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Unread 09-15-2010, 07:59 PM   #1
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Default My dog tore a ligament.

Hi everyone,I am looking for advise on what to do.Heres a little background.About 2 weeks ago he was chasing a squirrel and suddenly started limping on his rear leg.I thought he stepped on a thorn because I pulled many thorns out of his paws in the past.For about 3 days he was limping pretty bad and started improving over the next week.He has jumped over ditches and sprained his front paw several times in the past and recovered well in a few days.I thought this would be the case on his rear leg but he improved to a point then stopped but he did not seem to be in pain at all,he just had a slight limp that would'nt go away.So I decided to take him to the vet.I was sure the vet was going to say he just needs time but he was diagnosed with a torn ligament and offered two surgeries as a remedy.One is using a wire to stablize the knee and the other is using a plate.The plate was recommended because he is a large breed dog although he is only 70lbs and on the small side for a shepherd but he said for dogs 40lbs and over it would be better.

I walked my dog today and he was walking fine without a limp but after about 15 minutes he started limping slightly.He can support his wieght on his bad leg to pee and runs around and is his usual playful, happy self so I am having slight doubts about the surgery.

My concerns are that the fact the recovery will be several months of confinement.He would not be allowed to be free in the yard unless on a leash for bathroom breaks then he would have stay in the house or in a pen while I am at work.Not shure how he would take this.Everyone I know works during the day,so I probably would have to make a pen large enough so can go to the bathroom.He usually has free rome of a huge back yard during the day but if he runs during recovery he may damage the knee.The cost of the surgeries are $1,600 for the wire or $3000 for the recommended plate.The money is not that much of an issue although times are hard and I am just getting back to work from a long layoff.

The only thing is he seems happy and don't seem to be bothered by the injury and I know he may not have too many years left since he is 14,so putting him through this would be hard for me.On the other hand the vet says arthritice may develope and the other leg may be at risk for a similliar injury since he would put more wieght then usual on it.And if he injured the other leg he would be immobile.I am leaning towards the surgury but would like to here oppinions.Thanks

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Unread 09-15-2010, 08:30 PM   #2
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You have my complete sympathy, torn ligaments are not easy to deal with. My dog has had two cruciate and one meniscal surgery for the ligament she tore. I would definitely advise you to pursue the surgery for him as left untreated, more extensive damage can result and though at times he may not act like his in not in pain, dogs can be very stoic about pain until it gets to an unmanageable level. My dog would happily walk around the block with me and then just four or so houses from mine, would start to limp. With proper confinement and monitoring of activity, recuperation is honestly not all that bad. The fact that he would be confined while you are at work is actually a good thing in that it is harder to keep a recovering dog quiet while there are people or activity around. Keeping to the postsurgical guidelines that your vet gives you during recuperation is extremely important. At first my dog was only allowed outside to potty and that was it and she was supported by a sling whenever I did take her out. Her first walks were only down the driveway and back which seemed incredibly restrictive to me at the time; externally she looked to be healing very quickly and since she was feeling better she wanted to go further. It was hard to say no to those pleading brown eyes when I had to bring her back in and confine her but it was important to insure proper healing with no additional damage. Is your dog crate trained? I found the crate immensely helpful during her recoveries, though I moved it around to keep her in the same room with me as much as I could. The photos below were taken just after she came home from her second surgery. I hope to hear that Thor is feeling better soon :-)

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Unread 09-15-2010, 08:34 PM   #3
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I am so sorry to hear your dog has a torn ligament. This is a very stressful time for any owner who has heard the diagnosis from the vet. Over the years, I have had several rescues who were diagnosed with torn ligaments, and it is a long road. I have a website that may help you make some decisions. It may also arm you with information you may want to bring to your vet or to a vet for a second opinion. Take some time and read this website, and do some research. You DO have time to make an informed decision. Again, I am so sorry you have to go through this.

