We have a 9 year-old Bichon. I figure the dog blogging is well-covered here, so I don’t mention her much, but she’s a great little dog.
Anyway, she’s been lame in the right rear leg since the weekend before last. We took her to our vet as soon as possible last week and the vet says she suspected the equivalent of a canine ACL rupture, but wanted to treat conservatively, so she’s been on Rimadyl (anti-inflammatory) for a week. I took her back for an X-ray and exam under anesthesia yesterday, because she’s no better. The vet confirmed that there’s a CL tear and/or a meniscus tear. She told me that it is routine to repair these ligament tears surgically in larger dogs, but the standard of care for an older, small dog is to try to ease pain and inflammation and basically let the dog limp. So, more Rimadyl and a glucosamine supplement for a month and we go from there.
I trust our vet, and she works in a practice that doesn’t seem shy to recommend expensive care for the dog. Surgery for this is in the multi-thousands of dollars, depending on the procedure, and she says she might recommend it later. I’d pay it if I thought it would work but she says the procedure used in smaller dogs is an older one that isn’t as effective as the one used in larger dogs.
I know we’ve got a lot of dog owners here, so my question is: any of you have experience with rear leg lameness/ligament tears in small dogs? Any experience with surgery, or with braces or other non-surgical treatments? The braces I see on the Internet seem to be both expensive and Rube Goldberg-ish, so I’m reluctant to put down hundreds of dollars on a device that might not work and the dog would hate.
Davebo
Wish I could help but my experience is with much much larger dog(s).
Trust the vet.
Mikeg
I have a 30lb, Cavalier King Charles/Lhasa mix. At 2.5, she busted her ACL, with a slight tear to her MCL, left hind leg. During X-rays, it was discovered she had “bad wheels” as the Dr put it. Her hip ball was already arthritic and bumpy, and clearly was not sitting right in her hip ball joint. Surgery was rec’d, for the ACL, and hell, why we’re in there, do the hip as well (Look up Femoral Head Ostectomy). $2,400 was the total. She recovered great. Then, this past April — her right back leg… same effing thing. So, we performed the same surgery on that knee/hip. She hasn’t seemed to recover as well this time. Still seems uncomfortable on the back-right leg. Not lame… but def favors the other side. Not sure what I would choose had she been older. Good luck.
The Moar You Know
My neighbor’s dog is a small guy – I think Corgi body on Chihuahua legs – and he just keeps reinjuring himself as his body is just not built for his aggressiveness. At age 9, I would go with the meds-only program although with such heavy-duty anti-inflammatories you will need to watch her for signs of bleeding (panting, pale gums).
FWIW, my newly and dearly departed lab mix had this surgery many years ago, and it did work, although her leg was never quite right afterwards.
ETA:
My vet is nearing retirement age, and if there’s one thing I’m grateful about from losing my dog yesterday, it’s that she didn’t outlive the vet. He’s a kind man and a smart man and is not into this heroic bullshit that so many vets are plugging these days. My sister-in-law had a dog with an inoperable and incurable bone tumor, and her vet wanted to put the dog on goddamn chemo. Can you imagine? They couldn’t even say it would extend the dog’s life by a day, but were perfectly happy to charge some poor people 20 thousand fucking dollars to try. That’s unconscionable.
ThresherK
I wish I had some applicable advice also.
All I can offer is that one of our cats has slightly loose kneecaps, says our trusted vet.
Who cooda node that was a thing? Not us. I guess it’s all the power-forward rebounding he does.
Jeanne T
I haven’t had to deal with this myself, but I have hung around a lot of dog lovers and seen the results of ACL repairs on toy poodles and the like. Some did well, some didn’t.
It occurs to me that 9 years is not that old for a Bichon – their life span is 14-16 years, I think.
Myself, I would follow the conservative approach for a couple of months and if no improvement, get your vet’s assessment and then take all the x rays and your dog and consult an orthopedic specialist and see what they recommend. A second opinion can be a big help.
Hawes
Sorry, we did it on our lab a long time ago (the lab has since shuffled off his mortal collar). He was young when he blew out both ACLs and so it was either surgery or probably put him down. The surgery was worth it, because it allowed him to live. But it was not cheap.
ranchandsyrup
Us dead Enders know that Bobamacare provides for doggie hoverounds.
slag
I wouldn’t put any of my beasts on Rimadyl if I could at all avoid it: http://usatoday30.usatoday.com/money/industries/health/drugs/2005-04-11-dog-pain-usat_x.htm.
The Moar You Know
Also: if there is some arthritis/joint inflammation involved, ask about Adequan. There’s a shortage right now as the factory shut down for retooling a few months back, but they have reopened, so that shortage won’t last long.
Adequan gave my baby another year and some months of vastly improved quality of life. They need a human version.
a hip hop artist from Idaho (fka Bella Q)
I’d go with the Novox (generic) and glucosamine (comes in treat form!) as the surgery for the smaller dogs isn’t nearly as effective. It also isn’t always permanent and there’s a longish rehab period. Not to mention the expense. I’m impressed that the vet is candid and not pushy about a spendy procedure. Drs. Foster and Smith will sell you meds very cheaply, and many vets will price match to keep the med business in house. Our late Django, who had Cushings as well as arthritis, used them for the Cushings meds, which my vet couldn’t match as it was below his cost. They’re sort of the Canada of pet meds.
Manage the pain, skip the surgery. Which happily coincides with the advice you got from an actual DVM.
