A Conservative Management Experience – Pudge

I have a rescue Basset Hound/Golden Retriever mix who is almost 4 years old. He is a very mellow, chill couch potato that does have spurts of energy and playfulness, unlike our constantly crazy Yellow Lab. About 7 months ago, they were playing in the yard and he must have somehow hurt himself because after napping for a couple hours he wouldn’t put his left rear leg down. He even moaned every once in a while in pain. We called our vet that night (not a surgeon), and he said he was pretty sure it was his CCL and that we can have him evaluated first thing in the morning. However, in the morning he was able to walk on his leg just fine and no moaning or lameness since – so I was reluctant to even take him to the vet. The vet explained the drawer test to us, and then performed it on our baby (who let out the most heartbreaking squeals of pain I have ever heard). He said he couldn’t tell if there was a drawer sign. After sedating him and taking X-Rays he said he fully tore his ACL and recommended one option – immediate $3800 TPLO surgery. And he added not to wait more than 2 weeks before severe arthritis sets in. Side note: His X-rays showed signs of hip dysplasia. Even the lady at the front desk sadly asked me if that was my poor pup squealing. Needless to say I was mortified by the whole visit.

I was a little miffed by the way our vet recommended TPLO. We wanted to do our homework, so we saw an orthopedic surgeon who said he only partially tore his ACL and he recommended TTA surgery, but suggested we first try glucosamine/MSM/chondroitin pills along with strict rest for 8 weeks. We combined that with another antioxidant with glucosamine in a powder form. We were relieved that he suggested this first, as the TTA/TPLO are scary to me. He seemed to recover beautifully, he is a mostly chill dog so he didn’t much mind strict rest! He had no obvious limp and seemed to bear weight pretty evenly for months so we started to slowly introduce some exercise about 2 months ago. At the same time, we decided to switch to cheaper glusocamine pills and he remained to be doing great. We let him off the leash, take him for long walks, and he hasn’t had any signs of pain or lameness.

However, as of 2 weeks ago, he seems to be regressing. I took him for a walk, and wouldn’t even use his leg after a couple of hours. So we went back to strict rest and he was fine to put weight on it again the very next morning, just like at Day One over 7 months ago. Although he is using his leg, he does slightly favor his good leg and are concerned that the rest and glucosamine just isn’t enough for him, but I am praying that switching back to the other pills will do the trick.

Let me tell you, I love the hell out of my dogs, and have done more research and called more vets (holistic, surgeons, etc) than you’d ever imagine. We are trying to figure out what the next step should be. No matter what, we are going back to the other pills and they arrive tomorrow. We are also putting him on a diet dog food, he could lose a couple pounds. I have started massaging and icing his knee. I’m also doing a little physical therapy on him at home using a really helpful youtube video I found. Maybe a brace would help him?

We were so saddened by his setback that we are revisiting the possibility of surgery, as much as we don’t want him to go through that. But I am afraid of arthritis – some say NOT doing surgery causes it, some say surgery causes it. We don’t know what the best thing is for our dog and we want to do the right thing and make an educated decision. The TPLO/TTA seems so invasive, and aren’t sure if it’s worth the risk/cost. Or if since he is generally lazy the conventional surgery would be better for him. Maybe the Tightrope would be better, but I have researched and there are many failed cases of those as well as the other types of surgeries. Any advice or general direction would be greatly appreciated! Thank you in advance for your time!

We are trying to figure out what the next step should be, as surgery is something we are considering but we don’t know what the best thing is for our dog and we want to do the right thing and make an educated decision. The TPLO seems so invasive, and aren’t sure if it’s worth the cost or if since he is generally lazy the conventional surgery would be better for him. Any advice or general direction would be greatly appreciated! Thank you in advance for your time!

7 thoughts on “A Conservative Management Experience – Pudge

  1. So sorry about your baby.

    Yes, I would recommend to do the surgery (he might need it for both knees now by the sound of it).

    Deciding on the type of surgery to go with is a whole other story. I think you need to get a good understanding of each of them and then decide; or find somebody (a vet or surgeon) you really trust and go with their advice.

    My opinion and experience:
    – traditional (extracapsular repair) can work on a large dog; Jasmine, a female Rottweiler had it done on both of her knees
    – tightrope is a very similar idea, the main difference is the material used. Unlike the suture in extracapsular repair which is mean to eventually let go, this one is meant to last. Theoretically it should be able to withstand more abuse.
    – either of the actual joint altering surgeries have their pros and cons; personally I like the newest TTO (a hybrid of the two earlier ones) best
    – any of these surgeries can fail (suture can break, plates can get busted). We went with extracapsular because it is least invasive and if it does fail the damage isn’t devastating (basically you’re back to square one). When TPLO goes bad it can go really bad; but there are advantage to the joint altering surgeries also
    – physical therapy and religious rehab will make or brake success of any of the surgeries you might choose
    – most importantly, whichever surgery you’d choose make sure you have a surgeon to go with it; meaning one who has enough experience with it, is comfortable enough doing it and has a good tract record

  2. I’m so sorry.  Generally speaking, partial tears turn into full tears easily.  I thoroughly agree with Jana’s assessment.  Your dog is only 4.  Conservative management is now longer working for him.  I believe you are at a surgical crossroads.  Which to choose?-Traditional-Tightrope-TTA-TTO-TPLO.  I had a Cocker Spaniel (11 at the time) who had the tightrope.  He did great.  I currently have 2 Rottweillers with the TTO (9 weeks apart in their recoveries-stories here).  I have had friends whose dogs have had TPLO’s and the Traditional reapirs.  All have done or are doing well.  The choice is yours to make.  The overall lifestyle, age (young), and activity level as well as the financial consideration will all play a part.  But I do believe surgery of some sort is now in your court.  Physical therapy, in my opinion is very important.  Slow and steady progress will give your dog the best option at optimum recovery.       