http://www.tiggerpoz.com/
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Unread 09-15-2010, 09:00 PM   #4
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I very much agree with the recommendation for a second opinion, but not with some of the information regarding suggestions for more conservative treatment and "..that TPLO and TTA have become cash-cows for a number of veterinary ortho-surgeons who are making huge profits selling these questionable procedures by misrepresenting potential outcomes and risks to clients", nor has it been my experience that exaggerated claims of recovery are as widespread as this site would have one believe. Good sop of presurgical testing that includes thermal imaging, MRI, and CAT scans yield far more accurate information insofar as the extent and location of damage which very often helps drive the decision of which surgical option is preferred. The eight week 'wait and watch' can, in fact, be detrimental as even with constant monitoring a dog can easily further a tear and increase the level of damage. I do, however, think it is important in making decisions about treatment for ligament tears to not rely on the recommendation of the "GP' vet and seek the input of a specialist.
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Unread 09-15-2010, 09:57 PM   #5
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Quote:
Originally Posted by Haus Mansfield View Post
I am so sorry to hear your dog has a torn ligament. This is a very stressful time for any owner who has heard the diagnosis from the vet. Over the years, I have had several rescues who were diagnosed with torn ligaments, and it is a long road. I have a website that may help you make some decisions. It may also arm you with information you may want to bring to your vet or to a vet for a second opinion. Take some time and read this website, and do some research. You DO have time to make an informed decision. Again, I am so sorry you have to go through this.

http://www.tiggerpoz.com/
After spending half a lifetime involved in the world of sporting dogs; plus many years working in a vets office; I can't help but agree that there is some excellent information and suggestions on the above listed website.

I do have one question though. Who is Max, and what is his personal background regarding the subject? I didn't see anything relating to his credentials or actual experience in the field of ligament injuries on the website. Did I somehow manage to overlook it?
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Unread 09-15-2010, 10:18 PM   #6
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I don't know who has said exactly what about TPLO (and don't know if this is the cruciate ligament that you're dealing with).

I will tell you our experience with TPLO. I would do it again in a heartbeat. Ming tore his CL clean through and could not use his back leg at all. About a month before that, my former neighbor's young Staffie did the same. She had the more traditional surgery done. Sure, it was only $900 to the $2400 we spent on Ming. Her feeling was that even if it failed, she'd rather spend $2000K total than $2400. And if it didn't fail, well, a cheaper fix. Rational thinking.

Ming is a good bit bigger than the Staffie. He was about 95lbs at the time.

Recovery isn't really as difficult as it may sound. No, they can't go tearing around the yard at top speed and for the first several weeks a real walk is out of the question. But they aren't completely immobilized either. I wish I could remember how long it was before we were given the okay to let Ming accompany us to the mailbox (3 houses down) but to quote a number would be a guess. It's been too long. At any rate, after that point, life pretty much got back to normal fairly quickly although he still had to be kept from long walks or runs for some time, he was allowed a block or two a day for a while. Around the house he was able to go outside and take care of his business pretty much from day one. He didn't need help. Just control. I put a leash on him, took him out, brought him in, took the leash off. That was just for the first week or so IIRC. Of course, he didn't have a huge yard to play in. Plus he remembered the pain for a long time and was scared of using the leg too much.

The end result has been that Ming's leg has healed beautifully and this was three years ago that this happened. He spins on a dime and runs as much as a blind dog will allow himself to run (since he's more worried about bumping into things than he is about his legs). The leg is sturdy and I don't ever worry about it being a problem. Since this kind of injury happens often in the other knee down the line, I do worry about that but 3 years later and no problems. And since the fixed knee is solid, the other doesn't get any more pressure than it does.

My friend's Staffie however, did indeed reinjure the same knee and go in for the repeat surgery.

I agree with our forum director that a specialist should be consulted. I also agree that there are probably animals for which TPLO and the like might not be necessary. In Ming's case, such a large dog that already has a high risk of re-injury as well as tearing the other leg, I'd rather not take that chance and put him through additional procedures if I don't have to. I don't know the failure rate of TPLO so that is worth checking into. It may be higher in an older dog since the bone is actually cut and repositioned. The integrity of the bones is critical.

For me, the deciding factor would be the overall athleticism of the dog. My friend's dog was a highly active young dog who couldn't be slowed down and I'm sure this is why she injured the leg again. Ming is not highly active but when he gets active, all his weight goes on his hind legs. I believe we made the right choice for him.

