Dog Knee Injury » Weight Management

TPLO Ligament Surgery – Taylor

admin — Tue, 13 Jul 2010 23:44:28 +0000

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

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CCL Repair Forum for Dogs

admin — Mon, 28 Jun 2010 03:31:26 +0000

Have a question related to TPLO surgery, or want a recommendation for a veterinarian performing the Tightrope procedure in your area?

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

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CCL Injury in Both Back Legs

admin — 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 Injury

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Physical Therapy After CCL Repair

admin — 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 Injury

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Are CCL Injuries More Common in Certain Dog Breeds?

admin — Fri, 06 Jun 2008 00:34:40 +0000

Cranial cruciate ligament tears and ruptures can happen to any dog (or cat, although it is not nearly as common), but there are certain risk factors that make particular breeds of dogs more susceptible to this type of damage. CCL injuries are one of the most common orthopedic injuries in dogs, and is the most common cause of degenerative joint diseases in the stifle joint, like arthritis. While there is no way any dog can completely avoid their risk of CCL injury, there are a number of risk factors owners should be aware of, especially if they suspect their dog may have injured their stifle (knee).

Female dogs have been shown to have a higher incidence rate of CCL injuries, especially altered female dogs; this is believed to be related to hormones lacked by fixed females. Overweight dogs of both sexes are at an increased risk of CCL injuries, as the added strain and weight on the joint can lead increase instability. Poorly conditioned dogs, i.e. do not get much exercise, the “couch potato” personality, have also demonstrated a higher incidence of canine cruciate ligament damage. CCL rupture occurs in dogs of all sizes, but is most prevalent in larger breeds including Bernese Mountain dogs, Bullmastiffs, Chows, German Sheperds, Golden Retrievers, Rottweilers, Labs, American Bulldogs, and Saint Bernards. This is both due to their added weight, and the confirmation of a large breed dog’s leg – it tends to have a much greater angle than their smaller canine cousins.

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

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

Risk Factors in Dogs for CCL Damage:

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

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

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TTA Repair Postop Recovery

admin — 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 Injury

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Extracapsular Repair Postop Recovery

admin — 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 Injury

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TPLO Postop Recovery

admin — 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 Injury

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Conservative Management in Cranial Cruciate Injuries

admin — Wed, 23 Apr 2008 22:04:10 +0000

Conservative management is a non-surgical option for treating cranial cruciate injuries in dogs. Depending on the size of your dog, the severity of the injury and the duration of time since the onset of the CCL damage, your veterinarian may suggest CM in lieu of surgical intervention. Conservative management is focused around three basic principles:

Weight management
Exercise moderation/rest
Using anti-inflammatory medications

Maintaining your dog’s body weight at normal, or slightly below normal, levels will reduce the load placed on the injured joint, and may help to improve its function. This will allow your canine to strengthen the joint without adding any additional strain, adding stability and range of motion. Restriction of activity for at least 6-8 weeks after injury is a key part of successful CM. After about 2 months of little to no exercise you may begin reintroducing your pet to weight-bearing activities such as short walks, making sure to avoid any extremes in activity. Controlled walks and exercise will help to maintain and strengthen muscle mass while avoiding re-injury; owners need to be careful to limit their dog’s play during this time as there is an elevated risk of injuring the other leg while the originally affected leg heals. The use of anti-inflammatory medications during this time will help to limit painful episodes and encourage healing.

The outcome associated with conservative management of cranial cruciate ligament injuries is based on body size. Approximately 70-80% of small breed dogs and cats will return to acceptable levels of function over a 6 week period of time. Conversely, only 15-20 % of dogs over 30 lbs. will return to acceptable function. Surgery is often recommended for medium to large breed dogs that are over 30 pounds.

Conservative Management in Cranial Cruciate Injuries is a post from: Dog Knee Injury

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