Keith P.
@slag: I remember when Rimadyl was pulled off the market for people…it was an arthritis drug, but it turned peole’s skin yellow. Folks figured that since you can’t see much of dogs’ skin, and they don’t care what color they are, it was OK to use. But I remember at the time thinking “yellow skin sounds kinda like hepatitis…can’t be good for the liver”.
Betty Cracker
Your vet sounds trustworthy. And hey, you should talk about your dog more and post pictures, dammit!
mistermix
@slag: I have looked into the risks but I would rather she’s comfortable and if she ends up dying from a complication, so be it.
@The Moar You Know: Thanks, I do trust my vet, by the way, I just didn’t want to let the wealth of knowledge and experience here go to waste. One of the things I like about her is that she’s not intimidated by me asking her questions based on stuff gleaned from Google, etc. On the money thing, what I was trying to say is that I think she wouldn’t let economics get in the way of suggesting a treatment if it would work. She’s not going to recommend $20K chemo or bullshit like that.
raven
@The Moar You Know: We spent that much to fight Raven’s cancer but that was chemo, surgery and radiation as well as the two-and-a-half subsequent years that he made it. We say we wouldn’t do it again because of the toll it took on him but we’ll see.
fraught
The same thing with our 6 year old small Havanese. The vet wanted to treat him without surgery. He’s now back to normal after about two months of careful handling. I carried him up and down stairs, wouldn’t let him jump up and down from chairs, beds etc. I had to restrain him on the leash and not let him walk too fast. I weened him off of the anti-inflammatories after a few weeks. But I keep an eye on him because he’s very active again and I don’t want him to re-injure himself. Good luck!
Grover Gardner
I’ll second slag. Not to alarm, but be sparing with the Rimadyl. We gave it to a former dog of ours, medium-sized with serious back/leg pain, and she didn’t handle it very well. I ended up giving it to her only when she seemed especially bad, like not wanting to get up for a walk, etc. If there’s vomiting or diarrhea, I’d back off.
mistermix
@a hip hop artist from Idaho (fka Bella Q): Thanks for the Novox tip. If she’s on Rimadyl long-term, I’ll definitely switch.
ThresherK
@ranchandsyrup: If it were not so discriminatory in favor of cats, wouldn’t Obamacare have mandated Roombas to the market big enough for average-weight dogs to ride?
Jeanne T
Out of curiosity I just googled “Is Surgery Necessary For Your Dog’s ACL / CCL Ligament Injury” and came up with some links that suggest your vet is on the right track. Go take a peek when you’ve got a chance.
mistermix
@fraught: That’s good to hear, thanks.
raven
@The Moar You Know: Shit man, I just read the previous thread about your pup. I’m really sorry, not much else can be said.
mistermix
@Grover Gardner: She’s tolerating it fine. Since she’s only survived this long because of her extremely robust ability to vomit up the food she steals regularly, I’d expect her to be puking Rimadyl daily if it disagreed with her.
slag
@mistermix: I understand that calculation. I just wonder if there’s absolutely no other drug that might help instead.
Suzanne
I had this happen to a cocker spaniel. We did not do the surgery for the reasons you listed, and she just learned to compensate. After a year or so, you would never have known—her gait was just the same.
AdamK
I have an old pomeranian who limps occasionally and who has to plan carefully when he wants to jump up on the couch. I’ve already spent lavishly on surgeries for him (e.g. cataract surgery.) I decided to go the medication route if his limping gets any worse. He never was particularly athletic anyway.
Also, if one leg is sore, he has three others. I’ve only got the two total.
And being an old mammal myself, I figure there are some pains you just put up with.
raven
Rimadyl site. With that being said I have seen it really help my dogs.
ranchandsyrup
@ThresherK: that was in the kittycare fix amendment to Bobamacare that was defeated. Too bad because a Tunch-rated roomba would have worked for many dogs as well.
Mino
We have brought back large breed dogs with incomplete tears using confinement, mega Vit C doses and glucosamine/chondroitin. Main MAJOR thing is to confine the activity. No jumping. No racing around. Management is just as important as the meds.
Stella B.
ACL repair for humans is kind of questionable. We do it here in the US, but it’s much less common in Europe. There was just an article in the health section of the NYT questioning ACL repair for children. I have a physician friend who doesn’t want to take the down time for an ACL repair because it would interfere with her triathalon schedule. Her brother, an orthopedics doc, agrees. I’d use the Rimadyl on my dog, if it were me. I did have one elderly dog who developed stomach discomfort from it ( a hearty eater until she suddenly started hanging over her dinner just looking at it), but that got better with some Zantac.
Lizzy L
Novox is the generic version of Rimadyl. Same drug — cheaper.
Agree with those who have said be watchful with the Rimadyl/Novox. My 10 year old 60 lb dog has arthritis in his hips. He tolerates Novox if I give it to him once a day for a week, but used daily over months it gives him diarrhea/pain in the gut. Bad. So I only give it to him when he’s clearly in pain. I figure a little pain is better than having the drug chew up his digestive system. He limps a bit when we go for a long walk.
My vet requires blood work every six months to make sure that even this intermittent usage is not damaging his kidneys or liver. Expensive, but I’m willing to pay for it to be sure of that. He’s been on a regime of intermittent usage for about 2 years and so far, so good.
Good luck.
Bruce Lawton
All dogs do well on three legs so just let her limp with no pain killers as you want her to ease up on that leg. The supplements can’t hurt either. Let the dog heal at her own pace.
