Cranial Cruciate Ligament Rupture

[enzo_canecorso]

I absolutly love this post. I wish I would have been able to find helpful information like this 3 months ago. My (actually my 15 year old daughters) 4 year old, 75lb pitty tore his CCL, he also has bilateral ED. The vet had me in tears with his version of how Nero's life would end up if we didnt do the surgery. The surgeon was adament that surgery had to happen and wanted to do both at the same time, because the other side would tear eventually, and we were all set to do them. We ended up only doing 1 knee because I couldnt figure out how I was going to help him go potty with 2 broken back legs, and unfortunately the money was a factor. I honestly think that Nero was better before the surgery, he was a lot like how you described your dog (running the fence line and changing direction mids stride with no problems). The recovery was very hard on him and now we are 2 months out and he is just starting to get back to normal activities. Shortly after his surgery we switched vets and the new vet said that her dog has torn both of his and is living a happy, normal life without surgery. I really feel like I got duped and I am regretting the fact that I most likely gave my sweet boy a horrible arthritic future to look forward to. You cant tell me that breaking a bone to fix a ligament will cause less arthritis than the torn ligament would have in the first place.

Anyways, thank you for sharing this. I hope that it can help other people see that there are other options out there for their dogs.

 

[enzo_canecorso]

Just read the other comments and Dan, my heart breaks for you. Hang in there, please let us know how your pup is doing. I am sending positive thoughts and prayers your way

 

[Dan]

Dan, Any update here. How did things go? I am so sorry you are going through this. Often dogs act aggressive when on medications and I am sure his knee hurts like hell after the surgery.

Hoping for the best.

Hi Mike
Thanks for your interest.
The visit to the surgeon went ok.
Good in the sense that the leg is healing more or less as he expected.
Bad in the sense that it's in reality just so hard on the dog.
Apparently his recent reversal is probably due to his kneecap not properly locating in its groove and slipping from side to side.
This apparently is because he hasn't been able to exercise at all for so long, the muscle in that area has weakened.
It should resolve itself when he is able to start exercise again.

The recent visit was agonising as I had come to the decision that I would have had him euthanised that day if further surgery had been needed.
That's a tough call for anyone - but I have a wife and son who love the dog and it would have hurt them too.
I'd have had an hour drive home with my son - and then to tell my wife when she came home what I'd done.

If it were just the one TTA, I would have just helped him keep going - but with the poor outlook for the other knee and for his elbows, I feel that having seen the impact of surgery on this particular dog, I can't put him through it again.

I'm, just keeping an eye on him, and giving him daily NSAIDS and supplements.
If this doesn't keep him healthy and happy, we'll have to say goodbye.

He is the only pup in the litter to have had problems - the breeder knows all of them - having one himself and another poster on this forum having 2 others.
Just terribly bad luck for us and for the pup.

I wouldn't want anybody else to elect to euthanise their dog rather than have TPLO/TTA just because of my experience.
At the same time I wanted to share the experience because for some dogs, recovery is a lot harder than others and personal/anecdotal experience is more "real" at times than statistics on "success rates" etc.

3 weeks after operation he is still far from being himself - doesn't even get up when people come home - hardly takes an interest in what is happening around him.
He just seems depressed.

Thanks again for checking up on him.

 

[Dan]

Just read the other comments and Dan, my heart breaks for you. Hang in there, please let us know how your pup is doing. I am sending positive thoughts and prayers your way

Hi Enzo
Sorry to hear about your experience.
I've posted a reply to Mike updating on my guy.

I share your feeling about vets and your distrust.
The first place I went (on recommendation) did make clear that surgery was "elective" - but also made clear that the dog was facing severe arthritis unless we went ahead (less severe but significant if we did).
The fees were £4000.00 per leg TPLO plus the initial £1100 consult fee!
The vet I went to for a second opinion, quoted £1700 per leg - which rose to £2100 because of complications - the meniscus had to be removed also.