  3. We have a 7 year old Boston terrier with a knee issue. Unlike the golden-basset she is active. We also have a basset hound so we clearly see the difference! Ruby our boston is not putting weight on her knee…was told the same from our vet (tear ccl)…I found this website to help justify not spending 2,500 on a surgery…that could only be a short fix as well.
    the website is tiggerpoz.com/ FAQ is a good read. As well as the complete article.
    We are leaning towards a brace-$600 that she will have for life. My pets brace mypetsbrace.com. We are in PA and this place is closer to us. We knew she did not have a good right knee, but never had an issue until two weeks ago…she took off into a sprint and started limping later, by the end of the day she was non weight bearing and has been for almost two weeks.
    What brand glucosamine/MSM/chondroitin did you use?
    good luck with your pup…I really do not want to have the surgery on a dog with a knee the size of a nickel! Read the tiggerpoz. Very informative!
    Good Luck!

  4. The brace sounds like s good option for you, then.  These decisions are never easy.  Years ago, with my Cocker Spaniel, we opted for the tightrope surgery.  He was 11 and lived happily with a just like new knee until age 17. 

    I am sure your Boston will do just fine with a brace.  Being more active, like you said, it should work for you.

    I use Next Level Glucosamine/Chondroitin liquid.  Additionally contains:  MSM, Shark cartelage, Mussel, and Ester-C. 

  5. My 70lb Male Basset Hound tore his cruciate when he was 4. We were hiking in the woods and he came up lame while in full sprint after a turn. The vet said it was a cruciate and wanted to do sugury. I got three opinions. Sedated, he had no drawer sign. One vet explained that the repair is nothing more than a nylon tie like a thick fishing line, holding the knee together. This line would break eventually, but not until scar tissue healed around it making a ‘replacement’ ligament. It was also explained to me that a patial tear would do the same thing… if it didn’t turn into a full tear first. He said the negative of concervative mangment in partial tears is the risk of the full tear and removing any scar tissue that may be floating around in the joint.. which could cause arthritis trouble as he aged. I ran this by the other vets and they agreed(wish they had told me this, it would have saved getting second and third opinions). In my case I opted for conservative mangement. Within 6 months, he was active again and in a year, you would never know he had the tear. I never saw athristis symptoms in this knee.

    At age 11, he developed osteosarcoma in the opposite leg(I had thought it was another tear). He hobbled around on the Cruciate tear recovery leg for 4 months happy as can be with three legs and bone cancer. I had feared that his cruciate would cause him problems, but it as his achilles tendon that went on him.

    I think the events and treatment vary per dog. It’s possible this wasn’t a cruciate but I doubt it because I witnessed the injury happen and the symptoms of a partial tear were all there as well as opinions of three vets. Still, it’s my advice that if the tear is not complete, you’re better off NOT getting the surgery in most cases. It IS a gamble that you take as if it tears you could have to go through it anyway, but in my case, it was worth the risk and paid off for my beloved basset hound and I believe he was better off because of it. It’s been my experience that if surgery isn’t absolutely necessary, it probably best not getting it in most cases.

    Best of luck..

  6. Thank you for your replies.
    Ruby is basically in full recovery! We have the brace for backup but she has been doing great! Not the same activity as before injury… she has trouble jumping onto couch! LOL!
    I suppose it’s the pushing of the back legs… but she manages! She has even jumped onto a high bed on a chilly morning! We are happy we did not opt for surgery… as anything health related could always pop up! Her big older sissy is a 12 year old basset hound! Who still runs at 12… Well kind of runs! We have been lucky with her… but her days are numbered as a basset… hopefully she will have a couple more good years! Someone had a basset who ran to the front door ruptured something in her back… couldn’t move rear legs and had to be put down… So we never know unfortunately… Thanks again… Best of health to all the animals and their humans!

  7. My 1 year old Basset Hound has a knee socket issue in his back right leg. As it was explained to me is that the knee bone is not sitting properly in the socket, and from time to time it will pop out, causing him to limp and sometimes drag his leg. But after a very small pain pill and me massaging and manipulating the leg he’s a happy camper again. They wanted to do the 3500 surgery to carve the knee socket deeper so the knee cap could fit into it better. I don’t want to put my young boy thru that type of surgery. And the doc doesn’t want to neuter him until he gets a little older. So I am considering getting a brace for the back leg and getting a powerful gluco supplement so he’s off the pain pills. Any recommendations on products (brace and pills) ??Any thoughts?

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