Roger Moore
@The Moar You Know:
Yeah, the veterinary oncology gets way out of hand. That said, I have a former coworker who is now working as a radiochemist in a veterinary oncology research program. He argues that it’s a good half-way point for doing research. Naturally occurring cancers in pets are better models of human cancer than the typical lab model systems, and there are fewer ethical and regulatory obstacles to using experimental therapies in animals than in humans. OTOH, my impression is that because it’s research, some of the cost is carried by the research funding rather than the patients’ families.
raven
@Bruce Lawton: I knew a three legged sheep dog named Doobie, never missed a beat.
a hip hop artist from Idaho (fka Bella Q)
@Mino: Management is probably more important than the meds for recovery, but the meds can make the pups more comfortable during that time. The NSAIDs are going to come with some risks – short term is always optimal based on those – but I’ve seen them make a huge difference in quality of life.
raven
@Roger Moore: some of the cost MAY becarried by the research funding rather than the patients’ families.
nastybrutishntall
Acupuncture is offered by more and more vets – worth a try. Knees tend to respond well so long as there is not a piece of loose cartilage jammed in the joint keeping it from flexing. If you want to reduce the use of Rimadyl, there are great Chinese herbal formulas for joint pain. Mobility 3 from Health Concerns 1-4 tabs/day usually reduces the need for Rimadyl in about 2-3 days, if not eliminates it. It’s a human herb formula, but a lot of dog owners are my clients because the results are so quick and so profound.
Neither of these options are particularly expensive.
Roger Moore
@raven:
I think it’s almost always the case that some of the costs are covered by the funding. It’s just that some of those costs are things that you wouldn’t have to be paying for if it were a non-experimental treatment, e.g. salaries of the researchers developing it, specialized lab equipment related to the experimental parts of the experimental treatment, etc. You wind up paying about the same for a cutting edge experimental therapy as you would for an established therapy, even though experimental therapies are inherently a lot more expensive.
kindness
9 years old isn’t all that old for a smaller dog. Tears to ligaments, tendons & meniscus can’t be seen on x-ray. You have to have an MRI to see soft tissue and those run money.
I had my ACL replaced 3 years ago after a complete tear skiing. With me I had an arthroscopic procedure and was walking again in a week. Took two or 3 weeks to walk properly but I was able to walk free of pain. They also snipped some of my meniscus out that was flapping. Meniscal tears are more difficult as they don’t really have any good way of re-attaching the meniscus to the bone. Mine was a little flap and just cutting it out was the best solution. And it was the meniscal tear that caused most the pain. The ACL tear hardly hurt at all except when my knee would dislocate because there was no ACL to hold it back.
Good luck.
protected static
We’ve got a gimpy rat terrier. He’s got a back injury, not a leg injury per se, but the situation is similar: we’d need an MRI to even figure out what the exact problem is (we suspect a ruptured disc), to be followed by surgery to fuse his spine. Both procedures can easily be measured in kilo-dollars, and the surgery is iffy at best; our vet was quite clear on this.
So yeah – we carry him up stairs (he doesn’t have a problem going down, just up) and keep some Rimadyl on hand which we give to him only when he’s stressed his back and is obviously in pain. This started maybe three years ago, and after the first few months to get the swelling and pain under control, we really only need to give him the Rimadyl at most one or two days every three months.
raven
@Roger Moore: I see.
TrishB
My parents had a standard schnauzer with a blown ACL, so bigger than a Bichon, but by no means large. The vet recommended that we wait 3 months before even considering surgery. During that time, we had to minimize Freddy’s activity, no stairs, no jumping, and no running, so her time outside (and inside) had to be heavily supervised. The time and rest did the trick.
I currently have a mini schnauzer that had to be taken off Rimadyl/Vetprofen due to GI upset. She was switched to Deramaxx which seems to be doing the trick so far.
raven
@protected static: I pushed Lil Bit in a modified stroller for about 2 months while she recovered from a disc problem.
dexwood
We had the same experience with a 9 year old PBGV that was a bit overweight. Our very good Vet gave us the same advice about surgery. The dog, Wilson, was put on a diet to reduce the load, and given Rimadyl for three months, but every other day. The med seemed quite effective and really seemed to decrease his pain and discomfort. We had to do whatever was possible to keep his activities restricted. He limped for about a year, but it decreased during the end of that period. After about a year, he no longer limped, had lost 8 pounds, and returned to nearly normal activities without any further problems. He lived 6 more years.
Robert
My neighbor is going through something similar right now. She has a shetland sheepdog (it should be a small/medium dog) that is overweight. He has tears in the same place and they’re treating it with drugs until he loses enough weight to have surgery. The dog is half the weight he used to be and the vet still wants it lighter before surgery. It’s not an easy operation even on the ideal candidates and gets harder as the breed gets smaller. This dog’s been on the drugs since early this year and he’s doing as well as you can expect. He limps. He has trouble balancing when relieving himself. But he’s happy, he’s active, and he’s as loving as ever.
Summer
We had a small dog that probably got hit by a car or kicked really hard before we got her, so when she got old the ball and socket was completely shot. She limped for years and the vet misidentified it and we didn’t realize how much pain she was in until much later. She had surgery at nine and with the very careful walking was fully recovered weeks later. and SO much happier.
RoonieRoo
We went through this with our dog. But he is a large dog – 83 lbs and he was 1 1/2 years old. BUT I do have applicable advice.
