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

Want to know what the best dog knee brace available is?

Don’t be shy… Post on our NEW Dog Knee Injury Forum!

In response to the high volume of comments a lot of the post have been getting, I’ve opened up the forums as a way for dog owners to connect and discuss their dog’s orthopedic issues with one another.

How to post on the Dog Knee Injury Forum:

1) You must register for a user name to post on the forum.

2) After you’ve registered and retrieved your password from your email, log in (I recommend changing the password to something you’ll remember) and start posting!

3) Keep the comments on topic, and be nice. If anyone encounters any issues on the forum please post in the comments on this page/use the contact form, and I will look into it.

CCL Repair Forum for Dogs is a post from: Dog Knee Injury

Ben is doing extremely well at 2 weeks.

Day 2
Ben is feeling much better. On our walk, he actually lifted his good leg and stood on his leg with the surgery to go pee. Never thought I would be excited watching a dog pee, but that was amazing..

Days 3-4
Ben starting walking more and more. I actually caught him a few times standing on his hind legs looking out the window.

Days 5-6
I believe he started walking better than the day before surgery. Also, he is walking and standing normal. It is barely noticeable he is favoring his leg.

Days 7-8
Ben is starting to get his “gait” back. If you every watch a Standard Schnauzer, they kind of glide effortlessly across the room. He is actually getting it back. It has been months since I have seen him walk like that.

Ben is having a reaction to the staples. His incision is starting to swell and become red. The Vet has us come in and she gives him some ointment that will soothe his reaction. The Vet is amazed as to how well he is walking.

Day 10
Ben has his staples removed and his incision looks good after using the ointment.

Day 14
Ben is at the 2 week mark and is doing great. For the most part, Ben is standing and walking normal. However, he does still favor his leg on occasion. Per the Post Op instructions, Ben is walking a 1/4 mile twice a day. Muscle definition in his leg is starting to come back.

As he is getting better, it is getting harder to keep him under control. He wants to play at every chance he can get. He is feeling better than he has felt in months and is showing it!!!

TTA Surgery, 2 Weeks Post Op – Ben is a post from: Dog Knee Injury

Ben’s Story:

Ben is a 4 year old Standard Schnauzer. We believe he suffered a partial tear in his Left CCL in December 2008. We didn’t give CM (Conservative Management) a chance until about July 2009, when he was diagnosed with a CCL tear. Prior to that, it only appeared to be a minor injury. Since July 2009 when we started CM, Ben would start walking and standing normally, but would often suffer set back after set back. I will be the first to admit that most of the set backs were due to my stupidity. I guess it could be argued we never gave CM a chance.

A few weeks ago, we gave up and did some more research. The Vet indicated that he could be healed through CM, but if we wanted him to be the athletic dog he used be, then he would need surgery. Ben was/is my hiking buddy and used to go on 7-8 mile hikes in the Utah Mtns all the time. He could run for hours and hours without taking a break. The Vet believed he would never be able to do that through CM without being down the rest of the day and/or next day. We scheduled him for TTA surgery with an Orthopedic surgeon that is believed to be the best in Utah, if not the best in West. From our research, the TTA surgery appears to be far superior to the TPLO. Dogs tend to be healed within 3-4 months. Also, they tend to be weight bearing on the leg within 24-48 hours. Within 2 weeks, some dogs are pain free.

Ben made it through surgery just fine today. The Orthopedic surgeon called us and indicated to our surprise that Ben had a complete tear in his CCL and the Meniscus was completely torn as well. If I knew he had that much damage, I think we would have scheduled surgery much sooner. The Orthopedic Surgeon did tell us that he does not believe Ben will suffer anymore arthritis than normal because of our delay in scheduling surgery. His joint appeared to be clean with only minor swelling. The surgeon believed his recovery will be just as good as if we scheduled him back in 7/09.

At this point it is anyone’s guess if he would be better or worse with CM. As of now, we have the peace of mind that knowing the end is near. With CM, we never knew when the road would end. I will post updates on Ben’s recovery over the next several weeks.

Day 1 (after TTA surgery)
When I picked Ben up from the Vet, he was completely opposite from what I expected. I expected a dog that looked like he had been to hell and back. Instead, Ben was dragging the Vet tech into the room. As we were talking to the Vet, he sat on his leg that just had surgery. The Vet was impressed with the very little swelling around Ben’s leg. As we walked outside, he was practically dragging me to the car. His spirits are completely high, and looked like he wanted to go play.

