My poor dog is limping terribly.
August 21, 2010 8:56 PM   Subscribe

Please school me on different options and treatment for my dog's torn CCL.

Although we don't have a definitive diagnosis yet, my sweet dog's injury seems to suggest that she tore her CCL yesterday when she zigged when she should have zagged. We took her to the vet today, who gave her 100 mg of Tramadol to be taken every twelve hours to get her through the weekend's pain. She tries to put weight on the leg, but she really can't. We've been keeping her quiet (which isn't hard with her being drugged up), and she's only been outside to relieve herself. Luckily, my husband is big and strong, and can carry her up and down stairs, and she hasn't tried to get all wild and crazy. She's a rescue, and we think that she is about 3 years old, and she is tiny for a Rottweiler, and weighs in at a whopping 73 pounds. She is also spayed.
Obviously, surgery would seem to be the most logical route, but now I am starting to have my doubts. I started reading about a non-surgical option called Conservative Management, which claims to have a really good success rate if your dog's tear isn't that bad. Obviously, she'll have the surgery if she needs it, but I know that surgery itself carries inherent risks that I would rather not expose her to if we don't have to.
So these are my questions: do you have any experience with this yourselves? What did you do? Is surgery a good option? What can I do to make her comfortable and insure that she heals as quickly as possible? Is it true that a couple of spoonfuls of pumpkin a day will keep her from getting constipated from the meds? These are the sorts of things I need to know.
Any advice or anecdotes are welcome. I know that there are tons of other pet lovers here and I would really appreciate hearing what you have to say. My dog is so important to us, we really want to make sure that we do right by her.
posted by msali to Pets & Animals (12 answers total)
Best answer: I am not specifically aware of Conservative Management, but be prepared for the fact that in dog this size, surgery is often going to be your best option for long-term success. If you do not opt for surgery, you may want to look into a good knee brace.

If you do decide on surgery: you want a vet who's got a good anesthetic protocol and who's done a lot of cruciate repairs and has a good track record (this is not necessarily a boarded specialist). You want a Certified Canine Rehab Practitioner for post-op (and possibly pre-op) rehab. If you can find a vet who includes the rehab as part of the surgery package, so much the better. You want a good pain management protocol.

To my knowledge it is not worth the extra cost and slicing and dicing involved with TPLO, especially since there can be more complications involved. The traditional repair done by a skilled vet is likely your best bet.

And follow the restricted activity instructions to the letter, no matter what route you choose (and if you have surgery done, avoid, avoid, avoid a vet who doesn't give you detailed instructions about what is allowed and what isn't, you can make or break a CCL repair with poor post-op care). If you have a crate, use it, outside on a leash only, etc. Reduce her food quantity while she is laid up, and feed her out of stuffable toys so that she has to work for her food, it will take her longer to eat the smaller amount, and help reduce her boredom. You can clicker train her with some of her meals, teach her stationary tricks, there are loads of good books out there. You also need her to be very lean if she has an orthopedic challenge like this (it's healthier anyway). Good luck!
posted by biscotti at 10:37 PM on August 21, 2010 [1 favorite]

I once had a dog that blew out her ACL. She had surgery, needed a little rehab (ie, short forced daily walks that became longer walks with time, restrictions on things like jumping on the bed or couch), and pretty soon (6-8 weeks?) she was back to normal. This happened twice. It was my understanding that without the surgery, the leg would atrophy and become useless. So, surgery it was.
posted by Gilbert at 4:51 AM on August 22, 2010

Our close friends' dog tore either her ACL or CCL; I'm not sure. She's probably a little bigger than your dog. Ultimately,partially because she was injured for a while and hid it, she needed three surgeries (difficult repair,but the vet was well regarded). So this does not necessarily end with ONE trip through the OR,but as Gilbert says above, the option was that her leg become more and more useless over time.
posted by Medieval Maven at 5:16 AM on August 22, 2010

You can consult with a canine orthopedic specialist without committing to surgery, and they can help you work out your realistic options.
posted by galadriel at 6:59 AM on August 22, 2010

