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  1. #11
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    We are almost at week four post opt from a TPLO surgery and ACL removal, sounds like how Remy was prior to surgery. He had no trauma or anything... Good luck. Our regular vet referred us to an orthopedic vet, which was who made the diagnosis. There are lots of threads here on TPLO surgeries and recovery stories. Keep us posted.

  2. #12
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    Gah, this is all so overwhelming. We haven't taken him to the vet yet, because DH has to do it (He doesn't get along with other dogs, much less cats, and he's a leash puller). So I'm praying that it is not that because I posted on Nextdoor to get an idea about pricing and it's around $3000-4000, which is just not something we can afford. We live on a second floor and have to take some really treacherous outdoor stair (the metal kind attached to the side of the building). He might be on board with pooping in the empty rooms in the building were we live (like the one in the video) but I don't think he's going to want to pee upstairs. The only thing he has going for him is that he is very sedentary, so maybe conservative management will help him some. We will probably go with a brace.
    I just want my baby to be healthy and happy.
    Has anyone here gone with CM? How has the dog fared?

  3. #13
    Senior Dog Tanya's Avatar
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    I would discuss CM with a specialist as well. The specialist I saw did treat dogs that way as well and said it works well for small dog (I think under 30-40 pounds). For a very small tare and a sedentary dog it can work. But it needs to be done properly and for a long time with follow-ups. I don't know where stairs come in with conservative management. I like in a walk-up but thankfully it was my 40 pounds dog that tore the ligament (not that I am not having issues with my senior lab now). I think we have one member that successfully did CM with her pup. If you are on facebook there is a group for TPLO and for conservative management (and for orthepidic issues in general)

    Note that there are various types of surgery. TPLO is one of the more expensive (and most common) ones but there are other options. Surgery cost me $5000, but vetting is more expensive in general in my area.

    Weight loss is going to be crucial though. you are going to need him on the skinny side of healthy.

    ETA: when a ligament is torn it doesn't "regrow" or "re-attach". the principle behind conservative management is to stabilize the knee while scar tissue develops in hopes it can itself stabilize the joint. With a big dog that's clearly a bigger ask. and the bigger the tear the harder that is to do. Again, stats for this working on small dogs is pretty good (enough that i'd probably start there) but with large dogs...pretty low. It's important if you try it to commit 1000% because one "oops" can destroy all the scar tissue that developed up to then. You also want to keep the muscle mass as best you can and ensure they do not over compensate with the other leg so rehab is important because the other knee is at risk of also going.

  4. The Following 2 Users Say Thank You to Tanya For This Useful Post:

    Abulafia (03-11-2017), Annette47 (03-03-2017)

  5. #14
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    Haha. Going to the surgeon for an opinion regarding conservative management for a CCL tear is like going to a Trump rally asking for an opinion regarding Clinton. I have been doing CCL surgery for over thirty years and I am amazed how things have changed. We used to have two reasons for surgical correction: 1. Stabilize the knee and 2. Prevent degenerative joint disease (arthritis). When Bartles at U of Tennessee did his research on CCL surgery and long-term effects on the knees that had surgery done, he proved that there will be degenerative changes occur whether or not the surgery is done. So, that only left us with stabilizing the knee. It is very common that the knee will stabilize in time due to fibrosis and thickening of the joint capsule.

    The real advantage of doing surgery, IMHO, is to see if the meniscus is torn. If there is a meniscal tear and the meniscus is flapping around in the joint, the dog will never go sound. Otherwise, I think most dogs would do fine. Yes, doing a TPLO on a big dog will get them back into the field sooner, but just how important is that. Most people's dogs are not performance dogs and they usually do fine without the surgery. Now that I have been doing alternative medicine with acupuncture, I treat about 6 dogs a week that have torn their CCLs and have opted not to have the surgery. I have many of them coming in that you can no longer tell which leg was involved. The other thing to remember, is that there is no guarantee with the surgery. Not only are there real possibilities with post-operative complications, but many dogs that have the surgery do not go sound. Believe me, I work on just as many that have had TPLO surgery and still carry the leg as the ones that have opted not to do the surgery.

    It is certainly something to give a lot of thought when it comes to CCL injuries. My advice is to talk to a surgeon and listen to her/him and then talk to someone who treats them conservatively and listen to what they might have to say. We have lots of options these days (acupuncture, laser therapy, electromagnetic therapy and more). Worth being open minded about it. Good luck.

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  7. #15
    Senior Dog Tanya's Avatar
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    ok maybe most surgeons will recommend the surgery they prefer-do most. The one I did talk to was totally on board with rehab/conservative if one opted that route (though did mention what cases it tends to work better for and the issue iwth the meniscous). We really went over the various surgeries/CM and the pros and cons of each.
    But they did rehab in the same clinic as well :P

    But yes, maybe it's best to talk to a rehab specialist (someone with experience with CM for CCL issues) for an opinion on conservative management haha

  8. #16
    Senior Dog JackK's Avatar
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    My Cassie is 8 weeks out from surgery for a CCL rupture. She had the TTA procedure done and has been doing great so far. She is back to walking normally on all four legs and anxiously awaiting the doctor's approval for off-leash antics. We have a follow up visit on the 28th of this month for x-rays to make sure that the bone is completely healed. She should be cleared for normal exercise at that point.
    If you have any questions, feel free to message me and I'd be glad to respond.