As we were getting into the car, I was planning on picking him up and placing him inside the car. Instead, I opened the door and he leaped into the car. He missed and gave me a complete heart attack. I caught him as he was falling to the ground. I expected him to cry out in pain, but he acted like nothing was wrong. Once inside the car, he was jumping from seat to seat like nothing was wrong. Once he was home, he immediately went for his food.

At this point he is just toe touching on the leg with the surgery, but he is getting around fabulous on his 3 legs. About 5 hours later, I took him for his first walk. We walked past a few houses before we turned around. As we got close to home, I noticed he started walking on his leg. He continued to walk on it (with a limp) the rest of the evening!!!!!! It looks like my biggest challenge at this point will be keeping him under control so that he can heal properly.

TTA Surgery and CM – Ben’s Story is a post from: Dog Knee Injury

Potato’s Story:

Potato tore her knee muscle in winter. I had insurance, but because she was limping prior to a minor sprain, they didn’t cover it. I couldn’t stand seeing her limping around anymore so i paid the $3000 for the kind of surgery where they cut the bone so the leg isn’t bowed anymore and so it stabilizes the knee (TPLO). She is doing ok and today is the second day after surgery.

I thought I had sedated her enough, but I left the room for two seconds, and somehow she got off her chair. I was going to let her sit in it with my help but now that is off limits. Then today, I left her in my bedroom with her cone on, I thought she wouldn’t be able to get on the bed…but when i got home she was on it. I have no idea how.

The most important thing I have learned from this is…THEY WILL DO WHAT YOU DON’T WANT THEM TO DO. She doesn’t understand that these two attempts could have easily ruined her newly operated knee, and me underestimating her also almost wasted that $3000. I’ve learned that i can’t leave her for one second, and that she is going to have to be crated. She really scared me.

Also, her ankle is a little swollen, but thanks to this web site i might not have to pay another $200 to see what it is. One of your contributors said that their dog had just fluids trapped there and that massage and ice helped with them. I called the vet, and they are calling the specialist who did the surgery for me and recommended heat. If it continues past the weekend I will go back to the vet, but this website helped me with the initial panic.

Thank you so much!

TPLO, 2 Days Post Op – Potato is a post from: Dog Knee Injury

It has been 1 week since Tim’s TTA surgery, and she is now starting to get very playful. It’s going to be difficult to keep her quiet. Her surgical line from the TTA is beautiful, bruising and swelling are completely gone.

Days 8 and 9 were uneventful. Timber is enjoying the great weather, and she is putting more weight on her leg with each day.

Days 10 and 11 we had been working around the outside, so I decided to let Timber on the deck; I had both sets of stairs baby gated so she could enjoy the outside. Well… I suddenly hear my husband yelling, so I quickly run to the back of the house to find that Timber jumped over the gate!! She seemed to be fine but back in the bathroom she went.

I gave her a pain pill and her anti-inflammatory and she rested for the remainder of the day.

Day 12, Timber seems to be okay since she decided to jump the baby gate. She is definitely becoming more active…I am reminding her and myself that its only been 2 weeks, and she still has a good 4-5 weeks to go until fully healed from the TTA surgery.

Day 13-14, it’s been 2 weeks since surgery. Timber will be going in for suture removal on Thursday, and I am very pleased to say that she never once licked or bit at her incision – mommy is so proud of her!

TTA Surgery Recovery – 2 Weeks, Timber’s Story is a post from: Dog Knee Injury

What is a dog TPLO surgery?

TPLO stands for Tibial Plateau Leveling Osteotomy, which in simple english means that they are changing the bones of the knee joint to make them work in a different, more “level” manner.  The veterinary surgeon will start by making an incision in your dog’s injured leg, and the cut will be made down the length of the leg.  Through this incision the veterinarian will then access the injured acl (or ccl as it is more properly called in dogs) and begin by removing the severed, torn and/or ruptured ends of the ligament.  Once the cranial cruciate ligament damage has been removed, a cut is made in the top of the tibia.  Measurements are then taken and compared to those from the pre-op x-ray, and the tibial plateau is positioned to make the slope of the knee level.  A plate is then screwed into the top of the bone to allow the bone to heal in its new angular position; the metal plates can be removed later, although this involves another procedure.  To read more about this surgery click TPLO Surgery Procedure.

