Partial cruciate tear

[blackcob]

Need a bit of hand holding, if you would?

Daxy dog pulled up lame at an agility competition on 2nd March - well I say lame, she uncharacteristically refused two jumps so we retired and upon running her up if pushed I'd say she was fractionally lame on the right leg but nothing obvious at all. In fact there was considerable debate over whether she was lame at all, we had an audience of mad agility people for trotting her up and there was a 60/40 split right leg to left!

Anyway, spoke to my vet on the phone who prescribed anti-inflams and a week of rest, she had short lead walks only and skipped the next training session for a total of 10 days rest. On going back to club the following Tuesday she was 100%, rocketing round like normal.

Back to normal walks, no problems, then back to club this Tuesday just gone - and she was not right at all. Refused a straightforward jump, ran out at the A-frame, did the frame second time round but didn't make a single contact all night, she normally has a solid 2o2o but was slithering straight off and sitting on the ground instead. Most obviously her weaves were just not right, she was hitting them like she was going to fly through as normal then going on a complete go-slow and winding round them rather than single-footing as normal. I pulled her out after two runs and went home.

Back to the vet today, didn't tell him which leg I suspected, he had a good squeeze and immediately said right leg. She has some thickening over the knee joint and a little muscle atrophy over the thigh there to match. Fitting with the on-and-off very vague lameness/not quite right-ness, if I'm honest since about November/December time in terms of not quite pulling her weight in sled dog-y stuff, he thinks we're looking at a partial cruciate tear.

She's in tomorrow for an x-ray and joint tap to confirm. If it is a tear then he seems to be pushing for conservative management but warned that it could involve 3-6 months of rest and of course always the risk of it totally rupturing.

 

[lexiedhb]

Oh poor Daxy doglet.

Have a hand to hold and a hug..... fingers crossed its not a tear at all........

 

[Cinnamontoast]

Hmm, if it is a tear, go hugely conservative!! It may heal alone but as she's a very active dog and not little, you might need to consider other options. Poor Daxy pants!

 

[blackcob]

Yes he did say that - if she was a 'normal' dog he'd hardly be concerned at the moment, it'd be a case of a month's rest and taking it easy for a couple more. As it is I am expecting her to do a very great deal (and boy do I feel guilty now!) and we need to consider whether conservative management would bring her back to competitive fitness.

I am equal parts guilt and sadness at the moment, it seems so cruel that she's just starting out on a proper agility 'career' and it has been snatched away from us, maybe forever, but it would never have happened this early if she hadn't been doing all the stuff she does.

 

[Britestar]

My BC has a dodgy cruciate. If allowed to chase balls would pull up lame, refusing to put the hind leg down. He is 3 yrs old. Rest would improve it but still occasionally hoping.
Banned all ball chasing for 2 months and started him on Yumove tablets.
Yesterday got out to play with a ball and 100% sound after. Will continue with tablets and will be careful how much mad chasing about he does for another month or two.

 

[Dobiegirl]

Another hand to hold here, dont have any experience with cruciates but just wanted to say Im sorry and what cruel luck. If only we all had crystal balls wouldnt it make life easier but we dont and you had no way of knowing what would happen down the line. Your dog is very fit which is why it took so long to surface I believe. I think you need to be guided by your vet who is saying and doing all the right things. Hoping for a good outcome for Daxy,

 

[Jools2345]

my girl was the same as yours no major lameness, just on and off occasionally she would yelp if she jumped or span. as she is a real live wire who loves to bounce and spin they had to knock her out to manipulate the joint the movement was phenomenal. so they proceeded to surgery and i am glad they did as she had lots of damaged meniscus that needed to be removed and conservative treatment would never have sorted that out. they also suspect its not the first time she has done it as the joint was a quite damaged. 4 months on and still on the lead still on and off lame but not like before-no screaming.
cant ever see her being right though so a couple more months then she will be off lead and possibly on pain killers then we see what happens-unfortunatley she is not happy on lead and restricted so its gonna be a huge risk but i cant see her unhappy for the next 5+yrs

good luck with yours

 

[blackcob]

Have just picked up a very sleepy husky. Not good news - he was expecting to find a tear of maybe 10-20% but instead we are looking at more like 50%. All credit to sibe stoicism as until today she hasn't ever been overtly lame or indicated any pain. Following all the manipulation under sedation today she is visibly lame.

