Cruciates

[fiwen30]

A follow on from my ‘arthritis in hips’ thread - my boy has been formally diagnosed by the orthopaedic vet at our practice with a ruptured left cruciate, and likely has damage of some form to his right.

He’s booked in for a TTA operation on Tuesday morning, and I’ve been stuffing my brain full of info about the surgery type, the post op care, and recovery & rehab process. Cost was given at around £1.2-1.5k, which was less than expected. There is also the TPLO surgery, which would have to be done at the bigger practice, for the larger cost of £2.8-3.4k.

We’ll be taking him in on Tuesday morning, and he’ll be x-rayed before surgery. If the angle of his tibia is less than 30 degrees he’ll go straight into surgery for the TTA; if the angle is greater than 30 degrees the. the vet will phone and possibly recommend that we go for the TPLO instead.

Have been spending the day turning the living room into a hospital in preparation for his post op, so it’s not such a big change when he gets home. He’s almost 10 with a grade 2 heart murmur, which makes it more worrying, but I trust our vet and it’s not an option to not have the surgery when he is mechanically unsound as is.

Has anyone else had a dog go through some form of cruciate surgery? I’ve joined a bunch of fb groups, but I appreciate the practicality and pragmatism of everyone here!

Quick pic of Rogan realising that vet bed is amazing. His regular bed in the background will be changed out for a lower mattress tomorrow, as it’s a bit too high right now.

 

[BallyJ]

My childhood dog did aged 8(ish) and lived a sound and happy life until 15!
my brothers spaniel had the surgery 2 years ago and has been sound and working on shoot days since!
they both were great afterwards and although recovery is a slog, they both managed well even the 2yr old springer! I’m not sure on the name of the surgery but it was the one where they put a band in to support the ligament (if that makes any sense?!!) happy to answer any questions though if I can recall the answer!
Sending lots of heeling vibes, but I’m sure you won’t need them xx

 

[blackcob]

One of my sibes had a TTA for a partial cruciate tear aged 4, recovery was a textbook 12 weeks and she returned to work including agility and sled dog racing. Now at 11 it gives her no issues and she's actually more arthritic elsewhere than in her stifle.

I will say that sounds very cheap? I had it done in a first opinion practice for 1.8k in 2013, 2k including post-op x-rays, and the same procedure there now would be more like 2.5k-3k.

 

[fiwen30]

One of my sibes had a TTA for a partial cruciate tear aged 4, recovery was a textbook 12 weeks and she returned to work including agility and sled dog racing. Now at 11 it gives her no issues and she's actually more arthritic elsewhere than in her stifle.

I will say that sounds very cheap? I had it done in a first opinion practice for 1.8k in 2013, 2k including post-op x-rays, and the same procedure there now would be more like 2.5k-3k.

Did your girl just have the 1 cruciate tear? Or did she need the second leg doing later down the line? I know the percentage of dogs needing both done is very high, and it’s likely that Rogan has damage to some extent in his right leg too.

Honestly, the quote given was cheaper than I expected! I’d asked around to see what others had paid, so I wouldn’t get too much of a shock, and it ranged between £1k and £6k! Think most of those were in England, so maybe it’s a regional thing? Not complaining, we can afford £1.5k, but anything upwards of £2.5k would’ve been a stretch.

 

[fiwen30]

My childhood dog did aged 8(ish) and lived a sound and happy life until 15!
my brothers spaniel had the surgery 2 years ago and has been sound and working on shoot days since!
they both were great afterwards and although recovery is a slog, they both managed well even the 2yr old springer! I’m not sure on the name of the surgery but it was the one where they put a band in to support the ligament (if that makes any sense?!!) happy to answer any questions though if I can recall the answer!
Sending lots of heeling vibes, but I’m sure you won’t need them xx

Sounds like it was some variation of what my vet calls a ‘lateral suture surgery’, where the band is put in to replace the ligament, and then scar tissue forms to support the joint. It’s an older type of operation, but still effective in some dogs - as shown!

Thank you for the vibes, I’m more worried about him coming through the surgery, as it’s a big, invasive op. The recovery will be stressful in it’s own way, but the risk of anaesthesia always terrifies me.

 

[blackcob]

Did your girl just have the 1 cruciate tear? Or did she need the second leg doing later down the line?

No just the one, quite unusual as she does have terrible conformation! It was the same leg she had previously dislocated her hip on aged about 1 year old so we can only assume there was some degree of damage or laxity left after that which predisposed her to the later tear. It usually does end up being bilateral for most.

 

[JennBags]

Firstly, can I say what a good looking dog he is!
Our Westie had both legs done but at separate times, I think the major cost is the anaesthesia so maybe that's why it seems so cheap for both, although I think our operations were at least £1,500 each. I don't know what type she had, Mr JB was in charge of vets stuff for her.
The key thing is the recovery period, you cannot start feeling sorry for them and letting them out sooner than you should, as it just delays the recovery and does long term damage. Stick to the letter of the law. Our vet told us that the second op often had better recovery than the first as the owner was stricter the second time round! Certainly true in our case.
Suzie did get arthritis in her hind legs as she got older but YuMove helped, and until she was 13.5yo she was still pretty mobile, then she stopped being able to jump up on things like she did before.

