Demmy needs knee surgery

[kermit]

This is some crap. My K9 Demmy who I so recently posted proud pictures of has had some off and on lameness. Arthritis and a small bone spur in her hip. Adequin shots and rimadyl only helping a little. This is a working dog and it kills me to have to work her when shes not her tasmanian devil self. So the vet calls me today and wants another series of xrays. She believes that she needs knee surgery for basically a torn ACL. Work aside I am freaking out. Does anyone have any experience with this? She described shaving the bone flat and placing a plate in. Six months rehab on the outside. This will definitely be career ending for her. Jesvetmed-maybe you can help? Is this a successful surgery?

[Aggie_Ama]

I think my director said her dog (a lab) had ACL surgery. There are a couple of techs on here in addition to Jes being a vet.

((HUGS)) Good luck to your furbaby.

[OakLeaf]

Two of my dogs had three ACL repairs between them.

Unfortunately the vet clinic really didn't give us any instructions on rehab. Plus, these were pretty active dogs who'd never been crated before, and nothing short of a straitjacket was going to keep them off their feet.

They were definitely better once the knees were healed than they'd been before. But, from everything I'm reading now about human surgery, I wonder if they would've been just as much better four months down the road without it.

But those were acute injuries, too. I don't know anything, but they normally wouldn't do an ACL repair on a human for a chronic laxity, so I'd kind of be leery about doing it with a dog.

So I guess what I'm saying is that it seems like my dogs did benefit from the surgery, but if I were you, I'd very thoroughly explore the options for conservative treatment. If it's six months rehab anyhow, why not try at least a month or two of therapy before deciding on the surgery?

The other thing is, pain control. One of the vets... well, I'm still angry, and that's been over 10 years ago. But even if they do give your dog good pain meds post-surgery, you know how stoic dogs can be, so you can't take their behavior as an indication of anything but the most extreme pain. Now that I've had a taste of the pain of very minor surgery, I would absolutely make sure she'll be on narcotics for at least two weeks. Probably longer - my mom who hates pain meds was on strong narcotics for six weeks following her double knee replacement last year. I just don't accept that any mammal "doesn't feel pain the same way we do." (Of course most MDs don't think humans feel pain either, but that's another thread.)

Anyway, hugs and healing vibes, and good luck to both of you whatever you decide.

[PamNY]

Good luck to both of you. My first bulldog had ACL surgery years ago, and did well with a quick recovery.

Just based on conversations with other dog owners, I'd consider getting a second opinion.

Pam

[kermit]

Thanks to all. Right now I have to deal with the county contracted vet. This is a working police dog, and I love this dog. This vet fortunately is good about seeking outside help from specialists. I'm not your everyday "this dog is a tool" handler, and my vet has taken the extra steps. She loves her too. Although deep down I'm hoping she's wrong, I know Demmy isn't 100%. It's killing me.

[jesvetmed]

Kermit: ACL tears are usually diagnosed by a combo of xrays and sedation, which allows testing of "the cranial drawer sign" -- this means that when sedated, there is laxity in the joint that allows us to move the tibia forward (while holding the femur still). If the ACL is intact, you cannot do this.

They can be partially or fully torn, which relates to the amount of laxity present.

Here's a link to a more informative web page. http://www.vsasurgery.com/surgery/orthopedic/cruciate-ligament.htm

Recurring joint problems / pain and lameness definitely point to the acl.

As for repair -- a big dog like her needs to have a very good fix. If it's been going on a long time, then you likely already have had significant inflammation in the joint which has led to some degenerative changes (ie, early start of more arthritis).

But the idea of surgery is to stabilize that joint as much as possible... this is done in one of many ways, but for big dogs (especially ones that need to work for a living) TPLO is the surgery of choice. Only surgeons that have been certified to do so can perform this.

As for recovery: It is very important to follow instructions. Here's a link to post-op care from the same site as above: http://www.vsasurgery.com/surgery/post-op/tplo.htm

If you are not paying the bill, I would say TPLO is the way to go -- but it is more involved, more expensive, and requires more healing time. The idea is, however, that in a large dog, it provides more support & stability. In a smaller dog it isn't as important.

Having said that, we used to perform lateral tie-back surgery on all the patients at our clinic, including some very large dogs, and they seemed to do well, too. I think that if they are going to have trouble, they are going to have trouble. No matter which surgery you have done.

Also: Very important: They have a very high chance of rupturing the ACL / CCL on the opposite side if they have ruptured one. This is because it is related to their anatomy and make-up. What predisposed one, predisposes the other side as well.

I wish you lots of luck - let us know how it goes. Don't be afraid to have her checked out (and take your xrays) with a second doc for another opinion if you aren't comfortable with the one you get first.

Jes

[fastdogs]

I have had cruciate ligament surgery on one of my dogs, but it was an older dog already retired, so a real basic procedure was done with no consideration that the dog return to original function. The dog did fine, it was back when they had to have complete crate rest for a period after the surgery. Now, I think they go right into a rehab program that involves some movement.
I have known of coursing dogs (jackrabbit coursing on natural terrain) return to coursing and do quite well after ACL surgery, so I know some to return to a sporting function (it's quite grueling, involving long distances over rough terrain at extreme speeds).
Good luck! 20 years as a vet tech in the army and I have utmost respect for working K9s, I got to deal with the MWDs a lot.
vickie

[kermit]

xrays next wednesday, I'll keep you posted. Thanks everybody!