Conservative Management – Koko

conservative management

Koko is a 58 pound Labradoodle. She will be 9 in October. We were told she tore her right CCL in 2009, but we did not do surgery. We kept her activity down and began daily glucosamine and fish oil. Recently, she started limping again with the cold weather. We put her on Rimadyl and things seemed to improve until a few weeks ago she would not put weight on her left rear leg. She was x-rayed and our vet and a surgeon both said she needs surgery. After all is said and done, the cost will be $6,000 to $7,000 depending on whether we do them both at the same time.

I feel like we are letting her down if we put her down but it is hard to justify the cost and the rehab time for her. Now she is on Rimadyl, Tramadol, and a nerve block. I’ve been able to cut back on the Tramadol and she still seems to be improving somewhat. However, she is definitely still not walking right and not putting a lot of weight on the left leg. She’s always on a leash and usually will only go to the bathroom while on her walk. Not sure why she won’t go in our yard; probably just habit from years of having her daily walks.

Any advice? Are we being unfair to the dog? She is so sweet. I would hate to think she is suffering.

16 thoughts on “Conservative Management – Koko

  1. These greedy vets.
    How do they justify this amount of money?
    I can imagine that they charge $1500 total, make $800 for the operation, 2 hundred pays the nurse and $500 covers some other costs, not bad for a couple hours.
    These vets are greedy! Sad.
    They put loving dog owners in depression!

    We are all in the same situation.
    I am going to buy my dog a brace.
    I can’t find prolotherapy in many places.

    I will pray for your dog!
    God Bless.

  2. Bob, That is so far from the truth. Veterinarians are not greedy. I am sorry if your dog has an injury you can not have surgically corrected, but your vet did not do this and only wants to help you. It is expensive, but you have to look at why. It is not as simple as you are making it out to be. First, the equipment is medical grade which makes it expensive to buy. Then you have to consider IV catheter, fluids, IV pump, all the pain medication and antibiotics. Not to mention anesthesia. Not just the drugs to get them under anesthesia, but the drugs and equipment to make sure they stay under the correct level of anesthesia. This includes things like monitoring oxygen status, blood pressure, tempeture, and ECG. Lights are also a crucial aspect to visualize everything. Those lights average about 7k, per light. You also have to remember veterinary medicine is not a trade. These doctors are professionals. You have to go through a 4 year undergraduate school then a 4 year medical school. That comes witha hearty price tag. Most come out with loans in excess of 200k. I am sure if you want someone to cut corners you can get it done cheap….Just remember, you get what you pay for.

    1. Come on. As you can see by the hundreds of posts this is an extremely common surgery performed by thousands of vets all over the country. Defending recouping the costs of their medical training by charging more than most can pay at the ultimate expense of the animal is disgusting.

  3. Our dog 7 year old is schedule for Friday surgery. The estimated bil is …..are you sitting down? Between $2,900 and 4,500.
    We are in MA state where everything is expensive.

    Lily

    1. Hi Lily,

      Did you end up getting the surgery? Where in MA did you go? I’ve been looking at places around the Boston area.

  4. Your dog can get better without surgery,,there are studies by vets that show about 2 thirds of dogs, and yes even large dogs can recover well without surgery. It’s not easy but neither are these invasive surgeries. It requires patience for sure. I’m not saying surgery is never an option and if my lab was 3 I would probably have the surgery but she is 10. She has improved well with limited leash walks, metacam, Phycox and adequan injections. Check out tiggerpoz.com.
    There are studies online that prove conservative management can work.
    Here is a summary of a study published by the AVMA in 2011

    Bottom Line
    This study does provide some support for the contention that overweight, large-breed or giant-breed dogs have better long-term outcomes when treated with both surgery and non-surgical therapy rather than with non-surgical therapy alone. However, the limitations in these data are great enough that the case for preferring surgical intervention is not strong. The non-surgically treated patients had overall very good outcomes that, at most time points and by most measures, did not differ significantly from the patients who received surgical treatment. Additional evidence would be required to make a strong statement that overall surgery is superior to aggressive medical therapy.

