Tips for helping our dog while we manage his torn acl?
December 20, 2012 5:52 AM   Subscribe

Our 30 lb dog beast has torn (or ruptured) his ACL. He has a host of other medical issues, but the vet has put him on pain meds (he was already on an anti-inflammatory) and wants to see how he does by the end of two weeks. Because it's a common problem, I was hoping you folks might have some tips to make him as comfortable as possible.

A Lhasa/King Charles mix, Wilson is just about 10 years old, he also has epilepsy and an enlarged heart/bad heart valve (and on meds for both), so the vet is very not thrilled about putting him under for surgery, and neither are we*. Whether or not we get the surgery (which was quoted at just under $2k, not sure which one it was now that I've read up on 4-5 surgical procedures, will find out today), he could be in this state for many weeks so any tips on making him less miserable would be very appreciated. He loves snacks but we are aware he needs to cut back if he's getting no exercise. I wouldn't call him overweight but he could lose maybe 2-3 pounds. Fewer snacks will be hard on me, the softie, because I know it's one of the few things he'll be able to enjoy while in pain. I'm freezing a small kong with peanut butter right now to take to work when we go. Other ideas?

After a couple weeks of occasional wobbly knees, especially when getting up after sleeping, yesterday he completely collapsed on his left knee and less than an hour later at the vet was diagnosed with the torn ACL. He will put almost no weight on it, so what little movement he does is a painful hobbling. I am carrying him everywhere. Steps up to bed, steps down to go outside (front and back). We tried using a towel to help support his weight but that didn't work at all. We found this site with all sorts of slings and things. We found these braces too. Any experience with any of these options?

He doesn't cry much, except for a few moments last night when he seemed to be in an uncomfortable position. Otherwise he takes it quite stoically, so I am never sure if helping him adjust his position or lots of gentle petting is particularly welcome or not (like, would the knee feel better stretched out or bent? Or does it all depend on the injury and the dog?). Which is making me anxious, and I'm not generally the anxious type. Adding to that, he did not poop all of yesterday - my guess is because he can't support his weight to squat. He is managing to pee fine, thank goodness. I read that they can be constipated for up to 5 days after surgery, so I'm not panicked about that issue yet. His appetite is good.

(I did see this previous question and a couple other related ones.) Any tips or advice if you went through this with your dog would be most appreciated.

*He also has some kind of coin in his stomach which we found by accident a couple weeks ago because he swallowed a small rawhide whole and hadn't passed it. No sign of the rawhide but a quarter or who knows what is in there - and two weeks later a re-check showed it in the same place. Potentially this is also something that could require surgery because some coins can be toxic, or get caught somewhere. I mention this because if he's going under we may take care of both issues. But will definitely have more talk with the vet about that. He also hasn't had a seizure in much longer than normal, and I have this weird fantasy that the coin or whatever is leaching some mineral that is actually helping him. Probably not, I realize.
posted by Glinn to Pets & Animals (15 answers total) 2 users marked this as a favorite
Our 90 lb. lab mix went through the same thing - and ultimately had to have the really expensive TPLO surgery, which did the trick for him. In the meantime, the basic rules of pain meds, limiting exercise and activity, and lots of love and attention seemed to help him out. It's really terrible to see your canine friends having problems, but know that pain management with meds and being there for him really does help. I don't think a few extra treats will matter too much if he really loves them, but keep in mind weight does play a role in recovery from these injuries. Our dog seemed to find a more-or-less comfortable resting position on his own - and my understanding is that the pain is really present when they have to put weight on it. Good luck with your guy!
posted by gorbichov at 7:05 AM on December 20, 2012

Best answer: My family dog had two torn knee ligaments, I believe they may have both been ACL, and had to have them surgically repaired. He was ~120 lbs so quite a different size from your dog, but basically what we did was the pain meds and then we would help him to stand up if he needed it, but we generally tried not to do that because it made him nervous and he would struggle and seemed like it was making things worse. He had the most difficult time standing from a smooth surface, like wooden or tile floor, so we got a bunch of throw rugs to help him get up. We did not use any slings or anything, I don't think it would have helped much although it seems like it makes more sense with a large dog that is difficult to pick up on your own.

I think you have to judge by his behavior whether he likes something or not - certainly different dogs react differently to being injured. He may be stoic but he will still not purposefully hold the leg in a way that is uncomfortable if another way would be better, so I would not try to adjust his leg for him. If he isn't reacting badly to petting then he's probably fine with it, I am sure you would see a sign if it was bothering him.

I deal with ingested coins in humans and generally if they have reached the stomach they are not a problem because they have passed the narrowest parts of the GI tract (where they would get stuck) already. The coin does not sound like a big concern right now. I have never heard of coins leaching minerals and causing any particular physiologic effect in humans, they're usually just looked at as pretty benign things to swallow (they are the most common ingested foreign body in humans).
posted by treehorn+bunny at 7:08 AM on December 20, 2012

Response by poster: Thanks for the answers already. He's a pretty cuddly guy so we'll continue with cuddly behavior, unless he turns his head away or some other obvious sign. I'm sure you're right about him adjusting his leg on his own, but a couple times he was adjusting his position and the foot seemed to get folded oddly because he couldn't pull it up.

