Ruptured Cruciate Ligament

[jans]

Hi there, I'd appreciate any and all advice on a ruptured cruciate ligament in a small dog. My girl ruptured her right rear leg last week. My vet has put her on a course of anti-inflamm meds, and in 5 days she has gone from not weight-bearing on the leg to a pronounced limp.

The options I am faced with are leave her on the meds and we live with the limp, or have surgery. She's 5 years old and about half a kilo overweight. The vet said that with littlies, don't rush into surgery however the extra weight she is carrying needs to come off (not an easy feat). Before I commit either way I'd love advice from anyone who has been in a similar situation. The limp restricts her play and I have a house full of stairs so am worried that if I leave her and don't do surgery, that I will cause her problems like arthritis down the track.

If I do have the surgery, I'd like to know what to expect in terms of her recovery. I work full time but would take a few weeks off work to look after her. If I did that, when in terms of timing would be best? i.e the first 3 weeks post op, or as she becomes more active. Do they recover the full use of the leg after surgery?? Is she in any pain now??

Really appreciate any thoughts and advice on this.

Thanks Jans.

[Poodle wrangler]

Sorry, haven't had a dog with the same injury, but about the weight ....

I had trouble getting extra weight off my smaller dog (<10kg).

What worked was cutting his food intake by HALF.

I mean strictly HALF! No cheating!

It looks like a tiny amount, but remember they're only very small dogs. You might feel mean, but it's for your dog's wellbeing, not to make you feel good.

An overweight dog has only it's owner to blame.

I added more walking, but that's not possible in your case.

Best wishes.

Whatever you do, get that weight off.

[DeerhoundLover]

If it's any help, one of my husband's dogs had this injury some years ago and was operated. She did get back the full use of the leg without a limp but we were warned there would always be a weakness and predisposition to another injury. No idea whether this was the statistically probabvle result though.

[westiemum]

Hi Jans,

Have been exactly where you are with my westie boy. He ruptured his back left ACL about 18 months ago, while he was VERY overweight (and yes I take responsibility for that). He was hopping around and I believe in considerable pain.

We treated conservatively for six weeks with anti-inflammatories (they sometimes do come good apparently) with little result. He would seem to get a little better then bang! He would be limping worse than ever. One afternoon he was so miserable that I took him back to the vet and said I thought he needed surgery and he agreed.

The vet did a fantastic job - he is like a new dog: cost was 900.00 - worth every cent. His recovery was uneventful - he basically lay around on the lounge for a couple of days with plenty of analgesia (patch if I remember rightly) and a covering course of antibiotics (I think!). He had his op on the Friday and I stayed with him all weekend and then my mother had a couple of dog-sitting days with him - after that he was fine.

I also worked VERY hard on his weight which has made a world of difference to him. As poodle wrangler said, I cut his food down by half (including his low cal dry food) but for us it didn't work (and no I didn't cheat!). So after some advice from some knowledgeable DOLers I put him on a barf diet, initially heavy on the veggies, a little protein (all human grade) and cut out the carbs and dry food - all under vet supervision. It worked sensationally. It was a bit drastic but I had to be 'cruel to be kind' - he is such a foodie! And he's now very svelte with a waist! A lean mean westie machine!! :laugh:

After he had lost his kgs, I then reintroduced his favourite foods as treats until I worked out how much (portion size) he could have without putting on weight. Hi diet now consists of half a barf pattie or 80-100gs of meat with veggies at night and a snack in the morning (chicken neck). He also gets bones (on those days he doesn't get his pattie or his meat) and carrots for treats regularly and 'naughty' treats occasionally only (he's a fiend around blue cheese!). He dropped 2.5 kilos (about 25% of his body weight!) and has been stable around the 8 kg mark for sometime. I think in my case the weight loss has helped him enormously and is the key to long-term successful management of overweight dogs with ruptured ACLs

I'm very careful to keep him on the lean side now (low side of his normal weight range) to keep the pressure off his joints (as a rescue dog who lived in a cage for a long time he has arthritis and poorly developed back leg musculature as well ) - so I'm very very careful with his weight now - and it seems to be working really well - he is happy, healthy and bounces around like a puppy - and the side benefit to all this is that he doesn't have the skin problems he had before - they have completely cleared up - and I think that is because of his diet and the fact he has NO artificial colourings, flavours or preservatives - I'm really careful about that.