After you have kept her from activity (and I mean ANY activity) for at least 3 months while the tear heals you need to do one thing:
SWIMMING! If you can find a place to rent a pool or do aquatic therapy or the like, that will go a long way towards healing and strengthening the muscles that matter to protect her from further injury.
Without the surgery, there will be earlier onset arthritis then she would have had otherwise. Swimming can help push it off a bit more.
I’ve been swimming our dog once a week, 30 minutes for 3 years and it has done three things:
1) Helped keep him trim.
2) Built up the muscles on the side that had the surgery so that he can stand and run in a balanced manner. Before, he would cock his hip or lift the back paw every so slightly to not put full weight on it.
3) Prevented him injuring his other side or adding new injuries to the hurt side.
Jell-OH Schott
I second the comments re: Rimadyl. My vet won’t use it. My Meghan had a disc flareup a couple of months ago which caused her front right leg to go lame. We used steroids to reduce the inflammation and Gabapentin (which had to be specially compounded) for pain. We also started a course of laser therapy. She is back to her old self. Ask your veterinarian if there is a practice in your area that offers laser treatments.
Cathie from Canada
Here’s my contribution to this discussion —
We paid several thousand dollars for this surgery for our 100-lb labrador a year ago.
The way they did this surgery for him was to split the tibia and hold it apart with a screw, so that the tibial plateau was wider, then use the wider plateau to support the femur.
I can understand why they wouldn’t or couldn’t do this for small dogs — the bones and tissues are just too small and light.
It was a difficult recovery for our dog too — he isn’t great with anesthetic, and the recovery took six weeks and we had to be very cautious about stairs, etc. We had to set up a mattress for him on the main floor and prevent him from coming upstairs at night. We slept next to him for the first few nights.
He is fully recovered now and doing fine. But if it happens to the other ACL, I am uncertain about whether we would put him through this again.
We looked into the brace too — they have to be custom-made or close to it. For a fuzzy dog, I would think it would be difficult to get a good fit, while for a flat-coated dog it might be easier. That said, if it helped reduce pain walking and peeing, it would be a good thing.
evodevo
Our 6 yr old pit bull/heeler mix was also an athletic dog (used to do maneuvers like a cutting horse just for fun) until she evidently went after a squirrel or something (we didn’t see it happen, just heard the yelp) and came limping back. She was off her feet (and feed) for several days, in too much pain to get up. Seemed to be some psychological issues as well, like she just couldn’t believe it. Took her to the vet and he said nothing was broken, probably ACL, and only STRICT rest and A LOT of time would heal it. We kept her on restricted activity for several MONTHS, along with anti-inflammatories when it seemed worse (she would forget and take out after a squirrel/whatever) – baby aspirin is the least costly and proved effective. She also adjusted psychologically to not being a quarter horse any more and now is more careful. It’s been a year and a half, and she is much better, but will never be as agile as she was before the “incident”.
max
I know we’ve got a lot of dog owners here, so my question is: any of you have experience with rear leg lameness/ligament tears in small dogs?
That kind of surgery is reaching the limits of the ability of vets to do repairs on a small animal. (That’s why they’ve got a different procedure than big dogs, who are closer to human-sized).
If the tear gets much worse, you’ll be having to do surgery than anyways, but at this point you don’t have to and it may and still can heal. Surgery is a risk, especially if it doesn’t work. So going with the anti-inflammatories is the cautious route and that seems like a good idea to me. It requires patience but if it was some kind of potentially lethal organ problem incurable by surgery you’d be doing the same thing (administering pills and crossing your fingers).
max
[‘And even successful surgery with complete healing will increase the chance of future tears.’]
moonbat
We have a Schnauzer/terrier mix doggie and when he hit 7 years old he went through a spell where he seemed to have injured a disk in his back–could barely walk. Took our vet took forever to figure out what the problem was and Rimadyl was prescribed for a while but we were told that was not a good long term solution because of side effects. They wanted to cut, but I’ve seen enough human back surgeries gone awry that I wasn’t for that option. We went with pain relief and chondroitin supplements for a while, but believe it or not massage seemed to help the most. He recovered and at 9 years old is still going strong.
mistermix
Thanks for all the advice. She’s at a healthy weight for her size so that’s one thing she has going for her. She’s very active, normally, but I’m restricting her movement and giving her short walks so hopefully that will help.
Just Some Fuckhead, Thought Leader
and that’s a wrap
kc
@Betty Cracker:
Seconded!
And good luck; I hope she gets better.
RosiesDad
Mistermix: Just logged on and saw the post. Did not read through the 53 prior comments.
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.
Trollhattan
@moonbat:
Had to rub my eyes and read twice to confirm you don’t have a “Schwarzenegger-mix.”
Although that would be awesome. “Ah’ll be baak. Afta aye take a daaamp.”
Joy
My Golden had an ACL tear and did fine, but that’s a big dog. My friend’s Cocker had one and did well with the surgery. The main point I got from my vet (a trusted friend) is that it depends on the age, activity level of the dog and how diligent I would to with rehab exercises. My dog was active and I did the rehab that was recommended. I think Rosie’s Dad’s post, above, is extremely informative. It is a lot of money to shell out, but I didn’t see an alternative. It pained ME to see her walk around like that.
Tommy
I am kind of new here from a posting point of view. Lurker for years.
