doggie surgery? doggie scar tissue? doggie pain?

November 1, 2021 5:11 PM

Our 10 y.o. cockapoo has been diagnosed with a cranial cruciate ligament tear. We have to decide between surgery and "letting it heal".

I understand that doing nothing but waiting for scar tissue to build up is one option and could lead to arthritis and the other knee getting injured; I also understand that surgery means a very long rehabilitation and recovery time. I've read a lot on AskMeFi about people who opted for surgery. Has anyone not gone the surgery route? Can you share your experience with your pup? Mine is a 30 lb cockapoo who went a little too crazy running and jumping in the leaves yesterday. Thank you!

posted by aimeedee to Pets & Animals (8 answers total)

Our 30 lb Lhasa-Cavalier tore his one day doing not much at all. Just suddenly could not put weight on it. He was probably about 10 also. He was not a good candidate for surgery because he had congestive heart failure and epilepsy. And we were told not doing the surgery was a viable option for dogs up to 30 lbs.

So, he got put on pain killers and got carried up and down stairs for a few weeks and then slowly got back to normal. We did worry the whole time about his other leg, but he wasn't one for jumping around too much and we were lucky. I'm sure it was uncomfortable but he did not seem in constant pain and mostly acted like himself, which was reassuring.
posted by Glinn at 5:24 PM on November 1, 2021

So this happened this past summer to Annie, my nine year old cockapoo/lhasa mix.

We had two episodes of this within a single month this summer after she lunged at dog while on leash and a couple weeks later she too aggressively chased a squirrel. Both times, she got super withdrawn and wouldn't do stairs. She was fine after about ten days. After the second episode, it hasn't happened again and it's like it never happened. She's doing great.

Vet's recommended approach after a full exam was to just wait and see. Vet gave us carprofen (doggy tylenol, works really nicely) and encouraged us to give Annie more gentle exercise after she was feeling better to trim down a little so there's not so much weight on her knees. And fish oil, which we haven't done yet. She also said we might look into getting a ramp for the furniture to spare Annie the big jump up, but Annie's made of bouncy stuff so she's been able to hop up normally.

You'll get other comments here but that's what we did. We love our vet, so our approach is just to ask the vet what she would do in our situation and then do whatever that is.
posted by mochapickle at 5:30 PM on November 1, 2021 [1 favorite]

We had a Westie (~22 pounds) who had one knee surgically repaired (at age 11, IIRC) and the other knee healed naturally when it tore a few years later. There are a lot of considerations in choosing between the two options. One is that, while the first one heals, the other one is at greater risk of tearing as well, although the second knee is far more likely to tear no matter how you choose to treat the first tear. Another consideration is whether the conservative route is even an option, since a ligament torn all the way through will not heal without surgery. The healing process took longer, but not much longer, with the "conservative" route. The precautions for the post-surgical and the non-surgical routes were approximately the same - no running, no jumping, no stairs, etc. In both cases, we trusted "the wisdom of the dog" and it all turned out fine.

For a contrasting viewpoint, we have a neighbor whose Husky tore her CCL and is following the nonsurgical route. She has been limping for at least three years with it. She still takes very long walks, though.
posted by DrGail at 5:36 PM on November 1, 2021

I did one of each (with a cockapoo, no less!). My dog tore his first CCL when he was 4 years old and I had that repaired. While the recovery went fine from a medical perspective, it was EXTREMELY challenging from a lifestyle perspective. Because of the layout of my house, my dog basically had to be confined to a giant playpen for the entire 8-week recovery and he was a depressed, neurotic mess. It was miserable for both of us. He did end up a little bit arthritic in both knees, and at 8 or so years old, he tore the other CCL. Because of the miserable recovery situation from the first surgery, my vet thought it was worth waiting a couple weeks to see how things healed on their own. I'm a little hazy on the timeline, but things seemed to heal up pretty well in 3-4 weeks and he didn't have any more trouble with that knee than the one that was repaired.

