The Road from Dog ACL Injury to Recovery: Step by Step

cocker_spaniel

Two weeks after having surgery for a torn anterior cruciate ligament (ACL) and removal of a damaged meniscus, my dog’s stitches were removed today. Indeed, the road from dog ACL injury to recovery has been a long and interesting journey.

In a continuing effort to keep Fidose of Reality readers up to date, our road to date has included:

March of 2013: ACL partial tear diagnosis from doing a jump for the ball at the park

April of 2013: Cold laser therapy sessions at the local pet rehab center

May of 2013: Custom orthotic ACL stifle brace to wear for 4-6 months with modified activity (read: no jumping)

Early August of 2013: 90 days the brace and all seemed well

August 2, 2013: A 90-day update of the ACL saga

Mid August of 2013: Limp – pop – stagger.  My dog injured the same leg but worse. Surgery is required. A partial tear became a full tear.

cocker spaniel Dexter
Getting ready for the orthotic fitting.

Today, September 3rd,  he had his 5 skin staples removed without flinching.  I flinched a bit, but my little man stood there and allowed the vet tech to remove the metal pieces that bound his wound together.

Here is what I’ve learned and pass on to you, fellow dog moms and dog dads, if and when you are faced with this injury:

* The ACL (aka CCL) is a ligament that is commonly damaged. In fact, the surgeon who performed the repair on my dog says that more than half of his patients have this injury. Dexter also needed to have a damaged meniscus removed.

knee

* Keep your dog’s weight in check. Overweight dogs are at more of a risk to tearing a ligament or worse with the burden of carrying extra weight.

* Keep your dog active. Even if your dog is elderly or has any current health issues, check with your pet’s veterinarian on the types of activities he or she can do.  Mobility is pivotal, especially as means to combat atrophy (muscle wasting) and keep limbs mobile. There are things you can do to keep a dog active in the postop period.

* If your dog limps or appears to have any staggering or uneasiness in his or her gait, seek veterinary care. I know it sounds like common sense, but I cannot tell you how many folks I met in the many vet and rehab visits over these six months that waited to get help for their dog. Dogs feel pain as we do, but dogs are less likely to exhibit the level of pain they are experiencing. They truly are wolves at heart when it comes to disguising their pain. Often times, they will internalize it and not let you, their pack leader, know when pain is affecting them. Know your dog’s “normal” behavior so that you can act on the abnormal times.

* Be extremely careful when it comes to non-steroidal anti-inflammatory medications (NSAID,) proceed with caution. They can be hard on the GI tract as well as causing nausea, vomiting, diarrhea, or worse. Talk to your veterinarian about any potential side effects and proceed with extreme caution. We stopped using an NSAID after 10 days because we noticed issues.

* Do rehab and find something that works. Consider alternative things before immediately jumping to surgery IF your dog is a candidate. A partial tear in a smaller dog is more likely to benefit from conservative management like orthotics.

knee brace

* If your dog is older or has health issues that prevent him or her from surgery, a brace is a great option. Ensure it comes from a reputable company, that they work with you and/or your vet on the exacting process of a custom fit, and if possible, have access to the specialists so they can make one for your dog. We selected My Pet’s Brace and had a great experience.

* Look into homeopathic options for joint issues and pain but be selective and talk to an alternative medicine veterinary. Some practicing vets actually carry homeopathic meds in their practice: And thankfully my dog’s vet is one of them. We opted for Traumeel and Heel and had good success with them.

* Look into non Elizabethan collar (cone) options. I knew my dog’s biggest obstacle would come with having to wear that lampshade-looking device on his head for a few weeks. After looking into alternatives to the E-collar, which prevents a dog from licking and impeding the healing process, I found a viable and comfortable solution.