Seems like a good place to ask this question. I’d like to get a dog. Never had one. I expect to get it from a rescue place or a shelter. I am an active person and I want a dog that will like to run with me. Hike. I don’t want a small dog. I got cats for sitting on my lap :). My thinking from my research is a German Shepard. The rescue place a old dude from high school runs there are a lot of them that are 2-3. Folks that got them cause as puppies they seemed cute, but got large and active. But I also hear they have a lot of health issues.
Just asking …..
HelloRochester
Ask for steroids. Many vets will poo-poo this because long-term prednisone use in dogs invariably gives them diabetes if used daily for many years. We went through a few years of bullshit (and many thousands of dollars) trying to treat a case of post-poisoning pica in our 11 year old black lab until a younger vet said “I know you’re the type of people who would trade a couple years of life expectancy for higher quality of life for this dog and he’s being tortured by all these surgeries, so let’s try this.” We got 2 more good years before he got the diabetes.
Amir Khalid
@Tommy:
You got cats? Then you need a dog that won’t be a danger to them. You’ll remember that sad recent business about the sudden passing of Tunch, John Cole’s cat who was pretty much the blog mascot.
raven
@Tommy: I’d go for a mixed breed if I were you. They are great dogs but really prone to problems. I say that as the owner of a couple of cocker spaniels that have cost me a fortune.
Original Lee
@mistermix: Just one more suggestion: ask your vet about Ascriptin (buffered aspirin) for pain management. Samwise, our border collie with hip dysplasia, used Ascriptin for pain the last few years of his life. It’s not expensive and for a small dog, you’d probably be able to use half a tablet or less daily.
Original Lee
@Tommy: I’m partial to border collies, myself, and they generally love to be on the move. I would suggest an older dog (at least 3 years old) because the young ones frequently need more activity than a single person can give them. They also tend to be long-lived (15-16 years on average), and remain vigorous well into their teens. Our 10-year-old BCs both still routinely demand at least an hour of play/exercise/walking daily.
Jodi
My vet here in the north woods of Wisconsin offers laser and acupuncture treatment, and I have seen some pretty miraculous results in dogs with arthritic rear ends who have had one or a combination of these procedures. Not the same as a ligament tear, but maybe also can be a treatment for?
http://abcnews.go.com/Health/laser-therapy-staves-off-pets-arthritis/story?id=12974694
Ron
Um, I’ve had 6 different ones done on 5 different dogs to date, but I guess they would all be considered “big” dogs, in the sense that they were all over 40 pounds. None of the dogs were that old either, the oldest being 7. All the surgeries went well, if that helps. Come to think of it they all went well even if that doesn’t help.
walizonia
I am a veterinarian and have a lot of experience with ACLs in small dogs as my toy poodle tore both of them. The surgery that is done to correct it is an extracapsular suture. The first one that she got done resulted in a good outcome and quick resolution of the lameness. The second one was not quite so smooth and she limped for a good year before she started using that leg again. I think she finally used that leg because she developed lameness in yet another joint and she no longer had the luxury to take weight off the right rear.
I had both surgeries done by the same orthopedic surgeon so I don’t doubt that they were both well done. If your dog is healthy otherwise, I would consider getting it fixed as she is likely to tear the other one from the stress placed on the contralateral knee due to the torn one.
Tommy
@raven: @Amir Khalid: as a kid I begged my parents for a cocker spaniel every day of the week :). The places I’ve contact will require a home visit or two. I expect the dog and my cats will get some time. I don’t declaw my two cats and bet they can fend for themself. But if the dog is remotely violent to my cats, well he/she won’t come into my house again. I so recall the passing of Tunch. John saying he went to pick up a knife to kill the dog. I so understand that.
I just ask cause my brother and his wife keep buying these expensive pure breed dogs. They seem to get sick and die in a few years. 4-6. Now as they say bad fucking luck. Cause often times they spend thousands on them to not let that happen. But I’d like to lower the risk.
raven
@Tommy: These are my knuckle heads!
agorabum
@Tommy: There are shelters, and also ‘foster-dog’ organizations that keep dogs out of shelters (so no kill) until they can get adopted. Both are good routes. Labs are good, obviously, and if you can get a dog that has some mix in him (german shepherd mixed with something more gentle, or a Rotweiler / Lab mix, for example), that dog is more likely to be gentle. The ‘pure’ breeds have more issues, in general, although I’m not aware of problems with labs or golden retrievers. Samoyed is generally pretty friendly and strong for hiking (originally a sled dog) as well.
Tommy
@raven: my brother with Murphy, his Labradoodle on the day they got him. I think they paid like $3,000 for him. He is now the size of a small horse. I like that. When I head to their house we get along cause I “work” him. I tire him out. My brother and his wife both work like 60 hours week and have a four year old. They don’t have the time. So they are often amazed how claim he is around me. I say all this to say I can handle an active dog.
Tommy
@agorabum: My only long term experience I’ve had with dogs are with Labs and a Rotweiler. Both where over-the-top good. The Rotweiler was one of the largest dogs I’ve even seen. “Mean” looking. Maybe 160 pounds. Worse thing it might do was run into you or slobber a lot on you.
raven
@Tommy Look at that dude!
RosiesDad
@HelloRochester: Yeah, uh, no.
But thanks for providing proof that one shouldn’t get medical advice from non-medical people on the Internet.