You will want to confirm that this is true in your situation, but my vet told me that as long as you can manage the pain well enough (which we did not seem to have any trouble with) there really isn't a TON of risk in waiting to see how things heal on their own. If several weeks go by and things don't seem to be improving, you can just do the surgery at that time. Also, while it is possible you are at greater risk of the dog developing arthritis or injuring the other knee if you don't do surgery, I think you are at a pretty high risk of that just by injuring the first knee, whether you have a surgical repair done or not.
posted by mjcon at 5:37 PM on November 1, 2021

As a human who's had open knee surgery, and had a very bad ankle ligament injury heal with zero weight bearing for 2 weeks + limping for a month after that, I would choose time. I hope I never need surgery again. Surgery recovery for me was really tough bc the pain medication was never ever enough. I'm obviously not a cockapoo, but I knew what I was getting into and I could communicate pain very clearly, traits that give me a huge advantage over a dog, and it still sucked.
posted by nouvelle-personne at 9:03 PM on November 1, 2021 [1 favorite]

Our 7-year-old rescue (probably Lab/Shepherd mix) has injured both of her hind leg CCLs over the past couple years. She's a much bigger girl - about 85 pounds/38 kilos - and had been very active before the injuries. We've had concerns about an experience similar to what mjcon reports - confinement after surgery was gonna be really rough. So we tried a brace, which she was not able to tolerate for any period of time. We muddled through for a while without any good answers.

Then, this summer, we had to consult a veterinary surgeon about an unrelated issue with her toe. I asked him about the CCLs, and he said he would not recommend the surgery. Said it's not unusual for re-injuries to happen over time. Revision surgery, even if you commit to doing it every time, eventually becomes unworkable because of accumulated scar tissue at the site. He offered the option of an injection to the sites. Not cortisone, but something similar in effect, which she could do about every 6 months if it seemed helpful. Somewhat costly, at USD $500 per treatment. He said some dogs require anesthesia for the treatment, which adds a few hundred more to the cost.

In the meantime, she's on daily Rimadyl and has also started taking a supplement called Movoflex for joint health. We are finding that we can now walk her about 2 miles/3.2 km without protest or subsequent limping. The surgeon recommended we guide her weight downward by about 10%, which would improve her long-term mobility and take stress off the joints. She's not particularly overweight but he said the leaner, the better as we head into her elder years.
posted by sockshaveholes at 9:10 PM on November 1, 2021

This happened in both knees of my great dane. We opted not to have the surgery because she's old enough that I don't want to put her through two separate sugeries. Pain killers, lots of strict bed rest, and human assisted potty breaks for the better part of 2021 got her flying colors at her recent annual exam. She's got some arthritis, but no more than expected for an 8 year old dane.
posted by coldbabyshrimp at 9:21 PM on November 1, 2021

Dog size and weight are deciding factors for this, for me and you're on the "it's OK to be conservative" side.

Strict crate rest (so many stuffed kongs!), minimal on-leash activity working upward carefully, and pain meds, plus Prozac if the activity restriction makes them a neurotic mess (it's temporary, and you can do some in-crate clicker training that will help tire their brain). Slim them down aggressively- very aggressively. Gtting weight off helps the hurt knee but protects the other knee too! Add pumpkin or green beans or other high fiber veg.

I have a dog on the "probably not ok" side (50lbs) and he did wonderfully with the conservative option but I was able to buy a (so expensive!!) knee brace from a retired human orthopod that was wonderful. I went looking for them recently for a friend and they're no longer being sold :(

If you want to add a brace, you're looking for one that straps over to the other leg for support, not just a neoprene sleeve (does nothing), and they're usually pricy, but less than either of the 2 types of surgery (the lateral tie is for small dogs only, the (tplo) plate is .... a -lot- but is really what big dogs should get if they have a complete tear or you go with surgery).
posted by esoteric things at 7:54 PM on November 2, 2021