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  1. #1
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    Default CCL surgery in 35lb 12 year old dog? - Update post 31

    Update, post 31; Short version: He had the surgery today.

    A friend's dog managed to damage his CCL by racing around on the icy ground like a moron, and she's really freaking out about if he should have surgery or not, due to his age.

    The facts as I know them:

    The initial injury happened ~1 month ago and for some reason the original response was to wait and see. He's not using the leg at all, but seems perky and not bothered. (He's on something for pain, but I don't know what.)

    He's 12 years old, ~35 lbs and not overweight, some kind of mutt. Two vets - his normal one and the one who would be doing the surgery - have both said that they think he'll do fine with the anesthesia and have a good recovery, but my friend is a nurse and therefore paranoid about GA going wrong.

    In addition, the vet clinic where she was going to have it done doesn't have anyone there overnight, and he'd have to stay over after the surgery - they leave at 10pm (when he would be checked) and then someone comes in at 6am (another check) and she's worried about that, also.

    So, for specific questions:

    1. At his age and size, is it worth having the surgery done at all? (The specific procedure they want to do is something involving fishing line? She wasn't too clear about that. Apparently there's also a more invasive option, but that's not what they're recommending.) Or is this something he can live with and just be 3-legged weight bearing for the rest of his days?

    2. If he does have the surgery, is the no-one-there-overnight issue really a big thing, or is that fairly standard? Apparently her previous dog died overnight at a vet, so she's really nervous about that. (We do have emergency clinics in the area who would have staff 24/7, but I don't know if they necessarily have the best vets to do the surgery.)

    3. Anything else she should consider?
    Last edited by kdow; Feb. 4, 2011 at 11:47 PM. Reason: Update



  2. #2
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    1) I don't like anesthesia for older dogs when possible. I've lost one myself that way. I also don't (personally) believe in spending thousands of dollars on a pet, especially an older one (although with out knowing the actual cost of the surgery I can't comment).

    2) I would not be happy with the lack of overnight care.

    Can he live the rest of his life happy with out the surgery? That would be my question.



  3. #3
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    Oct. 29, 2007
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    Correct me if I'm wrong, but CCL is roughly equivalent to our ACL, right? I can't remember the name but I believe this is the surgery my dog had. Granted, he was probably 8 or so at the time (60lb dog).

    Recovery period kind of sucks because the dog has to be kept "quiet and calm" for awhile...which essentially means in a cage for a few days, then with a leash attached to him in the house. My dog's surgery fell around Halloween, so that was fun to keep him "calm and quiet" He did get some really good drugs for awhile though, he didn't seem to mind much of the recovery

    Also, the vet told us that usually when a dog tears one they'll probably tear the other. And sure enough, two years later Fo tore the other. He's also had complications with the myofascial tissue in that area. I don't know how this would compare to him running around on three legs. Something to keep in mind though, if she doesn't get the surgery and the dog ends up tearing the other ligament? My guess is that might be the end, since he literally wouldn't have a leg to stand on. He is getting older, so that might not be as much of an issue as it would be with a younger dog.

    We definitely had to make some lifestyle changes for our dog. We used to have a really long line that we'd hook him up to so he could be outside for hours doing his own thing. Vet nixed that after the surgery, the sudden starts and stops they do on chains is probably what caused it. So now every bathroom trip is a short walk on a leash (which he kind of enjoys actually). He also is getting arthritic and gets joint supplements.
    "Things turn out best for the people who make the best of the way things turn out." ~John Wooden

    Phoenix Animal Rescue



  4. #4
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    Mar. 6, 2009
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    Default Jingles for this dog and owner ~

    Just Jingles for this dog and owner ~
    Zu Zu Bailey " IT"S A WONDERFUL LIFE !"



  5. #5
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    Oct. 28, 2007
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    NY
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    My cat had acl surgery two years ago at age 14 or 15.
    She took it very well, adjusted to a string leash, escaped with her leg in a cast a few times (during a thunderstorm!) and in general was a PITA.
    She is fantastic at age 16+. The only thing is she sits like a dog now, the joint can't bend quite as much as a normal cat's can.
    I found out later that it was the first time that vet had done the surgery on a cat.
    It cost $1000 for the surgery and $1000 for the hospital stay. I had her stay 5 days because I couldn't handle her not eating so wanted an IV.
    I have refused to use a vet who didn't have overnight staff.
    It was worth it, she is an active, self-satisfying cat (like the character Snoopy always bopping along doing her own thing).
    She can still jump up on a chair, climb stairs etc. She doesn't climb trees anymore though.



  6. #6
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    Feb. 6, 2003
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    Get a second opinion from a vet with overnight staffing.
    ... _. ._ .._. .._



  7. #7
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    I have had a dog with 2 torn cruciates, and therefore 2 tplo surgery...the more invasive one, but the one that will most likely last her lifetime. It was done at an emergency type clinic, and staff was on 24/7...they better have been for the price.