The use of corticosteroids for musculoskeletal diseases needs to be done weighing benefits against detriment. Steroids reduce inflammation but also slow healing and can contribute to weakening tissue. So giving steroids to a dog with a cruciate tear will actually increase the likelihood of tearing the ligament on the other side which is now under more stress because the dog is walking around 3-legged or close to it. And will prevent the dog from building the needed scar tissue around the other joint that it needs to stabilize it.
RosiesDad
@Original Lee: Ascriptin (aspirin buffered with Maalox) is currently unavailable in the US market because Novartis ran afoul of the FDA for poor packaging practices at their Lincoln, NE facility. No info is available about its return to market date.
That said, dogs are much more likely to develop gastric ulcers from aspirin products than with approved veterinary NSAIDs administered at appropriate doses.
raven
@RosiesDad: We use Atopica to help with Lil Bit’s Immune-Mediated Hemolytic Anemia. It has never seemed to impact her itching but works for her AIHA. It’s funny that, because she has no tear ducts, the cyclosporine is also her twice a day eye med (well, ONE of her eye meds!)
Neutron Flux
@ mistermix: This is pretty late, but we have a 5 year old Bichon. She recently developed some serious pain. Our vet diagnosed arthritis and back pain from jumping on the couch. He gave her a shot of cortisone and it worked great. I am concerned about the long term viability of this approach, but that is where we are today.
raven
Wow. it looks like Lil Bit’s story for picked up by a UK Vet Net site!
a hip hop artist from Idaho (fka Bella Q)
@raven: Cool. You and your bride are such good parents, and Lil Bit is now famous.
raven
@a hip hop artist from Idaho (fka Bella Q): She was the cover girl on Meisha’s Hope a while back, I had never googled it to see what might be out there.
Trollhattan
@Tommy:
Boy, if that pic doesn’t elicit some “SQUEEEEs” around here, nuttin’ will.
If you want to run with a dog, and you do distances, that’s a big consideration, especially if it’s hot where you live. I’d think the adoption place can steer you in the right direction.
Within reason I think it’s best to find a dog you connect with well, as compared to preselecting a specific breed. I do understand the big dog preference and have it myself. Good luck!
stinger
I had a partial ACL tear on a 12-lb Norwich Terrier. I appreciate how far canine medicine has come, but am pretty unwilling to spend a month’s salary or more on surgery or other treatments with indifferent outcomes and with interim pain and unpleasantness that the dog is unable to understand or look beyond. In fact, I’ve switched from a brand-new high-tech pet hospital to a one-vet practice. Anyway, our cure for the leg injury was to minimize her activity (as much as possible with a little terrier!) for a month. She was completely over it after a couple of months and had many more happy, active years.
raven
@Trollhattan: My cocker Raven ran 5k’s with me for a number of years. I’ll never forget this woman that got all huffy and said “I wasn’t going to let that dog beat me”!
Kay (not the front-pager)
Surgery can be very hard on a little dog. Three years ago my husband dropped our son’s 5 lb chihuahua (he (my husband) is a cat person and didn’t know any better), snapping both bones in his right front foreleg. It couldn’t be set, so he had to have plates put in. Four months and $5,500 later the leg was healed, but the plates will need to come out soon if we want to prevent arthritis as he ages. I just can’t face that for the little guy. He had to go back every 2 weeks to get x-rays, check that the bone was healing but skin not breaking down, and have the cast replaced, with general anesthesia each time. It was traumatic for all of us, but especially the dog.
He also should have surgery on his back left knee to fix a shallow joint which causes his knee to pop out. We’re giving him the aforementioned glucosamine treats and keeping our fingers crossed it doesn’t get any worse. For now, he just lifts the leg and goes around 3-legged when it pops out. His leg is so thin it looks like a twig curled up like that.
I hope your dog can manage without the surgery. Bichons are bigger and sturdier than chihuahuas, and the controlled nature of her possible surgery would mean far fewer vet visits and faster healing, but it’s still traumatic. Especially since the poor dog doesn’t understand why it’s being subjected to that.
RosiesDad
@raven: Lil Bit is your Cocker? (#1 breed for AIHA.) We use cyclosporine (Atopica) or azathioprine (Imuran) as second line drugs to try to get these guys off of steroids in cases of recurrent hemolytic anemia. Imuran is substantially less expensive but many internal med specialists who are younger and smarter than me prefer cyclosporine.
The reason you use it to treat the dry eye is that this condition is caused by immune-mediated inflammation in the tear producing glands. Systemically administered meds will not get a high enough drug level to the glands to reduce the inflammation but topical meds are very effective at getting the job done. This is basically the same therapy as the drug Restasis, which is used to treat KCS in people.
BTW, your critters are cute!
raven
@RosiesDad: Right, when she got dumped her eyes were awful and they took her tear ducts out. The other meds are the result of her cataract surgery and trying to head off glaucoma. We figure the little stinker will lose her sight eventually but I am religious in my care for her. We are lucky to be here in Athens where we have plenty of expertise, she has an opthamologist, heart specialist and gp!
eta, I meant to say that the reason for the dry eye was specific to her tear duct removal but I’m sure you figured that out.
MazeDancer
Acupuncture for relieving knee pain was actually validated by NCCAM/NIH studies at University of Maryland in 2004. It’s not cheap either for multiple visits, but it’s worth trying a few times if you can find a good acu-Vet.
Also homeopathics – very cheap pills, less cheap to pay homeopath – work wonders in pets. (And humans.)
Star athletes get their ACLs reconstructed by star surgeons. Those same star surgeons will tell everyone else whose livelihood does not depend on pivot action to really, really wait and see. But you’ve had 3 vets say the same.