It's a shed load of money either way, and although both vets are nice people, they are in business and you can't help but feel that fees are always going be high because enough people with enough money love their dogs.
Thing is, there are a lot of great people out there who love their dogs who can't raise that sort of cash - or who have competing demands placed on them.
Pet insurance is full of ifs, buts excesses and limits.
Coming from the UK also, I suspect that the very fact that pet insurance exist tends to push vet prices upwards.

Although with my dog. I am convinced that an operation was necessary (there was loud "clonking" as he walked), I am as worried as you about arthritis in the future.
My guy has arthritis developing now at 2 years old.

I'm facing the fact that his life will likely end because of my decision when the arthritis sets in or if the other CCL ruptures.

I don't know whether this helps you as it has helped me, but there is a wonderful book/film called "Dean Spanley" about a man who has flashbacks to a previous life as a dog.
Get hold of it of you can - particularly the film which is actually an improvement/development of the book.

One of the thing that stayed with me is the fact that dogs live strictly in the present. They have no expectation of a future and no knowledge of their own deaths.

When asked to describe how he died (when a dog), the character recalls ...

"we were running home through the fields - and then - ... we were not"

(the dogs had been shot).

Its simple but beautiful I think.

Helped me feel a bit better about making the inevitable decision when the time comes.


Regards

Dan

 

[enzo_canecorso]

Dan - I will get ahold of that movie, and I've never thought of dogs not having any perception of the future or death. It is a comforting thought, for when that time does come. The movie is available on Netflix so I will be watching it this morning. Nero has already partially torn the other knee but we've decided to not put him through the second TPLO surgery. The farther away from the surgery we get the better he seems to be. Glad to hear that your pup's appointment went well, hopefully he turns the corner soon on his recovery. Take it one day at a time, that is all you can do.

 

[SDV84]

This is such a good post. It is very tough to weigh up what is the right decision for your dog.

We have just been through this with our 2 yo BM. She initially had an intermittent limp which our Vet had diagnosed just as a CCL strain and we were treating conservatively with acupuncture, supplements and exercises. Primarily with the focus of preventing progressing to a further CCL injury. Our vet had also noticed that the other ligaments in her knee were not strong and showing a lot of laxity. Unfortunately 2 weeks later the injury progressed and she began limping more (we believe she had partially ruptured it at this point) We continued conservative treatment with the addition of anti inflammatories. Unfortuntunately despite this 2 weeks later she went completely lame on the leg and was in a lot of pain when the CCL fully ruptured.

We would have loved to continue with conservative treatment for her, but in this case didn't feel it was the best option.

She had TPLO surgery 2 weeks ago and is doing really well, so no regrets so far. I was worried about choosing the right type of surgery for her as the TPLO is so invasive, but the specialist that performed it is very experienced with it so I had faith that that was going to be the best outcome for her. She seems to be in much less pain, and is fully weight bearing on it now and being an angel about her confinement.

 

[angelbears]

Another great post. Would love to hear how she progresses. Sounds like you had a great surgeon. That is a huge factor. Unfortunately, many vets are doing it that don't have enough experience.

 

[Dan]

Just a quick update on Ronnie after his TTA 8 weeks ago.

He has had his final Xray to check progress.
One of the staples holding the titanium wedge had "pulled" through the bone a bit, but thankfully the wedge is integrating well with the bone.

It has been very difficult keeping him from running and jumping.
We are still some time away from being able to take him out in public for fear he overexerts and damages himself.
It's a difficult balance between him giving the leg the rest it needs - and not allowing the muscle to weaken too much.
As the TTA method places more emphasis on strength of the patella ligament, good muscle tone is important.

Overall it seems to be successful so far, but the recovery (especially immediate post op) has been so tough on him that we won't operate again if the other leg develops the same problem.

We are keeping him on routine NSAIDS (meloxicam) and glucosamine/chondroitin supplements.
He'll begin hydrotherapy in a week or two.

Thanks to those who have taken an interest.
There has been some really useful information posted on these pages.

Best of luck to those in a similar position.

 

[Benson]

Hi All,

I need some help/advice!