 

[Rokele55]

I have no personal experiences. However, a colleague took her working dog to the vet who diagnosed a cruciate ligament injury requiring surgery. As the dog was at the end of its working life the decision was made to pts. At that point the vet backtracked and was able to recommend other treatment.

 

[deb_l222]

Button had her surgery aged 13 for a complete rupture. That was 3 and a half years ago and she’s still going strong. The other leg has been fine.

My advice, if you want full recovery, stick religiously to the post op plan. It’s there for a reason. Don’t be seduced by your dog wanting to do more, it’s not worth it. They will be back to normal soon enough.

Because Button was 13 when she needed surgery, I had to have a long soul searching conversation with myself whether I was going to put her through it but I don’t regret it for a second

 

[Cinnamontoast]

My springer, Jake, had both done via a TPL, the second one is 80% likely to go, the vet told me. I used an orthapaedic specialist, there was no way I was trusting the vet who is basically a GP and offered to do the wire thing! It was £3K per leg and the insurance wouldn’t pay for the 2nd, saying it was a pre-existing condition.


His recovery was very straightforward and he was back to full fitness in months. I’d say go slow as anything with exercise afterwards and he’ll be fine. We used a towel as a belly band to support him, but Mr Independent wanted to stand on his bad leg to pee etc.

 

[splashgirl45]

my little terrier had his done recently, it cost over £3000 cant remember the exact amount as insurance paid...the first couple of weeks he was very quiet and vet said it was because he was on lots of pain relief..the next few weeks were much more difficult as he was off the pain relief and couldnt understand why he wasnt allowed to jump on the sofa etc. i used a crate and put him in when i wasnt in the room then gradually had him out during the day but still kept him in the crate overnight for quite a while. he was signed off after 5 weeks and vet said he could go back to normal but i kept him on lead for a week and didnt let him race around. he is now fine

 

[twiggy2]

I have had a dog have the surgery, hers was caused by a trauma so the other one was not high risk to go but in all honesty I would not do the surgery again. Recovery was long and very hard work.
I had another dog do his and her recovered with rest he was a smaller dog though.

 

[Flowerofthefen]

Our little jrt ( no longer get with us) did hers at 2 years old. Had the OP and all was well. 3 years later she did the other. Spoke to vet who said with plenty of rest the outcome would be the same as if she had another OP. We gave her 6 weeks strict rest. She never had problems with either again.

 

[gunnergundog]

How much does your dog weigh? The TTA is generally more appropriate for smaller/lighter dogs.

Also, check what the price you have been quoted includes.

A few years back I rang three different specialist centres who quoted over 1.5k difference in price. One discharged the same day, another kept in overnight and the third overnight with constant monitoring. Also, is the 6 week check up and further x-rays included? Home pain relief meds? The list goes on and can quickly mount up sometimes making the cheap option appear not so cheap after all.

 

[GSD Woman]

I've had 3 dogs have cruciate surgery and Trip had to have both knees done. My first GSD and Trip had the lateral suture done as that was what was out there where I live at the time. Star had a TPLO and I won't ever do another. He had a horrible time and the plate had to be removed because it turned out to be infected. He finally got better and was back doing obedience when the pet sitter let him get loose and he was hit by a car.

 

[fiwen30]

Thank you all for your replies, it’s very helpful to hear how others have been through similar.

He’s around 20kg, maybe a little less now that we’ve been slowly trimming him down these past couple of months (initially thought it was arthritis), so he’s just about on the cusp of being ‘small-ish’.

Will ring up and speak to the surgeon again today to confirm exactly what will happen, when he’ll be allowed home, and whether the price includes blood work/follow up consults/xrays.

Our lovely vet physio phoned me this morning to see how we were, and get the date for the surgery. She says as soon as he’s home, she’ll either call or pop round, and go over his initial post-op recovery plan with me. She says she won’t let us go through it all on our own, and that we can call or text her about anything - I almost burst into tears!

His hydro team have been super supportive as well, and once the surgery is done we’ll be making plans to restart his sessions, focussing on rehab this time.

I’m still fretting about him going under anaesthetic, but trying not to worry as he catches on to my emotions so quickly. I’m confident that we’ll have a ton of support post-op, and so that part doesn’t seem as daunting as it probably should!

This whole ordeal has had some marked similarities to the struggles I went through trying to get the right care for my mum, except this time all of the professionals are actually forthcoming and supportive!

 

[fiwen30]

Spoke to our surgeon, and the price given includes post op vet care including follow up X-rays, plus an overnight stay, so we’ll collect him on Wednesday. He’s to take his heart medication tonight and tomorrow morning, but none of his pain meds tomorrow. Dinner is before 7pm, and then nothing.

