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Cruciate surgery and recovery

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  • Cruciate surgery and recovery

    My 7 year old lab mix is gong to have surgery to repair a partially torn cruciate ligament. A part of our pre surgery consultation, my vet covered the post op care, which includes eight weeks of either being on a leash at all times, even in the house (to prevent attempts to jump or leap and cause injury) and confinement to a crate when unattended.

    Has anyone gone through this type of surgery with your dog, and would you share your experiences including the good, bad, and possibly ugly?

    Thanks in advance!

  • #2
    What are they doing? TPLO?

    I'm very against TPLO....and I'm assuming that's what's being done, because if you were going with arthroscopic debridement/physical therapy, you wouldn't be discussing the PITA of post-op confinement. You'd be discussing PT schedules.

    Sorry. Big peeve of mine.

    Where are you having the surgery done? How fit is your dog? How much does he/she weigh, and is that weight a good weight for body type, or overweight for body type?

    Comment


    • #3
      My dog has had two tplo surgeries, and be prepared, when they tear one, another is to usually follow.
      The second, I was much better prepared.
      First off, my dog did not like an elizabethan collar...hated it, and freaked. So, I didn't let her wear it due to the freak outs.
      she tore her stiches out repeatedly, infections, etc.
      I found the air tire collar and she did fine with that. Smartpak sells it, and if needed, I could post it here or pm you with it.
      I did keep her crated, and the first surgery, she was fine being crated, since she was still young and had been crate trained. 2nd surgery, she thought she was being punished, since she hadn't used the crate for a few years.

      On discharge, they gave her a sling for me to walk her with.

      I was not as 'diligent' as I was on the first surgery. I made her stay in the crate the 1st week, but then I let her get on the couch or do what she wanted on one floor. I blocked the stairs, which she goes up to 'look' out the patio doors. So, I let her have just the downstairs and she was good and mellow, so I felt it was ok.
      If she was hyper, I would have kept her crated all the time, and out for walks.

      On her first surgery, I lined up a pt, but you know what, the infections, etc ruled that out.
      I did do the stretching exercises, etc.

      I think its like kids. your first, you are hyper, your second, you are a bit more relaxed.
      It also reflects on the dog. My dog was quite young, about a year at her first surgery and 3 for her second. She is mellow and I didn't feel she'd jump off the couch or run around the house. If she did, crate.
      So, a lot depends on your dog is my point.
      save lives...spay/neuter/geld

      Comment


      • #4
        ASB,
        I had the last tplo surgery done last year. My options were the in office surgery which would not last, or taa or tplo by a board certified ortho surgeon.

        why are you so against the tplo?

        Also, different ages and size dogs are different canidates for different surgeries.

        TIA for your response.
        save lives...spay/neuter/geld

        Comment

        • Original Poster

          #5
          She is having a TTA. She is about 52 lbs. The vet thinks she could lose maybe 4 or so pounds but nothing too drastic. I'd say fitness is average/below average. We don't do walks regularly but do play in the yard a bit.

          She has been experiencing intermittent lameness in the same leg for about a year and a half but has been significantly worse the past two months. We started cosequin ds last year in hopes of delaying this but we are at a point where a surgical intervention is needed.

          The vet clinic I go to for normal care is also an orthopedic referral hospital.

          Comment


          • #6
            I've had 2 dogs have the knee surgery where they used "fishing line" to secure the knee cap. In one dog, the surgery went great, and he was weighting it 50% on the 3rd day, and got better and better. Didn't have a really restricted recovery. Just told to keep him from jumping on furniture, getting too wild.

            The other dog was a wimp. He absolutely refused to even try to put his leg down afterwards, and ended up blowing out his other leg's ligament a few days later. Then he wouldn't get up or walk. Left him at the vet for rehab for a week, and got him back able to walk gingerly. He eventually healed, but got arthritis in the knee that didn't have surgery. (Vet didn't recommend it due to his reaction to first surgery).

            Comment


            • #7
              I would advise against the TTA, especially with her being a bigger dog. The TPLO is a great surgical option, when preformed correctly (I prefer by a board orthopedic surgeon)

              Its fishing line vs a metal plate... both have there pros and cons, the good bad and ugly. But if cost is not a huge concern, I feel that you are farther ahead to have a TPLO done. TTA was a good option back in the day, but it is being replaced for a reason by the TPLO... Longevity! Do your homework, the surgeons in my neck of the woods, use absorbing stitches to close the surgical sites. Follow your home care and follow up instructions to the word - the range of motion PT, staying on leash, using a sling for getting around, no stairs, no slick floors, e-collar on, no jumping, small room or crate confinement... just to name a few. It will get your dog back and moving quicker!

