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Failbhe 02-16-2013 04:54 PM

torn cruciate ligament
 
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So my dog wasn't using one of her hind legs... I thought I'd take her to the vet and he would say she has some arthritis, here have a few painkillers, put her on glucosamine and most likely it will clear up when the weather gets warmer. Nope. She's torn her cruciate ligament.

She's 9 years old, a VERY active and fit husky/german shepherd cross. She's never been overweight and goes crazy when she has to sit still for longer than ten seconds.

The vet mentioned in the appointment that sometimes the ligaments can get brittle with age. He said to put her on painkillers (Rimadyl) for a couple weeks and to come back and they'll take x-rays, apparently sometimes the dog can heal enough to adapt or something like that.

I used to work at a vet clinic as a receptionist so I'm a bit familiar with these things though I've forgotten a lot of it. As soon as he said torn cruciate my heart sank through the floor. From what I remember, when dogs were brought into the clinic for surgery they'd end up tearing the other one during recovery, and end up wobbly, arthritic, painful messes for the rest of their (usually short) lives.

Everything I read talks about the importance of KEEPING THE DOG QUIET during recovery, and honestly I just don't think it's possible. Pepper will explode out of her skin.

She's the best dog I've ever had and I absolutely HATE to think of losing her so soon. 9 really doesn't seem that old... but I guess she's not a puppy anymore either. I do not want to put her through surgery and a lot of pain to have her end up like those other dogs, weak, debilitated, and in constant pain.

Everything I google talks about going to heroic measures to save their dog and everyone assumes that you'll do the surgery. And maybe if she was 3, ok - but when she's 9, has already been limping on the other leg during cold snaps, and is impossible to keep quiet...?

Has anyone else with an older and/or hyperactive dog gone through this?

And a picture, just because I love my girl and I'm desperately hoping these aren't my last few weeks with her.

Sharpie 02-16-2013 05:03 PM

Keep her as quiet as you can for the next month. Get drugs from your vet to do it if necessary. I completely understand a) not wanting to do the surgery and b) having a dog that will go insane if kept quiet.

BUT! If you can keep her calm (using sedatives) and off the leg, make sure she gets her Rimadyl to reduce the inflammation, and keep her 100% on leash and NO stairs for 4-6 weeks (even when going potty), there is a good chance her knee can heal enough/add enough scar tissue that she'll be comfortable enough to keep going well, with only the occasional painkiller and glucosamine/chondroitin. Sucks in the short term, but if surgery is a no-go, it is you #1 best bet at keeping her around and comfortable and able to run and play for another 2-5 years.

If you cant/wont keep her contained in the short term, when the knee has the best chance of healing, she may never be comfortable using the leg again, which can indeed cause the other to blow out.

ETA: While she's in recovery, no feeding her out of a dish. Not because it's bad, but because you can put her food in puzzle cubes/toys and kongs instead, so that she can use some of her energy and time working on her meals instead. PM me for more 'how to keep a freaking nutcase dog 'calm' during recovery.' :)

Failbhe 02-16-2013 05:16 PM

Quote:

Originally Posted by Sharpie (Post 1897596)
Keep her as quiet as you can for the next month. Get drugs from your vet to do it if necessary. I completely understand a) not wanting to do the surgery and b) having a dog that will go insane if kept quiet.

BUT! If you can keep her calm (using sedatives) and off the leg, make sure she gets her Rimadyl to reduce the inflammation, and keep her 100% on leash and NO stairs for 4-6 weeks (even when going potty), there is a good chance her knee can heal enough/add enough scar tissue that she'll be comfortable enough to keep going well, with only the occasional painkiller and glucosamine/chondroitin. Sucks in the short term, but if surgery is a no-go, it is you #1 best bet at keeping her around and comfortable and able to run and play for another 2-5 years.

If you cant/wont keep her contained in the short term, when the knee has the best chance of healing, she may never be comfortable using the leg again, which can indeed cause the other to blow out.

ETA: While she's in recovery, no feeding her out of a dish. Not because it's bad, but because you can put her food in puzzle cubes/toys and kongs instead, so that she can use some of her energy and time working on her meals instead. PM me for more 'how to keep a freaking nutcase dog 'calm' during recovery.' :)

'Freaking nutcase dog' is definitely a good term for her. Love her to bits, and as a farm dog she's fantastic - thank goodness nobody ever tried to keep her in an apartment.

She's a strictly outdoor dog - mostly by her choice. When we let her inside she's panting and whining at the door until she gets back out, and that's one of my main concerns. I'll definitely talk to the vet about getting some sedatives because I have a feeling if we tried to put her in a crate she'd end up pacing in circles until she drilled a hole through the floor.

