Should I repair my old dog's torn ACL
September 9, 2018 11:00 PM   Subscribe

My dog tore his ACL. He's 15 years old. I need to decide whether it makes since to get surgery to repair his ACL.

The recommended surgery is TPLO. Our vet said that the decision to have surgery was a "toss up" because of his age. But our vet also sent us to a specialist who said that the dog would have no problem with surgery and that recovery was two months for most dogs but could be longer for older dogs.

Have you had an older dog with an ACL injury? Did you choose surgery? Were you happy with the results? Did you choose to forgo surgery? What happened?
posted by pizzazz to Pets & Animals (10 answers total)
 
I have an older dog that went through *two* TPLO surgeries in one year. While not quite as old as 15, I definitely don’t regret going through with it. The results have been stellar given her age and the obvious pain she was in for months beforehand.
posted by pipian at 12:08 AM on September 10, 2018 [2 favorites]


I think a reasonable standard is going to be the dog's expected quality of life afterwards. If this surgery results (eventually) in a full recovery of function, well, great. If the dog will never be able to get around, exercise, do dog things, well, the answer is probably no. It sounds like you're getting pointed in the favorable direction.

That said, age + immobility is a tricky one-- that 2 month recovery period is a lot of potential sedentary time for a old-timer; will the dog be able to be any kind of active, which will help recovery?
posted by Sunburnt at 12:50 AM on September 10, 2018


My middle aged dog tore her ACL five years ago. The vet recommended surgery but I read some studies showing that there were similar healing outcomes between surgery and rest. Instead of surgery, I kept my dog on strict rest for two weeks with no running or jumping. It worked -- she healed. The vet warned she'd develop arthritis. She limped for part of a day now and then, and then recovered in a day -- and this is the same potential side effect of the surgery. She ran and played as normal the next day after a limping day. My dog is now 10 and has no limp or pain at all.
I would not put a 15 year old dog through surgery for many reasons. The main reason is that I'd want my dog not to have to deal with surgery at that age. But another reason is that it really should be easy to keep a 15 year old dog from running and jumping for a couple of weeks.
Whatever you decide, best wishes for your dog's health!
posted by nantucket at 1:27 AM on September 10, 2018 [1 favorite]


We opted not to go with a surgical approach on our elderly Boxer and instead have treated with Cartophen. She had 5 injections every other day for 10 days initially -- the fourth was a miracle. She now gets one injection every month.

No harm in trying.
posted by DarlingBri at 2:24 AM on September 10, 2018


Our little one (Jack Russell/miniature poodle cross) had an extracapsular repair for a torn CCL at 14. She was pretty miserable during the six weeks of enforced inactivity, but pulled up well afterwards. Three months after surgery you'd never have known she'd ever had an injury.

She's nearly 19 now, very old and very stiff in the hips, not coping well with cold weather and spending most of her time curled up sleeping on her electric bed. Her mouth is in horrible condition because she won't let us clean her teeth, and the vet has advised that putting her under for any kind of proper clean up and tartar removal would probably kill her.

If your dog is a larger variety than ours, then at 15 they're probably closer to our little one's present stage of life than she was at 14, and it would seem likely to me that on balance their chances of further life of reasonable quality would probably be higher without major orthopaedic surgery than with.
posted by flabdablet at 2:45 AM on September 10, 2018 [2 favorites]


By the way here is the other thread -- it might have some good ideas.
posted by nantucket at 5:42 AM on September 10, 2018


Our now-deceased Westie tore both ACLs in the course of a few years. The first one, when he was 12, we had surgically repaired because it was completely torn and some bone spurs were developing around it. Over and above the rehab exercises we put him through, the vet gave him no real restrictions reasoning that if he felt like running or going up stairs by himself, he was obviously up to doing it. Within a few months, he was as good as new and back to doing everything he did beforehand.

When he tore the ACL in his other leg two years later, the vet said it wasn't torn completely through and advised non-surgical treatment. It took longer for him to get back to normal, but it eventually healed enough that he could go several days between limping episodes.

For reference, he died at age 16 which is definitely at the older end of the range for Westies.
posted by DrGail at 7:29 AM on September 10, 2018


It would help to know the size and temperment of your dog - I was told smaller dogs can recover with injections and time, while bigger dogs typically won't heal without surgery.

We had it done for our large (90+ lbs) dog at age 8 (and the other leg at age 9). Recovery in both cases was swift and nonmiserable, in large part because he's extremely sedentary - the forced lack of walking for weeks was not an issue and we were diligent about pain management meds.
posted by Ink-stained wretch at 10:20 AM on September 10, 2018


Response by poster: More info because people asked:

- The dog is a 35 pound mixed breed, and the breeds are unknown.

- His health otherwise is fairly good except that he has pretty advanced arthritis in his spine, which made him slow even before the ACL tear. Because of the arthritis, the vet advised us to only take him on short walks. Now with his torn ACL, we are not walking him at all. He only walks to eat and pee, but it's hard for him to get to a standing position on his own sometimes. He would be easy to keep still for recovery. At the same time, the surgery, even if successful, wouldn't have him running again, or even going on long walks. It would hopefully allow him to stand unassisted all the time and go on short walks, and could prevent more arthritis than he already has.

- The tear is complete, not a partial. None of the three vets we saw mentioned injections!

- It's been about 4 months since the tear, and he hasn't run or jumped in that time. The vet said scar tissue could eventually provide stability, but may take a year for an old dog. But I'm worried the surgery will make his life worse because of the pain, potential for complications, and the stress. Because he won't understand what is happening.
posted by pizzazz at 10:37 AM on September 10, 2018 [1 favorite]


But I'm worried the surgery will make his life worse because of the pain, potential for complications, and the stress. Because he won't understand what is happening.

Yes.
posted by nantucket at 11:10 AM on September 10, 2018 [2 favorites]


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