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Cruciate Ligament Tear

#1 User is offline   Koby's Mummy 

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Posted 12 March 2008 - 09:06 PM

Hi everyone,

I hope some of you can help with a problem my 1-year-old staffy has. A few weeks ago we noticed she was limping on her back left leg, took her off to the vet and he said her main complaint is a partially torn cruciate ligament. He also said she has a luxating patella, but he didn't seem too worried about this since it didn't seem to be what was causing her pain. In addition to these things, he also said she has arthritis.

I am a little concerned that he diagnosed all of this without any x-rays etc. He did it all by poking and prodding her until she reacted. Is this normal?

He said that all we could do was take her home, wait for the ligament to tear completely, and then get her in for surgery. He didn't advise of any special treatment in the meantime apart from starting her on glucosamine and anti-inflammatories. Oh and also trying to lose a little weight.

From what the vet said, surgery is the only option and just a matter of time, but from reading past posts I get the impression that there are mixed results from the surgery and that some dogs live quite happily without it. If our staffy needs the surgery, we won't hesitate to get it done. But if there are other things we can do to avoid it, I would like to know what they are. Can someone provide any specific tips on what we can do?

What exercise should she be doing or not doing? Keeping in mind the vet said she needs to lose a bit of weight. Over the last couple of months we've been very slack and not been going for walks, however we live on 5 acres so she has the run of the block if she wants it. We also have a couple of dams that I suspect she goes swimming in because sometimes she comes back smelling like a rubbish tip. Also occasionally we go to the beach for a bit of a run and a swim.

At the moment she is only limping sometimes, so it doesn't seem to be bothering her too much. I'm not really sure how I will know when the ligament has torn completely and therefore its time to go back to the vet. From those who have been through this experience - is it something that I will definitely know when it happens?

Thanks to anyone who can help - sorry about such a long post!

#2 User is offline   lucknow 

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Posted 12 March 2008 - 09:19 PM

If your dog tears a Cruciate Ligament surgical repair is essential, it is a very painful debilatating condition. The luxating patella is something that many dogs live with successfully and arthritis can be a side effect of this.
I would think it wise to seek a second opinion or see a specialist if your dog is being diagnosed with arthritis at such a young age.

#3 User is offline   kiahzen 

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Posted 12 March 2008 - 09:42 PM

If it is only partially torn then your best bet would be to rest her for a good few weeks, by this i mean in a crate and confined..
Only going out on lead for walks, This will help the partial tear to repair itself and not be so painful.
It may hold like this but being a younger dog i would assume that it will completely tear at some stage and the surgery will be needed.

Considering her age i would be saving up now for the surgery and getting the weight off her and trying to maintain her muscle mass as after the surgery she will lose a lot of muscle and you want the other leg to be as good as it can be so that you can try and prevent the other leg going too.
The surgery will be needed to maintain joint health and to stop the arthritis from getting worse in the joint.
The best form of exercise at the moment would be swimming, it is low impact and will not put any pressure on the knee.
Also if she needs to lose weight then cut her food back as it is going to be hard to do too much exercise with a partial torn cruciate.

She may never completely tear the cruciate but with a luxating patella i guess that the whole leg isn't as strong as it could be.

Our Rotty tore his cruciate and it did heal and hold for approx 2 or 3 months till it completely tore, you can tell when it has happened as they are in pain and wont hold any weight on the leg.
The vet can tell that a dog has done its cruciate from the Drawer sign, basically they manipulate the knee and it will have movement.

We didn't know that our boy had a partial tear as the 3 or 4 vets that he went to couldn't tell, we kept him crated and gave him anti inflammatory along with glucosamine and Vit C powder to try and maintain joint health. You can also give joint guard.
He did stop limping for about 2 or 3 months until he started to limp and show signs of pain again, this is when we took him to a surgeon for a second opinion and he had TWLO to repair (basically replacing the ligament with a titanium plate). This option you will be looking at around $2500 to $4000 for the operation, however you can get the older method (De Angelis) this is around $700 to $1500 depending on the vet.

After either of these operations you will need to keep her confined to a crate for at least 8 to 12 weeks and only lead walking to the toilet only during this time is permitted.

#4 User is offline   Tiggy 

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Posted 12 March 2008 - 10:18 PM

Sophie my Staffy ruptured her crutiate when she was 1 year old but she did have some lameness on and off a bit before then so I think it had a tear then ruptured. Sophie had the operation where the surgical wire replaces the ligament which cost $1200. I had to crate her for 8 weeks after the surgery. She's now nearly 2.5 years old and after some initial soreness after she'd been to active on it, she's now back in full exercise without any soreness and she's a very active dog.