Oh, one more thing which may help: the longer you leave the bad leg untreated, the more likely it is that your dog will rupture the other knee. And be prepared for the fact that it is still possible that the other knee will go even if you address the injured knee quickly (it happens all too often)
posted by biscotti at 7:23 AM on August 22, 2010

Definitely a Certified Canine Rehab Practitioner (CCRP). They may include swimming during recovery (or even before surgery), and recommendations about kinds of exercise.
posted by idb at 7:43 AM on August 22, 2010

Best answer: My lab/shep mix tore her ACL when she was four and there were two options for her: getting a plate/pin/screws, or a TPLO. I opted for the latter. The rehab regime was strict in one regards - no climbing stairs or inclines for, I remember, 12 weeks or so. After I think four weeks she could take longer walks twice per day. The no-stairs rule was easy - put up a baby gate - I slept in the living room to keep her company.
She recovered as planned to full capability - she's ten now and shows no signs or arthritis. That first week was tough for her - a lot of pain and swelling, and she was pretty dopey from the dog equivalent of a Duragesic patch. I think about it sometimes when we go for a walk or to the dog park, and I'm glad to have done it.
posted by nj_subgenius at 9:23 AM on August 22, 2010

Given her young age and large size, she will probably need the surgery for a full and active life. My dog has had both done. Yes, it sucks, but it works. Make sure you understand all the surgery techniques and options and go ahead and have a consult with a specialist if you aren't getting the answers you need from your vet.

We ended up going with our vet doing the old school (no plates) repairs at her regular practice, but my dog is smaller than yours, and my vet is not your vet, so I can't advise that for you. Good luck., sorry to hear it.
posted by rainbaby at 2:13 PM on August 22, 2010

Kaylee had this happen to her left knee a few years ago. And, as we were warned, her right knee went six weeks later due to the stress put on it while her left knee was out of whack. Both surgeries went great. We were given antibiotics and pain meds. The pain meds seemed to do the job as she never seemed to be in any discomfort.

I've never heard of Conservative Management and can't help you there.

I have one suggestion: should Raina need a cone, get her a clear one. Kaylee fought the opaque cone but was fine with one she could see through.

Good luck with whatever you decide to do!
posted by deborah at 2:36 PM on August 22, 2010

Best answer: My sweet dog Mabel is going through this right now. My vet recommended the surgery after sedating her and x-raying the injury. Apparently, you can skip the surgery but that increases the likelihood that the opposite knee will end up with the same problem. This was back in May, and it's only been in the last month that I've felt like she's finally doing better.

So, keeping it simple, I would recommend the following: (if you choose to have the surgery)

1. Ask around for an orthopedic surgeon vet. Apparently they exist, mine used to work at the zoo!

2. Read everything they give you, and follow ALL of the recommendations.

When I picked Mabel up after her surgery, she was deceptively mobile. She walked on the injured leg right away, and even tried to run. I should have made sure that she never could run. I think that I was encouraged by her attempts at movement and play, and I wasn't as restrictive as I should have been. It was only after I started keeping her on a 8 ft. lead at all times (when she was outside) that she started to make very visible improvements.

3. Be prepared for a very long healing process. Mabel still limps occasionally, and whimpers sometimes too. She can't really jump up anymore, so depending on what she's trying to do that could be good or bad. Also, stairs are a struggle.

Good luck with whatever you decide!
posted by secrethandshake at 4:01 PM on August 22, 2010

Response by poster: Update:
We took the pup in this morning for x-rays and I just heard back from the vet. Evidently, our girl broke a toe! It's really funny, because one of the very first things I did was manipulate her digits on her toe, and she didn't even flinch. The doctor did the same thing, and got the same result - that dog has some amazing ability to not show pain.

I talked to the vet about Conservative Management, and we are setting up a plan to keep our girl on major restrictions. Evidently it should take between six to eight to heal, and we will redo the x-rays in about six weeks. Right now she is having bloodwork done, and she is getting splinted. I'll pick her up this afternoon.

Thank you everybody for all of the excellent advice. Once again, the green has come through for me.
posted by msali at 8:22 AM on August 23, 2010

That's a nice ending...
posted by nj_subgenius at 4:56 PM on April 8, 2011

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