Granted, some dogs will figure out how to get through garments and bandages, so I wanted something easy to use, safe for my dog, and that would not dampen his spirits. Enter the onesie from Tulane’s Closet.  Oh and folks who guffaw at a dog who wears clothes or who turn their nose up at the idea of dogs in couture, get this: My dog is totally okay with a onesie because, after all, it’s just clothes to him. If clothes aren’t your thing, consider a soft cone.

dog_onesie
Short and sweet: the sessions and the dog

* If you end up needing to have surgery on your dog’s issue, get a board-certified surgeon. We received a referral and found the only doctor in our area that is board certified to perform this surgery.  Someone with that skill set and extra knowledge goes a long way. Oh, and the surgeon’s bedside manner was spectacular, too. We had a consult first and only then did we decide to have him perform the surgery.

* Decide what type of ACL surgery best suits your dog: There are a variety of them and I highly recommend you check out a reputable source. Fellow pet blogger, Jana Rade, has done extensive research on this topic.  We opted for the extracapsular repair: Basically fishing line is sutured into the area of the ligament tear. With time, scar tissue will form where the ligament damage is, the line will break, and the scar tissue serves to keep the bone connected to bone where once a ligament performed that function. Each dog is different, with different needs and injuries, and a qualified, caring surgeon will explain options to you. There is also nothing wrong with a second opinion. Here’s a shot of Dexter after he came out of surgery and we got to take him home the same day:

dog_knee

What I Would Do Differently

* If your dog has a partial tear of a ligament, don’t wait to start rehab and get an orthotic. I wish I started sooner.

* Be sure to eliminate jumping and any sort of movements that are harsh on joints. I should have used a baby gate to block off the bedroom. Jumping off a bed with a boo boo leg is not ideal.

* I’d not change much else that we did as a family. Life is full of coulda, woulda, and shoulda….and I have no major regrets.

dog_babygate

What Happens Next

* With the 5 staples out, we are allowed to increase walk time to about 20 to 30 minutes. No running for a long while. We were also given the okay to start physical rehab. With a center nearby, we will go that route. A variety of PT (physical therapy) options include underwater treadmill, strength training, range of motion exercises, and cold laser therapy.

* By the way, we have pet health insurance and it has been amazing for us throughout this process and the past 20 years of being a customer. I am not being paid to say that: The insurance helped immensely: they even covered the majority of the cost of the orthotic device.  I’d do anything I needed to for my dog, but having the cushion of pet insurance in place helped.

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Costs

The costs vary from vet to vet, surgeon to surgeon, and city to city. Here’s a breakdown of some of the costs we incurred:

Custom orthotic brace for left stifle:  $625

Six cold laser therapy treatments: $250

Extracapsular surgery with same-day release from veterinary hospital: $2,000

My dog’s love and devotion coupled with good health: Priceless.

Comments

  1. Great informative post. Hope we never need this information! Glad Dexter is doing well so far and has the staples out. I’m sure with all your help and care he will heal really well!

  2. I’m so glad that Dexter is doing so well in his recovery! It seems like it has gone by so quickly!
    Thank you so much for the detailed post. It is really helpful for me and I’ve been watching Dexter’s updates closely. I have to admit that I’m a bit jealous that you guys are 2 weeks out now and Sherman and I are still waiting, but now I might be better prepared!

    • I think of Sherman often, Jen. It has gone better than expected and I am knocking on simulated wood here. We go back for a recheck at the end of the month.

  3. We’re SO glad that Dexter is doing so well after surgery! Please keep everyone posted as his treatment progresses? Being able to understand what he’s been going through is invaluably educational for everyone that reads your blog.

  4. When Callie tore her ACL, our vet referred us to the veterinary specialists here in Greenville. He had already given me an excellent idea of what was going on, and how it might be best “repaired”, so when the surgeon sat down with us for the consultation less than a week later, we had an excellent idea of what the surgery would entail. And what Callie’s rehab would be like. It has been slightly more than six months since the TPLO surgery and Callie’s leg is like new. She is a senior, so it’s taking a while for her beautiful feathering to grow back in — to match the other leg — but the important thing is that she can run and play in the yard again. And when she’s tired, she stops on her own and just lays down in the grass and lets Shadow & Ducky have all the fun.

