Knees, ACL and CCL tears

[DennasMom]

Thought I'd make the subject line easily searchable...

I'm searching and not finding a lot on the group's personal experiences with CCL tears, TPLO surgery and other knee related issues...so...

Anyone here been through a CCL injury? (I'm guessing YES).

What did you do? Surgery? Conservative Management?

I read Griphon Mastiff's blog on Brinkley, which was very helpful. http://gryphonmastiffs.blogspot.com/2012/12/MastiffTPLOSurgery.html

I also read the recommended link on Conservative Management (CM): http://www.tiggerpoz.com/index.html

Which now has me third-guessing my recent decision (second-guessing was last week) to get a surgical consult for Denna.

Denna tore her CCL sometime last November, and we didn't really think anything of it - I figured it was an over-exertion injury, and she'd be fine in a few days. She did seem fine, although if we went for too long of a walk, she'd start limping... so walks got shorter. She probably re-injured it running after my sister's dog over Christmas (which I put a stop to quickly, but not immediately)... so... fewer walks, more naps... without smaller meals... she put on 10lbs over the last 3 months.

Talked to our vet on Feb 1st, she took x-rays and diagnosed CCL tear with onset of some arthritis. She put us on meloxicam to get Denna using the leg a bit, which worked. After a month, we stopped the meloxicam and the limp returned worse than before...so... we're back on meloxicam and my vet suggested surgery.

Today, I went to a holistic vet and we talked for about an hour with Denna napping at our feet. After all the talking, he did not suggest any alternative treatments (and he's a certified acupuncturist, which I was hoping he would offer)... he gave me the names of a bunch of surgeons in the area that would do a good job for us. He also gave us some high-potency curcumin tablets. Which makes me scratch my head, because from the turmeric group on Facebook, the concentrated curcumin is no better (and may be worse) than good ol' golden paste. Hmpf....

Now I'm thinking we'll go back to restricted movement at home (on-leash in the yard), add in some water therapy, higher doses of turmeric, glucosamine and chondrontin, lower doses of calories, and check back in a month to see if we're improving. And... getting off the meloxicam (or at least reducing the dose to every-other day), and letting her limp - which is what the CM link above suggests is better for natural knee scar tissue development. If there's no improvement in another month, then do surgical consult?

The other gotcha, is fitting in a surgery and post-op care in our summer schedule... we really need her to be mobile by the first of September, and preferably the first of August when we have events planned that she's a part of. Her limping during those events would not be catastrophic, but her not being able to walk up stairs would be.

Thoughts??

 

[Hector]

I'm sorry, but I have no advice. Sucks all around. I hope something is done that will improve her situation.

 

[Boxergirl]

I have no advice either, but I hope someone here chimes in.

 

[NYDDB]

Yes- Mateo went through CM with what at least one vet declared was a full tear CCL. I am sure I wrote about it here; it happened towards the end of 2014 (also when there was another dog going through the same CM treatment for his CCL.)

Long story short, it's a commitment, but well worth it, as the body will eventually build up scar tissue to help support the knee, given enough rest, and supportive gradual and gentle rehabilitation (we did swimming, underwater treadmill, physical therapy, cold laser, and massage. And a few supplements. Oh, and I did use acupuncture a few times -- the effects were amazing, but it's something you have to kind of keep up (and it became very pricey.)

It took close to 18 months (including a few minor setbacks, which is to be expected), but Mateo was able to heal enough to run short spurts, climb up hills and steps, and walk completely without a limp. I would honestly say his recovery was within the 90% range from where he was prior to the tear.

Every dog is different, but even my regular vet was amazed at his progress and eventual healing--- he is now using the protocol I did with Mateo and suggesting it to his other patients.

Do not let people tell you big and giant dogs cannot heal from this injury- that's a myth, as I had one that did. Patience, persistence and faith will go a long way on this journey, if you decide to go down this path--- plus a whole lot of education and research! Maybe Mateo was the exception, but I could not have been prouder and more pleased with the results from CM over surgery.

I would be all over the tiggerpoz website, if you decide to do CM--- I found it very, very helpful.

It's a tough decision, I know... all the best as you figure out what is best for your girl!

 

[DennasMom]

Thanks NYDDB!
18 months is a LONG time... did you have to restrict all activity to slow walks and no stairs during that entire time?
I'll see if I can find your thread from 2014...

On another note... I think the curcumin tablet the hippie vet gave us disagrees with her... we spent all night rotating between the bed and outside... trips every two hours. The second trip resulted in ALL of dinner being rejected (two BIG piles in the yard, thankfully not on the bedroom floor... so glad Denna still uses the door bells!!)... the rest were just random wanderings to nibble on grass. So far, breakfast is staying down, so I hope that was it. I might try it again next week, just to be sure that was the culprit.... but not on a weeknight.

