Asia the Pit Bull’s story came to me via email. I thought it was important to share both to help Asia’s owner get some feedback on how to proceed with recovery, and to also illustrate many of the questions that plague us as we decide what the best approach for our dog.

To put it simply, my answer is always YES – if you are questioning whether or not to get a second opinion you should do it. Veterinarians vary greatly in their approaches to CCL injuries, and it is important for you to find someone that you feel will work with you to resolve your dog’s issue in the way you find most suitable; whether that be a more conservative approach or going right into surgery. There really are no “wrong” decisions here, it just depends on your particular dog, situation and preferences.

Asia’s Story

I have a 12 year old Pit bull. Sweetest dog I’ve ever had in my life. She’s never acted old, she’s very healthy, vibrant and fun as ever, people even think she’s a puppy.

Last Sunday she ran around a little too rough with the other dog and came in the house limping. I didn’t think it was anything serious. But then I noticed it wasn’t getting any better. I thought I’d check both legs, check her paws, her ankles.

5 days later I noticed her knee was POPPING, I could feel and hear a clicking sound going in and out when she would sit down. I then had a sick feeling overcome me, just predicting it was going to be bad. I researched on-line and everything I read was terrifying.

I called the vet the next day and got her an appointment. He explained that the ligament had possibly torn, and that the bones were rubbing together. He compared it to an acl tearing in a human, but he said to be careful because it could rupture. He told us to wait two weeks to see if anything would get better.

The longer we wait, the more I feel we should get a second opinion. What if waiting causes more damage, irreversible damage? I’ve read that arthritis could quickly set in if injury is not treated with surgery right away, or surgery can have a harder time recovering the more I wait.

My dog is depressed, lonely, gaining weight and in pain. It hurts to see her like this. I have limited funds, I am a student and it’s Christmas time and I’ve never been more stressed.

My question is.. should I wait the two weeks or go with my instinct and get surgery as soon as possible? I am willing to take out a big loan from the bank to pay for my dog. The other issue is, she is older. And recovery may be very, very, very had for her. I have put her on a raw holistic diet, and I mix a senior multi vitamin supplement in her food. I have given her omega 3 as well..

Anything else you can reccommend?

1 Month Update

Since the injury I’ve put Asia on Holistic raw food, omega 3 fatty acids and a natural anti inflammatory supplement for bone heath as well as doing conservative management for over a month now.

Some days Asia seems like she’s not in pain at all and will try to run with the other dog (which I have to stop her!), gets excited when she’s about to eat, if she sees another dog she gets excited, and heck she even acted like she wasn’t in pain at all at the vets.

But other days she limps around, and lays down at every chance she gets…and that popping sound is terrifying me. It’s almost impossible to tell if conservative management is working. We took her to the vet again and he asked us if she was getting better, and I honestly couldn’t tell him. I told him I was worried that it may get worse the longer we wait, or that the other leg will give out, or the other front legs will be over worked. He understood my concerns and talked about the TPLO surgery. Because of her age he seemed apprehensive in performing it. He discussed with me the risks/ cons to the surgery. He said he wanted to give Asia a blood test to see if she would be healthy enough to handle the anesthetic. I agreed.

The blood test results were very good. He’s surprised at how healthy she is for her age. He then referred our Asia to a specialist outside of town who performs the TPLO surgery. He said they did it at their hospital, but their way isn’t as advanced. All her information is now sent to this hospital I just need to contact them to set up a date to see Asia. So as it stands, we are deciding on whether Asia should do surgery or continue the conservative management. I am going to call the hospital our vet referred us too tomorrow and get that second opinion.

Should I Get a Second Opinion? Asia’s Story is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

I adopted Mousse, a pure bred chocolate lab, a little over 2 years ago – she was 15 months old. In the words of my vet, Mousse is exuberant. She was always ready to run, fetch, swim etc. etc.

Then, about 6 months ago, she started having problems with her back right leg. I took her to my vet several times and was told each time, she was okay. I had the vet take X-rays of her hips and her right knee. They looked OK and he said she might have strained a muscle and I was to give her Rimadyl and Tramadol. I did and it was slightly better and then … worse: she was having trouble going up the stairs and getting in and out of the car.

We went to Oradell Animal Hospital with the X-rays and the orthopedic specialist there said she had torn the CCL’s in both back legs. The good news was that it was repairable and he proceeded to show me how the TTA would work and then said it would cost $4300 … each leg!! I’m sure he saw my jaw drop to the floor, and he was decent enough to suggest that if I could go outside the NY Metro area, I might find it less costly.

