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Ethical dilemma


frizbee
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I have a large male 6yo cross breed.  I love him dearly and can't imagine life without him, but have just found out he has a ruptured cruciate ligament.  I am familiar with the different types of surgery and also the repercussions of not having surgery.  My main concern is that he will be confined either in a cage or small space for up to 6 weeks or longer.  He is a very active dog and I don't think he (or I) will cope with this restriction.  My other dilemma is that even if I am able to pay for the surgery, there is still a chance his other leg will go (another 5-6 grand) and there is a possibility of arthritis, which he already has in his hips.   I am prepared to pay for the surgery, but I do shift work and live alone.  It seems really cruel to leave him alone unable to move around for that long every day.  I am so torn.  I don't think I could live with myself for not trying to give him a better quality of life, but the thought of him suffering breaks my heart too.  I will talk it over with another vet and get a second opinion.  Appreciate any feedback/advice. 

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Hi Frizbee

 

My female working line GSD did both her cruciates and she has just had surgery to repair both in February. One was misdiagnosed for a year so she was still sprinting around and doing everything normally apart from pulling up a bit lame (she is one tough nut!) but after a year the other knee just couldn't cope with the additional pressure anymore and also ruptured and that's when we found out after an appointment with the specialist that both had gone. She is very full on when in work mode and uses and abuses herself so it was just life's wear and tear unfortunately.

I can sympathise with where you are coming from. The confinement was something i was really worried about as my girl is also very active and i wasn't sure how she would cope. I was even more worried when they called me less than 12 hours after her surgery to come pick her up as she was fully weight bearing on both legs and was trying to bolt her way out of the cage they had her in. However when she was home in her normal environment she was much more settled and almost seemed to know that she had to rest.

 

The specialist also said she didn't have to be confined to the crate (which she had never used before) but she could also be in a small room with non slip floors. Right from the start we just did lead walks with her to the toilet and let her be outside with us on lead so she had a change of scenery ect and she seemed to manage this okay.

 

She has recovered fairly quickly touch wood and is now back to doing gaiting and a small amount of running. The main thing for me now is to build her muscle back as by the time she went in for surgery she had quite severe muscular atrophy.

 

It wasn't cheap as you know but i was told without it she would have been completely lame within a year. The initial phase of the operation and confinement is a very scary thought but i am very glad i did it as she is just a different dog now. Back to her usual happy self. The one thing i will say if you decide to go ahead with it is to find a vet who will give you instructions or refer you to a good physio afterwards as that is what will help the most in recovery i feel.

 

Good luck and let us know how you go!

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3 hours ago, frizbee said:

I have a large male 6yo cross breed.  I love him dearly and can't imagine life without him, but have just found out he has a ruptured cruciate ligament.  I am familiar with the different types of surgery and also the repercussions of not having surgery.  My main concern is that he will be confined either in a cage or small space for up to 6 weeks or longer.  He is a very active dog and I don't think he (or I) will cope with this restriction.  My other dilemma is that even if I am able to pay for the surgery, there is still a chance his other leg will go (another 5-6 grand) and there is a possibility of arthritis, which he already has in his hips.   I am prepared to pay for the surgery, but I do shift work and live alone.  It seems really cruel to leave him alone unable to move around for that long every day.  I am so torn.  I don't think I could live with myself for not trying to give him a better quality of life, but the thought of him suffering breaks my heart too.  I will talk it over with another vet and get a second opinion.  Appreciate any feedback/advice. 

Hi Frizbee

 

What's the ethical dilemma? Is the alternative PTS? (Apologies if the alternate is meant to be clear and I haven't got it). 

 

At 6yrs old, there is likely still plenty of life loving dogness to be lived. 6 weeks out of another 5+yrs is a drop in the ocean. Some great advice to be learnt here from many dog owners who have been through cruciate surgery from their dogs. My last dog had it done at almost 10yrs old. Much less than half the responses from people who gave advice had said their dog needed the other one done. Also, on a decent diet, good care and luck, she did not get arthritis - our vet surgeon was very happy about that. So from the dog perspective, there is plenty of life, and if there is only a chance of the other one going, there is the same if not more of a chance it won't go. And arthritis is only a possibility. Accidents with dogs are always a possibility too. 

 

I think you are overwhelmed by the cost, and thinking too far ahead of yourself - think of the now, and the better quality of life to be had after the surgery. The various procedures are quite commonly done and done well now, and there is a lot of advice in plenty of old threads (and others who will come in and provide tips here) to be soaked up. It is definitely a shock to the system how much it costs, but in hindsight, not only do I think it was the best decision ever for me and my dog, I don't know anyone else who has done it and thought never again.  