#5 User is offline   Kajtek 

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Posted 12 March 2008 - 11:04 PM

My girl is recoverving from the TTA operation (titanium plate insert). Day 7 and we are counting the days before stiches come out. We are then looking at 2 months of gentle on-lead exercises and 2 months of bringing her back to the 'normal speeding bullet'. If all goes well she'll be 100% (she is 3.5yo, so hopefully the op will make her life happier). We've had the surgery done by Dr Tony Black in Sydney and he is wonderful. He claims that the recovery rate and the lasting effect of TTA is 100% but...it's a long and expensive road (all up ~7K).

Good luck
Anna

PS Apparently the ligaments just DON't fix themselves in dogs >10kgs.

#6 User is offline   cavNrott 

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Posted 13 March 2008 - 12:02 AM

View PostAnna, on 13th Mar 2008 - 12:04 AM, said:

My girl is recoverving from the TTA operation (titanium plate insert). Day 7 and we are counting the days before stiches come out. We are then looking at 2 months of gentle on-lead exercises and 2 months of bringing her back to the 'normal speeding bullet'. If all goes well she'll be 100% (she is 3.5yo, so hopefully the op will make her life happier). We've had the surgery done by Dr Tony Black in Sydney and he is wonderful. He claims that the recovery rate and the lasting effect of TTA is 100% but...it's a long and expensive road (all up ~7K).
PS Apparently the ligaments just DON't fix themselves in dogs >10kgs.


I agree ligaments don't fix themselves in bigger dogs. Scar tissue builds but won't hold in a big dog wherease it can sometimes hold in a small dog. Arthritis is a problem though.

My Rottweiler now 7yo had TWLO on both knees. The first at 18 months and the second one 12 months later. She has titanium plates in both knees.

I wish the TTA option was around in those days because its seems to be a much better option than TWLO.
Hope all goes well for you Anna.

#7 User is offline   puggy_puggy 

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Posted 13 March 2008 - 02:18 PM

Get the weight off her. Cut her food back & add vegtables as a filler.

From what the others have said sounds like the best option would be to get her operated on soon to repair the ligament rather then waiting for it to try and repair itself. I would be getting a second opinion from another vet.

If you do choose to not operate straight away and see if it reapirs itself you need to purchase a wire crate to confine her in straight away. Only letting her out on a lead to go to the toilet. So no exercise at all for at least a few weeks or so. She will either be in her crate or on the lead for a quick toilet stop. It may seem cruel but it's the only way that the ligment might heal itself.

If you do choose to operate you will also have to go with the crating and toilet breaks on leads option.

#8 User is offline   Koby's Mummy 

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Posted 13 March 2008 - 03:10 PM

Thanks everyone for your advice.

Today I am concerned that she has completely torn the ligament as she is now walking/running without putting that foot down at all, whereas before she would only lift it up every couple of steps. She was tearing around the yard this morning with a relative's dog, so i'm not sure if she has done more damage or if she has simply overdone it a bit. Her personality seems a little off this afternoon too, which makes me think she is in some pain.

Can someone clarify for me the two different surgical methods? TTA and TWLO? What do they stand for and how do they differ/compare?

I don't like the idea of the crate - it does seem cruel. But if that's what has to happen....

Also, with her food. At the moment she's really only having one meal a day, in the evening she has some chopped-up dog roll mixed with some dry food. I like the idea of replacing some of it with veges - but what do I cut back on? The dry food or the dog roll? We've always had trouble getting her to eat dry food ever since she was a puppy unless its mixed with something else. We also recently swapped back to the food bowl she had when she was younger, which is a lot smaller so therefore she is getting smaller portions.

I also want to start using her kong again, to give her a bit of extra stimulation and keep her from getting bored. Can anyone suggest any healthy options to put in it?

#9 User is online   Rappie 

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Posted 13 March 2008 - 03:34 PM

Ideally, a dog with a partially torn cruciate ligament or even a suspected cruciate injury shouldn't be running anywhere. This is an injury that does require strict rest and then a gradual reintroduction of exercise.

As for the surgical options:
TTA = tibial tuberosity advancement
TWO = tibial wedge osteotomy
TPLO = tibial plateau levelling osteotomy
You may also hear about the traditional / De Anglelis suture method - this is still commonly done on large dogs, but the other techniques are often a better choice for large active breeds if it is financially viable.

