriction. The leader line placed in the knee will break at 2 to 12 months post-op, and your dog’s scar tissue will support the knee on its own. Restriction of movement is absolutely key for the successful healing in patients undergoing extra-capsular imbrication repair surgery. Rest will help to encourage fibrous tissue formation and also prevent the premature breakage of the monofilament suture stabilizing the joint during the healing process.

All dogs with CCL injuries will go on to develop some level of arthritis. It is a good idea to have your dog’s knees x-rayed during your yearly veterinary visits to examine the presence of arthritis and determine what type of treatment plan would be best for your pet to make them the most comfortable.

Extracapsular Repair Postop Recovery is a post from: Dog Knee Injury