Lola is a German Short Haired Pointer – very active, spins and bucks like a bronco 30 or 40 times a day!

When she was about 7 she started favoring one back leg, not even weight bearing at times. We took her to the vet when this went on for a couple days and he said it was a ACL tear and recommended surgery. When informed we would have to keep her calm for many weeks we were overwhelmed – there is no keeping this dog calm so post op would be pretty difficult. I read about it online and talked to some people whose dogs had surgery and who still have a lot of pain due to arthritis. We decided to take a wait and see approach using Glucosamine and Rimadyl.

Within 4 months she was her old self – truly amazing! Then two years later she started limping again. We took her to a new vet who specializes in holistic medicine. He offered surgery, but said he thought a wait and see approach was okay, too. He squeezed Lola’s leg and showed us it wasn’t really painful and that the arthritis is minimal. He said she seemed to be favoring it like it was a “trick knee” rather than from pain.

He encouraged us to take her off Rimadyl, but to keep Glucosamine and add Fish Oil. He told us that he thought adjusting her spine through chiropractic measures would be worth trying. He adjusted her spine and she hopped up and started running around like her old self. We brought her back in 3 weeks and then in another 3 weeks for two more adjustments even though she was acting perfectly normal after her first visit.

It has now been 6 months and she has continued to be her crazy, spastic, spinning and jumping self. We are very happy that we gave her those months to recover the first time. Her quality of life is amazing, I believe better than if she had gone through the pain of surgery and certainly it was less costly than surgery! I encourage everyone to see a holistic medicine vet before making a decision on surgery.

Conservative Management for Knee Ligament – Lola is a post from: Dog Knee Surgery and Ligament Injuries

I have a very active 4 1/2 yr. old Boxer/Rott mix. I adopted her when she was 6 months old from the animal shelter here in Bozeman, Mt. It was Love at first sight! I was suffering from severe depression/servere anxiety disorder at the time, and when we met she put a smile back into my heart and life – I guess you could say she saved my life and I saved hers!

About 4 months ago I noticed that she was having severe difficulty rising from a sitting position, and also just sitting down, and she was favoring her right rear leg. I thought she just ran a little too hard, as she also has a very stong prey drive. She also loves to run (man can she ever go). I took her to our vet, and he thought just a mild knee sprain at that time.

However, she has pogressively been getting worse, and now it has turned into both rear legs. We have since seen the vet for a third time last month and he has now said more than likely she has a partial ccl tear in both of her knees. I was devasted to hear this news, and I have cried alot of tears watching her struggle, and not be able to run or even get up on her own.

I have her on Tramadol for the pain, and high doses of Dasuquin daily, my vet also wants her on 10,000 mg of fish oil too. He has said she will more than likely have to have surgery if she tears her ccl’s all the way, and I just do not have the 4,000 dollars to do this at this time. We are hoping and praying that this CM will work for her.

So far she is doing a little better, as long as I do not let her run AT ALL, and have to keep our walks short. Needless to say, she seems to be getting more and more depressed as the days go by, as she is not happy if she cannot get out and run off some of her high energy. It breaks my heart, but I know that it is for her own well being – I just hope that she understands that too!

I will keep you all posted on her progress. Thank you everyone for all of the stories, it has really helped me in dealing with this setback. I wish all of you and your doggies a healty recovery!

One last thing – I forgot to mention the surgery that my vet wants to perform is the Tightrope, I am going to be getting at least two or more opinions before I do make that decision if it comes down to that.

Conservative Management for Bilateral Ligament Tears – Brandi Lee is a post from: Dog Knee Surgery and Ligament Injuries

When massaging your dog following a cranial cruciate ligament (ACL or CCL) injury it is important not to just focus on the injured knee joint, but the entire body, especially when initiating the massage. Some of the benefits of canine massage include: enhancing the human-animal bond, relieving pain and decreasing swelling.

Dr. James suggests a massage technique starting by working from the toes up to the affected knee joint. While massaging the area around the joint (or anywhere else in the body) you may encounter “knots”. You can relieve the pressure in these points by placing firm, direct compression on the area for about 20 seconds, leaving time for it to rest before returning to the area.

Massage Therapy for Dogs – Video is a post from: Dog Knee Surgery and Ligament Injuries

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 Surgery and Ligament Injuries

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 Surgery and Ligament Injuries

Hello! In June my 7 year old English Bulldog, Kata, was running on her walk when she seemed to step wrong or something. She continued to run and play, not seeming to be bothered much. I assumed it was just a pulled muscle or something.

Then last week we had her off leash and she took off after a cat. She came home limping and would not put any weight on her left rear leg. I took her to the vet a few days later and the vet thinks it is a cruciate ligament injury. The vet did not do x-rays (as she knew if we decided on surgery the surgeon she referred me to would want to do her own) so I do not know the extent of the injury.

She is currently on Rimadyl (only a week’s supply as of now) and is putting weight on the leg, but not a lot. I can tell it is uncomfortable for her to squat when going to the bathroom. Overall she is pretty mellow, only trying to jump and “trot” when someone comes home. We have not been walking her and she is devastated since right now it is finally starting to cool off (we live in AZ). I am so torn as to what is the best choice for a 7, almost 8, year old bully who still seems full of life and not in much pain.

I want her to be able to run and play though, but don’t want to put her through a painful surgery and recovery if she can recover with just CM.

How to tell? I know that there is no rush to make a decision, however, I feel like the more time that passes the older she gets and more risk comes with age for surgery. HELP!

Conservative Management Advice for CCL Injury – Kata is a post from: Dog Knee Surgery and Ligament Injuries

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

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

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

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

June

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

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

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

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

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

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

4 Months

Alternative Treatment for CCL Injury – Pepe is a post from: Dog Knee Surgery and Ligament Injuries

I just wanted to add China’s story…she’s another APBT with bad knees. Three years ago she injured her left ACL and I didn’t have the funds or heart to deal with surgery. I opted for the A-trac brace and had great success. She never chewed it or complained about it…there were a few times that I noticed it was rubbing her hair away and/or chaffing her skin so I just cut the toe out of a sock and used that as a protective layer for her skin. After 12 weeks of wearing it she was using the leg without limping and the only noticeable injury/issue was that her leg was a bit atrophied but I assumed that was normal (it returned to normal a month after full use).

Recently China injured her other knee…and I’ve contacted Wound Wear again and plan on buying a brace for her right leg along with another brace for her left, hoping that will keep her from re-injuring it during the next 12 weeks. And just an FYI I know the left brace was still in good shape when I took it off last I just can’t find it. It’ll be interesting to see how she does with two nearly rigid knees.

Here is a picture of China standing with her left side brace on.

Thank you guys you offer a wonderful service. There’s nothing like watching your dog in pain and not knowing what to do. Keep up the good work!!

A-Trac Brace Experience – China is a post from: Dog Knee Surgery and Ligament Injuries

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 Surgery and Ligament Injuries

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 want information on buying natural supplements or homeopathic treatments for dogs, please visit our – Homeopathic, Alternative and Natural Medicine Guide

Holistic Alternatives to Pain Management in Dogs is a post from: Dog Knee Surgery and Ligament Injuries