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Traditional Surgery for Large Breeds – Garth the Lab

My very active and large Labrador retriever partially tore his right CCL when he was only 9 months old. My vet examined him under sedation and the knee was stable albeit slightly more loose than the other side. He was put on 8 weeks of rest and Previcox. I leash walked him for the 8 weeks and allowed him free in the house and off lead to go to the bathroom but no running around or rough-housing. He continued to limp slightly at night until between week 6 – 7 when the lameness disappeared and hew as 100%. He then went on to have 5 months of very normal activity – running, leaping, playing, rough-housing. He also grew to weigh 110 lbs.

Suddenly when we thought we had it beat, the leg completely tore. He was holding it up and would not even place it down – hopping on three legs. He was seen by my vet, as well as an orthopedic surgeon who came highly recommended, and does both traditional lateral suture and TPLO surgeries and was trained by Dr. Slocum. Both advised (given his size and activity level) that a TPLO would be best – allowing him to recovery more quickly and with less risk of injury after surgery. I did not feel comfortable with the TPLO and opted for a traditional surgery.

I was advised that a traditional surgery most certainly does work well for a large and/or active dog, however, the first 8 – 10 weeks is critical for a successful outcome. The dog must not be allowed to do too much or else the wire can be stretched and break too soon causing instability due to not enough scar tissue. However the surgeon advised that once the scar tissue is formed that the knee is just as stable as if the dog had a TPLO. There is no more chance of a failure with a traditional once that scar tissue is allowed to build just because you have a big and active dog.

I was extra extra careful and did not allow my dog off lead for the first 10 weeks even in the house. He was in an x-pen in the family room and crated at night and leash walked 4 times per day. We went through a lot of bones and stuffed Kongs.

At 10 weeks I allowed him free in the house and quickly he resumed jumping on the sofa and bed and tearing around with my other dog despite me trying to keep him more quiet but he seemed fine.

At 13 weeks he did get away – ran and slipped outside. He came up lame again, however, two days of rest and he was fine.

At 4 1/2 months post-op he is doing terrific – can’t tell which leg had the surgery and he’s trotting around soundly and is allowed off lead. He is not back to rough-housing outside with other dogs at the dog park yet – not until 6 months post-op.

We are at the 5 month mark this week and he’s doing great – galloping off leash in the snow and going for 2 mile walks. A traditional surgery can be very successful for a very large and active dog.

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25 Responses to Traditional Surgery for Large Breeds – Garth the Lab

  1. Jana Rade February 22, 2011 at 8:03 pm #

    Yes, totally agree with all of it.

    Traditional technique can be perfectly successful in large dogs (Jasmine had it done on both knees, she’s a 100 pound Rottweiler) and the post-op period is crucial for its success.

    • SRahkola August 30, 2011 at 12:29 pm #

      Hi Jana:
      Thank you for your posting about Jasmine. I have been blessed with 6 Rottweilers (2 at a time until each passed on). I, too, opted for the traditional “old-fashioned” knee surgeries with 3 of my Rottweilers (in the past 15 years) and all 3 surgeries were successful without re-injury or complications and provided them with happy, active lifestyles until their deaths. It is such a relief to find a posting from someone with a large breed dog who has had sucess with this type of surgery. I currently have a female Rott who will be having knee surgery and it has taken me a while to even find a vet who still performs this surgery. Many, many vets ONLY reccomend the “gold standard surgeries” such as TPLO, but unfortunately not all pet owners (who adore the pets) can afford those surgeries. I am a firm believer in NOT throwing out older surgery methods that have been successful in the past, just because newer tecniques have been developed. While I am not disrespecting the newer surgeries, I believe that pet owners should be provided with ALL options, not just a handful.

      • Jana Rade August 30, 2011 at 8:43 pm #

        Well, one of the main reasons is that they all have to have performed certain amount of TPLO surgeries to get certified and that’s what they’re all doing. As that’s the only thing taught (really) that’s what everybody recommends.

        It is usually the old-timers who do the traditional type.

        We were willing to spend the money for the TPLO but didn’t like how invasive it is. We chose traditional repair because it’s minimally invasive. We combined with stem cell therapy which came to the same price as TPLO in total.

        But no bones had to be chopped and the risks were substantially lower. We are happy with our decision.

        • SRahkola August 31, 2011 at 5:46 am #

          Thank you for your reply, Jana. While I do understand the certification process, I just find it sad that so many vets do not even mention traditional surgery which may be an option for some dogs. I hope that our postings will encourage other dog owners to research all methods, work with their vets to find the best solutions, and eventually have success and a well-healed, happy and healthy dog. Best wishes.

          • Jana Rade August 31, 2011 at 8:55 am #

            I agree that it is sad, because it is substantially less invasive. Also studies are showing that 18 months post op there is really no difference between the surgeries.