Meniscus tears are tricky as the meniscus, like cartilage, cannot heal itself. But pain might still be managed through all the means advised.
However, if it comes to surgery the same rules apply to dogs as to people: Experience Counts. (In people, there have been many studies as to how in orthopedic surgery, especially, surgeons with massive experience have better outcomes.) You want someone who has done this hundreds of times. This exact repair on your size dog. No beginners.
Also, there must be some human expert orthopedic surgeons who love their dogs and have worked out adapting their innovations – they are always innovating, surgeons are competitive – to dogs. Alas, dogs are even used in developing new techniques. So maybe at the big vet schools at Universities that have Medical School/Research Hospital affiliation. Cornell maybe?
So ask around. Maybe people here have some contacts at universities with Vet/Med collabs? Maybe some ortho surgeon has tiny show dogs and he/she has collaborated with some vet and they developed some minimally invasive canine meniscus repair…
It could be out there. Google offers this guy who adapted an ankle technique to dog knees in 2008 http://www.sciencedaily.com/videos/2008/1203-new_surgery_for_fidos_knees.htm
gsp
Hey Mistermix,
At work and not able to read the posts above but I have a Boston Terrier (about 22-24 lbs) who tore her cruciate in right hind leg at the age of 3 years. It required surgery as she was lame and appeared to be in discomfort. Surgery attached back but being 3 and energetic during the healing process she ripped apart what the vet used to keep it attached (think it was some kind of nylon piece) so had to go back and this time it healed. For a couple years there would be the occasional clicking noise that would last a number of hours but never seemed to bother her but nothing the last 2-3 years.
At the age of 8 she tore the cruciate in her left leg chasing a cat requiring surgery again to attached it back. This was a different vet as we had moved and had much more experience at doing this surgery. This one went very well. She is now 12. Occasionally the leg (more the right) causes her to move more in a more tender way though 95% of the time you wouldn’t know any better but you can feel the roughness or scar tissue (especially right leg) with arthritis developing.
Both vets had said the dog would be better off with the surgery than not having it. It was called a cruciliate tear but assuming the same as what you describe.
She is referred to as the $25,000 dog now with everything else she has managed to do to herself. Had I known of Cole with his injury proneness back when we she came to us, would have incorporated his name into hers somehow.
May yours heal quickly.
Trollhattan
@raven:
Love it!
Used to run with our first Dalmatian, back when I could run. He was completely fine for any distance so long as it wasn’t too hot. In the heat he’d just stop and flop at some point. (Dals were bred to run with coaches the day long, and still have 25-mile horse and dog trials.)
The bigger problem running with Bruno was SQUIRREL.At 70 pounds, he could knock me flat or drag me to the next county.
Read recently the thing to watch when running with a dog is to keep them at a trot, because they do that with the mouth open and thus, can stay cool. Faster than that they’re running and must do so with a closed mouth and…no cooling. Funny how I never bothered to notice that, myself.
raven
@Trollhattan: We have a place where you can get in a really good run in the shade so we’d go there. The roots were and issue but they didn’t bother him. My runnin days are over too and they won’t let my pups in the Y to swim with me!
mistermix
@walizonia: The extracapsular repair is the one our vet described as an option. I am concerned about the other leg. Thanks.
ixnay
Haven’t read the entire thread, simply don’t have the time. Here’s what I know as a vet (note: I do not do these surgeries myself): Sometimes they work. Sometimes they don’t. Big dogs, poor owner compliance (i.e. not getting the part about strict cage rest for 4 or 6 months), bad genetics: less likely to work. Small dogs, good rest, serious owner compliance, likely to do OK, with or without surgery.
It’s important to ask about the success rate of the individual surgeon. It is also important to find out the outcome for patients who have cage rest alone. The natural scarring process will tend to tighten up the knee, and both reduce the instability and the discomfort.
Another important point: there are a whole bunch of different procedures for ACL injuries, both in dogs and in humans. If there were a truly great answer, then everybody would be doing the same procedure.
Middle-Aged Fogey
I guess my first commenting attempt didn’t take. To recap:
My nine-year-old bichon, Sabina, was just diagnosed yesterday with an ACL tear in her back right leg. To avoid/delay surgery, the vet wrapped the entire leg, from the bottom of her paw all the way up to her crotch, in an Ace bandage that prevents her from bending her knee at all. She’ll stay in the bandage until Monday, Sept. 16, at which time she’ll be re-examined and, if all goes well, freed of the bandage.
The vet’s theory is that immobilizing the leg will allow scar tissue to build up and reinforce the knee area (she tore the ACL because her kneecap was dislocated as she jumped on a couch, and she landed poorly; dislocated kneecaps are common in bichons). Once the wrap comes off, I’ll give her slowly-increasing walks, starting around eight minutes and growing until we’re back to her usual 20-minute walks in a few months. As part of her physical therapy, I’ll take her on uneven ground (e.g., hills), which will force her to use her knee in ways that flat ground doesn’t require.
Assuming all goes as planned, the vet thinks Sabina will be back to “normal” (well, normal for a nine-year-old bichon) in a few months. If she were a larger dog, the vet would’ve recommended surgery, but that treatment often isn’t required for (and/or as successful on) small dogs. That said, if the treatment doesn’t work, surgery remains an option, though an undesirable one, from my viewpoint.
