Symmetry: Not Always a Beautiful Thing

I posted last year about our 9 year-old Bichon who had the equivalent of an injured knee (CCL rupture of the stifle in one of her back legs). Her repair and the subsequent rehab went well, and she had been running around like a pup since Christmas. When we had her surgery, the surgeon said that his exam showed that the other knee will probably go. It happened last night, and she’s completely lame in that leg this morning.

Last time this happened, I had a lot of good advice from the dog owners here, so I’m going to ask again. If you have a small dog that had a CCL rupture, did you have any conservative treatment that worked? (And that’s a small-c conservative, not letting the free market decide.) Note that a lot of the therapies I see involve weight loss, and this dog is at a healthy weight, so that’s covered, at least. And don’t be afraid of the alternative medicine suggestions, I’d like to hear what’s worked because I’m looking to avoid another surgery and 10 weeks of recovery.

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27 replies
  1. 1
    Paul in KY says:

    What would happen if you did nothing? Would dog still be able to walk & crap? Is the animal in pain?

  2. 2
    Craig says:

    I’m sorry if you’ve been over this ground before, because I’m new to the conversation, but I have to put in a word for hydrotherapy–either the aquatic treadmill or free-swimming variety. I’ve seen dogs make strong recoveries, and we will use hydro whenever we can in the future. It’s not a cure-all, but it can really help develop strength and control.

  3. 3
    Amir Khalid says:

    Some MH370 news, in case anyone missed it:
    Najib has issued a definitive statement, after a briefing from satellite operator Inmarsat the UK Air Accidents Investigation Board, that the missing flight MH370 ended in the southern Indian Ocean. From his statement:

    We deeply regret that we have to assume beyond any reasonable doubt that MH370 has been lost and that none of those on board have survived..we must now accept all evidence suggests the plane went down in the Southern Indian Ocean.

    ETA: The Guardian liveblog.

  4. 4
    Paul in KY says:

    @Amir Khalid: Very sad, Amir. Thank you for the info.

  5. 5
    Citizen_X says:

    @Amir Khalid: Sad, but good to finally know.

  6. 6
    Pengie says:

    We have an older cocker who blew out his ACL on Thanksgiving. He’s right on the line for weight where they are able to recover without surgery, and we have serious doubts about his ability to rest and recover if we did opt for surgery. Since it doesn’t cause pain, we’ve been letting it heal on its own. We did buy a set of steps so he doesn’t have to jump from the floor to get on the bed, and he doesn’t have a problem with sofas. It’s slowed him a bit, but I’ve noticed he has been favoring the leg less and less as time goes by. He was running around three-legged for a while, but now puts some weight on it. He’s not going to get back to where he was, but his brother had the same injury with a successful repair when he was much younger, and never got back to where he was either. It seems like something they can live with if they’re not very large dogs.

  7. 7
    Jamey says:

    I hate to break it to you, but your dog will never be able to drive the lane, and will lack the explosiveness off the line to keep up with elite receivers retrievers. Advice, based on the experience of acquaintances whose dogs had similar injuries is to let natural healing take over, and try to find workarounds so your pooch doesn’t have to jump or sprint.

  8. 8
    TrishB says:

    Here’s a link with some good info on activity restricition for acl/ccl injuries in dogs: http://www.tiggerpoz.com/id3.html
    A few years ago, we had a standard schanuzer with a blown ccl, and it was about 14 weeks of restricted movement before she was back to normal.

  9. 9
    Mnemosyne says:

    Even with humans, they will sometimes advise intensive physical therapy to build up the muscles of the leg rather than surgery — that was one of the options when I tore my ACL (though I ended up going with surgery anyway). Raven is always suggesting that you call a local school of veterinary medicine for ideas and/or treatment when something complicated comes up, so that may be an option.

  10. 10
    Lee says:

    I’ve sent a link to this post to my wife (a veterinarian). If she has time she might weigh in.