    The fishing line is less $$$, less invasive and recommended for the smaller dogs and older dogs.

    I have had dogs at 12(large breed dogs) undergo surgery and ga.

    I would like that they have round the clock care, and I would ask since they don't, you'd like to take the dog home, will bring back in the am, etc.
    Otherwise, I'd probably look around.

    with this surgery, the dog would be heavily drugged, but if they were alert enough to start eating/chewing on stitches or just getting into trouble, and no one was there, well, thats a bit of a problem for me.

    As far as not doing the surgery, you put the dog more at risk for arthritic conditions, since weight now is on one leg, one hip, back becomes misaligned, etc, etc.
    save lives...spay/neuter/geld



  8. #8
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    I wouldn't consider surgery on a vet without overnight staffing.
    "We can judge the heart of a man by his treatment of animals." ~Immanuel Kant



  9. #9
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    Oh and after six weeks in a cast I cried when I saw her little leg. It truly looked like a chicken leg. Even my vet was shocked and checked with the surgeon. She had a pin put in temporarily that "popped" out. So be prepared for a scary looking leg when they first take off the cast.



  10. #10
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    Oct. 25, 2007
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    My dog was not put in a cast. She had metal plates, and was stapled shut.

    She did live in her crate.
    First time was a nightmare...she hated the elizabeth collar, ripped out all her staples numerous times, just a very bad patient per the vet.

    I ended up getting her the bubble collar that smartpak carries and she was ok for that. I did everything per the book.

    second time around...had the bubble collar, no ripped stitches. Kept her in the crate for a week, with walks on a leash, then let her be loose in the house...I know when people are coming, so I could leash her, otherwise, I blocked off the upstairs and let her be herself. She was older, so not into the crate. She was happier, found a spot to sleep and kept herself quiet.

    I think its really important to be prepared...such as having the right collar, not every dog can tolerate the elizabeth collar. Also, gates to block off areas so they don't run from room to room, or climb stairs.
    save lives...spay/neuter/geld



  11. #11
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    Quote Originally Posted by Chall View Post
    So be prepared for a scary looking leg when they first take off the cast.
    Agreed. Poor dog looked like Frankenstein.
    "Things turn out best for the people who make the best of the way things turn out." ~John Wooden

    Phoenix Animal Rescue



  12. #12
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    Dec. 27, 1999
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    Our dog weighs about 50 lbs and has torn both stifles. When she was younger the vet recommended surgery and she recovered fine. She did the second one when she was 12 and he said at her age, he didn't recommend it because it tends to result in worse arthritis? And they can learn to compensate with all the large muscles in the hindquarters and get around just fine. Our dog did so. She is now 14 and has some trouble with stairs, but honestly I think she's just getting old--didn't have any problems until about a month ago.

    Jennifer



  13. #13
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    Have the surgery, transfer to E clinic for overnight monitoring, transfer back for post op day 1, take home that night. It's done all the time.

    Or, have a TPLO done at a specialty clinic that has a big enough surgical load to have 24 hour staff.
    Michael: Seems the people who burned me want me for a job.
    Sam: A job? Does it pay?
    Michael: Nah, it's more of a "we'll kill you if you don't do it" type of thing.
    Sam: Oh. I've never liked those.



  14. #14
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    We had our older Cairn Terrier blow his ACL twice. We had adopted him at 7 years old, so I'm guessing he was 8 the first time, and 10 the second time.

    The first time we did the cheaper, regular surgery. Recovery was a pain (ok, HE was a pain! You can't keep an terrier down). Second time we paid more ($600-ish?) and had laser surgery done. Quick and easy recovery. We couldn't just let it go -- he was in too much pain and our back yard had a big staircase down from the deck and a hill. If I remember correctly, he had a blood test (or some kind of test) to be sure that he'd be okay being put under.

    I would look into having the surgery at a vet with overnight staffing.
    "Our greatest glory is not in never falling, but in rising every time we fall." - Confucious
    <>< I.I.



  15. #15
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    Quote Originally Posted by Grataan View Post
    Have the surgery, transfer to E clinic for overnight monitoring, transfer back for post op day 1, take home that night. It's done all the time.

    Or, have a TPLO done at a specialty clinic that has a big enough surgical load to have 24 hour staff.
    Based on pretty much everyone agreeing that they'd be uncomfortable about leaving the dog overnight without supervision, I told her to talk to some of the E clinics in the area to find out if they have someone who could do the surgery, or if the dog could, as you suggested, be transferred.