    • We talked it over with our vet and the main surgeon if we should do extracapsular or TPLO and ultimately went with extracapsular. Based on Dexter’s size and the injury coupled with the fact that double lines would be done, I felt like we did the right thing. It sounds like you did, too, and I am paws crossed Callie and Dexter are done with injuries! Thanks for the input, and continued wags.

  5. Well your vet charges lots less then the ones in our area! My pal Casey’s next surgery will be $3700. Whenever our pets get sick or injured we always think what if or just IF and rack ourselves up with guilt forever. Whatever we do we do what we feel is best at the time and just suffering forever doesn’t do any of us any good. Sounds like Dexter is doing great! Sandra & Dolly
    PeeS: We heard that if you have it happen once there is a good chance it will occur in another leg so paws crossed for Dexter this is his only one!

    • Hey Dolly. Sometimes the price can vary depending on what type of surgery it is and the size of the dog, nature of the repair, etc. So $2,000 was for an extracapsular repair but perhaps your pal, Casey, is larger and had a TPLO?? Either way, I hope we are done with surgeries. I feel like I’ve aged 10 years in the last 6 months LOL

  6. Dexter is quite the trooper. Thanks for all the tips. My Pierson is quite the jumper. He’s my bouncy boy. I never thought of it as something that could cause problems later.

  7. A very interesting and informative article. I think they have come a long way with doing surgery on dog knees and legs. Dexter you are a great patient. I was surprised how much they shaved on Dexter’s leg. I love all the pictures of Dexter smiling. Thanks Carol for writing the article. Hugs and Belly rub to Dexter.

    • Thanks a lot, Sharon. I know – I was most surprised by how much they shaved, too – and the redness from the danged close shave. He grows fast like a Chia Pet, so knock on wood. 😉 Woofs to S & S from us!

  8. Thanks for this article. I enjoyed teading about your dog. My dog is a 60 lb pit bull & he had bilateral suture surgery less than a week ago. I stumbled across your site when I was looking for suggestions for alternatives to ecollars, from people whos dogs had knee surgery. Id really like to try an inflatable collar, but not sure it would prevent him from licking his incisions. He’ll be down for a while so id like to find him something a tad bit more comfy 😉

  9. Thank you so much for the story and information! I pick my Golden Retriever up from his surgery in a couple of hours 🙁 I’m not excited to start this process or see him in pain! We live in a split foyer, Do you have any recommendations for stairs in the first couple of days/weeks after surgery? I’m so nervous about taking him outside to go potty for fear he’ll slip on the steps or fall down. I feel like an over protective mother ha ha, hoping his Puggle brother leaves him alone as much as possible!

    • What procedure did your sweet Golden have, Kirsten? Yes, I live on second and third floor so we baby gated the steps so he could not have access. Your guy is a bit bigger weight wise compared to my Cocker. Check out the GingerLead sling and see if that can help. I would really recommend he not weight bear on steps, and your surgeon will be specific on that. I also bought a dog stroller and they even make them for dogs like Goldens. I was just on vacation and saw a GoldenDoodle who had surgery recently being pushed in one. They are doggy buggies. The recovery is long but your sweetie can do it. Please keep us posted. Stop by our Facebook, too, if you can post a photo. http://www.facebook.com/FidoseofReality

  10. Next week my ornery but sweet havanese Oscar has his ACL repaired. Thank-you so much for your informative blog. I feel a little more prepared!