I started talking to people and got numerous recommendations for veterinarians, animal hospitals, veterinary schools. I read whatever I could on the internet and became more knowledgeable about TPLO, TTA, extracapsular – traditional and Tightrope.

TPLO and TTA were scary to me on two fronts – the actual surgery where they cut the bone and then plate/screw it into a different angle, and the recovery period during which the patient cannot be active or the repaired bone could be damaged (lots of horror stories about permanent damage, lameness, even amputations!)

Knowing my Mousse, traditional suture was not a good option – she’s too active and too big … even at a svelte 67 lbs. So I started to ask about Tightrope. Although they don’t do it there, the vet at Blairstown (great place) thought Tightrope might be a good choice. Mousse and I went to Univ of Penn Vet. – very good session but they don’t do many Tightropes and they were recommending TPLO. I had also contacted Cornell Vet College, but they don’t do Tightrope.

I then emailed Dr. Cook at Univ Missouri (who came up with Tighrope) and he was kind enough to send back information and a list of facilities in NJ and NY. I researched the list via the internet and made an appt. with Dr. Henrich of Tranquility Vet Clinic (western NJ). About halfway into the appt., I felt we were in the right place and scheduled the surgery. Oh what a relief to finally be able to make the decision!

We drove (it’s about an hour west of us) back to the clinic on Monday 11-8-11 and they put a pain med (Fentanyl) patch on the back of her neck. The surgery was the next morning; I dropped her off. Dr. Henrich called me around 12 to let me know the surgery went well and I could pick her up late afternoon/ early evening. I drove back to get her around 6pm – my poor Mousse was still groggy, her entire back left end was shaved and she was wearing a giant E-collar – she looked miserable!

The incision is about 6 inches long, held together by 15 staples. (I count them regularly : )

The first few days were fraught with anxious moments but I muddled through. I have her harness on almost all the time to control her forward momentum and a beach towel knotted around her waist makes a good handle so I can keep her from putting full weight on her back legs. We only go outside to pee/poop and she sits in the sun while I rake leaves.

Sat. 11-12-11 we went back to have the patch removed and to get another laser treatment (it helps to reduce swelling and promote healing). The Dr. was pleased with how the knee looked and that Mousse is able to put it down (not putting weight on it though).

She is more active than she should be and they had given me some tranquilizers to keep her calmer which definitely help. She does not like the crate or the E-collar, but I have no choice if I have to leave the house. I still get kisses on my chin so I take that as a good sign.

Sat the 19th she is scheduled to have the staples removed … one less thing to worry about.

Follow Up: 11/16

Mousse is putting more weight on the repaired (left) leg and would love to go for a real walk. She seems more comfortable with the reduced-size cone but is getting more obstinate about going in the crate when I have to leave for work.(I didn’t crate her before the surgery.) Hopefully I can pack up the crate again after the staples come out this Sat. The knee and suture line look very good to my unprofessional eye so I’m feeling positive about the future.

Staple Removal: 11/19

Just back from staple-removal. The vet is very pleased with Mousse’s progress and we now have some physical therapy exercises.

Unfortunately, the cone is still required as there are still two small openings in her suture line. These are expected to close in the next few days … as long as she doesn’t lick and irritate them. I can also extend her walks a bit. So small steps forward … but it’s all good : )

Recheck: 12-1-11

We met with Dr. Henrich, the vet who did the Tightrope surgery and he was very pleased with Mousse’s progress. She’s walking so well that there’s even a chance he may not have to operate on the right knee.

We reviewed the exercises for physical therapy which I do at home and he gave us the okay for moderate walks. We go back on 12-15.

I’ll keep you posted.

My Decision to Pursue Tightrope Surgery – Mousse is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Our 6 year old yellow lab tore her first ACL 2 years ago. After 4 months of limping and unsuccessful medications we had a traveling surgeon Do a TTA. She came home with 15 pages of instructions. It took months but she did finally regain all use of that leg.

Recently she tore The ACL in her other leg. We found a fantastic Vet in Faribault MN that does both TTA and TPLO. Lacey got a TTA like the first, but our experience was SO much better. We actually met the surgeon and felt a lot more informed. Lacey just got her staples out and is started on a rehab program. She is nearly normal already! Lacey is doing fantastic and we actually saved $1000 over the first surgery. It pays to do research and shop around. Our Vet did not refer us, we did our own homework.

TTA Surgery on Both Knees – Lacey 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

Beauregard (TTA SURGERY) tore his right CCL when he was about 8. The vet verified the CCL damage and sent us to a surgeon in the Phoenix area. Post surgery recovery was good with no limping or other signs of discomfort after about five to six weeks.