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Sorry about the injury.    Maybe it would help if you listed and considered the alternatives.    From what I've heard and read, Conservative Management (no surgery) requires  even longer strict confinement and restrictions than are required after surgery, and particularly for a large active dog, may not be effective even after all that time, so surgery is required anyway.  Extracapsular repair is cheaper in the short term, but probably not a really good option for a younger larger more active dog.   Again if that fails, TPLO, TTA or TTO may be required anyway.  And I guess at the back of your mind is the other alternative .. PTS.

 

There is a really great FB group  which has a heap of information and discussion, and is hugely supportive.  Canine Cruciate Recovery group.

 

It would be good to have a good discussion with a vet, either specialist ortho, or general vet who has a particular interest and plenty of experience in performing different surgeries, to discuss options, costs, recovery time and so on.   A procedure which is not widely mentioned in the US based FB group, is TTO .. developed in Australia by a NZ surgeon.   My own vet likes it as the time to weight bearing is shorter, recovery time easier (though it still depends on bone healing, and prevention of infection), and in his opinion outcomes are better.

 

As Panto has said, while confinement, and prevention of slipping, is important, crates are sometimes not necessary .l.. and not even doable for a large dog with a cone of shame.   Is there any chance you could get someone to call in to check him once a day maybe?

 

Feel bad for you, with hard choices ... wish you luck.

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My little dog did her cruciate and I also look after a boxer who has done both -- our shared vet recommends less confinement in the healing process and both have had good progress so maybe chat with your vet more about having the dog roam the house/yard more freely when recovering

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My 12kg dog has ripped both his back cruciates in his younger years, he partially tore one, then fully tore it, and then partially tore the other. I didn't know about DOL (to get a second opinion) or much about the options available so I just went with what the vet said. She was right, he recovered well! :) 

She gave us an assortment of meds, and said he had to be on "bed rest" for a month or so. (Same happened on the other occasions) 

Luckily we have family who have a small backyard and are home pretty much all day. So we'd drop him at their place every morning for about a month. He couldn't run around there because they only have a small backyard (but if it was big we would've just put him on lead), and since they are home he was supervised and couldn't do anything silly. He went fine, loved the attention and was happy to snooze in the sunshine despite being an active bouncy young dog (that's how he ripped them!) He recovered fully without surgery, but he is a smaller dog. We will start giving him arthritis prevention joint supplements soon since he's turning 8 and that's something to keep an eye on.

 

So I know we are really lucky to have family who could mind him, but I would highly recommend that as an option if you can find a friend or family member who can mind him most of the day. 

Otherwise look into doggy daycare or maybe a pet sitter? Or if you have any retired/stay-at-home parents as neighbours you could perhaps ask them to watch him? 

 

If that isn't an option, perhaps you could set up a little room for him if you have a small room, or a tall puppy pen, or a crate or something. And give him puzzles or long lasting chews and things to keep him entertained and using his brain. If you can squeeze in a little bit of training every day with your shift work that would also be excellent. I'm sure you can find videos on YouTube or blog posts about games and training for dogs on bed rest. I think I've watched some before. If you're too busy with work perhaps you could see if there is a dog trainer (that you trust) that could either mind him at their house  or drop into your house while you're working to give him a bit of training or games to keep his brain thinking. Tire him out that way rather than physically :) 

 

Good luck!! :crossfingers::hug:

Edited by Scrappi&Monty
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Our great dane had her ACL done in 2011 (she is now 11yrs and 4 months old) and had a great recovery.  

 

We didn't confine her to a crate, but had her shut in the lounge room (not big) if we were out and supervised outside.  Hubby works shifts so was generally at home.  She has now developed arthritis, but probably would have anyway due to her age. She has never injured the other leg. We found that early on in the recovery period she was happy to laze around, but we had to keep an eye on her at about 3-4 weeks when she wanted to be more active.  We found her running around with our greyhound a few times, but it didn't do any lasting damage.

 

Good luck with whatever you decide to do.

 

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There's a lot of things you can do to help dogs in confinement. I would start crate training now and look into all the wonderful enrichment activities you can provide to give your dog's brain a good workout. Mental exercise can be more exhausting than physical exercise. An easy one that requires little effort from you is a snuffle mat.

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Thanks so much everyone for your responses.  I"m sorry I can't reply to all your posts individually, so a great big thank you, all your responses have been very helpful.  It's so good to know there are alternatives and there is the strong possibility of a good recovery.  I am definitely overwhelmed and I think I need to talk more with my vet or another one, when I get another opinion.  The recommended surgery is TTO, which involves re-positioning the bone, done by a specialist.  I am hoping to get more advice and a better quote soon. 

