Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information » nutrition

Alternative Treatment for CCL Injury – Pepe

Mandie — Fri, 30 Sep 2011 02:06:32 +0000

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.

My 6.5 year old Cockapoo, Pepe, ruptured his back left ACL in May – it was diagnosed by vet the following day. I didn’t want to jump into surgery right away and our vet was not pushing us. I work for a company who makes a vet line of supplements, so after discussing Pepe’s situation with our company vet, I’m electing to do the Conservative Management option while supplementing him with the following: MediHerb’s Boswellia Complex (anti-inflammatory), Gotu kola Complex (tissue repair), and Canine Musculoskeletal Support from Standard Process.

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

At 4 months post injury, Pepe is about 75% recovered, and back to running on all fours and jumping on the furniture and bed. We’re continuing to give him Boswellia Complex and Gotu Kola Complex from MediHerb, as well as Canine Musculoskeletal Support from Standard Process, and a good foundational diet of grain-free quality dog food (Fromm) and frozen raw “meatballs”.

Alternative Treatment for CCL Injury – Pepe is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Does CCL Repair Surgery Lessen Arthritis Risk?

Mandie — Tue, 24 Jun 2008 23:01:20 +0000

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 and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

CCL Injury in Both Back Legs

Mandie — Sun, 15 Jun 2008 20:54:57 +0000

It is not unusual for dogs who have a cranial cruciate ligament rupture in one leg to develop one in the other leg. It is a little unusual to have two severe ruptures at the same time, but it does occur, especially in large breed dogs or overweight canines. Generally the signs of this type of injury will manifest itself in the dog with an impaired gait, shaking while walking, and/or dragging the back legs. It is not unusual for veterinarians and pet owners to think that partial paralysis is present or that the severe lameness is due to spinal disc disease because of the severity of the presentation.

Surgical stabilization of the stifle (knee joint) is advocated by most veterinary surgeons when cruciate ligament rupture has occurred in both knees. Despite this, there are not any long-term studies that compare surgical repair to conservative treatment over the lifetime of dogs to show that surgery is actually beneficial when compared to long term comparison with medical treatment alone (i.e. anti inflammatory medications, supplements, CM followed by physical therapy). Conservative management does work, but it is a bit more difficult in the case of a dog with a double CCL injury. There is no need to rush into surgery, despite what your veterinary surgeon may advise. Dogs can do very well for prolonged periods of time doing CM, with smaller dogs and dogs proportionate for weight to size (meaning they are not overweight) often making full recoveries without surgical intervention.

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 and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Preparing Your Home for a Post Operative Dog

Mandie — Thu, 12 Jun 2008 20:05:12 +0000

Before bringing your dog home from CCL repair surgery, you will want to make sure everything is set before their arrival. If you have already been practicing CM (conservative management) prior to surgery, odds are your home is already adequately prepared for the return of your canine patient, but it is always better to be safe than sorry. Below is a list I have compiled of ways to consider dog-proofing your home while your pet is recovering from cranial cruciate ligament repair (CCL) surgery.

Get your dog used to his new place well before the surgery date. If you are crating a dog that is not used to being crated or confining a dog that is used to having run of the home, it is important to get them used to this change prior to bringing them home from surgery. I recommend starting this transition as soon as you are aware of the upcoming surgery.
Cover your floors with non-skid carpeting; this is especially important if you do not already have carpeted floors. You will want to do everything possible to ensure your dog has no chance of slipping or sliding on an uncovered floor.
Disconnect the doorbell and place a sign on your door advising people not to knock; the more quiet you can keep your home, the better for your dog.
Have leashes hanging on the doorknobs everywhere in the home where your dog may go outside for bathroom breaks; there is nothing worse than searching for a leash to let your dog out when they are in pain, or getting them all riled up because you can not find their leash.
Have chicken stock, rice, boiled meat, and pumpkin on hand in case your dog is refusing his regular food after surgery.
Prepare the area your dog will sleep the first night home by covering the bottom layer with plastic. If your dog is not staying overnight at your veterinary clinic the day of surgery, there is a good chance that he may wet himself during the night due to the high volume of IV fluids they are giving during surgery.
Have ice or ice packs to help reduce swelling for the first few days after surgery. You may also want to have hot compresses available for the 3rd day on – it is best to follow your veterinarian’s advice with regard to the use of hot and cold compresses.
Cover the windows to prevent your dog from getting overly excited by outdoor creatures and excitement. Again, do everything possible to keep your dog’s recovery area safe and quiet.
Make sure you understand the dosing instructions and have the proper medications for your dog upon leaving the clinic. Everyone has their own way of managing medication administration, some make charts, others record the times given, and some people will tailor medications around meal time. We found that the easiest way for us was to set up a web-based calendar (we use Google Calendar) to send us an SMS text message whenever a dose was due.