 

[DennasMom]

I'm tracking Denna's progress on her other post, if anyone wants to keep tabs.
http://www.mastiff-forum.com/index.php?threads/dennas-got-a-limp.29881/

 

[sjdavenport]

I guess I'm in the fix it quick club. I opted for TPLOs on both of Mazey's knees ASAP after they ruptured. Her first one went two years ago. Her recovery was a bit slower, and the osteotomy site took longer than average to heal. It took her about 3 weeks post-op to use the leg well, and maybe 5 months to be released for full activity. Today, that knee is solid, and she has very minimal arthritis there (and she's 12). She ruptured the other one 6 weeks ago. Even though she's an older dog, I wanted to get her back to doing the things she loves as quickly as possible, and for her, that meant surgery. She will be released for full activity at probably 14-16 weeks post-op. We are very active, and do most of our activities off leash, so confining and restricting her activity for an unknown number of months while knowing all along that arthritis was developing in that knee just didn't feel like the right thing to us. She's recovering much more quickly this time. At 4 weeks post-op, we're doing 20 minute leash walks twice daily.

Her just before surgery:

 

[sjdavenport]

16 days post-op:

 

[sjdavenport]

And being allowed to join the gang for our walks again at 22 days post-op:

I know it's super tough decision. I hope Denna does well! Good luck!

 

[DennasMom]

Love that Mazey does so well!!!

I've read and heard a lot of miracle stories about TPLO surgery... and we were ready to dive in... then I read some horror stories... so decided to do more research...

The horror stories that pushed me to go the slow non-surgical route were:
1. Metal implants corroding in the leg, causing cancers
2. The rehab process post-surgery can be pretty much exactly like doing the slow non-surgical route, although in "most" cases, for a shorter duration
3. Many stories about how "severe" post-surgical pain is "normal" for a few weeks

Plus, from what I can tell, arthritis is a given with or without surgery.

Add in that Denna's not an overly active dog as-is, so restricting activity is not really a hardship to her way of life. We've actually INCREASED the number of walks we do each week... they're just really short in duration, and/or at a really slow pace. We got out to the beach this weekend, and she was bouncing all over the place... we put in over 15,000 steps on Saturday, and today (Monday) she barely showed a limp at all... it was better today than it was last Monday, for sure. Maybe we just need to spend more time at the beach!!

Add to that Denna uses the leg and it's only after walking too far for too long that she starts to limp, so could be a small partial tear... or could be she is good at ignoring pain.
I plan on adding some anti-arthritis injections to her regimen soon... Adequan seems to be recommended often.

Here's her contemplating the sea this weekend at Kalaloch Beach in the Olympic National Park:

 

[Courtney H]

I'm currently going through this with my female (Cora).

About a month and a half ago, I noticed a limp. Suddenly. I thought she had pulled a muscle, so I waited a couple of days. It didn't go away, so off to the vet she went. They did and exam and determined she had a partial tear (maybe). Pain meds were prescribed for two weeks. After she was off of them for a week, the limp returned. So back on the meds she went for another two weeks. During that time, I had her on restricted activity and leash walk only. One day while I had her out on her leash, she decided to go turbo and started running circles around me. Then, up went her bad leg and she completely stopped putting weight on it. I rushed her to the vet. During the exam, they determined that she completely blew out her CCL. Luckily, they had openings for surgery on Friday, and this happened on Wednesday night.

So things have been going well post op. But yesterday I noticed a clicking or popping sound when she puts too much pressure on that bad leg (3 days post op). Today (day 4), I am still hearing it. She's having a hard time going to the bathroom, probably because she's not wanting to squat. So she only goes when she absolutely cannot hold it any longer. And this morning she kind of hopped a little bit and twisted like she was in pain, and refused to poop.

I am stressed to the max. I've cried and cried for her. I have done everything the surgeon told me to do. She has been in a confined space with complete rest (except bathroom breaks), medications as scheduled, cleaning the wound, cold compresses 4-5 times a day... This popping noise is freaking me out. I called the vet yesterday and got the on-call doctor (they were closed for Memorial Day) and she wasn't really sure if it was a problem. She wanted to give it a couple of days to see if it persists. Luckily, I have an appointment for my male (Axel) today for his check-up and rabies vaccine. So I will be bringing it up to them.

Has anyone else heard this popping noise at only 3-4 days post op? I'm hoping Cora isn't the only one this has happened to. I just don't know what to do...

 

[DennasMom]

What kind of surgery did they do? TPLO?
I've heard sometimes the meniscus has issues post-surgery, and that can make a popping noise... worth getting a recheck with your surgeon to see if they need to go back in.

There are some great groups on FaceBook with TONS of surgical & rehab experience. They could definitely help with your fears with more suggestions and recommendations potentially well beyond what the vet has given you.

Here are the groups I'm following:
Orthodogs (dogs prepping or rehabbing from surgery): https://www.facebook.com/groups/469832443089113
Mastiff Health (all about big dogs, not just CCL tears): https://www.facebook.com/groups/Mastiffhealth/
Canine Cruciate Stories (for those trying to avoid surgery with CCL issues, although some have had surgery, too): https://www.facebook.com/groups/caninecruciatestories/