Of course we're worried about his other knee also. Ugh! We don't have loads of spare dough but we would do the surgery (and the other knee too, when/if it's needed) if it meant a good recovery and quality of life after recovery, but first we'll have to decide if going under is worth the risk to his heart. On the one hand he's relatively young for a smaller dog, but his additional health problems mean lots of tough decisions.

(As for the coin, the vet said certain older pennies (I think) are made of things that can be problematic, and that because the xray magnifies the image it's really hard to tell what kind of coin it is. But that problem is sort of on the back burner. We've been told to look for vomiting as a problem there.)
posted by Glinn at 7:45 AM on December 20, 2012

When our dog went through this, the vet suggested icing it, especially if it was warm to the touch. You may want to call and ask about that. We also put throw rugs on the kitchen floor, as mentioned above.
posted by rainbaby at 8:19 AM on December 20, 2012

We also had the TPLO procedure done for a 11yo 60# lab mix. The results were great -- gave him another two years of pain-free movement. His surgeon was a veterinary ortho specialist who also prescribed hydro-therapy post-op. It was basically a treadmill at the bottom of a water tank -- high water levels supported his weight while he walked, and as he healed, the water level was gradually reduced until he was supporting full weight on his knee. That might be something to ask about as a possible rehab alternative, if the equipment is available in your area. (We were lucky enough to be near a major vet school at the time.)

Throw rugs are a big help on hard surfaces, as others have suggested. We tried one of the slings, but found that supporting him with a towel under his midsection was faster, easier and he adjusted quicker to it once he understood we were trying to help, not restrain him. But again, much bigger dog -- you may be just as well off with careful lift-and-carry. Our dog used to sleep on the couch, but couldn't get to it when he was injured. A big chunk of memory foam wrapped in a old blanket became his favorite bed during this time. It was warm, easy to get on and off, and provided the support he wanted without a lot of "fluffing" like many other dog beds.

Our biggest problem was the three steps we had to negotiate to get outdoors and in again; he had never used a ramp and teaching an older dog to use one when he's hurting is a major challenge. (I highly recommend ramp training for bigger dogs when they're young, based on this experience. Lifting a big dog up and down stairs several times a day is no treat for you or for the dog.)

Good luck and best wishes for a speedy recovery for your buddy.
posted by peakcomm at 8:58 AM on December 20, 2012

My lab mix was put on pain meds and glucosamine and chondroitin(sp?) The worst part for her was the exam to see what was hurt. She took it easy herself with no prompting from us. No limping after about a week.
posted by PJMoore at 9:27 AM on December 20, 2012

Our dog also took glucosamine/chondroitin post-surgery, chronically. I will note he never had awesome recovery, he had chronic pain and eventually had to be put to sleep because he spent a lot of the day crying in pain (poor guy). This could have been more an arthritis problem because he was a very big dog.

By the way there is a website out there with very strong sentiments on it about dog ACL injuries that you might want to check out. I'm a people doctor, not a dog doctor, but it looks worth checking out the literature - I know that human orthopedists have often been found to be overly enthusiastic about the use of surgery in cases like this, and the fact that your little guy has some serious medical issues that make surgery less desirable makes this more important for you.
posted by treehorn+bunny at 9:38 AM on December 20, 2012

Poor, poor Wilson... good for you for getting this checked out. I am the mom of the Westie in the question you referenced. It's been almost a year since Fergie's surgery. He had a repair done by our regular vet, creating a suture. The surgery went really well. Recovery entailed 8 weeks of us sleeping on the floor (because he likes to sleep on the bed with us and was forbidden from jumping), carrying him up/down the stairs, and leash-only walks and bathroom breaks. We also started him on a joint supplement at that time, and reduced his feeds so that he lost about 5 lbs. He received PT 2 times a week at the vet's for about 4 weeks, and that also included laser treatments, AND we had to ice and massage the surgical site three times a day for about 6 weeks. We did everything faithfully.

Fast forward to today. Fergie lays on his bad knee quite frequently, and it ends up being sore/stiff. But, it's nothing that bothers him. It's just like human surgery--it will never be quite the same. But he runs, jumps, and plays like he did pre-injury. It has definitely contributed to his quality of life, now that he's an old dude of 9 years. I suspect he's getting arthritis in his hips, though, and I also think that switching to a new type of senior dog food has made him put a few pounds on; we are going to try to get him to lose a few more pounds (he's at 23 now) to see if that helps. Weight management is a big part of it, especially if you have a little chunk who loves to eat.

Personally, I would be concerned about putting a dog under who has heart issues like Wilson. Fergie's biggest issue was his allergies, and thus his frequent doses of prednisone, which can interfere with healing. We waited a while until he was OK for the operation.

Here are a few questions to ask yourself:

1. Are you willing to comply with a potentially complicated recovery process? What is the recovery process your vet would want you to take? We probably were extra cautious, but I wanted the best possible result.

2. Are you committed to limiting food, so he can lose some weight? What is the ideal weight for him? Joint issues and osteoarthritis (which is inevitable in older dogs) are ameliorated by proper weight (and sometimes exercise--but ask your doctor).