He has presented me with two options:

Conservative management. We rest her totally (crate/housebound) for three months and have strict exercise management for another several in the hopes that the knee will scar sufficiently to stablise itself. This would usually be recommended for dogs with a less than 50% tear, small dogs and old dogs. It can be successful in larger active dogs but the management is that much harder and the risk of a future rupture is ever present. The risk is that we could follow a gruelling regime for six months, have a rupture anyway and then be performing surgery on a scarred, thickened joint with a potentially damaged meniscus which could have a poorer eventual surgical outcome. No anaesthetics and invasive surgery required.

Surgery. He's an orthopaedic specialist and the procedure he prefers is the TTA. It's invasive, traumatic and costly. A good success rate - 96% return to full function. Whether this would be full agility/sled dog function we wouldn't know until months later. The recovery is quicker than the conservative option, with walks within three months and potentially full atletic function after six. All usual risks of surgery - anaesthetic, infection, failure of procedure.

He is leaving this decision entirely to me - for him there is nothing to choose between them, she is on the cusp of recommendations for both options in terms of her weight, size, amount of damage etc.

She's home with painkillers and I am to call back Monday - he can do the surgery on Wednesday if I give the go ahead.

 

[MurphysMinder]

If she were mine, I think I would go with the surgery. As I understand it the TTA is the better operation and anything that will shorten the recovery time has got to be better for an active dog like D. I know its easy for me to say it so glibly when I am not facing it, but it does sound like the better option. Give D a cuddle from me for being a brave girl.

 

[Dobiegirl]

Oh dear thats awful, I can only say what I would do in this case and opt for surgery as this seems to have the best success rate. I would also be checking with my insurers to make sure they would pay out. Poor girl what ever you decide she is going to be out of action for a long while and I dont envy you her recuperation period where she is going to need rest.

 

[blackcob]

It will be covered by insurance, I was worried they would run with that claim for her dislocated hip a few years ago (it was the same leg) and try and exclude this but our vet is adamant that the two are not related - or at least not for insurance payout purposes - and will be submitting the claim forms as such. The cost will be roughly £1500 but we have a £6000 limit and lifetime cover.

MM, it's Rob from SE/what used to be OP - you know my feelings on their equine vets but I do trust him and he specialises in this technique, he's the only vet in this area who does it as far as I'm aware, everyone else refers them elsewhere. He's not pushing me for surgery but is trying to give me as much information as possible to make the decision which I respect him for. He's due to go on paternity leave any day now so his only caveat was that if I give the go ahead it must be done next week as he wouldn't let anyone else do it.

She has been so brave and is all grumpy and groggy.

 

[Spudlet]

Whatever you decide, many good wishes coming to you from this direction

 

[MurphysMinder]

Well as you know I have no faith in their equine vets either, but if your vet specialises in the technique I think you are right to put your trust in him. I know the small animal vets at the practice I use do this surgery in preference to the TPLO because they believe it gives far better results.
Poor groggy D, I am sure she is making you feel very guilty.

 

[Jools2345]

what ever route you go down (i don't know what I would do in your shoes) do look at top dog on facebook and down load their recovery timetable/sheet, i down loaded it and took it in to my vets to get their opinions and they felt that the advice and excersizes were great. also everyone advised start on a good joint supplement straight away to reduce arthritic damage to the joint

 

[Cinnamontoast]

I'd go the surgical route personally. Jake came back to 100% fitness after the TPLO op. He didn't do agility but he was a very active dog.

Almost inevitably, the second cruciate tends to go (so my orthopaedic vet told me) so perhaps better to get an operation so the other leg is more supported.

I found green lipped mussel was the best thing, shove salmon oil on her food and keep the exercise up so the muscle is maintained to support the joint.

 

[blackcob]

After a bit of research I've got some Yumove on order, they have salmon oil regularly anyway. I was also told that the second one goes in something like 40-50% of cases and that arthritis is an inevitable consequence of either tear or rupture with or without surgery.

Insurance will cover 12 sessions of hydro, depending on how she's doing she can start swimming at something like week 10 so we'll use those up and a few more besides to get her back to fitness.

I am still majorly wibbling, she's been on rimadyl again for a couple of days now and you'd hardly know there was anything wrong, any lame steps are so fleeting I am second guessing myself. She Is Not Pleased at not being allowed to play in the snow. Trying to work out the logistics of dealing with her post-op is already stressing me out, I am working stupid hours at the moment and R is already winding me up in various ways.