He appears to me to be pain free these days - in fact sometime later the vet clinically had difficulty working out which leg he repaired without looking at his notes., the surgery worked so well.

So surgery is what worked for me. Personally I wouldn't leave him on meds with a limp if it could be avoided - you risk putting undue pressure on the good back leg which puts that leg at risk too - would be disastrous if the second back leg ruptured as well. And yes I think if left unrepaired the risk of arthritis goes up which brings with it its own set of problems and expenses. And yes I would get that half kilo off - in a small dog I think it can make a big difference.

Anyway, I hope that helps. Good luck with it all and please let us know how you get on.

Cheers

Westiemum

Hi there, I'd appreciate any and all advice on a ruptured cruciate ligament in a small dog. My girl ruptured her right rear leg last week. My vet has put her on a course of anti-inflamm meds, and in 5 days she has gone from not weight-bearing on the leg to a pronounced limp.

The options I am faced with are leave her on the meds and we live with the limp, or have surgery. She's 5 years old and about half a kilo overweight. The vet said that with littlies, don't rush into surgery however the extra weight she is carrying needs to come off (not an easy feat). Before I commit either way I'd love advice from anyone who has been in a similar situation. The limp restricts her play and I have a house full of stairs so am worried that if I leave her and don't do surgery, that I will cause her problems like arthritis down the track.

If I do have the surgery, I'd like to know what to expect in terms of her recovery. I work full time but would take a few weeks off work to look after her. If I did that, when in terms of timing would be best? i.e the first 3 weeks post op, or as she becomes more active. Do they recover the full use of the leg after surgery?? Is she in any pain now??

Really appreciate any thoughts and advice on this.

Thanks Jans.

Edited April 21, 2008 by westiemum

[jans]

Bless you, Westie Mum - that is exactly the sort of information I was looking for. Mine, too, is a resuce - a foster failure actually. I had thought the surgery would be way way more than $900 - phew I had thought at least $2k, and also thought I would be looking at months, not a week or two, to recovery. I can definitly cope with that.

In terms of diet, she is on a very strict diet as it is, but I am obviously overfeeding her. She had a liver shunt which was surgically addressed about 18 months ago but only partially successful, so is on Hills LD wet and dry food. I will have to be strict and cut back on her food and ignore those big brown eyes begging for more.

I'm in Melbourne and my vet is taking Werribee for the surgery. I hate taking her to Werribee - did you have any trouble finding a good surgeon??

Thanks heaps, Jans

[westiemum]

Hi Jans,

You're very welcome - I've learnt sooooo much from kind knowledgeable people on this forum its nice to give a bit when I have something to offer...

My boy was on a strict diet as well - but it wasn't working - so after lengthy discussions with the vet we decided to drop the carbs and dry food - he told me that even the low cal dry food has 'plenty' of calories in it anyway - and we thought probably too many for a small dog - and health-wise my boy hasn't missed it. So sometimes it might not be the amount you're feeding but it might be the type of food - or both! (I also wonder about whether or not the lack of moisture in dry food is actually good for them given that their natural diet is full of moisture... anyway but that's for another time). Yep I know what you mean about those big eyes begging for more - but I had to be cruel to be kind. I find the veggies (frozen mixed black and gold if I'm in a rush) or whatever is in season and cheap from the markets - carrots, zucchini, broccoli, pumpkin, peas I think are the main ones - two types usually per meal - about a cup full - fills them up without the calories while they're losing weight. I cut the veggies up and find it literally takes a minute and then soften them for 2-3 minutes in the microwave (he has dodgey teeth) - but I basically keep them as raw as possible - then serve with a pattie or a little meat. I find its worth the little extra effort and I genuinely believe that I've saved a small fortune in vet bills. Having said all that I'm not at all familiar with the dietary requirements of a doggie with a liver shunt - so best to check with your vet. I found it really helpful anyway to do the weight loss thing under vet supervision - even though it was as bad as fronting up to weight watchers :laugh: - and if I'm passing the vet - they are always happy for me to dash in and put my guys on the scales... so I really do keep an eagle eye on their weight.