If you have steps, make sure your dog does not have access to them; use a gate or barricade to prevent any premature stair climbing.
Boredom usually sets in pretty quickly for dogs during the post operative period, and having indestructible toys on hand can help to alleviate some of this stress. Frozen Kongs and bones can provide hours of distraction, which is a must for an owner that is unable to be with their pet at all times.
Make arrangements to take time off from work or have someone check in with your dog throughout the day for at least the first few weeks post op.

Preparing Your Home for a Post Operative Dog is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

When Can I Expect My Dog to Have a Bowel Movement After CCL Surgery?

Mandie — Sat, 07 Jun 2008 02:08:22 +0000

Many dogs will not have a bowel movement for the first 4 to 5 days after surgery, so if your dog falls into this category, do not worry. There are a number of reasons why a dog will not have regular bowel movements after surgery including – fasting prior to surgery, not eating well during an overnight or extended hospital stay (dogs frequently do not eat well when they go home because they are fed highly digestible food that produces little stool while hospitalized), and pain medications that contain narcotics (such as tylenol with codeine, tylenol 3, tylenol 4, morphine, fentanyl, tramadol) can have a constipating effect.

If your dog does not have a bowel movement on the 5th day of being home, a stool softener such as metamucil can be fed with the ok from your veterinarian. Be sure to check with your veterinarian before giving your dog any over the counter constipation products, as they may interact with medications they are currently taking for pain or to fight infection. The typical dose of metamucil is 1 tsp per 25 kg mixed in with each meal (this will need to be canned dog food or a “wet” meal); feed immediately after mixing, as the metamucil will gel the food and may make it less palatable.

If you have any concerns with the regularity of your dog following cranial cruciate repair surgery contact your veterinarian before any self remedy.

When Can I Expect My Dog to Have a Bowel Movement After CCL Surgery? is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Physical Therapy After CCL Repair

Mandie — Sat, 07 Jun 2008 01:18:44 +0000

Each veterinarian seems to have their own theories regarding how soon physical therapy should be started after ccl surgery and what techniques work best. Other veterinary surgeons will write off physical therapy all together, preferring for the dog to remain quiet for the first 6-8 weeks after the repair, gradually returning to exercise. While it is always best to go along with the instructions of your vet, I do want to point out that studies done by the American College of Veterinary Surgeons have shown that dogs beginning rehabilitative therapy within 48 hours of the procedure tend to heal faster and have greater range of motion than dogs without any physical therapy.

The best way to assure your dog is on the right track after his cranial cruciate ligament repair surgery is to incorporate a varied regimen of passive range of motion, balance exercises, and slow, controlled, leash walks. Range of motion exercises, also referred to as “ROMs”, should be demonstrated to you by a professional before you undertake them on your own, as you can do damage to the healing tissues in the knee with the wrong technique. There are canine physical therapists skilled in ROMs, and if you are unsure of your skills it is best to seek the help of a professional to ensure the safety of your dog. Balance exercises can also be tricky for unskilled owners, and it is best that a qualified veterinary physical therapist perform balances exercises with your dog; think placing your dog’s belly on a ball while helping him to bear weight and flex the knee.

Swimming is an excellent non-weight bearing activity, but only after the incision site itself has had time to heal. All therapies should always be cleared through your veterinary surgeon, prior to their implementation. If you have access to a pool and a dog that loves to swim, this can be a great way to help them regain lost muscle mass while working on ROM exercises in a zero resistance environment (decreasing the likelihood of injury).