 

[HBM1]

My rottie ruptured hers when she was four. Such a brave girl, the first I noticed was when her thigh muscles on one side atrophied. I took her to the vet and when he did x rays he couldn't believe she was still walking about with no signs of pain. He gave two options. Leave her, as she was happy, mobile and her muscles appeared to have taken over...or...have an op to fix a band to take over..this would have meant months of recuperation. We decided to leave her and six years on she is going strong! I am sure all cases and dogs are different..but It can have a good outcome.

 

[Cyrus]

BC pretty sure this what happened to a friends male working malamute would you like me to pass your details on so you could find out how he delt with post operative care etc?

 

[blackcob]

Yes please matey, happy to add people on FB or I'll send you my email address?

Just thought, CT, I hope you are following your own advice and guzzling the fish oil - have they sprung you out of hospital yet?!

 

[Cinnamontoast]

Yes please matey, happy to add people on FB or I'll send you my email address?

Just thought, CT, I hope you are following your own advice and guzzling the fish oil - have they sprung you out of hospital yet?!

Yuk, no way! None of my joints were affected, thank God! Dunno how given the size of the blasted horse and the fact that the wound starts above the knee and then goes down the calf

I thought post op would be a trauma with Jake, he wasn't crate trained. He was a diamond, however, never whined about being rudely shoved in a cage with no warning! We were madly strict, did the whole halti, lead, towel under belly to support him weeing etc. We lead walked for weeks then gradually allowed him time off lead, built him up very slowly and honestly, he was 100% afterwards. Until the second one went but we just rinsed and repeated and again perfect recovery. The main thing was keeping him out of drafts and off the floor, hence the kuranda bed. We also padded existing beds to ensure he was off the tiled floor and ot feeling the cold seeping through.

It's hard work, I won't lie, but so worth it.

 

[Cinnamontoast]

And yup, I'm home. Living my dream lifestyle, covered in a duvet, being waited on, leg up on the lazyboy, watching Buffy re-runs Shame I can only do a zombie shuffle everywhere!

 

[blackcob]

Nothing short of a miracle that your knee joint wasn't smushed, I know it's not really a comfort given everything else but

And yuk indeed, when I was a nipper my nan once forced me to take a cod liver oil capsule, I gagged on it and it burst in my throat, I had fishy hiccups for hours and it made me throw up.

D is very much at home in crates and still uses her big 48" one by choice so I'm hoping it won't be too much of a trauma, though I can see her creating merry hell if I lock her in to take R out for a walk, god knows how I'm going to manage that. Have been out today to buy a spare duvet to make a nice squishy crate nest. Pondering how to deal with toileting - I hope the snow has gone by then, she hates peeing on deep snow but I can't carry her that far to find a clear bit!

I hadn't realised until I finally officially booked her in today that they will be keeping her overnight. They might change their minds when she starts howling...

 

[Cyrus]

Look on my friends list for a Matt Hodgeson it was his boy Rebel his 2nd recently went too

 

[Cinnamontoast]

I'm super lucky my knee didn't get smushed, I know. I'm ruddy grateful! I have no idea how no ones were damaged given what a huge horse she is and the injury is over the back of the knee.

She might surprise you about being in the cage. I was amazed at Jake, although he occasionally had the cat in there with him for company.

You might want to clear a patch of snow for her to wee on the ground. Don't be amazed if she takes ages to deign to go. If you can support her weight somehow, do, the strain of crouching will be quite difficult for her.

We moved the cage from room to room then eventually let him lie on the bed in the lounge having been supervised from the kitchen and made to walk super slowly between rooms. His brother was very careful with him, fortunately.

 

[blackcob]

She's awake and has a new bionic knee.

What he found surprised him. There was very little tearing of the ligament, it was just hugely stretched - to the point that there was total laxity in the knee when he opened it up and put the joint spreader wotsits in, there having been at least 50% previously. There was consequent tearing of the meniscus where it's had a good grind during these lax periods. Fits with the very intermittent nature of her lameness - up to a certain extent she's been supporting it herself with other muscles but after prolonged or intense exercise these run out of capacity and then we get the grinding and the lameness. Also shows how we managed a positive drawer sign on several occasions despite there being no rupture, it is just that loose.

I was a bit 'oh god' when he said he'd gone ahead with the TTA despite the lack of tear/rupture but the meniscal damage proves that there is an ongoing instability in that joint and it will only continue to get worse without stabilisation. They don't unstretch themselves, even with months of rest, and it clearly wasn't doing its job if it was letting all that mensical damage happen.

So not an easy decision (for the vet either, he took a second opinion mid surgery) but having done some more reading it looks like the right one. Thank you to whoever pointed me towards the Orthodogs group, by the way, it's been very useful and I haven't found a single case where a stretch didn't turn into a rupture or severe joint degeneration so it's been an extremely reassuring resource.