    While it is reasonable to tell dog owners that there is some evidence their pets will benefit more from having surgery than not having it, we must also inform them that most dogs will have a good long-term outcome even without surgery. And it is important to emphasize that even with surgery, aggressive management of weight and physical therapy are important elements of comprehensive and successful treatment. For those owners who cannot afford surgery, or those patients who are not good candidates, there are still effective therapies that can be offered.

  5. My 5yr old pit mix tore her ACL on her left back leg last year. Our Vet did not recommend surgery but said it was an option. I opted for maintenance. I’ve done the laser therapy, adequan shots and bought a $750 leg brace customized just for her leg. I am continuing with daily herbal supplements and fish oil, tramadol and ice only when needed, deramax on very rare occasions. I have limited her ball chasing to only running not jumping with brace on. She lives for the ball and could not take it away from her.
    She still favors the leg but she is managing fine without surgery. A couple months ago I was speaking to a couple in the vet’s waiting room, they told me they opted for surgery and not 4 months later their dog slipped running into the kitchen and tore it again. Wasted money.

    1. Hi , My Dog is at the point of partial tear. I am going to do suppliments, low activity, and look into a brace. My neighbors had the surgery for their dog and that night she died of belly bloat! I have had 2 dogs get belly bloat within 24 hours of a procecedure and that was with careful monitoring !!

    2. Hi I am curious to hear how things are going now? Why did your vet not recommend surgery… did your dog have a partial tear or full? Do you still use the brace or now years later is the brave no loger something you have to use… my dog 6.5 pit mix recently tore his right ccl and I’m feeling a bit overwhelming with my options. I’d like to avoid surgery if possible (not due to costs) but moreso due to potential complications etc. My dog is a very anxious and has skin issues which I know increase infection risk… all of which add to my concerns for surgery. Any advices/tips… things you learned In the process would be great to hear from someone whose gone through it… thanks again. Hope all is well with your pup now.

      1. My vet said surgery was an option but not necessary. The brace was only temporary. On and off by year 2. Year 3 and on,, we never used it again.. She actually got back to 95 pct of her motion. Jumping was not an issue.. Since then I have had 2 others in my pack tear their ACL.
        I was fostering when my big guy 115lb American Bulldog tore his. The rescue did not have the funds to do the surgery. I ended up adopting him after 2yrs of fostering. For him with no brace, no laser therapy, I wish he had gotten the surgery or I had adopted him sooner. He really favors the leg years later. He is not in pain but it changed everything for him. He has to sit with the leg sticking straight out, he doesn’t play much and he doesn’t like to walk. Having said this my 50lb red nose pit tore his ACL. Within 6 months without surgery and without a brace was back 100pct. I believe weight plays a big role in the out come.

        1. Thanks for responding. My dog is 65lbs so I’m hoping we can get by without surgery… you mention you didn’t use a brace for your pit and he was better in 6 months… what did you do for him (ie. How much resting how much walking… did you let him get on the sofa, at what point did you increase activity/decrease resting etc)

  6. We live in the UK and had a neopolitan mastiff with cruciate problems. A homeopathic vet treated him and he was sound until the day he died. We now have a 3 legged Springer spaniel with a similar issue and will be going back to the same vet
    There are non invasive choices that work. Good luck

  7. Dylan has been treated prophylactically following initial injections of cartrophen (1 weekly x1 month). He has seen the chiropractor & homeopath & they are both delighted with his progress. Like people, animals react differently and the most important consideration has to be the welfare of your animal. If you believe hour dog to be in pain then you must do everything you can to stop that pain. Quality of life is all important and you need to explore all the avenues. We were told that our neo needed surgery within 28 days or he would be crippled for life & the homeopath kept him away from the knife for the rest of his life – after 6 months the “regular” vet admitted to being astonished by the improvement and discharged him. Google Nancy Morris, homeopathic veterinarian in kempsey, Worcestershire, England. She won’t be able to advise over the phone/net but maybe she has contacts in the states who could help.

    Good luck

    Jan

  8. For our 50lb red nose we did the laser therapy a couple times. And used anti inflammation meds only as needed. We kept him still for a couple weeks, then only a leash when let outside. I would say about 2 months of us controlling his activity. By month 3 we let him off leash. He favored the leg for about 3 more months. By month 6 he didn’t seem to have any issues. Today he is the 2nd fastest in my pack. Which I currently have 7.

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