TPLO Cost?

A Tibial Plateau Leveling Osteotomy is a difficult veterinary procedure, and you should expect to be billed accordingly.  While prices vary across the US, I can tell you first hand an estimate I received for my 90 pound dog.  The estimate came with both a high and low price, and included all of the pre and post operative care, barring any complications, which are not included.  This estimate was from a veterinary speciality hospital, and my dog would have stayed overnight following the surgery with monitoring and pain control.  The low end of the estimate was $3,892.79 and the high end of the estimate was $4,03.58 for TPLO surgery.  The lowest quote I have seen for a TPLO knee repair was $2,500 at a rural veterinary clinic in one of the midwestern states, and I have heard up to $6-7,000 for a TPLO acl surgery at one of the leading veterinary school’s affiliated clinics.  Vets are aware that the cost of a TPLO surgery for your dog can be a difficult burden, and many are willing to work with you to cut out on extra costs and/or create payment plans.

TPLO Surgery Dogs is a post from: Dog Knee Injury

Timber is a 6 year old female shepard mix; she is my baby. In August 2006, Timber tore her left ACL and she underwent TPLO. She recovered beautifully from TPLO surgery. Nearly 4 years later, she developed an abscess over her TPLO scar. I took Tim to my local vet, and she said that it looks like it could have been a suture from her surgery that did not dissolve. In for surgery to remove the abscess she went.

After two weeks the abscess started to grow back, so I took her to the surgeons office (who did the surgery 4 years ago), to find out that the stainless steel plate she had, had become infected. He recommended to remove the plate left in after the TPLO surgery. On Feb 7, 2010, Timber went in for plate removal, and on that same day she was also diagnosed with a torn ACL in her right knee. I was told I needed to wait 1 month until she had her right knee operated on because she had 2 types of bacteria growing on the plate in her left leg; she needed a course of antibiotics.

So we waited, and mommy did her research. After plenty of reading I chose the TTA (Tibial Tuberosity Advancement) surgery, which uses a titanium plate. I felt that she was at a greater risk of rejecting the stainless steel plate with the TPLO surgery. I did my research on the two type of metals, and titanium seems to be the better of the two, so we went with TTA.

TTA Dog Knee Surgery, Timber’s Story is a post from: Dog Knee Injury

I dropped Beau off at the vet’s at 7:30 am and went on to work, warning all my co-workers to expect a basket case in the office that day. By 8:30, I had a call from the vet’s office. I started panicking, but it turned out that they just had a question about when he’d received his last dose of Metacam. The technician told me he was fine – so fine that he wouldn’t go to sleep with the pre-anesthesia like a good boy should! We decided he was looking for cheese – that’s what he usually gets when he goes to the vet.

The morning passed slowly, but by 12:30 I had a call that the surgery had gone well, Beau was in recovery, just waking up, and we arranged to pick him up at 4:30 that day. Leaving him overnight was an option, but because the office was not staffed at night, we felt that it was best to just take him home. The vet agreed and encouraged us to do so.

Upon arriving at the vet’s office, we had some much welcomed good news! The meniscus had not been damaged. And the CCL had only partially torn. He had still needed the surgery to repair the tear, but this could only be good news for his recovery and long term prognosis. Our wallet fared slightly better than the estimates as well. The total cost of the surgery and take home medicines was approximately $1,500. (This does not include the initial x-rays and exam.) Of course, seeing Beau again was the best part! He hobbled and he was a bit groggy, but he was glad to see us! He’d been shaved more than I had anticipated and he wore a purple polka dot bandage, but he was managing to “walk” which I hadn’t expected. His “walk” has his bad leg either slightly lifted or with an awkward (and rather eerie) toe dragging gait. We lifted him into the car and took him home. Once home, I did have the foresight to make sure he stopped on the grass to relieve himself so that he wouldn’t need to go outside again for awhile.