As to the cost of surgery - that's what I paid here in Adelaide and included the extra fluids I always ask for but not the post-op meds - I think they were extra. I've heard the cost of ACL surgery can vary wildly and the quality of the surgery doesn't always increase with the increase in cost in my experience - so it pays to get a second opinion and shop around, while being careful about the quality and experience of the surgeon. (Don't forget most vets will allow you to pay off the cost of the surgery over time - and that can be a good way to go too).

Personal recommendation is a good way to go IMHO. I didn't have any trouble with finding a good surgeon - my vet is fantastic so I've been really lucky. Maybe some Melbourne DOLers who have had similar surgery might be able to give you some recommendations... anyone?? The bottom line for me is if you are not happy and you're gut is churning with anxiety, then get a second opinion, and then a third if necessary... its too important to get it wrong.

So good luck with your little guy.

Cheers,

Westiemum

Ed cos I can't type and spell at the same time!

Bless you, Westie Mum - that is exactly the sort of information I was looking for. Mine, too, is a resuce - a foster failure actually. I had thought the surgery would be way way more than $900 - phew I had thought at least $2k, and also thought I would be looking at months, not a week or two, to recovery. I can definitly cope with that.

In terms of diet, she is on a very strict diet as it is, but I am obviously overfeeding her. She had a liver shunt which was surgically addressed about 18 months ago but only partially successful, so is on Hills LD wet and dry food. I will have to be strict and cut back on her food and ignore those big brown eyes begging for more.

I'm in Melbourne and my vet is taking Werribee for the surgery. I hate taking her to Werribee - did you have any trouble finding a good surgeon??

Thanks heaps, Jans

Edited April 21, 2008 by westiemum

[jans]

Thanks again Westiemum. The diet for a liver shunt is to only eat the Hills LD food so it's portion control rather than substitution for this little girl. However her brother is starting to put on a bit of weight too (bad bad mummy), so that's great advice about the vegies, I'll definitley give it a go now rather than wait until he gets into the same condition.

Any DOLers recommned a good surgeon as an option to Werribee??

[churchie]

Hi,

Milly my Border Terrier hurt her cruciate ligament about 5 weeks ago. I took her straight to the Vet where she was given an anti-inflammatory needle and tablets for about a week. I was instructed to keep her off the leg as much as possible, and absolutely NO jumping or running and only slow lead walking. I also live in a 2 storey house so when she went to bed she was carried up stairs with me. If she was sitting next to me on the couch then she was picked up and carried with me whenever I went anywhere. I learnt quite quickly that 3 years of obedience training meant nothing to her, if I asked her to sit and stay. . So basically she was kept on a lead attached to me pretty well most of the time.

So for the first 3 weeks, she was virtually carried everywhere, and only allowed out in my courtyard on her lead and a very very small walk up the street (about 2-3 houses lengths), maybe twice a day.

The vet wasn't sure if it was ruptured or strained but when I took her back after the initial 3 weeks he thought it was definitely strained but might of had a small tear in it as she was quite a bit better and putting weight on it and walking with a slight limp, and if she had completley ruptured it there wouldn't of been this much improvement.

The vet is very happy with her progress and we have another month to go before we see the vet again. But she is now allowed a very very slow walk around the block twice a day. Still no stairs, jumping chasing the cats etc. etc. Then after this month, she goes back to the vet and we will see how she is going and what/if any increase in her exercise we can do.

Milly probably was a little bit over weight but she had recently lost some weight before the accident.. so I am also very aware of how much she eats now.... and she mainly gets veggies and a bit of meat, and am trying to cut down on the treats as well. Easier said than done when you are trying to keep them quiet and contained I know.

I have bought baby gate to lock her in my study when I am working, to keep her as quiet as I possible can, and that definitely helped. I have also been told, it is what you do in the recovery that contributes to how well they heal (surgery or non-surgery), so although Milly could and desparately wants longer walks especially off-lead have restricted her exercise to what the Vet advised. I am not sure whether doing this will avoid the surgery option for us or maybe just defer it but the Vet seemed confident, so will be guided by his expertise and experience.