Failbhe 02-16-2013 09:16 PM

So, new problem... :P She won't pee while anyone's watching! Since she's always been an outdoor dog this hasn't been a problem... Well, I guess sooner or later she'll have to or make a mess in her crate!

Sharpie 02-16-2013 10:18 PM

Lol! My girl had the same issue. Wouldn't potty on leash. Didn't pee for 36hours, didn't poop for 5 days. Got over it within a week and after some praise and a treat for pottying on leash.

Barbara47 02-17-2013 03:34 PM

I had this problem with a 7 month old lab and we also had his brother at the same time. We kept him confined in a 1 metre square wire dog kennel in the house and on the veranda (two separate kennels). After about a week he calmed down to the fact that this was his life for a while. We allowed his brother and the cats to stay around him and improvised chew toys that were half in - half out so the two dogs could chew on he same toy together. We put a TV down at his level to help occupy him and now 5 years later as I remember those 6 long months I cringe but would do it all again.
We are now in the process of going through this with a 900kg drought master bull that we have confined in the cattle yards and have been pumping him full of glucosamine-chrodroitin...amazing stuff. It's been 2 months and looks like he will be able to rejoin all his girls in maybe another month. We haven't done a TV for him, LOL, the chickens seem to keep him entertained.
900kg of bull is a lot easier than a 30kg lab puppy!
Good Luck

nikelodeon79 02-17-2013 05:44 PM

If you are going to attempt to heal her without surgery, you're looking at a minimum of a YEAR, not a month.

8-10 weeks very restricted, to allow the scar tissue to form.
The rest of the time building strength in the leg so it doesn't tear again.

It's called conservative management, and there's a yahoo group all about it.

I attempted CM with my GSD. I let her off leash too early and she re injured the leg. I opted for surgery at that point (one year after the original injury). She had a TTA surgery and the recovery time is MUCH quicker. Within a couple months, she was running off leash.

If I had it to do over again, I would opt for surgery immediately.

The surgery she had was quite pricey, but there are other, cheaper options. There is an orthodogs list on Yahoo Groups that has great info on all the available surgical options.
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nikelodeon79 02-17-2013 06:11 PM

I wanted to elaborate more on this so I hopped on my laptop so I can quote more efficiently. :)

Quote:

Originally Posted by Failbhe (Post 1897586)
She's 9 years old, a VERY active and fit husky/german shepherd cross. She's never been overweight and goes crazy when she has to sit still for longer than ten seconds.

The vet mentioned in the appointment that sometimes the ligaments can get brittle with age. He said to put her on painkillers (Rimadyl) for a couple weeks and to come back and they'll take x-rays, apparently sometimes the dog can heal enough to adapt or something like that.

How early was she spayed? Early spay/neuter (before the growth plates close) is a huge risk factor in injuries like these. My Luna was spayed at 10 weeks.

She could've also just landed wrong or slipped on ice... it happens with active dogs.

X-rays can show changes in the joint but they can NOT show the ligament. Only an MRI can do that, and they're still expiramental in dogs because they are very cost prohibitave. The main way vets diagnose ligament tears is with a "drawer sign" tests. Basically they manipulate the knee to see if it moves from side to side (like a drawer). If you bring your dog back in after a month worth of healing and your vet attempts a drawer sign test, the scar tissue will tear and you'll be back to square one. Also: please do not allow your vet to do a sedated drawer sign test.

Quote:

From what I remember, when dogs were brought into the clinic for surgery they'd end up tearing the other one during recovery, and end up wobbly, arthritic, painful messes for the rest of their (usually short) lives.
No. No. NO. This may be true with hack job surgeries, but if you choose a board certified veterinary surgeon, you couldn't be in better hands. The orthodogs list will likely have a recommendation in your area. That's how we found our surgeon, Dr. Levine in Inver Grove Heights, MN.

While it is true that dogs are very likely to tear the other knee, it is not due to the surgery, but due to other factors:

1) They may be predisposed to this kind of injury (for example due to a pediatric spay/neuter)
2) They are overcompensating with their good leg.

In the latter case, since Conservative Mangement (CM) actually takes LONGER than most surgery recoveries, the chance of tearing the other leg is absolutely still there (and some would argue is a greater possibility).

There are a lot of very nicely worded sites on the internet that tell you that you are evil and wrong if you choose surgery. That it's torture for your dog and will end up crippling them. I'll tell you my personal experience.

Luna tore her knee. We did CM to the letter. That meant MONTHS of on leash potty breaks. Lifting her up and down the stairs. Keeping her absolutely, completely, 100% quiet. Believe me, in a very active German Shepherd with two other dogs in the house, this was NOT easy. She was absolutely and completely miserable. She started growling and snarking at the other dogs. This was NOT her personality.