            The main difference is during the post op. Now, of course dog with a very steep tibial plateau slope might not be good candidates for the traditional repair.

            But the technique had been “black balled” for not good reason.

            Of course the new generation of vets might not even get the opportunity to learn the traditional technique. It is always safer to go with the technique your surgeon is most comfortable and experienced with. Or look for one who is comfortable with the one you want. What you don’t want to do is to make them do something they might not be able to do properly.

            Even putting the suture technique aside though, there are THREE other knee repairs, yet most seem to be recommending the one only. I think that if one has enough interest in the process they’d bother to learn/or at least be aware of all options.

  2. wustaz April 22, 2011 at 4:39 pm #

    I am so happy to read this. My 95lb 15 mth old black lab just had traditional surgery on Wednesday. We don’t get him home till Monday. I know it’s going to be a long road to recovery (especially when we have 3 other dogs) but I know it’s going to be so worth it. Gus is going to be spending lots of time in his crate over the next few weeks to keep him calm. thank you for posting your story, it gives me hope.

  3. Amber April 23, 2011 at 4:33 pm #

    I’m happy to read Garth has done so well. My golden retriever/chow mix, Teddy, had a traditional repair done almost three months ago. He has also lost almost 20 pounds to help him get back to a healthier weight! Everything has been going wonderfully until last night he got away from me and took off to chase whatever the other dog was running towards . . . It was dark and I never saw what happened but when I went to retrieve him and his leash he was dragging behind him, he was laid out and couldn’t walk without me forcing and dragging him back into the house. His pain is definitely coming from the “good” nonsurgical knee!!! I can’t believe it. He is back to square 1 or maybe worse. His vet will see him Tuesday. I am scared to hear his options.

  4. Rachel April 26, 2011 at 6:08 pm #

    We have also used the traditional suture method for our 6yr old 100 lb Lab. However, we have had multiple surgies. This all begain about 2 yrs ago with His Right leg, vet immediately said he had torn ACL and recommended this surgery we had it done within days of diagnosis and were extremely cautious during his recovery, but 1 month after surgery he was limping again and seemed to be regressing so we brought him back in and to our amazement as well as the vets..the band had broken! They said we needed to repair it immediately..again within a few days of diagnosis he had the surgery. This time we were so cautious I swear he didn’t move without some type of assistance until 3months post surgery. Thus far the right is doing great! Then not even a yr after the 1st initial surgery he tore his LEFT ACL! We knew the drill and expected this to happen as they had warned us that it was to be expected. We had the surgery done again…and implemented the same strict recovery methods as before. Now here we are nearly 5 months post surgery and there is movement in the knee once again! So now we are looking at the 4th surgery (2 on each leg) in less than 2 yrs. Our vet is now talking about TPLO possibly and I am completely turned off at this procedure. We are going to have the same surgery performed as before but I wonder if there is a better solution. Has anyone had similar experiences with this procedure?? I feel that we are just wasting time and $$$ and want nothing more than my Lab to be painfree and able to resume some quality of life. Any thoughts or suggestions would be greatly appreciated! He means the world to both me and my husband!

  5. Patty May 11, 2011 at 8:32 am #

    I know this is a discussion of larger breeds, but I wanted to share my experience with my 30 lb Pembroke Welsh Corgi. He had traditional ACL repair on March 1. We are now 10 weeks out from surgery and he is doing great. As with any active dog, it has been difficult to keep him quiet. I have found a way to exercise him that has been inexpensive and yet very effective rehab. I purchased a large horse water trough and put it in my garage. I started out swimming him 5 mins 2 times a day as soon as the stitches were out (2 weeks). He is now up to 25 mins once a day and then walking 3/4 – 1 mile. He is trotting well and I’m having trouble keeping him slow. The vet is very pleased with the results and it has cost me less that $100 for rehab including the cost of water to add hot water each day to the tub. I use a flotation vest to keep him floating since he has to basically tread water. Pete competes in Dock Diving (yes, a Dock Diving Corgi) and we look forward to returning to competition after 6 months.

  6. kerry May 11, 2011 at 3:28 pm #

    Great to hear of large dogs doing good with a Traditional repair. I have an 81 lb lab that tore his acl 8 weeks ago. Its taken me that long to decide what to do, all the while we are doing strict conservative management on him also.I ruled out a tplo or tta and decided to go ahead a go for a Traditional. What i’m amazed at is the division in the vet community of the entire torn ccl issue and the various surgeries that go with it. Also you have some that are advocates of conservative mamagement and some that are completly against it. I had one vet say CM for 8 weeks and if hes showing progress to continue it, and ortho surgeon who wants to do tta(but was completly ok with doing a Trad on him if i wanted and said it should be successful if proper aftercare is taken) and another vet who is not board certified but has a special intrest in orthopedics say absolutly he only does TPLO on large dogs. Its really difficult for the comsumer to have this much division!