My 3 year old (56kg) DDB cross tore his cruciate 7 days ago running for a ball in the park. I heard a yelp when I wasn't looking and he start limping quite badly.

Since the incident I have been to the vets twice;

1st day post injury - visited vets and was advised to start with conservative management and see how he does for the next 14 days. If improved surgery might not be needed.

4th day post injury - after a call from my dad telling me of a loud popping when he walks We went back to the vets for X-rays (manly due to our panic). When shown the results the same vet who initially suggested CM then started advising TTA surgery after speaking to the head vet at the surgery. To be honest, as the vets said, the X-ray doesn't even show the ligament and they can't be 100% sure on the extent of damage... Only indication from tissue surrounding area. From try to do the drawer test they said it was quite hard to perform because he is so muscular but they feel the slight drawer movement.

I really want to give conservative management a try for the next two weeks to see how he does but scared it might cause more damage. My dog is in normal spirits and still seems happy. We restrict him to the living room, only take him out in the garden with lead 5 times a day for a couple minutes. He doesn't jump on furniture as has never been allowed.

What does everyone think? I would take this approach quite comfortably if I didn't hear the loud clicking/popping that I do he walks (see video below)

Any advice would be much appreciated!

Bandogge Mastiff ACL - 7 days after injury - YouTube


Thanks

 

[marke]

i personally would wait on a surgery . it appears he is actually putting some weight on it .... i'd crate him and walk him on a leash so he doesn't completely stop using it . if it improves after a couple weeks , i'd give him more time ...... if it looks like it got better , don't let him go back to normal use . a tricky part of an injury like that is knowing when to let him forget about it ...... the best results i've seen have taken a solid year .........

 

[marke]

when i say walk him , i don't mean for exercise . to go to the bathroom , and just around the yard , at minimum until he's not limping ......

 

[angelbears]

I totally agree with Marke. I would get him on a supplement like phycox, I have provided a link to Amazon. Read the reviews. Some say that waiting to have surgery can cause arthritis. However, once there is an injury there is going to be arthritis anyways. That is why I would start the Phycox and stay on it for life. (or something similar).

It takes a long time to get over an injury like this, with or without surgery. You think that they have recovered because they aren't limping or showing pain but they aren't. Honesty, once you have an injury like this it is going to be a life long struggle. They will get better and live a normal life but they will be prone to reinjury or tearing the other legs ligament.

Here is a website that I found extremely helpful for CM.

Non-Surgical Treatment

Here is the link to Phycox.

Amazon.com : PSCH Phycox Max 90 Count Canine Soft Chews : Pet Bone And Joint Supplements : Pet Supplies

 

[DMikeM]

No way to tell in an xray if there is a tear or rupture. Try conservative, I was told Jade needed surgery immediately but after 2 weeks of rest she was walking pretty good and after a month you could not tell she had an injury. It has been 2 years since and I have to look hard to see her show any sign of a limp. Also don't let them do anymore drawer tests. it can cause a tear to be a full rupture. Get an ultrasound or MRI if you need to know for sure.

These links might help.
Cruciate Ligament Damage in Your Dog or Cat

This one is best.
Dog ACL Injury-- Is Surgery Really Needed?

 

[Benson]

Thanks for the response guys! Really appreciate it!

What about the clicking which can be heard in the video? It sounds really bad?

This something you've come across before? Will it ease up?

 

[marke]

clicking could be a few things , it needs to clear up also ...... i'd rest him for another good week , with nothing but getting out the crate for bathroom breaks , it's hard to do , but it is in his best interest ...... look at it at the end of another week of complete rest ..... there are a lot of knee injuries aside from a torn acl , some can be fixed with a scope .........your vets initial recommendation of waiting 2 weeks i'd agree with , at least giving it that long ..... not sure how much moving around he's doing , but he needs completely crated except to use the bathroom .... if you don't got a crate , i'd get one , they're pretty cheap ..... I've seen where the dog wouldn't even think of touching the leg to ground for weeks ....... the key I believe is you got to lock him up .........