Dog blew a CCL. Now what?
January 2, 2012 8:44 AM   Subscribe

Dog blew a CCL. Now what?

My 8-year-old male Westie has been diagnosed with a ruptured cranial cruciate ligament (CCL). His primary care vet has referred us to a specialist for a surgical consult.

I have read up on the two main procedures to correct this, the TPLO and the TTA.

What I am wondering about is if we need surgery at all. Here are the facts:

1. Dog is 8, probably has 6-8 more years ahead of him.

2. He is in good health, but suffers from seasonal skin allergies. We have settled on Atarax and the occasional course of prednisone to treat uncontrolled itching. We were also planning on allergy shots to see if they will work as well (since he's getting older and probably not able to take the prednisone as his organs get older).

3. He lives a sedentary lifestyle. He chases squirrels in the backyard and enjoys the occasional flat, level walk. One of his favorite things to do is just sit on the patio or in a patch of sunshine in the backyard and watch the world go by.

4. He weighs 25 lbs. Yes, it's big for a Westie, but he's about 30% taller than the average male Westie I've seen and therefore has more mass to him. He is at a good weight for his size, according to his vet.

We are treating him with tramadol right now for the pain while we figure out what to do. I don't want him to be in pain for the rest of his life, but I can't really understand if a dog of his size and activity level truly needs a surgical procedure for this, or maybe he can get by with the TTA instead of the TPLO. And I wonder about the pain level, too: his vet said it felt like it was blown a while back (he just starting exhibiting lameness in that leg), and he's never once yelped or growled when anyone touches the area.

Any experience with this would be appreciated. I'm just trying to educate myself on this.
posted by FergieBelle to Pets & Animals (10 answers total) 1 user marked this as a favorite
My mother's dog tore a ligament about a year ago. Because of the dog's age (12 or 13) she decided not to treat it with surgery.

Honestly, the dog seemed pretty miserable for about six months, even with pain medication; it seriously seemed to impact her quality of life. Now, a year later, and at fourteen, the dog is finally in a bit better spirits--she's in the mood for walkies most days, happy about food and visitors again, though she still limps a bit. The leg injury means she definitely still seems like an "old" dog--some days, she really doesn't want to get out of bed. I can't imagine resigning an 8 year old dog to that kind of life, but that's just me. Best of luck to you.
posted by PhoBWanKenobi at 9:11 AM on January 2, 2012

Best answer: Extra capsular suture repair is another alternative for a surgical fix. It requires a longer recovery but is less invasive and is usually a lot less expensive. However, it is not the right choice for every dog. If your dog is otherwise healthy, and you can afford it, you should consider the surgical fix. Make the appointment for the surgical consult.
posted by little miss s at 9:14 AM on January 2, 2012 [1 favorite]

Our dog tore her CCL around the age of five. We didn't go through with the surgery because we couldn't afford it at the time. She limped for about eight months, and then never again showed any sign of a problem with that leg. She lived to be 18.
posted by raisingsand at 10:18 AM on January 2, 2012

Best answer: Find a vet who does good extracap repairs - much less invasive and expensive than either the TPLO or the TTA, works just as well if the vet is good. As of yet there is zero evidence that the TPLO or TTA actually result in better results, and there is an increased risk of complications and arthritis because of the bone removal. You do not need a specialist, just someone who has done a lot of them and is good at them. Make sure you arrange for PRT before and after, and make sure the vet has a good pain management protocol.
posted by biscotti at 10:42 AM on January 2, 2012

Oops..there is LESS risk of arthritis and complications with an extracap repair. Be aware that an extracap is STILL SURGERY, it's just not surgery which involves removing chunks of bone.
posted by biscotti at 10:45 AM on January 2, 2012

Best answer: Was the diagnosis made on the first visit? I ask because our 23 pound, 7-year-old mixed breed was recently diagnosed with a CCL tear. Our vet put him on painkiller/anti-inflammatory medicine and asked us to bring him back in a week. When we went back for the follow-up, the vet said that apparently the dog either hadn't torn his CCL as initially thought, or that it wasn't bad enough to require surgery. Now, 6 weeks later, he seems mostly fine. We catch him limping maybe once a week or so. If it gets worse, we'll take him back again, but for now: no surgery required!
posted by pril at 11:14 AM on January 2, 2012

Response by poster: @pril, we first took him to the vet around Dec. 4 because he was lame in his left hind leg. At that point, an x-ray was done and the only indication was luxating patella; the expectation was he'd get better over the next few weeks, which he did. On Dec. 31, during a follow-up visit, the doctor sedated him and two different docs palpated the leg and they both think it's blown, with scar tissue indicating it's been gone for a while. He couldn't go on prednisone at that time, as he was finishing up a course from his allergies, and it would be too much on his system.

@biscotti, I was hopeful that you'd answer as I'd read your input on other TPLO questions. I am going to look into the extra-capsular fix and bring that up at the consult.
posted by FergieBelle at 11:47 AM on January 2, 2012

I'm a vet, but I'm not your vet, so this isn't medical advice.

Trust your doc to get you to the right specialist. If your doc isn't recommending a specialist and is instead trying to convince you to let him do the repair, get a second opinion. When you get the ortho referral, talk to the vet about what makes your pet unique. Did the RDVM grade the movement in the joint? Did the rads show a joint where the hard tissue was in decent condition? Is the dog a good surgical candidate? Are you willing to commit to the PT?

The cruiciate is the new hip dysplasia. It is common enough and expensive enough to treat that there are a lot of different options out there.

If it were my pet, and I was not a vet, I would be weighing the consequences of mid to long term pain management (costs and wear & tear on the body) vs. surgery. Sometimes, by the time you do 8 months of pt, blood work and pain mgt, you're approaching the cost of the surgery. If you are going to go the surgical route, I think in most cases the TPLO is going to give you the best outcome. Some of this is because the vets performing the procedure are likely to be more well trained, and some of it is just because of the mechanics of the surgery. I would also be asking about the chances of the other knee going, and what to do in that event.

The one thing I can tell you for certain is that keeping your pup as lean as possible will be a huge help.
posted by Nickel Pickle at 5:50 PM on January 2, 2012

This happened to my 11 year-old Wheaten on Xmas Eve. Good times!

With an estimate of $2-3k for surgery (mimimum) and after consulting this very helpful link we have decided that surgery is pointless/unnecesary.

She's already showing improvement and is not in pain.
posted by eggman at 8:35 AM on January 3, 2012

I am in a very similar situation-3 year old 18lb dog, tore CCL last week. I decided on an extracap, mostly because the invasiveness of the TPLO and TTA made me nervous. Also-the dog is small, and my vet thinks the more invasive procedures are not necessarily proven to have better outcomes with small dogs.

One middle ground option to look at is having an extracap type surgery done with a stronger material. My vet does them with some sort of kevlar type material in bigger dogs, so the suture is less likely to snap or dog was too small to use this type of material, but if he hadn't been, I would have absolutely considered it, even at a significant extra expense. Yours might be just enough bigger to use the different material.

The dog just had the surgery done today and is staying overnight, so I can't speak to recovery time yet. I can tell you that the estimate they gave me was under $1000 to have this done, which was much less than I expected.
posted by mjcon at 7:19 PM on January 4, 2012

« Older Books that help form a person   |   Laptop whiteout Newer »
This thread is closed to new comments.