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  1. #1
    House Broken Sir Winston's Avatar
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    Your Stories and Information About Labs with Cranial Cruciate Ligament (CCL) Tears

    Cranial Cruciate Ligament (CCL) tears are unfortunately quite prevalent for labs. Many of us on this board have had to make difficult decisions about how to handle these injuries. The surgeries are quite expensive and rehabilitation of the leg takes a long time. But there is light at the end of the tunnel! After the leg mends, the joint stabilizes and rehab strengthens the leg, most dogs return to active, happy, healthy lifestyles.

    Given that we lost our old posts, I think it would be beneficial if members who have dealt with their lab's CCL tear would tell their stories about it and dispense any advice or information they think is necessary. If you have questions about CCL tears and treatments, please feel free to post them in this thread.

    Winston's story is below.

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  3. #2
    Puppy Labowner's Avatar
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    Having become a member before we got Abby and reading so many post about this problem, We decided to get a pet policy for her as soon as she came home. At least this would help with the finical part of the problem.

  4. #3
    House Broken Sir Winston's Avatar
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    Winston tore his ACL in 2011, when he was 2 years old. He would start to limp after walks. Resting him seemed to help, but only for a time. Eventually, he got to the point where he could not put any pressure on his back left leg. I took him to my vet, who performed a drawer test and diagnosed the torn CCL.

    Being a first-time dog owner, I had no idea where to begin. My vet informed me he could perform a traditional (or extracapsular) repair, which is basically a procedure where the surgeon uses suture to simulate the torn ligament's function and stabilize the dog's knee joint. This procedure is the least expensive approach (my quote was for ~$1,000 with X-rays), but it does have drawbacks.

    One of them is that its success rate in larger dogs is variable because there is a chance the dog could break the suture before enough scar tissue builds up to stabilize the joint. If that happens, you have to redo the surgery. Winston was overweight at the time (about 100 pounds) and the strongest grade of suture the vet could order that met recommended specifications was for a dog that weighed 80 pounds. He could do the surgery, but my dog was bigger than recommended. Furthermore, my neighbors had tried it with their lab, and she had to have it done twice because the suture broke the first time. She is a small lab, probably ~55 pounds.

    Given that information, I decided to research other options. I began reading up on the Tibial Plateau Leveling Osteotomy (TPLO) and Tibial Tuberosity Advancement (TTA) procedures. A brief comparison of them can be found here. These surgeries are similar but take different approaches to stabilizing the joint. Both use metal plates - steel in the case of the TPLO, and Titanium in the case of the TTA. Both have a very good track record with large breed dogs, particularly in the short-term following surgery. I called every specialist in the region to compare prices. The best deal I could get on a TPLO was $2,400 and for a TTA $1,600.

    In the end, I decided to go with the TTA. I thought the probability of success was higher than the traditional repair given Winston's size. I liked the idea that he would be able to put weight on the leg sooner than with the traditional repair, because I was worried about him tearing the CCL in his other knee. The chances of a dog tearing the other CCL following the first is between 20 and 40 percent. I thought getting him to use his repaired leg and reducing his diet would be the best way to prevent this from happening.

    However, given the significant chance he could tear his other knee, I had to be prepared to finance fixing his other leg. As a result, I opted not to go with the TPLO, even though it has been around longer and is the more common procedure. The initial savings was about $800, but that would double to $1,600 if he tore his other CCL.

    The vet who performed the surgery was located just outside Knoxville, TN. He had been trained in the procedure by doctors at the veterinary school at the University of Tennessee. He was very friendly and treated me with respect. He told me about competing theories about releasing the meniscus, and other trends in the latest veterinary journals. He asked for my input about what I wanted for Winston. This is another tough decision. If you do not release the meniscus, there is a chance that the dog injures it and has to have follow-up surgery. On the other hand, some studies suggest it can lead to osteoarthritis. In the end, we opted to release the meniscus.