  11. 11

    I have another dog related question that hopefully someone can answer. 3 weeks ago we adopted a senior minipoodle, Petey. He’s a sweetie who has had a hard life – he was a stray who was hit by a car.

    2 weeks after we adopted him we found out that he has a seriously dislocated hip, and will probably require expensive surgery. It was undiagnosed for months, partly because the foster mom and I both assumed his weird gait was the aftermath of the accident and surgery. I think the vet hospital that did the surgery (and saw him at least 7 times afterwards on various matters) was negligent and is hugely culpable. The new vet I took him to on an unrelated matter saw the problem instantly and took xrays to confirm.

    He’s on painkillers now and I’m taking him to MSU vet hospital on Monday and he will prob get orthopedic surgery that night. MSU says surgery costs run from $2K to $10K.

    The rescue we adopted him from is currently “considering” whether they should pay for this surgery, however we feel they have an ethical obligation to do so because (through no fault of their own) they adopted out a dog with a serious untreated pre-existing condition and didn’t tell us. We understand that when you adopt any dog (esp. a senior) you are responsible for all costs, but we’ve only had Petey for 2 weeks.

    Question: is there an official code of conduct or ethics for rescue organizations that would indicate that the rescue should pay?

    Any other suggestions?

    Thanks for any and all input.

  12. 12
    alhutch says:

    Mix – My 9 year old Fox Terrier (Egan) ruptured his right hind CCL about 1 month ago. He underwent TPLO surgery 3 weeks ago and is progressing well. He is a very active dog and I wanted him back to his old self and this path seemed like the best way. I have mentally prepared for the other to go at some point.

    Which repair did your Bichon get? The reason I ask is if the TP angle isn’t too severe, maybe she can get away with no repair (depending on activity level, how much jumping she does, etc.). Weight/size of dog also seems to correlate with how well a dog ‘comes back’ without repair (30 lbs. seems to be the inflection point). Smaller dogs tend to do much better than large ones just letting nature take it’s course.

    Also, Egan had some meniscal tearing, so doing nothing wasn’t really an option (something to have checked out).

  13. 13
    evolved beyond the fist mistermix says:

    @TrishB: Thanks, I’ll take a look.

    @Pengie: The silver lining in this whole thing is that the dog is in no apparent pain and after her last injury she limped around fairly happily for weeks before she had surgery.

  14. 14
    evolved beyond the fist mistermix says:

    @alhutch: She had the procedure where they support the joint with fishing line, not the TPLO, which the surgeon recommended for a smaller dog (15 lbs). The leg that had the operation recovered well.

  15. 15
    Sister Rail Gun of Warm Humanitarianism says:

    Pet blogging. Close enough. This could use some more publicity.

    The Goathouse Refuge, a no-kill cat shelter in Pittsboro, NC, has an opportunity for matching funds if they can raise $9K by the end of the month. They’re a little over a grand away from making the goal.

  16. 16
    alhutch says:

    @evolved beyond the fist mistermix: She may not need surgery, but it seems like the restriction “recovery” time is something you can’t really avoid.

  17. 17
    RoonieRoo says:

    My experience with the blown dog ccl is strictly in large dogs – 75 to 90 lb dogs. We had the TPLO since for large dogs, it really is the best option.

    But even with my dogs screwed up structure, he has not blown his second ccl and after 5 years it’s not looking likely. The things I changed after the first one is part of why that hasn’t happened. I got his weight to as trim as the vet would allow and we swim once a week. The swimming has done a lot towards re-balancing his whole back end and strengthening the muscles that support that knee

    Where your situation is different, I highly recommend that you look into hydrotherapy or at least taking your dog to swim for 30 minutes at least once or twice a week.

  18. 18
    tk says:

    If surgery becomes a necessity then call your local bichon rescue or any rescue and ask for a referral to a surgeon. They have pounded the pavement to find the best and the least expensive vets out there.