The evening was fairly uneventful. Beau had trouble getting in the lying down position, but he managed after a time – perhaps as much as 15 minutes. We gave him a little food, administered his pain medication on schedule and tried to ensure that he was as comfortable as possible. One odd thing was that he didn’t really sleep, his eyes were open and just staring ahead. But since he otherwise seemed okay, we let him be. He became restless around 2:00 am, and we took him outside, re-dosed him and tried to settle him down. Once again, he had some trouble figuring out how to lie down and he was also disappointed that the couch access had been blocked, but eventually he opted for his own bed that we had brought down from upstairs. I believe he actually slept much better than we did that night.

Beau’s Day and Night of CCL Surgery is a post from: Dog Knee Injury

Our dog Beau is a seven year old Golden Retriever and master of the household! He’s friendly, fun, energetic and spoiled! Unfortunately, we learned early in his first year that he also has hip dysplasia. Until now, this has not stopped him from having an active, doggy life. However, in late November we noticed some on again, off again limping and after a few days of this, we took him to the vet to check it out.
After an exam and x-rays (done under sedation) the bad news turned out to be a ruptured cranial cruciate ligament. Our vet said that this is a common injury in dogs, particularly large breeds and particularly dogs with hip dysplasia who tend to alter their gait and put added stress on the knee ligaments. While humans tend to tear these ligaments in sporting activities (the football player who misses the season due to a torn ACL), dogs put much more stress on their knees (stifles) and are more prone to rupturing these ligaments over time, without a significant trauma. We were presented with the following options for Beau:

1. No surgery. Treat with rest, physical therapy, pain and anti-inflammatory medications. Our vet did not feel that the ligament in a dog this size would heal on its own, however, and indicated that the likely outcome would be abnormal wear and tear leading to arthritis which would continue to worsen over time, becoming chronic and debilitating.

2. TPLO surgery (Tibial Plateau Leveling Osteotomy). This is a surgical procedure in which the head of the tibia is surgically altered and plated to create a new joint angle. A new angle is created in the stifle to prevent the femur from sliding off of the tibia. This surgery would need to be performed by an orthopedic veterinary surgeon and would be very expensive. We were never actually given an estimate for this surgery, but my research puts the cost in the $3,000 – $4,000 range. Our vet indicated that this procedure is considered by some to be the gold standard in treatment. However, due to it high cost and invasiveness, she did not recommend it for a seven year old dog.

3. Traditional Repair surgery (Extracapsular Imbrication). This procedure uses a strong leader line placed within the knee to provide stabilization. As it was explained to us, the downside of this procedure is that the line will eventually break and it is impossible to say when. It could be that the line lasts five years, or it might only last two months. With a large dog like Beau, our vet didn’t feel this was our best option.

4. Modified Traditional Repair surgery. This is the same procedure as in number 3 above, except that the dog’s own muscle is used to provide the stabilization, which is much stronger. As the area heals, it heals around this graft of muscle and further increases the knee stabilization. The cost of this surgery, as well as the surgery in 3 above, depended in part on whether or not the meniscus was damaged. The meniscus is the pad between the bones of the joint – a shock absorber. Estimates for this surgery were from $1,700-$1,900. Our vet recommended this option, which would be performed in their offices by a different veterinarian with extensive experience in this procedure.

To be honest, we didn’t give option 1 too much consideration. Neither my husband nor I could bear the thought of our middle aged (but not old), active dog declining early in such a painful manner. On the other hand, TPLO surgery was simply too expensive for us to consider and our veterinarian seemed to think this surgery would be warranted for a young dog, but not a seven year old dog. Option 3 seemed too risky and also was not recommended by our vet for a dog of Beau’s size. Thus, we elected for the Modified Traditional Repair using the dog’s own muscle to stabilize the knee. I was unable to find much information on this modified type of repair on-line, but it may be that there is a particular name for it which I was not searching under. I did see information on the Tightrope repair surgery, but our veterinarian felt that this was not in favor currently. One very sober fact: the vet told us that 40% of dogs that rupture the CCL eventually rupture the CCL in the other leg. Whatever choice we made, we best be prepared to make it again.
Unfortunately, we learned the next day that the veterinarian who was to perform the surgery was out of town for several weeks. The surgery was scheduled for December 8^th and our job was to keep Beau quiet and calm until then!

Our Dog Beau and His CCL Injury is a post from: Dog Knee Injury