P.S. - I am also giving Milly some muscle and joint power from Pet Ark, my Vet didn't think this stuff made much difference but I thought it couldn't hurt.

Fingers crossed for you.

Regards

Deborah

[westiemum]

Hi Churchie,

Yes that was the story with me up to six week mark too and is a good way to go as well if the vet isn't convinced its ruptured - mine wasn't entirely convinced either.

What tipped me over the edge and why I opted for surgery at the six week mark was my lovely old boys misery - he was clearly in pain, listless and miserable. So surgery was the most sensible option for us. But I so hope the non-surgical route works for you and Milly. Will you let us know how you get on?

Cheers

Westiemum

Hi,

Milly my Border Terrier hurt her cruciate ligament about 5 weeks ago. I took her straight to the Vet where she was given an anti-inflammatory needle and tablets for about a week. I was instructed to keep her off the leg as much as possible, and absolutely NO jumping or running and only slow lead walking. I also live in a 2 storey house so when she went to bed she was carried up stairs with me. If she was sitting next to me on the couch then she was picked up and carried with me whenever I went anywhere. I learnt quite quickly that 3 years of obedience training meant nothing to her, if I asked her to sit and stay. . So basically she was kept on a lead attached to me pretty well most of the time.

So for the first 3 weeks, she was virtually carried everywhere, and only allowed out in my courtyard on her lead and a very very small walk up the street (about 2-3 houses lengths), maybe twice a day.

The vet wasn't sure if it was ruptured or strained but when I took her back after the initial 3 weeks he thought it was definitely strained but might of had a small tear in it as she was quite a bit better and putting weight on it and walking with a slight limp, and if she had completley ruptured it there wouldn't of been this much improvement.

The vet is very happy with her progress and we have another month to go before we see the vet again. But she is now allowed a very very slow walk around the block twice a day. Still no stairs, jumping chasing the cats etc. etc. Then after this month, she goes back to the vet and we will see how she is going and what/if any increase in her exercise we can do.

Milly probably was a little bit over weight but she had recently lost some weight before the accident.. so I am also very aware of how much she eats now.... and she mainly gets veggies and a bit of meat, and am trying to cut down on the treats as well. Easier said than done when you are trying to keep them quiet and contained I know.

I have bought baby gate to lock her in my study when I am working, to keep her as quiet as I possible can, and that definitely helped. I have also been told, it is what you do in the recovery that contributes to how well they heal (surgery or non-surgery), so although Milly could and desparately wants longer walks especially off-lead have restricted her exercise to what the Vet advised. I am not sure whether doing this will avoid the surgery option for us or maybe just defer it but the Vet seemed confident, so will be guided by his expertise and experience.

P.S. - I am also giving Milly some muscle and joint power from Pet Ark, my Vet didn't think this stuff made much difference but I thought it couldn't hurt.

Fingers crossed for you.

Regards

Deborah

[jans]

Yes, good luck with your Millie, Churchie. Fingers crossed it's just a strain or a minor tear. My vet announced very positively that it was a rupture with my Bells so I think surgery will be the way to go for her and I'd hate to think, as Westiemum's did, of her becoming listless and miserable.

BTW, I have a baby gate too - best investment I ever made for securing a dog or three.

[westiemum]

Ditto on the baby gate - the only difference is to keep the dogs out of the cat's laundry (his only place of peace!)!!

Cheers

Westiemum

Yes, good luck with your Millie, Churchie. Fingers crossed it's just a strain or a minor tear. My vet announced very positively that it was a rupture with my Bells so I think surgery will be the way to go for her and I'd hate to think, as Westiemum's did, of her becoming listless and miserable.

BTW, I have a baby gate too - best investment I ever made for securing a dog or three.

[churchie]

Hi,

Thanks.. fingers crossed Milly and I don't have to go down the surgery path, as she definitely isn't listless or in any pain, she just isn't happy about being kept quiet or contained.

I will let you know how we go...