    Be sure to keep Cocoa on a leash and away from jumping or running until the repair is made. The surgeon on our consult told me that there is another ligament in the knee that can be injured prior to correction of the CCL. For success of the surgery, it is important that it be intact at the time of surgery.

    Best of luck and look for a good orthopedic surgeon.

    Jack

  9. #17
    Senior Dog SamsonsMom's Avatar
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    Quote Originally Posted by Dalila View Post
    Gah, this is all so overwhelming. We haven't taken him to the vet yet, because DH has to do it (He doesn't get along with other dogs, much less cats, and he's a leash puller). So I'm praying that it is not that because I posted on Nextdoor to get an idea about pricing and it's around $3000-4000, which is just not something we can afford. We live on a second floor and have to take some really treacherous outdoor stair (the metal kind attached to the side of the building). He might be on board with pooping in the empty rooms in the building were we live (like the one in the video) but I don't think he's going to want to pee upstairs. The only thing he has going for him is that he is very sedentary, so maybe conservative management will help him some. We will probably go with a brace.
    I just want my baby to be healthy and happy.
    Has anyone here gone with CM? How has the dog fared?
    So sorry to hear about your situation. Do you give your pup any joint supplements now? You should also look into Golden Paste. Just do a Google search (Doug English Golden Paste). The first thought that came to my mind with the location of your apartment was "If that was me, I'd ask the apartment manager if I could move to a ground floor apartment." My pups are like my kids. Not sure if that is an option for you. Best of luck.

  10. #18
    Senior Dog Abulafia's Avatar
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    So, yes, that looks like a classic CCL tear. I'm sorry to hear it—our girl tore hers on Dec 16th of last year. She had surgery on the 23rd. We have just completed our 11th week Post-Op from a TPLO operation.

    In spite of what one of our resident DVMs wrote above—both my Vet and our surgeon discussed CM with us before even discussing surgery. Both said that that was something we could try, and they'd support us. So—while some Vets and surgeons may push surgery, that was absolutely not the case in our situation. Then again—you need to have people you trust.

    I had of course researched the bejeezus out of the injury and options prior to our surgeon's appointment, and by then I had already decided that TPLO was what made the most sense for us.

    Our surgery was done with a local (Seattle) Veterinary Surgical clinic that specializes in orthopedic surgery. Our dog—a 20 month old intact bitch with no other health problems—has had an absolutely boring textbook recovery. We followed our surgeon's PT recommendations (which are paralleled in the TopDog TPLO recovery guide), began doing hydrotherapy and laser therapy at the surgeon's after week three or so, and continue with very slow and steady PT: she is now up to 45 minute walks 3 times a day, with very specific exercises. Oh, and we bought cavaletti poles and she does those exercises, too.

    She is also down nearly 9 lbs (we have another few we'd like her to lose.)

    She had no perceptible limp, and has not since probably two weeks post surgery. Frankly, she looks no different now than she did before her accident, save she's slimmer and probably more muscular. The complication rate of TPLOs is quite small—slim chance of infections early on if the dog is able to get at it; even slimmer chance of plate rejection.

    A few observations, having delved into communities of people who have dealt with this injury and various surgeries or attempts at CM:

    1. CM often doesn't work in the long term, esp for large dogs—it depends upon the development of scar tissue to stabilize the knee, but doesn't really stop the problem. If the underlying problem is joint disease, arthritis will likely only accelerate. In what I've seen of larger dogs, CM may hold things off a while, but that's all it is: a delay.

    2. The longer you put off surgery, the more muscle mass the dog loses in the injured leg. The non-injured leg becomes hypertrophic, and the whole body geometry goes out of alignment. I highly suspect that this is what leads to second legs blowing the CCL in cases of CM or delayed surgery.

    3. Most people rush the recovery, before the dog has rebuilt muscle to equal levels. Our dog was operated on within a week of her injury, and was on controlled 5 minute potty walks from her first day back from surgery. And yet even those five or six weeks of very reduced activity led to a 6 - 7 cm circumference difference between surgery and non-surgery leg. And she's a young, muscular, healthy dog. The muscle loss can be fast, and it takes a while to equalize things again. Until this is done, the dog is at risk for further injury.

    It's a tough decision, I know. But anyway, the above has been our experience thus far.
    Hidden Content Hokule'a ("Hoku") / b. 06.08.15

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  12. #19
    Puppy
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    I wanted to update on Cocoa's situation. We decided not to do the surgery. It's just too much money and considering where we live it would be too risky. We did manage to find a brace that normally retails for $300 for $75 on ebay. We got really lucky because it was just his size. Nonetheless he doesn't like wearing it too much because it's hard for him to lie down when he's wearing it. But I did notice he is limping less and he seems to be getting "used" to his injury, if that's possible. He's getting fish oil and joint supplements daily as well.
    I also put him on a diet and he's lost quite a bit of weight, I know that will help a lot. I can tell that the left left (the one with the torn ACL) has atrophied some, and it sort of breaks my heart, but he seems to be doing well.

  13. #20
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    Thank you for the update...I'm glad to hear he seems like he's doing well. Good thoughts headed your way that he will continue to be OK with this approach...that brace sounds like a really good find.

 



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