They are all different surgical methods that have a similar aim. The De Angelis provides physical support to 'recreate' the ligament (a very simple explanation), while the other methods try to neutralise the forces on the stifle joint itself to reduce strain (again, a simple explanation). I will have some time later if anyone would like to see some basic sketches of what the surgeries involve.

#10 User is offline   puggy_puggy 

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Posted 13 March 2008 - 03:50 PM

Kobe's Mummy it's cruel for your dog to exercise on it's injury. Crating is the only way. You could also use a small puppy pen but she has to be kept quiet. If you get her operated on and let her run around you will have wasted your time the vets time and put your dog through an operation for nothing.

I am not sure on the exact time that you will need to keep her crated for after the operation, others who have been through it with thier dogs will be able to tell you, but it would be at least for 3 weeks or more.


As for feeding. Dry food I think is ok if you have a good brand but those meat rolls IMO are not very good at all. She would be better off with you adding vegtables and human grade meat, kangaroo, fish & chicken to her dried food then the dog meat rolls. There are many opinions on what a good dried food is. (Some say that there is no good dried food) Over the years I have feed Science Diet but have always added vegtables, egg and different forms of meat to the dried food. Last year I switched to a BARF diet which has no dried food in it at all but vegtables, fruit, egg, youghurt, chicken, fish, offal and other red meat & bones. Have a read up of BARF and RAW diets. You may decide to change over completely to a no dried food diet or change to only some dried food, good quality, and some vegtables and meat.

This post has been edited by puggy_puggy: 13 March 2008 - 03:58 PM


#11 User is offline   Koby's Mummy 

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Posted 13 March 2008 - 04:12 PM

Yes I would definitely have done things differently over the last few weeks regarding keeping her from running around like a crazy dog, IF the vet had explained this to me. He did not mention anything like this. His basic attitude seemed to be 'take her home and bring her back for surgery once it's fully torn' and that was about it. Although he does seem to know what he's talking about, it's this sort of thing that makes me think I should get a second opinion.

Thanks puggy puggy, I will look up those diets.

#12 User is offline   Kajtek 

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Posted 13 March 2008 - 07:19 PM

I cannot claim any expertise in these matters, but have done lots and lots of research before "condeming" my heart-dog to TTA. As I understand, there is absolutely nothing you can do if the ligament is completely torn. It must be fixed surgically. Sure, keeping your dog on the slim side is a great help - less load on their knees and hips. Unfortunately, this WILL NOT solve the problem. I recommend that you do a bit of net surfing on this subject and decide what to do next.

Anna

PS
CavNrott many thanks for the well wishes. The Madame (my dog) and I are most grateful.
I hope that with no expense spared, lots of love from her mum and papa, great vet surgeon, and lots of dilligence, Our Baby will be well.
(As you can probably tell....middle aged couple with no kids. Except 2 of the 4 legged variety :( )

#13 User is offline   Tiggy 

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Posted 13 March 2008 - 09:05 PM

I found Sophie actually liked her crate. She'd put herself in before I left for work. I had to come home at lunch time to let her out to the toilet and she'd have a sunbake :( .

#14 User is offline   puggy_puggy 

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Posted 14 March 2008 - 06:06 AM

View PostKoby's Mummy, on 13th Mar 2008 - 05:12 PM, said:

Yes I would definitely have done things differently over the last few weeks regarding keeping her from running around like a crazy dog, IF the vet had explained this to me. He did not mention anything like this. His basic attitude seemed to be 'take her home and bring her back for surgery once it's fully torn' and that was about it. Although he does seem to know what he's talking about, it's this sort of thing that makes me think I should get a second opinion.


I definatley would be changing vets. When my girl pug sprained her elbow last year my vet told me not to walk her, let her jump off the couch or have her playing zoomies with my other pug for two weeks. She was put on a course of tablets and injections and was fine after the two weeks. I have since had a step built for her to get up and down off the couch and steps built for my bed so she can up and down off their without jumping. :laugh:

A sprained elbow is a lot less serious then a torn ligament.

#15 User is offline   Clyde 

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Posted 14 March 2008 - 08:11 PM

Having just gone through this with a Malt who tore her cruciate running down stairs, my orthopedic surgeon also fixed the patella which has always been a bit dicky. It's worth discussing with your vet to have both operated on so that the cruciate is not weakened by the patella. Chances are your dog already has some athritis so best to start some sort of supplements asap

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