              Good Luck!

              Comment


              • #8
                Our vet only recommended a TPLO for my 75 lb Lab because she is 1. young (3 years) and VERY active. There are studies in the veterinary literature that a TPLO (in a large dog) reduces the risk of arthritis developing in the joint down the road. Had my dog been under 50 lbs, we would have gone with the lateral suture repair.

                I did have a Samoyed years ago that had three traditional lateral suture repairs done (the fishing line broke two weeks after surgery the first time - then the vet admitted he should have used a stronger line - gee, ya think?)

                The TPLO is very invasive. They basically cut a crescent-shaped segment off the top of the tibia, rotate it and hold it in place with a plate and screws.

                In any case, my TPLO dog did very well after surgery. She did receive an epidural for pain control during the surgery, stayed the night in the hospital and came home the next day with a fentanyl patch. We ended up removing the patch in a day as it caused excessive whining/panting/anxiety. She managed just fine on Deramaxx and Tramadol for the next two weeks or so and then was off all pain meds.

                At the time, I was a vet tech at a large referral hospital with an orthopaedic department. My dog's surgery was done by a board-certified orthopaedist.

                We did not do any formal PT after the surgery, just followed the vet's protocol of increasingly longer walks. We did not allow her up or down stairs (except the 4 steps to get into the house, and then she was assisted with a towel sling). Walmart is your friend if you have tile or hardwood floors. They have big, cheap rubber (latex?) backed throw rugs. Put them everywhere They're easily washable too.

                We did purchase an exercise pen (I think from Petco) for confinement when we had to leave her alone. That was probably the best thing we did for her. Otherwise, for the first two weeks or so, she was confined to our living room (carpeted) with a baby gate.

                Best of luck to you and your dog. You would never know my dog had surgery on the leg - no limp, she runs around the farm & swims. We think it helped that we saw the injury happen (stepped in a hole while running). That happened on a Tuesday and she was in surgery on Friday.
                Last edited by tarynls; Jun. 22, 2011, 08:59 AM. Reason: eta: ex pen info

                Comment


                • #9
                  I haven't read through everyone's posts here, but we've been through it with our Springer Spaniel. He tore his years ago and had the surgery to repair it. We did everything we were supposed to, crated him all the time for the first month except to go to the bathroom on a leash. He went nuts. He's his own worst enemy and I had no choice but to keep him crated for the month. After that we limited his space with baby gates. You can't afford to have the doorbell ring and him go crazy just to undo the surgery. However, 2 mos. after my dog has his repair done, he got out the door and he jumped off the deck and guess what, he undid the surgery....so back in we went. We were super duper careful for this round of post op. He recovered fully, but a year later, he tore the other knee and it's likely your dog will do the same. I'm sorry to say that but I think you need to be prepared for another surgery down the road.
                  My only advice is be super careful and take the conservative route to recovery. I had to get meds. to sedate him in the beginning.
                  Good luck!
                  "If you've got a horse, you've got a problem"

                  Comment

                  • Original Poster

                    #10
                    Thanks everyone for your replies!

                    I've been reading a lot about the various types of surgery, and I definitely see a great deal of debate regarding which type of surgery is best for which dog. Surgery of any kind freaks me out a bit (she is my "kid" after all) but I am confident in what my vet and I discussed and how we will proceed.

                    I work from home, so my plan is to keep her in my home office which has no furniture for her to jump up on and I can keep her confined for observation. We do have a crate that we used to housebreak her as a puppy (and later she shared it with our second dog when she was being housebroken). I probably will use that at night just so I dont have to worry about her wandering downstairs. I just worry about her sanity. She loves to go out in the yard and play and up to 8 weeks of being on a leash....who knows how she will be at the end of that experience

                    tarynls...do you mind if I ask which hospital in Jersey you had this done? You can PM me if you prefer.

                    Thanks again everyone!

                    Comment

                    • Original Poster

                      #11
                      Originally posted by wishnwell View Post
                      He went nuts. He's his own worst enemy and I had no choice but to keep him crated for the month. After that we limited his space with baby gates. You can't afford to have the doorbell ring and him go crazy just to undo the surgery.
                      Good luck!
                      I was posting as you responded....this is EXACTLY what I am concerned with. The UPS man drives my dog absolutely bonkers (even when he isnt stopping at my house but just driving by) and I dont need her injuring herself when they ring the doorbell!

                      Originally posted by wishnwell View Post
                      He recovered fully, but a year later, he tore the other knee and it's likely your dog will do the same. I'm sorry to say that but I think you need to be prepared for another surgery down the road.
                      We have pet insurance....but there is a 12 month waiting period from the cruciate surgery on one leg to the second leg (should that happen) for them to cover it. I dont want to take any chances as I dont think I could afford this out of pocket!