    After the surgery, rehab began. I kept Winston in a large crate while he heeled. I also purchased a ramp so he could get on and off the porch. I slept in the living room with him for two months while he recovered. It was a rough haul. We gradually began doing a rehabilitation program. Vets will provide some information in this regard, with varying levels of detail. I actually got a TTA rehab guide here (the PDF version is free). It gave specific exercises for us to do after an appropriate amount of time. They were helpful.

    Rehab is touch and go for a while. You take two steps forward, and one step back. Some days are better than others. I managed the pain with Rimadyl (or Novox, the generic equivalent).

    Winston is 5 now. He's healed, and he moves better now than at any point in his life. He can walk, run, jump and generally act crazy when he has the mind. He doesn't have a perfect gait when he runs, but he can still run faster than me. He's now about 80 pounds, and we go on walks most days (usually about 3 miles a day). So far, he's not torn his other CCL.

    Winston then:


    Winston now:

  5. The Following 6 Users Say Thank You to Sir Winston For This Useful Post:

    Calla (08-02-2016), hunter (09-23-2016), Jdog (10-30-2017), Polly Pipkin (09-10-2016), ronmcq (05-29-2014), ZRabbits (05-26-2014)

  6. #4
    Senior Dog Berna's Avatar
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    I think this should be a sticky.


    Cookie blew his left knee back in 2010. We tried conservative management first (rest + Rimadyl), but no luck. He had the traditional (extracapsular) repair.




    And a video:




    The surgery was a success.

    And a year later...




    In August 2011 Cookie tore his right knee. We scheduled another surgery, however conservative management solved it this time.

    Cookie will be 8 years old in a month. He was also diagnosed with mild elbow dysplasia two years ago. He is on raw and glucosamine + chondroitine supplements (Flexadin).

    And here is a recent video, taken at the beginning of this month:

    Cookie Black Snowflake
    July 12th, 2006. - May 25th, 2023.

    Hidden Content

    Hidden Content

    Hidden Content
    Hidden Content | Hidden Content | Hidden Content | Hidden Content

  7. The Following 5 Users Say Thank You to Berna For This Useful Post:

    hunter (09-23-2016), Jdog (10-30-2017), Polly Pipkin (09-10-2016), ronmcq (05-29-2014), ZRabbits (05-26-2014)

  8. #5
    House Broken monsterpup's Avatar
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    We have two TPLOs under our paws. Going strong at age 6. Hope it continues. And very thankful for pet insurance!

  9. #6
    Senior Dog Tanya's Avatar
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    How did I miss this post!

    Here is our story, though not a lab. Penny is a 3-4 year old mixed breed around 44 pounds. Herding bred mix (I generally go with BC mix).

    May 7th we had a great day. Went for a canicross run with friends. Had a great first agility practice of the season. After agility we played fetch in a fenced grassy field (maybe 1-2 acres) and she returned on three legs. I did not hear a whimper and she was begging for me to throw it again. We wrapped up and went home and I hoped for the best. But by the next day she was visibly in pain and upset. I gave her Rheuacam and she reacted to that so we ended up at the e-vet who suspected CCL tear. We booked an apt with an board certified orthepedic surgeon and my regular vet. Both confirmed CCL tear. In fact the surgeon showed me (you could see it just flexing the knee). For penny, being a young athlete and still thre legged almost two weeks after the incident i considered two options: thightrope and TPLO. I went with TPLO (for other dogs I would have considered other alternatives). It was scheduled for a bit under a month from the initial incident: June 1.

    Surgery confirmed a full tare and meniscus damage (he has to remove some of it).

    We are almost 6 weeks post op and I won't lie, it's been rough. but we have had and continue to deal with infection which has set us back a great deal. There is light at the end of the tunnel it's just very hard to see :P

    I will update again once we do the x-ray (at 3-4 months). We may be looking at removal of the plate if the infection isn't clearned but one step at a time.

    As we stand I am unsure on the final outcome. Will she be able to go back to sports (agility, dock diving, canicross) or not? We'll have to discuss (with rehab person and surgeon) after rehab and conditionning.

 



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