  11. I have an 11 year old Chow Mix who weighs 68 pounds. She had the extracapsular surgery 2 years ago on her right back leg but that leg never fully recovered. She got around great but was using mainly the left back leg. Three days ago she was running around the yard and tore the left ACL. If I do surgery it will have to be a TPLO because is her left leg is no better than the right one she will not be able to walk. I see a specialist on Monday. I have 6 steps and no one to get her in and out of the house except my elderly parents. I have to do something because I am having to use a sling now to get her in and out. The recovery for the first surgery was difficult. I am wondering if recovery for TPLO is about the same or worse. I wish I had done the TPLO on the first leg. She is very active when pain allows and is 68 pounds. Do they usually fully recover with the TPLO? Are they NWB and for how long? It was diffiult to keep her NWB when she had a good leg. She won’t be able to walk until she is allowed to bear wt. I don’t want to put her through this unless she has a good chance to recover, but I am not ready to give her up either.

  12. Hi. My almost 13 year old little girl ( Candy) had the surgery 3 weeks ago yesterday! My question is, how long will she limp? I am so paranoid that she is going to tear the repair or that she already has? We have been carrying her to the potty as we live in a high rise in downtown Seattle but we didn’t confine her to her crate. She is a low key older dog but as she has been feeling better she is trying to run around our apartment. Sometimes she limps worse some days and I am so scared she tore the repair so just curious.

    Thank you

    • Hi Linda and glad to hear from you. I hope your little Candy is doing well. I know that dogs are resilient and many of them want to get right back to their regular routines. The orthopedic surgeon who worked on our dog’s torn ACLs twice gave us a pretty tight schedule for weightbearing. Depending on the size of your dog and what you’ve been instructed thus far, expect her to limp for a few months. It will wax and wane but will get better.

      For the first week it was to the curb and back for potty breaks and we carried him out.
      Week 2 and 3 it was 5 minutes of weightbearing allowed.

      And it increased from there. You don’t want her running like that – they feel better and want to hurry and run – but they can re-tear the leg.

      So my advice is to restrict her activities like that and to prevent boredom, check out my things to do when the dog has surgery info.

      Keep us posted. Heal up, Candy! http://fidoseofreality.com/how-to-manage-a-dog-after-acl-surgery/

      • Jackieboy had a TPLO done April 3rd ..we go back the -17th for staples out.I have him restricted to a sm area in living room..which was ok,but today has decided wants out and crys..taking him out to pee and poop has been nerve-wracking for me..worrisome he s walking too far..has to go quite a distended to get off our deck to yard,,using a sling walking him out,then take it off as he won’t go with it on..he seems to be doing well,but I worry is he on it too much?..we don’t have pet insurence costs have been $46oo to date,and he does also have partial tear in other leg.He s 10 may 6th,wt 77..he s a healthy big guy ( am trying to get wt down)he has some arthritis too..So now the next 6 weeks he will still be on leash..but in house wonder if ok to give him a lille more room area..I was only told after sutures out stays on leash can walk 5 min walks and slowly increase.nkthing on rehab..there’s a dog swimming place near us..thinking it would be good if we can afford it to have him go there 1-2 times a week for strengthening the leg..will ask vet…how long in house did you confine your dog? I realize he can’t go on the furniture or bed ( which he loves) but maybe more living room space…It hasn’t been an easy time,trying too keep him quiet,he wants to go..

        • Hi Nanci – You sound like a great dog mom and taking such good care of your Jackieboy. TPLO can be a bit longer to recover, as I have seen with many other dogs who had the procedure. I would just be careful he doesn’t twist or slip and probably with time I would give him more room. My dog is medium sized and was never alone, so someone was always here to keep an eye on him. He started to get depressed and so we even bought a dog stroller for him so he could go for walks to the park. I would sit with him and we even went to a farm and watched the cows. He was so much happier. They even have big dog strollers. Check the company Pet Gear on Google.

          Yes, swimming is a great way to build muscle back up and help him regain strength and use that leg he had operated on.

          Here are some more things we did so he was not just laying around sad:

          Keep us posted! http://fidoseofreality.com/how-to-entertain-a-dog-after-surgery/

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