                      Comment


                      • #12
                        Originally posted by ClassNTime View Post
                        I would advise against the TTA, especially with her being a bigger dog. The TPLO is a great surgical option, when preformed correctly (I prefer by a board orthopedic surgeon)

                        Its fishing line vs a metal plate... both have there pros and cons, the good bad and ugly. But if cost is not a huge concern, I feel that you are farther ahead to have a TPLO done. TTA was a good option back in the day, but it is being replaced for a reason by the TPLO... Longevity! Do your homework, the surgeons in my neck of the woods, use absorbing stitches to close the surgical sites. Follow your home care and follow up instructions to the word - the range of motion PT, staying on leash, using a sling for getting around, no stairs, no slick floors, e-collar on, no jumping, small room or crate confinement... just to name a few. It will get your dog back and moving quicker!

                        Good Luck!
                        Actually, the tplo and tta are very similar recent improvements in surgery. In my situation, both were done by a board certified ortho surgeon.
                        TPLO I believe is a bit more invasive or severe in the cut. But TTA is also pretty invasive too.
                        I am beyond the research of the two types by a few years, so can't recall it all. But, I do know TTA is not replaced by the tplo, but rather more are doing tta vs the tplo.

                        I did not have the option in my situation for the first surgery, but did for her second. I chose to do tplo for both.
                        If I could have done tta for the first, I would have preferred it, but my vet was not certified yet to do it, plus equipment costs, etc.
                        My pup is a 95 pound lab. And she was young. The fishing line surgery is better suited for small dogs, or older dogs.
                        Young and active or large if able, would do best with the tta or tplo, per my vet.
                        save lives...spay/neuter/geld

                        Comment


                        • #13
                          The ups guy drives my dog to delerium for his dog treats!!! LOL.

                          I kept her in a crate to avoid any issues like running to the door or getting up too quickly.
                          save lives...spay/neuter/geld

                          Comment

                          • Original Poster

                            #14
                            Originally posted by fivehorses View Post
                            The ups guy drives my dog to delerium for his dog treats!!! LOL.

                            I kept her in a crate to avoid any issues like running to the door or getting up too quickly.
                            Love that he gives treats!

                            My dog was absolutely traumatized yesterday. First we had houseguests so she was excited. Then I took her to the vet and the UPS man was there delivering stuff and she about lost it in the parking lot. When we finally got into the waiting area she was panting as if she just ran a marathon...and we hadnt even seen the surgeon yet!

                            Silly dogs

                            Comment


                            • #15
                              Check into the support braces for these dogs. I have two friends who had dogs tear their cruciate ligaments, one did nothing but crate the dog during the day, normal interaction with kids and family life, running around outside, the other with the harness. Both recovered on their own. I would never do this hideous surgery with all of the pain. It took a year for the first dog and he got nothing extra in the way of supplements, he does get a food with glucosamine as an ingredient, the other dog nothing but the harness which she tolerated very well, and that too took about a year.

                              I think the vets make a ton of money out of this and certainly the surgical instrumet folks do. I went to a veterinary surgical conference earlier this year to work for manufacturer of surgical steel instruments and you would not believe how rich these guys are getting. Only one vet said that the early spays and neuters have considerably to do with the epidemic of torn ligaments and meniscus. Do they recommend a change of protocol, of course not!
                              Last edited by Calamber; Jun. 22, 2011, 07:03 PM.
                              "We, too, will be remembered not for victories or defeats in battle or in politics, but for our contribution to the human spirit." JFK

                              Comment


                              • #16
                                there's no solid proof that the incredibly invasive TPLO surgery works better than a simple fish-line repair; IMHO vets like it cause it costs three times as much.

                                I believe there is much stronger correlation between post-repair arthritis and how quickly after the rupture it was repaired, than in HOW it was repaired- for example, many dogs sort of gradually tear it, being sort of off and on lame for several months before finally going dead lame, and these dogs are almost certain to develop arthritis later; other dogs, who have an acute injury, followed by a short period of strict confinement and then immediate repair, are much less likely to develop arthritis.

                                There is proof that institution of a confinement/ intensive physical therapy regimen, preferably one that includes underwater treadmill work, produces FAR better results than the usual simple confinement. So you might want to consider checking the dog into a physical therapy center after the surgery for a few weeks, or finding one you can take the dog to easily on a regular basis.