We slowly built her back up. First short walks, then increasing in duration and frequency, finally up to trotting around.

Finally, at six months into her recovery, we let her off leash.

Six months later we let her inside from a romp in the yard and she was limping on three legs.

Did she reinjure herself? Somehow tear the scar tissue that is supposedly STRONGER than the original ligament (if you believe what the CM camp tells you)? Or was she injured all along, just doing a very good job masking the injury (as dogs will do). I can't be sure, but I believe it's the latter. So, my dog was IN PAIN for a full year.

We went to surgery. She had some very good painkillers. We were immediately taking her for (very short walks). We worked with a very good rehab therapist to make sure we weren't placing undue strain on her good leg. Within months, she was running around the yard as if nothing had ever happened.

She does obedience. She does tracking. She does agility. She does skijoring.

Does this sound like a broken down, painful mess of a dog?


Quote:

Everything I read talks about the importance of KEEPING THE DOG QUIET during recovery, and honestly I just don't think it's possible. Pepper will explode out of her skin.
Yep, this is important, even MORE so if you opt for CM. There are simply no room for errors. One error, and you are almost back to square one, because you've re-torn the scar tissue you were slowly building.

This was a HUGE factor in why we opted for surgery when it happened a second time. Luna was absolutely positively MISERABLE when we were CM. The thought of another year of that was devastating. I knew she couldn't take it.

Quote:

She's the best dog I've ever had and I absolutely HATE to think of losing her so soon. 9 really doesn't seem that old... but I guess she's not a puppy anymore either. I do not want to put her through surgery and a lot of pain to have her end up like those other dogs, weak, debilitated, and in constant pain.
Even if you can't do the surgery (it is VERY expensive... Luna's was $3100), it isn't a death sentence. Give CM a try... join the Conservative Management list and they'll give you lots of ideas on different was to keep her mind stimulated during recovery.

Check out CareCredit if you want to look into surgery and can't afford it. That's how we were able to pay for Luna's surgery (and I have crappy credit, so I was surprised I was approved).

My brother and SIL opted not to have surgery for their lab, and they didn't do FULL CM (they did only a month's worth, rather than the necessary 6 months to a year). She does limp a lot, particularly after a lot of activity and if it's cold. She does seem happy and healthy otherwise... she just runs on three legs instead of four.

Quote:

Everything I google talks about going to heroic measures to save their dog and everyone assumes that you'll do the surgery. And maybe if she was 3, ok - but when she's 9, has already been limping on the other leg during cold snaps, and is impossible to keep quiet...?
I do understand your hesitation due to her age. If she's limping on the other leg it's certainly possible the other one is already torn. I would recommend joining the orthodogs list... LOTS of good info on there. There are plenty of people who have faced the same decision you have: an elderly dog with a torn CCL.

A consult with an orthopedic surgeon would definitely be a good idea, just to figure out what all your options are. You aren't bound to surgery, and if you find a good one they'll be honest with you about their recommendation based on her age and activity level.

Good luck, and feel free to ask any questions you might have. I have extensively researched both surgery and CM, and have gone through both. Your girl looks like such a sweetheart and I wish you both the best of luck!

Failbhe 02-18-2013 09:55 PM

She was about 5.5-6 months old when she was spayed.

I think she slipped on some ice - or perhaps fell off of a snowdrift, there are some tracks that look like that could have happened. We were away for two days and she was limping when we got back, so I'm not sure exactly when or how it happened.

Quote:

Originally Posted by nikelodeon79 (Post 1899137)
My brother and SIL opted not to have surgery for their lab, and they didn't do FULL CM (they did only a month's worth, rather than the necessary 6 months to a year). She does limp a lot, particularly after a lot of activity and if it's cold. She does seem happy and healthy otherwise... she just runs on three legs instead of four.

This is essentially what we'd be hoping for... I know she wouldn't recover fully (at least, probably not) without surgery, but at her age and her activity level... I am definitely very concerned that she would either re-injure the same knee or else tear the other one during recovery.

We are going to make another appointment with a different vet and get another opinion. $3K is a lot of money to spend on a dog who's already 9 years old - but if it would give us a few more years, we may consider it. I think my husband would give up a kidney and maybe some bone marrow if it would save the dog!

cakemom 02-18-2013 10:06 PM

You've been given great advice, but I wanted to just add the reminder to watch her kidney and liver functions on Rimadyl, it can be tough on them.
Good luck. We had the surgery done on our big guy about 10 years ago. I assisted and all I had to pay was the surgeons fee and JUST that part was 800 bucks back then. Luckily I was working for our then vet, an did for 10 years.
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