We have a Help Em Up harness to lift him in and out of the boot, and had a practice with the new, sturdier, longer ramp - a couple of goes on a shallow incline, and then he was up and down it in and out of the boot like a pro! He’s such a good natured, willing lad - his brain works at a hundred miles an hour when he’s learning something new, and he tries his heart out to get things right. The difficulty is me figuring out the right way to explain things to him!

 

[GSD Woman]

Fingers crossed fiwen30. I've run enough anesthesia on animals in severe conditions to know how a good technician/nurse makes the difference.

 

[gunnergundog]

Good news re costs and good luck for the op.

 

[twiggy2]

Hope it all goes smoothly

 

[fiwen30]

Thanks all, appreciate your well wishes!

Dropped him in this morning, might get a call when his bloods are done, the op is around 11 and then I’ll get a call at lunch time. Just hoping beyond hope that the surgery goes smoothly, and he comes round ok. Any spare vibes would be much appreciated.

 

[Clodagh]

He is very beautiful. Wishing him well.

 

[fiwen30]

Good grief, what a day!

Got a text saying his blood work was ok, and that he was going under. Phone call 20 minutes later, he had X-rays to check the angle of his tibia - had to be 30 degrees or less for the TTA surgery, and his was 42!! Steepest the vet had ever seen.

We could’ve gone with a lateral suture surgery, but I wasn’t happy with that for him if I’m honest.

He’s come round from the anaesthetic, thankfully, and we’re collecting him later.

Next step will be getting in touch with the big vet hospital, and pursing a TPLO instead, hopefully. It’s double the price, which will be difficult for us, and we’ll need careful management to preserve his right leg for as long as possible!

It’s not great news, definitely not the worst news we could’ve got today, but certainly not what I’d expected. It’s a pretty rare thing for dogs to be greater than 30 degrees in the tibia - it’s usually seen in small breeds.

I love him to pieces, but sometimes I wish I could go back in time and throttle whoever crossed a rough collie with a jack russell! That big collie body on little JR legs were always asking for trouble. What a stressful day!

 

[Clodagh]

I'm sorry to hear that. I wondered what breed/s he was, like a collie but not quite.
I hope you can get him happy and not go bankrupt in the process.

 

[Cinnamontoast]

I was looking at the face and thinking rough collie/toller!

The money is a killer, my vet broke down the bill, £4 for gloves, I was like ? Little buggers are worth it, it’s just so hard to suddenly find £3K.

 

[Moobli]

Sorry to hear it didn't go to plan today. Have you looked into conservative management to try to allow it to heal by itself? It might not be possible but it is definitely worth researching.

 

[TheOldTrout]

What a lovely dog.
One of my jrts had a damaged cruciate ligament, it was treated with anti-inflammatories rather than surgery though.

 

[fiwen30]

Thanks, I’m biased of course, but he really is a beautiful dog, inside and out!

Moobli: I’ve been doing a lot of reading, including about conservative management. Unfortunately, Rogan does fall on the wrong side of the advised weight for dogs which have a higher chance of recovery through CM. With him being an older lad, and formally very active, we think it’s best to spend the time recovering & rehabbing from a surgery with a high chance of success, rather than spending time on CM to likely have to have surgery & then rehab on top of that time.

We picked him up this afternoon, and he’s been resting in his hospital pen all day. It’s clear he’s so tired & groggy, but he’s not settled to a proper sleep yet. Wasn’t allowed any of his pain meds till tomorrow morning either, so he’s very pottery and sore ? But it’s good to have him home, and we’ll be calling the specialists in the morning.

It might be a case of having to combine the TPLO with a ‘closing wedge’, as his tibia angle is so steep, but can’t speculate till we’ve discussed with the specialist. It all sounds like money though.

 

[sbloom]

We're on week 8 of rehab with our 7 year old 77kg Dane. Here's what the vets report said:

A right stifle effusion and cranial drawer were evident following palpation and manipulation of the right stifle. Radiographs also revealed an obvious effusion in the right stifle. A right stifle arthroscopy confirmed a complete CCL rupture, as suspected (first two images below). A right Slocum TPLO (third image below) and medial
meniscal release were then performed.

It's been challenging, as everything can be with a giant breed, but he's progressed well with no major setbacks. He's now having physio, we're doing raised poles most days (!), we're at 25 mins walk twice a day. And over £5k lighter.

 

[fiwen30]

Glad your GD is recovering well sbloom! I saw the pics of your raised poles ?

Our referral went through, and we’ve got a cheeky appointment with one of their orthopaedic surgeons first thing tomorrow, luckily it’s not an overly long drive!

Both of their surgeons saw the initial X-ray, and again call him ‘complicated’, which in my mind reads as ‘difficult and expensive’ ? They would often have the consult and the surgery all on the one day, but for us they want to examine him first, possibly do more scans, and have a chat before committing to a type of surgery.

Have asked to speak to their finance team while we’re there. Price depending, we may need to pay part cash and part finance, ano so it’s best to find out all the options.

We’ve had such a chill day today - he fully recovered from yesterday’s anaesthetic overnight, and has been his usually bouncy, happy self. It’s going to be crap to go back to worrying and stressing again.