                                Comment

                                • Original Poster

                                  #17
                                  Originally posted by wendy View Post
                                  there's no solid proof that the incredibly invasive TPLO surgery works better than a simple fish-line repair; IMHO vets like it cause it costs three times as much.

                                  I believe there is much stronger correlation between post-repair arthritis and how quickly after the rupture it was repaired, than in HOW it was repaired- for example, many dogs sort of gradually tear it, being sort of off and on lame for several months before finally going dead lame, and these dogs are almost certain to develop arthritis later; other dogs, who have an acute injury, followed by a short period of strict confinement and then immediate repair, are much less likely to develop arthritis.

                                  There is proof that institution of a confinement/ intensive physical therapy regimen, preferably one that includes underwater treadmill work, produces FAR better results than the usual simple confinement. So you might want to consider checking the dog into a physical therapy center after the surgery for a few weeks, or finding one you can take the dog to easily on a regular basis.
                                  It's definitely been developing (as mentioned over the past year and a half at least) and in looking at the xrays you can see arthritic changes, including her hips and spine.

                                  Our vet recommended physical therapy in West Chester which is not far from me. Hopefully it is something I can do, at least a couple of times.

                                  Comment


                                  • #18
                                    My Little (27 lb) dog had surgery on both his knees at about 18 mos. In his case it was his patellas as well as the cruciate on the left.
                                    Because of the structure of his hind legs, vet felt that TPLO was best for the left. And since he was lame on the right at the time, he did the "fishing line" procedure on the other side. I really trust that he chose the appropriate procedures for my dog.
                                    Dog was confined for the first 8 weeks (of snow and cold and rain...lovely to have to take out on a leash!) Complicated by his sister wanting to play! Vet used a thickly wrapped splint for the first week and doggie was a good boy and didnt chew, so avoided the "cone of shame". He is now 12 weeks out and only has a slight limp on the left, due, I think, to weakness. We continue to do more walks and he seems to still be improving.

                                    Comment


                                    • #19
                                      Originally posted by comingback View Post
                                      I was posting as you responded....this is EXACTLY what I am concerned with. The UPS man drives my dog absolutely bonkers (even when he isnt stopping at my house but just driving by) and I dont need her injuring herself when they ring the doorbell!
                                      You have a PM.

                                      Forgot to add, we put a sign on the door "DO NOT RING DOORBELL". That was very helpful.

                                      Comment


                                      • #20
                                        Originally posted by fivehorses View Post
                                        ASB,
                                        I had the last tplo surgery done last year. My options were the in office surgery which would not last, or taa or tplo by a board certified ortho surgeon.

                                        why are you so against the tplo?

                                        Also, different ages and size dogs are different canidates for different surgeries.

                                        TIA for your response.
                                        My oldest Doberman, soon to be eight years old (in two weeks), ruptured her first when she was about 18 months and her other about 18 months later. We were fortunate enough to have a surgeon at Iowa State who was doing a procedure that at that time was experimental. I'm traveling this week, and it's been several years, so if you need more details contact me offline and I can look up more info when I'm home. We decided against the far more invasive TPLO procedure and obviously ruled out the "fishing line" procedure (for an 85-lb active young Dobie). There is a lot of data that shows significantly more development of arthritis and scar tissue in dogs who've had the TPLO procedure, as they age.

                                        Our girl had an arthroscopic debridement. They went in using three tiny incisions, cleaned up the "frayed" ends of the cruciate ligament, I believe removed the damaged meniscus as well. There is no "repair"....the theory behind this is that you are not creating further trauma to the joint/to the leg and that the surrounding muscles compensate for the loss of the cruciate.

                                        She stayed at Iowa State for a couple weeks for intensive physical therapy, which started the very next day after her surgery. She walked on an underwater treadmill and later swam in a therapy tank. She thought she was in heaven, as I joke that she was a Chessie in a former life! She had the same procedure with the same surgeon on the other leg approximately 18 months later. Now, at nearly eight years old, she is fantastic. Shows no signs of issues with those knees, and runs, jumps, and swims with the rest of them.

                                        AFAIK, the surgeon was leaving to go to the vet school at U of M shortly after Storm's second surgery. I don't know if he is still there or not.

                                        Main takeaways?
                                        Minimally invasive (less risk of infection, less stress)
                                        Shorter recovery time
                                        Less chance of arthritis as the dog ages
                                        No hardware to worry about - scar tissue, granulomas, even shifting
                                        No "fishing line" to break

                                        We are happy. And went into that first surgery with eyes wide open. If it didn't work, she could have the TPLO done. But I wanted to give her the chance to have something done that was minimally invasive, less risky, and had the potential to have a better outcome, short-term AND long-term.

                                        Comment

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