  7. wustaz June 21, 2011 at 4:45 am #

    update on Gus. He is at about 8-9 wks post traditional surgery now. His weight is down about 8 pounds and I think we have finally turned the corner in his recovery. He would feel good and do something that wasn’t good for him and we would take him back to week 1 recovery. He did that twice. finally I asked for sedation for him and we kept him sedated for almost a month. It worked and he was able to stay more calm and let his leg heal. He is on regular activity in the house now, unless he is feeling full of beans -then he goes in his crate for a bit to calm down. He is starting rehab this week. I am looking forward to the water treadmill and the cold laser therapies. I know it will do him good.

  8. Jana Rade June 21, 2011 at 11:35 am #

    Good to hear about Gus! Yes, setbacks happen easily, glad you found a way of avoiding them.

    Rehab will do him a lot of good, both the cold laser and underwater treadmill are truly great!

  9. Nena August 5, 2011 at 2:55 pm #

    Thank you so much for sharing I did not even know there were other surgical options. Our vet just told us of the type your dog had. Then I was reading about the TPLO etc and was worried we did the wrong thing. Duke is 60lb pit mix and is 3 days out of traditional lateral suture surgery. He is already putting some weight on it (when vet brought him out to us today Duke was using his hind leg “Lightly”). We knew we would have a long recovery time so we purchased an XXL 54″ H 42″ L crate and additional orthopedic bed for it. If he is comfortable and can see us at all times that is what I want. It also allows our very active female pit to see Duke and “talk” but not hurt him by playing too rough. Duke was a little upset when he had to be crated as soon as we got home but we gave him and Daisy (female) a large chew bone each and they soon got interested in the bones and not upset by the separation or Duke being confined. Thanks Again for sharing your experience has made me feel a lot better.

  10. Jana Rade August 5, 2011 at 3:22 pm #

    Jasmine has lateral suture surgery for both knees two years ago, she’d going great.

    Neither our original vet or the orthopedic specialist mention any options other than TPLO. And yet there are many.

    extracapsular repair (lateral suture)
    tightrope
    TPLO
    TTA
    TTO

    Glad Duke is doing well!

    Orthopedic bed is always good.

    We didn’t crate Jasmine, she is good for staying calm in the house.

  11. wustaz August 11, 2011 at 4:46 pm #

    update on Gus again,,,,, he is awesome!! he is 3 1/2 mths since his surgery and no one can tell he had surgery. I even have to look to see which leg it is. I owe a large part of his recovery to the rehab that he did. I really think the cold laser and the water treadmill and the swimming pool have made a remarkable difference in his recover. He is still building up muscle but that is a work in progress. I never thought we would be here back in May

  12. deb October 3, 2011 at 11:03 am #

    hi, my 60-pound boxer/pitty mix has been diagnosed with partial tears of both cruciate ligaments, and the surgeon is recommending the traditional lateral repair to each, one right after the other…any opinions on this? i am mostly worried about the 23 stairs i have up to my apartment…i cannot carry the dog…will she be okay eliminating upstairs at the beginning? are there pads or something i can use to persuade her to go in the house? when will she be able to do the stairs at all? SO WORRIED!!! please help me…thanks, deb

  13. Jana Rade October 3, 2011 at 11:25 am #

    Hi Deb, is your surgeon aware of the stairs?

    Jasmine (100-pound Rottweiler) had the lateral suture repair done on both knees and worked out great for her. She was not allowed to use stairs (would have been couple in and out of the house with towel support but we built a ramp for her instead).

    I am worried about those 23 stairs for a number of reasons; not just during the first few days. Jasmine was not allowed to use flights of stairs for months. (If I remember correctly the situation isn’t much different with TPLO or other surgeries)

    There are indoor dog potty products, whether she’s going to be happy using them.

    I think the best idea is to bring this up to your surgeon, because this indeed is a problem.

    Is there any chance staying somewhere else? Your parents’ or friends’ for example if they have easier access in and out of the house/apartment?

  14. Deb October 3, 2011 at 11:42 am #

    Jana, thanks so much for your reply….no, there is really no other place we could stay, this is it…but I will be moving out of here to a first-floor place in 6-12 months, so i am really wondering whether it wouldn’t be better to delay the surgery till then…keeping her on pain meds, glucosamine/chondroiton and minimal activity (aka conservative management) till we’re in a better living situation for recovery…does this sound like a reasonable plan to you? no, surgeon is not aware of stairs, i need to talk to him i guess…trying to avoid the $150 consult fee…

  15. Jana Rade October 3, 2011 at 11:58 am #

    6-12 months is really quite a long time to leave the knee unstable too :-( (conservative management really requires even stricter regiment than the post-op)

    Your surgeon won’t answer a simple question over the phone without charging for it? Even the one at our fancy orthopedic hospital did (after initial exam etc).