Deborah

[lucknow]

Surgeon wise if you want one of the best around try Wing Tip Wong. I think he still operates at Werribee but he also works out of other clinics. A staff profile and contact details from Melb Uni are here:

http://www.vch.unimelb.edu.au/staff.php?staffID=523

Unfortunately a specialist surgeon will cost thousands rather than hundreds (so back to your original estimate). Some GP's have quite extensive experience in uncomplicated ACL repairs and are well worth further investigation.

Good luck with your decision!

[Kelly_Louise]

My cattle dog blew both her cruciates, and yes was a bit overweight (which we know can attribute to the Cushings disease :D ). Churchie, I can honestly say that having surgery was the best thing I ever did - not sure about your case, but with mine it really was. Chloe had a tibial wedge osteotomy. It was expensive $3000+ per leg plus oncosts, the recovery mentally and physically exhausting, frustrating, and painful to have to see her restrained... but if I had to do it again, I wouldn't change a thing. And you know, I worried she wouldn't cope (being 8 + at the time) with the changes etc, but they really do adapt - they may not like it but they accept. And now Chloe, at 10, is like a young dog again. The results were utterly amazing and we very rarely need to worry about her legs at all. No one would ever guess there was ever anything wrong. But I won't lie, it was tough. She had her first leg operated on in December 05 and the recovery was long and draining. Luckily I had my family at home with her all the time - but she had someone with her nearly 24/7. She got the all clear around April/May 06 and in May/June 06 she had her second leg done. She got the all clear there in about September/October. It was tough because Chloe used her leg straight away so it was hard to keep her from moving around too much. There were tears, arguments, wondering whether I had done the right thing.... but looking back, it was SO worth it for Chloe.

We tried some alternative methods (meds etc) before her surgery, but progressively she just got worse and worse till she could barely move (especially if she had been too active previously). Not having dealt with blown cruciates before, we really didn't know what our options were. Luckily a surgeon at our normal vet referred us to a specialist vet who gave us options and performed the surgery, and Chloe hasn't looked back since.

I guess it depends on your circumstances and severity of injury, but I just wanted you to know that we are one of the cases that had surgery, and although tough... was really worth all the sweat and $$.

Best of luck for you and your girl. I hope that things turn out well whatever option you are best advised to take.

Best advice, find a vet you trust 100% to do a perfect job... makes it all so much easier!!

[cavNrott]

Surgeon wise if you want one of the best around try Wing Tip Wong. I think he still operates at Werribee but he also works out of other clinics. A staff profile and contact details from Melb Uni are here:

http://www.vch.unimelb.edu.au/staff.php?staffID=523

Unfortunately a specialist surgeon will cost thousands rather than hundreds (so back to your original estimate). Some GP's have quite extensive experience in uncomplicated ACL repairs and are well worth further investigation.

Good luck with your decision!

I second the recommendation of Wing Tip Wong. He did the TWLO surgeries on my Rottweiler's knees. Her recovery was excellent.

[westiemum]

Great post Kelly Louise - That's great that things worked out so well for Chloe too.

Your post really well illustrates the difference between general vets and specialists I think - a very good point - mine is a general vet with excellent surgical skills who I can absolutely rely on to tell me if anything that is required is outside his expertise or experience - so your advice is spot on

Best advice, find a vet you trust 100% to do a perfect job

. Yet I'm the same as you - if I'd had to spend four times this amount then I would have - my guys are my responsibility for life - come hell or high water - and I'd borrow to afford the surgery if I had to - but I realise that might not be possible for everyone.

Cheers,

Westiemum :D

My cattle dog blew both her cruciates, and yes was a bit overweight (which we know can attribute to the Cushings disease :D ). Churchie, I can honestly say that having surgery was the best thing I ever did - not sure about your case, but with mine it really was. Chloe had a tibial wedge osteotomy. It was expensive $3000+ per leg plus oncosts, the recovery mentally and physically exhausting, frustrating, and painful to have to see her restrained... but if I had to do it again, I wouldn't change a thing. And you know, I worried she wouldn't cope (being 8 + at the time) with the changes etc, but they really do adapt - they may not like it but they accept. And now Chloe, at 10, is like a young dog again. The results were utterly amazing and we very rarely need to worry about her legs at all. No one would ever guess there was ever anything wrong. But I won't lie, it was tough. She had her first leg operated on in December 05 and the recovery was long and draining. Luckily I had my family at home with her all the time - but she had someone with her nearly 24/7. She got the all clear around April/May 06 and in May/June 06 she had her second leg done. She got the all clear there in about September/October. It was tough because Chloe used her leg straight away so it was hard to keep her from moving around too much. There were tears, arguments, wondering whether I had done the right thing.... but looking back, it was SO worth it for Chloe.