3. What is the plan if this doesn't work? Sutures break (rarely), bone doesn't heal properly... what would be the next step?

Another thing is to get a second opinion. I am glad I did; not only did I save a bunch of money, I feel like I got the best possible service. I don't think I would have gotten the same care for Fergie had we gone to some specialist vet. Our vet was qualified to do the surgery, and it was such a non-complicated case, I felt completely comfortable that this was the right way to go.

Best of luck in your decision.
posted by FergieBelle at 11:12 AM on December 20, 2012

We did the TPLO surgury on our 75 pound lab and it was quite successful. He moves without pain now and seems to be fully recovered, tho the recovery period was difficult b/c he thought he could run and jump much sooner than the vet did. A friend's much smaller dog (25-30) pounds recovered after several weeks of restricted activity without surgery. With our dog I found keeping lots of cushiony stuff in his crate and staying downstairs with him and just hanging out as much as possible so he wasn't tempted to try to sneak upstairs was helpful.
posted by Cocodrillo at 11:47 AM on December 20, 2012

Our 12 year-old, 120-pound dog tore her ACL a few months ago. We've opted to try the nonsurgical route, mainly because of concerns we have about her age and other health issues that would make surgery and recovery difficult (if not life-threatening). So far, so good.

Our pup has hip problems so was on Metacam already. Shortly after her injury, she had a 4-week series of Cartrophen injections, which really seemed to help with her mobility overall. She then had two rounds with a physio, and has prescribed exercises (for both legs) that my husband does with her every day. And she eats prescription "joint-supporting" dog food (I don't know how much of a difference it makes, really, but since she's in a good place now, we're not going to change anything).

She's not 100% – she's somewhat stiff after lying down for a while and isn't very good on slippy floors (which was actually the case before her injury, too, due to her dodgy hips). But all in all she's doing very well and doesn't seem to be in discomfort (apart from the short-lived stiffness) – she goes on a 3-4 short walks/trots every day, can poop/pee just fine, and is her usual happy, goofy self. (Her leg would need to get stronger before she'd be able to try a full-on run, but her hips pretty much preclude her from even attempting that.) She sleeps just fine – in all sorts of positions. She has lots of padding on her beds, and we've also put down area/throw rugs on any uncarpeted floors.

We'll bring her back for physio and checkups with the vet to monitor her progress, but as of right now, we feel her quality of life is definitely good enough that surgery isn't warranted. The only thing that might change our minds is if she re-injured the leg, or tore her other ACL.
posted by lovermont at 1:13 PM on December 20, 2012

The more weight he loses the better right now. Small dogs have a decent chance of recovery without surgery but you're going to want to keep him on the thin side from now on. I wouldn't be giving him peanut butter, really high quality dog food and meat or fish or eggs, that's all.
posted by fshgrl at 1:39 PM on December 20, 2012

Response by poster: I really appreciate all the personal stories, and he seems to be just a tad more himself this evening, and I'm glad to read/hear about the non-surgical successes. We're waiting to hear back about ice and/or some kind of wrapping option.

I know peanut butter is high fat, arrgh, but it's a really small Kong and has chunks of carrot with maybe a teaspoon of peanut butter. Plus that really kept him busy and happy-seeming for a couple hours. But certainly not more than one a day (at least with peanut butter), and when he has snacks he gets a smaller dinner (which is Blue Diamond chicken/rice).
(Also - two poop piles - HOORAY!)
posted by Glinn at 2:45 PM on December 20, 2012

Response by poster: treehorn+bunny, so sorry it went poorly with your big guy, and thank you for the info.
posted by Glinn at 2:47 PM on December 20, 2012

My Rhodesian Ridgeback had hip problems, and had to be immobile for long periods of time recovering from surgery. This was a wonderful opportunity to work on her down/stay obedience with tons of treats.

Yes, this involves interaction from you, but as you extend the period of time that you can get the dog to down/stay, obedient dogs can end up staying for 30 minutes.

Healthy, homemade, gluten-free and vitamin-laced cookies were our primary treat. She loved them. They were mostly peanut butter with some other additives. Peanut butter has "tons" of fat in it, but it's the "good" kind of fat like Salmon, not the bad kind of fat. Feel free to feed your dog as much peanut butter as he or she will tolerate, although the unsweetened kind is way better for your dog than the cheap grocery store brand kind.

Also, if you can, make sure your dog is drinking tons of water. I trained my Ridgeback to drink and pee upon command. Drinking on command was useful for helping flush the byproducts of healing post-surgery, and peeing on command was useful for limiting the amount of movement -- no sniffing or all of that, just pop a squat as fast as possible.
posted by SpecialK at 6:21 PM on December 20, 2012

Response by poster: Short update:
He really is getting better each day, and it seems he'll recover on his own without surgery. Which is great! But he does need to be watched and we've had to put up a baby gate so he won't go up the stairs. Rug runners have also helped. He does get a bit restless but I hope to start going for short walks soon.
posted by Glinn at 7:53 AM on December 31, 2012

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