    So I think that's what she's going to do - for some reason, both vets are pushing really hard for her to have the surgery done Right Away This Second which I don't really understand - the injury actually happened a month ago, and he hasn't done anything additional to it. While I can understand that there's a limit to how long you leave things when playing wait-and-see, I don't get why there hasn't been discussion of the possibility of surgery right from the start, so she'd have been able to do more research.

    (It is possible that they mentioned it, but like I said in my original post, she is a nurse and fairly conscientious about such things, so she's not really the type to go 'lala-OMG-WHAT DO I DO?!?!!?' because she knows that often it's necessary to research the procedure or the specialist or what have you.)

    In any event, as a brief update, apparently the dog is now using the leg in question to some degree - he was scratching himself with it, and has been bearing some weight on it, though not consistently.

    That was something he hadn't been doing, so I don't know if it makes any difference in terms of what the best treatment would be, if it suggests that he might do fine without the surgery? (I did also tell her to ask about the possibility of the other leg having the same problem later, as I do think that's a factor in deciding what to do.)

    I want to thank everyone who has responded, btw. I know it made her feel better that I'd been able to communicate with people who'd had experience with that type of injury and surgery.



  16. #16
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    The longer you go without surgery the worse the arthritis is and the harder the injury is to repair.
    Michael: Seems the people who burned me want me for a job.
    Sam: A job? Does it pay?
    Michael: Nah, it's more of a "we'll kill you if you don't do it" type of thing.
    Sam: Oh. I've never liked those.



  17. #17
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    Quote Originally Posted by Grataan View Post
    The longer you go without surgery the worse the arthritis is and the harder the injury is to repair.
    So would you say he definitely needs the surgery, it's just a question of finding a way to do it where he's not alone overnight? Because I know she's thinking that maybe she doesn't need to do it now if he's starting to use the leg.

    (I did mention the arthritis concern.)

    None of our family dogs have had this sort of injury, so I'm trying to help her make sure she does the right thing, but I don't have any personal experience, so it's difficult. (If I could say 'well, when it was my dog, I ...' I think it'd be more reassuring.)

    The closest I've come recently was my rescue, Pirate, needing dental surgery to remove a broken tooth, and the issue there wasn't if he needed the surgery (because he quite obviously needed it removed) but just finding a vet who could do it who handled him well. (For some reason - possibly because he's bigger and has Rottweiler coloring? - a lot of the vets would have a very forceful manner when trying to examine him, and he's not at all a dominant dog and tends to get anxious, so it was a horrible combination, because they'd just get him more and more wound up. It just seemed like a disaster waiting to happen.)



  18. #18
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    I would either euth or do the surgery (but at a better vet clinic that has round the clock staff). Dogs CANNOT live comfortable lives with a torn CCL, that's ridiculous. Some people claim that small dogs can be re-habed from a torn CCl by using a brace/ intensive forced rest (i.e. crate the dog for 6 months) but such a regimen sounds cruel to me. If you do the fish-line surgery, you get better recovery if you embark on an intensive physical therapy program immediately after surgery rather than doing casting/forced rest, so look into that, it also improves the dog's quality of life over prolonged period of forced rest.



  19. #19
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    Quote Originally Posted by wendy View Post
    I would either euth or do the surgery (but at a better vet clinic that has round the clock staff). Dogs CANNOT live comfortable lives with a torn CCL, that's ridiculous. Some people claim that small dogs can be re-habed from a torn CCl by using a brace/ intensive forced rest (i.e. crate the dog for 6 months) but such a regimen sounds cruel to me. If you do the fish-line surgery, you get better recovery if you embark on an intensive physical therapy program immediately after surgery rather than doing casting/forced rest, so look into that, it also improves the dog's quality of life over prolonged period of forced rest.
    Part of the issue is that I can't convince her how stoic dogs can be - he seems bright and happy and "not in any pain" but I know that doesn't necessarily mean much. Pirate's tooth had to be quite painful (his canine was snapped off and clearly in bad condition and his gums were inflamed) but he acted perfectly normal.

    She's apparently read somewhere online that small dogs have an 80% success rate of coping without the surgery, but I have no idea how they're defining success.



  20. #20
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    Going with the less invasive fishing line surgery is probably a good choice for an older, smaller dog if surgery is to be done. I've got a client with beagle a little younger than the one mentioned here who will probably have the surgery done at my office in a few weeks. The owner's done a month of pain meds and rest without improvement.

    We have a board certified surgeon come in and then we send the pet home later the same day. I'm not sure why the dog in the OP would stay overnight. I understand why so many would be uncomfortable with the dog staying alone overnight, but at least in my area no general practices have overnight staff. That said, if a pet can't go home we have a plethora of e-clinics where we can transfer a pet for overnight care. Some clients opt to take their chances and leave a pet overnight because they can't spend the money on the e-clinic.



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