I honestly don't believe that surgeons came up with TPLO in order to make more money but to devise a method to fix the problem such that it didn't recur and yielded a stronger joint for dogs that needed it. For example, if I had a dog that was an agility dog of any size, TPLO would be the answer because traditional surgery is likely to fail. That it costs so much more is understandable when you see what is done to effect this secure joint. It's really rather amazing. But no, it's not for everyone. And at 14, if you think he'll be slowing down such that he won't be terribly active then maybe the wire is sufficient.

Don't take my word for it - or anyone else's on the 'net. Talk to people who are in the business of treating dogs and working with dogs and that have seen both surgeries if you've time.

BTW, Ming had torn his CL a little bit a couple of weeks prior to the surgery. I thought it was just a strain and didn't react because he limped a little and then was fine but only favored it now and then. Otherwise he continued to be his normal playful self. Then we stood outside and he did one of his patented spins and I heard it snap and he collapsed. That partial tear now could very easily be a complete tear in time.
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Unread 09-15-2010, 11:06 PM   #7
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"Max and Tigger" are fairly infamous on the internet for this take on ligament surgery. Chessie's ligament issues were far from the first I have dealt with with dogs and this is one of the sites I first I had looked at then researched extensively before proceeding with Chessie's treatment. It would have been great if there were more truth to it and support from the medical world, but there wasn't and neither is it the experience of most dog owners who have faced ligament injuries or degeneration. This first experience occurred in 2002, it wasn't until 2004 that the first TTA was available. Even since that time tremendous progress in surgical treatments have been made, not only in type of surgery, but in fine tuning and advancing the procedures themselves so that much of what is cited there is no longer current. I think the only part of that article that I can agree with is the recommendation to seek second (and I would include specialists input) and the supportive role of supplements and guided PT/exercise after the chosen surgical intervention.
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Unread 09-16-2010, 02:11 AM   #8
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Thanks Haus Mansfield for the link.Here is some more info on thor's condition.It is the cruciate ligament and the TPLO is the surgery his vet is recommending.I did not know that x-rays do not show ligaments.The vet was showing me the knee on the x-ray and I thought he could see the injury but I could not see anything,however he showed me some bone fragments which he expained were from the ligament tearing from the bone.I believe most of the diagnosis was from the manipulation as Thor was sedated.In the article it talkes about misdiagnosis with this as some dogs have looser stifle joints.

The vet explained that there is another vet who comes to his office once or twice a month to do the TPLO surgery.There is specialized training for this surgery.I can get Thor in on the 23rd of this month because there is another TPLO surgery that day.But if I want to wait it would be another month before Thor could get the surgery because the vet will be leaving for a vacation soon after the 23rd.

I think I will get that second opinion because Thor was walking norally this morning even runnig around in excitement for his walk.During his walk I kept thinking he may have been misdiagnosed but a second opinion seems like the next logical step.The first exam included x-rays and sedation.Do you think the vet who does the second opnion will do the same?And should I look for an orthopedic specialist?Thanks everyone for the help.

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Unread 09-16-2010, 02:34 AM   #9
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With my current dog, the specialists were able to add an MRI, cat scan, and thermal imaging to better examine the extent of damage to her ligament. I'm not sure where you are located but very often those services are available through a specialty veterinary center or the orthopedic specialist's office. Maybe you could get the second opinion via this route. They are also able to schedule any surgery around your needs and schedule since they tend to more so many more of them (which is a plus for experience and being up on the latest procedural improvements as well). My dog was operated on by a veterinary orthopedic surgeon in conjunction with the internal medicine department and she received wonderful follow-up care from both.The cost to repair the CCL will fluctuate based on the state that you live in, the experience of the surgeon, the weight of the dog, the invasiveness & complication level of the surgery, etc. I live in New York where things tend to be pricey and I have seen prices range from 2200 and up. If you don't know of a specialty center near you, it can be really helpful to call the nearest university with a good veterinary medical school to ask for a recommendation. I think the second opinion is an excellent idea both to give you more information about Thor's condition and the extent of the damage as well as to gain as much information as you can about your surgical options.
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Unread 09-16-2010, 11:37 AM   #10
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just to add one comment. Ming did go to a specialist center for his surgery and was treated by an orthopedic surgeon there v. at the vet. The level of care he got there was excellent and I was very confident in the folks who did the surgery knowing exactly what they were doing. Look into it. There could be one in your area.
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