  16. Deb October 3, 2011 at 5:36 pm #

    I’m gonna call right him now Jana, thanks for your encouragement. This is my first dog ever (I’m 52 years old), I love her dearly but I am by myself and limited financially. I have never dealt with vets before (apart from the usual checkups and vaccinations), had no pet insurance (did not realize such drastic things could go wrong with a young dog) and am kinda reeling with disbelief that all of a sudden i have to find thousands of dollars to have this done immediately and nurse her back to health for six months or more.

    I get your point that 6-12 months is really too long to wait, and also that conservative management really means being more restrictive than you’d have to be post-op so really at THIS point, she shouldn’t be doing the stairs, but I just can’t move till March at the earliest…

    My children do not live in situations I could take advantage of….my daughter’s in a third-floor walkup in Brooklyn and my son’s in an elevator building in Hoboken but it’s no pets!

    I suppose really the only option will be to hope she learns to “go” in the house and accepts not going outside for weeks I guess after each surgery? how many weeks would you say it would be before she could do the stairs at all if she has the traditional lateral surgery (doc says that’s all she needs, tears are partials and she only weighs 60) one knee at a time?

    i guess i gotta call the surgeon and hope he will answer these questions over the phone, i’m gonna try, thanks again Jana, this site is MAD helpful

    deb

    • Jana Rade October 3, 2011 at 5:37 pm #

      I think she’d be pretty unhappy having to go and stay inside for weeks … also exercise regimen is needed during the recovery.

      If she was older I’d say go with a brace instead, but if she’s young fixing the knees surgically is best for her.

      Perhaps with some good support you and your surgeon can come up with a plan. There are some slings out there that perhaps could work and allow her to use the stairs safely. The one our vet has has foam loops that go around the hips, I think something like that would be the best as it cannot slide back and forth. (toweling or under the belly slinks might work but I think the one going around the legs would be the safest)

      I can’t find a picture of it but I would think that perhaps with that you guys could make it up and down those stairs safely. Why don’t you ask you surgeon if he knows this product and knows where to get it.

  17. Jana Rade October 3, 2011 at 5:38 pm #

    I called our vet and found out which product exactly it is; it’s called Bottoms Up Leash and the website is here: http://www.bottomsupleash.com/

    • Deb October 3, 2011 at 5:39 pm #

      wow jana that bottoms-up thingie looks amazing! not what i was expecting at all! i think that may do the trick! i am excited! i wanna get this done for her, i don’t like watching her suffer at all and i know waiting increases the chances she will wind up with arthritis…have bookmarked the bottoms up site, thanks again, will keep you posted!

      deb

  18. Deb October 3, 2011 at 5:38 pm #

    i think that’s the best advice i’ve had on this Jana and I really respect your opinion…i’ve heard of the sling thing, i have a friend who’s also a 50-something woman whose dog is about 10 pounds bigger than mine and she had to bring her up and down stairs (not as many as mine, but still) after she had the surgery on one knee…

    i can’t see waiting six months or more when it’s obvious to me my Lila’s in a lotta pain and can’t even jump on couches or beds anymore and like you said, she’s still so young, still a puppy really, just turned two! it is genetic with her, there was no traumatic event, but it was getting worse for a while and then one day last week it took a HUGE turn for the worse and i knew i had to get her x-rayed and they said yep, both of them are partially torn…

    i will ask the surgeon about the sling thing, i hope it will solve the problem and let her have the surgery soon and recuperate here in the wintertime in the apartment she knows which can be made safe for her except for the darn stairs…i can take a week or more off to be with her 24/7 that time and then i can go back to work slowly, she won’t be alone much, again the closer to the holidays i do it the better for taking time off and other people like my daughter being here to help take care of her…

    thanks again for all the awesome advice Jana, so very much appreciated,

    deb

  19. Kate February 15, 2013 at 1:41 pm #

    I wanted to thank everyone For the input here. I have a 90lb 8 year old lab that completely tore his right ccl. I also live in a second floor appartment, we are going in for traditional ligament repair in one week. I very worried about the stairs, I have been fretting about it non stop since I heard about the no stairs for months. I asked my vet if I needed to move to a lower before having the surgery done. He is very informative and has been doing these repairs for 20 years. He said there wasn’t much time to move and it was more Important to get the repair done as soon as possible. He said that we could work around the stairs. We are planning on carrying him downstairs for the first few weeks(my boyfriend) I cannot pick him up and of course we will carry him back up, and we are practicing with a sling now so he is comfortable with it, so we will plan on using a sling to help him with the stairs When I am home alone and he needs to go out. I know this isn’t ideal, but as the vet said there isn’t much of a choice. Any additional advise anyone has on the stairs would be really appreciated.

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