We tried some alternative methods (meds etc) before her surgery, but progressively she just got worse and worse till she could barely move (especially if she had been too active previously). Not having dealt with blown cruciates before, we really didn't know what our options were. Luckily a surgeon at our normal vet referred us to a specialist vet who gave us options and performed the surgery, and Chloe hasn't looked back since.

I guess it depends on your circumstances and severity of injury, but I just wanted you to know that we are one of the cases that had surgery, and although tough... was really worth all the sweat and $$.

Best of luck for you and your girl. I hope that things turn out well whatever option you are best advised to take.

Best advice, find a vet you trust 100% to do a perfect job... makes it all so much easier!!

[jans]

Thanks everyone for the advice. I had googled cruciate ligaments and got lots of information from a surgical perspective, but it's not the same as first hand from someone who's actually been through it.

[redkidsmum]

Hi there, I'd appreciate any and all advice on a ruptured cruciate ligament in a small dog. My girl ruptured her right rear leg last week. My vet has put her on a course of anti-inflamm meds, and in 5 days she has gone from not weight-bearing on the leg to a pronounced limp.

The options I am faced with are leave her on the meds and we live with the limp, or have surgery. She's 5 years old and about half a kilo overweight. The vet said that with littlies, don't rush into surgery however the extra weight she is carrying needs to come off (not an easy feat). Before I commit either way I'd love advice from anyone who has been in a similar situation. The limp restricts her play and I have a house full of stairs so am worried that if I leave her and don't do surgery, that I will cause her problems like arthritis down the track.

If I do have the surgery, I'd like to know what to expect in terms of her recovery. I work full time but would take a few weeks off work to look after her. If I did that, when in terms of timing would be best? i.e the first 3 weeks post op, or as she becomes more active. Do they recover the full use of the leg after surgery?? Is she in any pain now??

Really appreciate any thoughts and advice on this.

Thanks Jans.

Hi,My Toy poodle is only 12mths old and Ruptured a cruciate ligament.He also has Luxating Patellas on both hind legs so worried the other knee will go also.He has had his operation a few months ago on the ligament and kneecap but is still very very lame and has trouble rising from rest.Hard to know if the op has made it worse?? He is not overweight but he is his own worse enemy as despite the pain loves to run !!!! .He is on glucosomine daily and the vet is now trying weekly injections of Cartrophen??? He was to be my new stud boy,that wish fell in a big heap ;) Have had him steralized ,then his big op,poor boy has not had a good start in life but we love him heaps and he is the nicest natured boy you could wish for.

[Koza]

Hi jans,

my dog (though bigger, dalmatian type) had CLR on both knees. After initial small trauma she had fairly long decline, for about a year, and when we found out its CLR and operated, there was about 50% damage. She had 3 operations, since her body rejected the atrificial ligament twice. We had the "older" type operation, when the bones are basically drilled and tied together. There are dosens of different procedures for this op, it all depends on what your vet is confident with...

So she spent about 6 months "in bed" ;). Streight after that the second ligament ruptured completely, we had an op fast, but it didnt work well for about a year! She kept limping and hopping. Finally suddenly one beatutiful morning Stella was OK. Sometimes after too much play she is a bit sore, and she restricts movement a bit, so we keep a pack of Carprophen at home. She is on glucozamine, too. But generally now, after 2.5 years, Stella can run, jump (we restrict jumping, but she tries) and play to her heart content. She will be 6 next week.

This operation (by a non-specialist vet) cost us about 1300. I must mention, of course, that our vet did the second op on the first leg for 50% and third op for free, which was very nice.

[Koza]

We did take time to sit with her, twice there were school holidays, so my daughter spent time at home.. and twice I took some time. She used to stay outside during the day, but now she's a lounge dog and stays inside, to prevent her from crazy play with our other dog. She looks after the house:)