A year later he tore his left CCL going after a ball. Same story, same surgeon. This time, although he seems to be able to walk normally, he has a pronounced limp when he gets up from a prone position. The limp goes away as he continues to walk. The big problem is that he seems to be losing control of his back legs. Sometimes he will cross the two legs and nearly trip and fall. He gets around okay and even takes short walks but is almost 13 years old now and is much slower than he was before his surgeries.

I know he’s getting older but the apparent loss of control in his rear legs concerns me. It doesn’t seem to be getting any worse but I’m wondering what the cause is. His knees were recently x-rayed and the vet didn’t see any problems with the TTA repairs. Any ideas?

TTA on Both Knees – Beauregard is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

Duke, age 5, 110-lb, Black Lab tore his ACL in January of this year. Tried conservative management, but seemed to have frequent relapses.

Took to UofFL small animal hospital, and they wanted to do TPLO. My local Vet then suggested doing a TTA. I decided to try CM a little longer and told him so. Finally, went back to the Vet and said I didn’t think CM was going to do the trick whereupon he said he thought there was enough fibre left to do the traditional imbrication procedure. I went ahead with it and the initial progress seemed very slow…

Now, it’s been almost 8 weeks post op, and Duke has made a huge leap in progress in the last week or so. Starting swimming therapy with him tomorrow. Would love to compare notes with any other Lab owners who have had same procedure done, and hear success/failure stories. I have had Duke on Glucosamine/Chonrdoitin since his surgery.

Extracapsular Imbrication (Traditional Repair) – Duke is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

After a couple of months she was due for her needles. I mentioned this lameness to our vet, who diagnosed a partial knee ligament tear. She was extremely active, chasing balls for 30 mins every afternoon and a 5 km walk every morning. The vet suggested rest to see if it healed.

We decided to use a conservative method. She recovered very well. We started to increase her exercise levels after the 6 month mark, she was starting to play and run around off lead with no bad effects. We were very cautious when adding ball games, not allowing her to chase the ball, only to retrieve it after we had thrown it and it stopped bouncing. All was going according to plan and we were very happy.

We then made the decision to allow her playfriend over, a 12yr old jack russell. They played several times with no problems, then one day she was lame again, the feeling of depair was unbelieveable. After going back to the conservative method again, she was not recovering as she had before. The limp was there nearly every time she rose after a sleep. We decided to get her operated on. She weighs 21 kgs and the vet made the decision which method was best for her and her active lifestyle.

I am so impressed with her, she has the best nature imaginable! I got the crate 3 days before and got her used to it. No problems there.

She didn’t have any arthritic changes, which i was worried about because of the time from the first lameness. The bandage fell off on day 2, but she didn’t worry the wound at all. Some allergic reaction to the stitches, but no real problems. She has been an angel, just sleeping in her crate and chewing kong toys.

I take her out on the leash for a few hours every afternoon and sit in the backyard with her. At least she can watch the world go by. She was putting weight on it within a few days.

We are now at week 5 and she walks without pain or limping. I have started to allow her a trot now and then, very little signs of limping. I have been doing the passive range of motion from day 5, and think it has helped. Her leg is quite thin, but when the weather warms up, I have ponds near me that she can swim in. Hopefully she continues to improve. We will be sure to keep her weight down, and she will only be allowed to play ball in the pond.

I hope she never needs the 2nd leg done, but at 5yrs old i know there is a good chance it will happen. Good luck to everyone out there going thru this, it is very stressful. When tango went in for the stitches removal, my vet asked how we were and not how the dog was!

Traditional Repair After Conservative Management – Tango is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information

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

Stetson had his TTO surgery today, just 9 weeks after my girl, Rave. His accident is an unfortunate co-incidence. Neither is related to their agility involvement. However both dogs being athletic competitors, we want a great outcome thru both the surgery and the ensuing physical therapy.

I have been very well pleased with Rave’s recovery and decided the exact same treatment options for my boy, Stetson.

Two years ago I fostered three Rottweiler’s over the summer. (Phoebe and Manning were adopted by new families, quickly) Stetson’s response to training was so overwhelming and solid, I adopted him from the rescue myself! He was too good to let go and he fit in nicely with my own two girls, Raven and Sable, also Rottweiler’s. He is a Clydesdale sized dog with a personality to match and a desire to please.

Naturally, at some point in time we will be able to book consecutive PT sessions. Maybe I can at least save on some gas?

TTO Surgery with Laser – Stetson is a post from: Dog Knee and Leg Injury, Canine Cruciate Ligament Recovery, TPLO Surgery, CCL Injury Diagnosis, Dog Knee Brace Information