Some owners have also chosen to go a more holistic route with their dog’s post operative therapy, seeking out the assistance of a professional skilled in acupuncture. The use of animal acupuncture, and similarly acupressure, in a dog recovering from ccl repair surgery may help alleviate post op discomfort, which can help your dog to heal more quickly from surgery. A growing number of veterinary clinics are now integrating western techniques such as acupuncture and massage into their practices, with many offering these services on site. Acupuncture and acupressure can be used in conjunction with ROM exercises and hydrotherapy under the supervision of your veterinarian.

The long term prognosis for animals undergoing surgical CCL repair is good, with clinical reports of improvement in 85-90% of the cases. Unfortunately, degenerative joint disease or osteoarthritis progresses regardless of treatment. Long term outcome includes a decrease in activity over time, an increasing level of disability, an adverse response to cold weather, and stiffness after inactivity related to progressive degenerative joint. Weight loss, an exercise regime of daily moderate activity, and the use of joint supporting supplements like glucosamine and chondroitin can help to improve these adverse clinical symptoms.

Physical Therapy After CCL Repair is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

What to Expect After CCL Surgery

Mandie — Fri, 06 Jun 2008 01:38:06 +0000

Whether your dog has undergone a TTA, TPLO, Tightrope, or traditional extracapsular imbrication repair, the steps following surgery are generally the same. Whether your dog stays the night at the vet’s after surgery, or head home with you the day of the procedure, the first few days following the CCL repair should be dedicated to making your dog feel as comfortable as possible. Be aware that your dog may have lost his appetite as a result of the surgery, so have stocks, rice, chicken, pumpkin and other whole foods readily available if he refuses his regular dog food. Oral pain medications should never be given on an empty stomach, and having a number of different foods at your disposal will help make medication administration much more pleasant for you and your pet.

Make sure to give prescribed medications that control pain and reduce swelling in the stifle joint. If at any time you do not feel your dog’s pain is being properly managed, contact your veterinarian for advice on manipulating the doses to make them the most comfortable. Just as each dog is different with their injury, each dog will reaction to medications in their own way. Some dogs may become anxious, while others may be so heavily sedated that they are unable to go outside to relieve themselves. You want to avoid these extremes, work with the dosing to obtain both proper pain control without complete sedation.

Check the incision for signs of infection daily which include swelling, pain, discharge and redness. This is obviously not possible if your dog came home with a modified Robert Jones (or similar) bandage, but the same rule applies – check the area around the cast each day, making sure to check for any swelling, discoloration or infection. When checking the surgical site, a cold compress can be applied to the stifle three times daily, 10 minutes per session for the first 2 days to help reduce the swelling. Starting on the third day after surgery, a warm compress can be applied to the stifle in order to soften the connective tissues. Your veterinarian will instruct you as to whether to also pursue range of motion exercises or physical therapy at this time – this will depend on which procedure your dog underwent.

Your dog should remain on a leash at all time for at least the first two months following surgery. They should also not go up and down steps, or be on uncarpeted floors. Exercise should be limited to to short leash walks for two months. During the third and fourth months after surgery, exercise should be gradually be increased to normal.
Running, jumping, and rough play are not allowed during the first four months after surgery.

Just remember to listen to your dog. They will make you aware of their comfort level, and let you know when they are ready to start using the injured limb more. No one is perfect, and we have all had those “oops” moments when our dog tried to do too much too soon, but just stay positive. Your dog has a keen sense of what you are thinking and feeling, and this ultimately will have an effect on their recovery.

What to Expect After CCL Surgery is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

TTA Repair Postop Recovery

Mandie — Fri, 02 May 2008 01:25:39 +0000

One of the benefits of the newest of the cranial cruciate repair surgeries, the TTA, is the length of time required before your dog can return to exercise and a life without restrictions. Because the ostoeotomy (cutting of the bone) in the tibial tuberosity advancement procedure is done in a non weight bearing area of the knee, dogs are able to return to normal activities more quickly than they would be able to after undergoing a TPLO or the traditional (extracapsular imbrication) surgery. Most TTA patients begin weight bearing during walking within the first 24 to 48 hours after completion of the surgical procedure.