I have been a total mess for most of the day thinking about my dog's options.  I just want him to have the best possible quality of life and I have been trying to imagine him confined in a crate/cage and I just know he won't cope.  I don't want him to be the kind of dog who turns aggro or further withdrawn from lack of stimulation and activity.  Even now he's trying to run around and wants to play and chase things. I had to block the staircase coz he ran up after me so he could snuggle with me on the bed.   I love him so much, my cheeky boy.  I'm already missing our afternoon walks.  If there's a way we can get thru the weeks/months then I'll give it a good go.  Mental exercise is definitely important and hopefully we can come up with some innovative ideas to try out.  I will definitely check out the Facebook page, thank you.  I"m not sure I will be able to afford physio as well, but perhaps I can get some helpful tips to try out and also get some family involved to help out.  Again, I really appreciate everyone's feedback.  Bless you all x

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A "baby gate" will keep dogs from over-exercising on the staircase.  I think they are usually min $75-80 through to around $150.  Aldi will have them for $45 in stores tomorrow (today, Wed 12th) , so good buy for anyone needing a quick fix across stairs or a room doorway. 

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When my large dog had a carpal arthrodesis operation I set up the spare bedroom for her. Took the bed out and put dog beds in, interactive toys, etc. Still hard on her but even the vet thought she was too big to be crated for that long.

Edited by Diva
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Hey Frizbee ... I see you are in NT.    On the FB Canine Cruciate Recovery group there is a girl in Darwin who has had good success with TTO (twice) on one of her big Pitbulls ... gorgeous dogs.   She did struggle with persuading him that he needed not to be getting out of his x pen .. but she got it sorted, and he did really well.   If you decided to join that group, and can't track her down, flick me a PM and I can point you in the right direction.   When I was having discussions with my vet about possible surgery, with the plan of getting my 8 year old BC back into agility,    TTO was his strong recommendation..

 

There are recommendations for post op rehab on that group in the files, and you may be able to organise some online help .. one of the DOLers is a canine rehab vet.  (GOtta love the internet!)

 

So very pleased to see you are feeling a bit more like you have realistic options available to get your boy back on his feet.  Onwards and upwards now..

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On 12/07/2017 at 4:51 AM, Scottsmum said:

If you say where you are someone night be able to recommend a speciaist. 

 

 

Thank you yes I've got a specialist and am currently getting another quote. Fingers Xd for saving a few dollars and getting a good specialist.  :)

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On 12/07/2017 at 3:06 PM, Tassie said:

Hey Frizbee ... I see you are in NT.    On the FB Canine Cruciate Recovery group there is a girl in Darwin who has had good success with TTO (twice) on one of her big Pitbulls ... gorgeous dogs.   She did struggle with persuading him that he needed not to be getting out of his x pen .. but she got it sorted, and he did really well.   If you decided to join that group, and can't track her down, flick me a PM and I can point you in the right direction.   When I was having discussions with my vet about possible surgery, with the plan of getting my 8 year old BC back into agility,    TTO was his strong recommendation..

 

There are recommendations for post op rehab on that group in the files, and you may be able to organise some online help .. one of the DOLers is a canine rehab vet.  (GOtta love the internet!)

 

So very pleased to see you are feeling a bit more like you have realistic options available to get your boy back on his feet.  Onwards and upwards now..

Thank you, yes I'm definitely getting my head around things a bit better than the other day lol.  So glad that I found this forum.  Now just need to win the lottery lol. I am waiting for approval to join the CCR group of facebook, cheers.  I've also spoken to a few people including a dog trainer who has given me some tips.  I'm just wondering how I will encourage getting back into the cage after a toilet run, but we will cross that bridge. 

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On 12/07/2017 at 0:43 AM, PossumCorner said:

A "baby gate" will keep dogs from over-exercising on the staircase.  I think they are usually min $75-80 through to around $150.  Aldi will have them for $45 in stores tomorrow (today, Wed 12th) , so good buy for anyone needing a quick fix across stairs or a room doorway. 

Thank you, yes I"m on the hunt for a cheap 2nd hand one.  I actually used to have one when he was a pup to stop him bounding up the stairs before he was toilet trained.  Meanwhile I have a makeshift fence to keep him confined.  Next will be to train him in the crate before the op so the transition is a bit easier.  Having him confined is going quite well, considering he's so active.  He seems quite content despite his limited activity. Lots of toys and plenty of positive encouragement helps :)

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