There is no way of proving it but there is a good chance some of this stretching occurred all those years ago when she dislocated that hip - though she recovered well, having several weeks of total rest, the damage to the ligament was done. Consequently there's been gradual damage of the meniscus, now highlighted because the degree of damage is now enough to cause lameness and of course the increase in workload she's had.

I get to pick up my poorly wolf tomorrow lunch time.

 

[Cinnamontoast]

Cor, you didn't hang about! Good job the vet got on and did it, it wouldn't have resolved with conservative management. Will Ricoh leave her alone? How long does the vet suggest for cage rest?

 

[Jools2345]

She's awake and has a new bionic knee.

What he found surprised him. There was very little tearing of the ligament, it was just hugely stretched - to the point that there was total laxity in the knee when he opened it up and put the joint spreader wotsits in, there having been at least 50% previously. There was consequent tearing of the meniscus where it's had a good grind during these lax periods. Fits with the very intermittent nature of her lameness - up to a certain extent she's been supporting it herself with other muscles but after prolonged or intense exercise these run out of capacity and then we get the grinding and the lameness. Also shows how we managed a positive drawer sign on several occasions despite there being no rupture, it is just that loose.

I was a bit 'oh god' when he said he'd gone ahead with the TTA despite the lack of tear/rupture but the meniscal damage proves that there is an ongoing instability in that joint and it will only continue to get worse without stabilisation. They don't unstretch themselves, even with months of rest, and it clearly wasn't doing its job if it was letting all that mensical damage happen.

So not an easy decision (for the vet either, he took a second opinion mid surgery) but having done some more reading it looks like the right one. Thank you to whoever pointed me towards the Orthodogs group, by the way, it's been very useful and I haven't found a single case where a stretch didn't turn into a rupture or severe joint degeneration so it's been an extremely reassuring resource.

There is no way of proving it but there is a good chance some of this stretching occurred all those years ago when she dislocated that hip - though she recovered well, having several weeks of total rest, the damage to the ligament was done. Consequently there's been gradual damage of the meniscus, now highlighted because the degree of damage is now enough to cause lameness and of course the increase in workload she's had.

I get to pick up my poorly wolf tomorrow lunch time.

although my dog had blown hers she had meniscus damage too and the only option to sort the meniscus is to remove it, mine is still lame though not consistently so and its 3.5months since surgery and she is still on the lead-she does have wizzy moments in the house and these that make her lame, she has been crated and on a lead all the time till the last 2wks-so not a great outcome for her and has been very stressful as she has a few blips along the way. saying all of that she is much happier than before the surgery-good luck with yours and keep us informed

 

[blackcob]

We're very lucky that our usual vet is an ortho specialist and the only one across the six or seven practices that does the procedure. Poor chap had two to do today, he'd pencilled Dax in last week pending my decision on Monday but also had an emergency one come in this morning - a rottie he'd done the right leg on four weeks ago which had managed to ping the left one overnight and was consequently totally immobile!

His decision to go ahead was based on the fact that no, it almost certainly wouldn't have resolved with CM, once it's stretched it's stretched and despite being intact it was not performing its function (and hadn't been for a while, given the tearing to the meniscus).

Ricoh is a furry little traitor who has enjoyed his day of peace, he'd be very happy as an only dog. He will leave her well alone thankfully, it is her that mauls him about, he just wants to veg out all the time.

Unless she's very restless and hammering about the house on the leg he said not to 100% crate rest her, if she's happy to be up she can potter as much as she likes on a non slippery surface. Crate is all made up with a new duvet so I'll be encouraging her to stay put for as long as I can. Stair gate has been moved to the bottom of the stairs so she can't climb or jump off anything.

I've made up all the kongs I possess.

 

[blackcob]

A lovely nurse has just given me a call to let me know that D's had some dinner (a forbidden junk wet tin, nom!), was helped outside to try for a pee (no dice, she has a bladder of steel) and is now sitting up a bit more alert but nicely settled.

It is very weird to not have her around tonight, fingers crossed she's a bit more up and about tomorrow and can come home. Pee logistics are going to be interesting given that we still have tons of snow.

 

[Pix]

Poor Dax! Must be a relief to know that at least she's settled in for the over night stay, and isn't howling the place down.

Do you have an area you could clear of snow for a toilet? Even if it was paved and right outside the door, she might pee there if you shovel some snow off and then throw down some compost?

Fingers crossed for a stress-free, easy recovery