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.

At 2 weeks post-op you will need to visit your surgical veterinarian to have your canine’s stitches removed and evaluate their progress. They should be putting weight on the leg by this point, and at the very least, exhibiting toe-touching behavior. Your dog will also have rechecks at 4 and 8 weeks, and at 8 weeks postop your vet will take radiographs (x-rays) of the stifle to make sure the bones of the knee are healed. If at 8 weeks your dog’s bones have healed and he is bearing weight on the injured leg, your vet will allow you to begin to incorporate exercise back into your dog’s daily routine. You will want to start off slow, paying attention to your dog’s comfort level, working your way up to the point your dog was at pre-injury. Many TTA dogs are completely healed by 3 months.

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 and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Extracapsular Repair Postop Recovery

Mandie — Wed, 30 Apr 2008 23:39:35 +0000

Your dog will be in a lot of discomfort upon their arrival home from surgery. This is especially true if their extracapsular repair was an out patient procedure, and they were released back into your care the same day of the surgery. It is important to follow all the instructions your veterinarian has provided for pain management, as well as antibiotic use, to be sure that your pet has the best recovery possible. Within the first 24 hours after traditional repair, it is normal for dogs to not put any weight on their injured leg. Your dog may have a modified Robert Jones bandage on his limb, further restricting movement, and decreasing the possibility your dog will try to do to too much, too soon.

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.

At 6 to 8 weeks you should begin strength training exercises to help your dog rebuild some of the muscle that was lost during the recovery from the extra capsular repair. Your dog will let you know how much exercise they can handle, and you should try to gradually do more and more each day. Water therapy is a great way to regain muscle mass, as it is gentle on the joints and discourages any sort of jerky motion that can be damaging to the joint. Your dog should not be engaging in any rough housing or unsupervised play during this period, as there is an increased potential of injuring your dog’s opposite cranial cruciate ligament.

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.

Extracapsular Repair Postop Recovery is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

TPLO Postop Recovery

Mandie — Wed, 30 Apr 2008 02:01:52 +0000

While it may carry an increased risk of complications, the recovery from TPLO surgery is often more rapid and complete. About half of all dogs undergoing the tibial plateau leveling osteotomy procedure will be able to walk on the injured limb within 24 hours of post operative recovery. Within 5 days post-op, most dogs will begin weight bearing on their injured limb. After 2 weeks a moderate amount of weight-bearing can be expected. Dogs with partial tears heal more quickly than dogs with complete tears and those requiring removal of the meniscus. During this period it is important to keep your dog quiet with no movement other than bathroom breaks, this is the most crucial period for healing and bone growth.

Around 6 to 8 weeks your veterinarian may want to take x-rays of your canine to be sure that the leg is healing properly. The radiographs taken during this period should show healing full, or almost complete healing at the osteotomy site. All lameness should disappear from your dog by the 10 week mark, although some intermittent lameness is to be expected when first reintroducing exercise.

At 2 months postop your dog should be taking leash walks. These supervised walks should get longer and longer each week in increments your pet is able to tolerate, until your dog is able to walk at least 30 minutes pain free. One of the best ways to reintroduce exercise is to take a few short walks each day rather than one long walk, as this technique is easier on the stifle; dogs exercised in this way also tend to heal faster.

Between 4 to 6 months post-op most restrictions of exercise can be lifted. If your pet is a hunting or agility canine they will need to wait until at least 6 months post op to return to their pre-injury activities. Unrestrained activity prior to this period can lead to injuries in the opposite CCL, spraining of the soft tissues or fractures around the surgical site.

Follow up care of the TPLO dog should include yearly rechecks with a veterinarian to evaluate the degree of arthritis in the knee. While the TPLO procedure will help to slow the progression of arthritis in the joint, no surgical procedure can ever completely rid your dog of this degenerative condition. There are a number of veterinary treatments available for dogs with arthritic tissue, and often the best treatment is to catch the disease in its early stages and take action.

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