  19. 19
    tk says:

    If surgery becomes a necessity then call your local small dog rescue or any rescue and ask for a referral to a surgeon. They have pounded the pavement to find the best and the least expensive vets out there.

  20. 20
    RosiesDad says:

    My answer is the same as it was the last time:.

    I am a practicing veterinarian and I have repaired several hundred torn CCL’s (cranial cruciate ligaments–the dog equivalent of our ACL) by this point in my career. (I am not a surgical specialist but I learned to do them in school and enjoy orthopedics so I continued to do them in general practice.) My perspective is this: in smallish dogs (~25 lbs or less), 75% will manage conservatively. But the time frame is longish; 6 weeks to 3-4 months. Over time, your dog’s body will build a band of scar tissue around the joint that will provide long term stability. This presupposes the possibility of a meniscal tear that might benefit from surgical debridement. (this is the 25% that do not manage well conservatively.)

    So if your vet thinks that your Bichon has a partial tear, carprofen (Rimadyl) and nutraceuticals (I would recommend Dasuquin, which is glucosamine/chondroitin + fatty acids from soy and avocado, plus an additional Omega 3 supplement) for a period of several months is a reasonable course of action. If you find no improvement after 6-8 weeks, I would reconsider surgical options.

    I hope you find this helpful.

    To this I would add that if you have a rehab vet in your neck of the woods, have that doc examine your dog and formulate a rehab program for you.

  21. 21
    sb says:

    Wow. That looks like the splitting image of my little girl. How much does yours weigh? Just curious…

  22. 22
    John M. Burt says:

    “[D]id you have any conservative treatment that worked? (And that’s a small-c conservative….”

    That sounds like a cue for me to remind everyone that you can be a conservative veterinarian or a conservative Catholic or even a conservative Trotskyite, but you can’t be just “a conservative”.

    Historically, the people in the U.S. who have called themselves “politically conservative” have been conservative Liberals like former President George H.W. Bush, as opposed to progressive Liberals like Bernie Sanders or moderate Liberals like President Obama. Liberals may disagree about details of policy, but all varieties of Liberals have historically agreed on the basics, those truths which a famous progressive Liberal called “self-evident”.

    And then there are “Movement Conservatives”, but I don’t want to get into discussions of abnormal psychology just now.

  23. 23
    WaterGirl says:

    My vet in central Illinois is one of only a few dually licensed veterinarian/physical therapists in the country. They do a lot of water therapy with injured dogs, but I have no idea what they would recommend for this problem.

    I don’t recall where you live, but I would be glad to contact my vet to see if he could recommend someone similar in your area. (Or maybe even do a consult with your vet?) Let me know if that would be helpful.

  24. 24
    Carol says:

    Colorado State University teaching hospital of the Veterinary school has this very informative page about the condition which includes both surgical and nonsurgical options.

  25. 25
    Scott says:

    @Craig: I will vouch for this method. About 4-5 years back my 45-50 lb mutt had a similar injury. I set up a 12″round, 2′ deep pool in my garage and had her swim several times a day. I would get in with her and guide her on a leash while she swam making sure she couldn’t touch bottom. I also kept her on a leash and avoided any stairs when I took her out to do her business. It took a couple of months but it worked. She is now almost 13 and can run up and down stairs easily. I keep her food down to about a cup a day and she also gets glucosamine chewable twice a day. Good luck with whatever you choose.

  26. 26
    she's crafty says:

    I remember when my dog (25 lbs) tore her CCL, the vet said that sometimes with small dogs, they recommend cage rest and seriously limited activity. My pup was just a little too big, and she won’t do a cage, anyhow.

  27. 27
    evolved beyond the fist mistermix says:

    @RosiesDad: Thanks. I’m looking at the rehab vets and will also be consulting the surgeon who did her repair. The concern is that her other (repaired) leg is nowhere near 100% and I’m afraid she’s going to wear it out even with pretty serious activity restrictions.

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