Ask your vet about a wrap treatment, is my suggestion. It may not work, but I can’t see it doing any harm. Well, it’s taking Sabina a little time to get used to hobbling with a straight back leg, but she’s performed both bodily functions outside already, and she’s walking more today than she did yesterday. She’s even managed to get up and down off my couches a few times; she basically did a paw-stand dismount. (I don’t recommend that, but she has exceptional balance.)
In any event, best of luck.
TrishB
@RosiesDad: Question for the vet if you have a moment. None of my dog’s vets know what is going on with this. Yes, she has specialists as a diabetic with Cushings, cataracts, glaucoma, and let’s just put etc in there for good measure.
Why are certain generic meds hard to come by recently? Pepper had a corneal ulcer in early spring and both my local small town vet and the Cincinnati specialist mentioned that minocycline was getting difficult to find and stupidly expensive. Now as the owner of a doggie with the aforementioned afflictions, expense isn’t my main concern, but this isn’t the first time I’ve heard this mentioned. What the heck?
Moe Gamble
@slag:
I had an 8-month old pup die from Rimadyl as well.
Moe Gamble
I’ll just put in that my last experience with small dogs was as a kid, but my experience with large dogs is that unless a bone is protruding through the skin or there is internal bleeding, you should support their bodies in healing themselves.
This is my holistic vet: http://nancybrandtdvm.com/
She saved my dog’s life with a phone consultation. She had me provide nursing care instead of $12k worth of surgery ordered by my other vet, who told me my dog would die that night without the surgery. (I felt my dog was dying at that point from medical torture.) My dog healed in days on Dr. Brandt’s prescription of bone marrow broth, hot water bottles and massage.
She cured another dog’s supposed hip dysplasia by prescribing a change in diet. She’s also helped us through cat and dog injuries.
Bodies are made to heal. Let your dog heal, and manage pain with something other than Rimadyl, which killed my 8-month-old pup after I was told it was perfectly safe. Manage pain with hot water bottles, maybe massage. Dr. Brandt will know.
RosiesDad
@TrishB:
We think that it is the greed of generics manufacturers. Old drugs that used to be available and very inexpensive have either become much more (sometimes prohibitively) expensive or have disappeared entirely. We plug the gaps with other commercial drugs (minocycline replacing doxycycline and tetracycline) or by getting meds from compounding pharmacies. It is very frustrating all the way around.
Jean
My small dog, Sundae, who is a schnoodle (part schnauzer and part poodle), and weighs 13 pounds, tore a rear ligament. The vet said that small dogs in good shape (Sundae is 13 yrs) usually build up enough scar tissue to support the leg over a few months. We continued walking her (she hopped at a fast walk), and gave her anti-inflammatory meds for a while. She is now just fine! The vet said surgery would mean keeping her from jumping for a year. We did keep her from jumping up and down from our bed, and Sundae was doing great in a month or two.
Scott
My dog, a 45 lb mutt had a similar ACL issue. I chose not to do surgery but based on some research, I did this:
In my garage, I set up a 12 ft diameter, 2 ft deep pool (about $80), filled it with water, and 2-3 times a day, she swam for about 10 minutes each. I had to get in with her and walk her around and make sure the feet didn’t touch the ground or she didn’t climb out. After about a month or so, she got well. I also give her glucosamine (found at most pet sections of grocery stores. Also made her lose weight (I wish I had as much discipline). At 12, she seems healthier than in a long time.
TrishB
@RosiesDad: Thanks for the reply. Greed is what I was guessing, but sometimes I do try to have a bit of faith in humanity, Seems that it’s misplaced. Now that I think of it, I may be mistaken on whether it was mino, doxy, or tetracycline that we ended up with. It just seemed so odd that something so flipping basic was now hard to come by. Hell, Pepper needs a spreadsheet for me to keep her meds straight and the vet and I have a list of compounding pharmacies for some of her prescriptions. The one thing that keeps this all going is that each time she meets a new vet is that they are amazed at her condition when she had this mess of diagnoses for almost 4 years.
bystander
Double TPLO (R and L stifles, 6 mos apart) on a small female Australian Shepherd. Total success. Bitch was 100%+ and back herding cattle after recovery. Survived fully mobile to 13 yo. The vet who performed the procedure on Molly was the same one who invented it.
another Mildred
As a long-time Newfy owner I’ve dealt with many an ortho issue, including a TPLO repair of a torn cruciate, lots of arthritis, and most recently with my current girl a deeply malformed carpus that required a couple of titanium plates in there to stabilize and rebuild the joint. (yes, lots of $$$) But Newfies are like potato chips, you can’t have just one, and you can’t resist more.
I always tried a more conservative approach first, including a range of NSAIDs, depending on what the dog tolerates, and what seemed to work. For my current girl, the NSAID of choice seems to be Metacam (Meloxicam), instead of Rimadyl or Deramax. I know there are others, but those, after using buffered aspirin (and of course Glucosamine/Chondriatin for prevention). For the arthritic dogs, acupuncture and water PT both have been very helpful. I have a local vet who is trained as a veterinary acupuncturist (and her husband is an orthopedic specialist–handy).
I also warm- and cold-pack the joint in question, as needed, and monitor activity levels. Not terribly hard to do with Newfs, in general, since they mostly just hold down the floor.
But it’s funny, people always assume the cost to care for big dogs is feeding them (all but one of my dogs have come from Newf rescue)…no no! Its the cost of vetting them… they use more Frontline, get more joint issues (darned breeders), all that stuff. They don’t eat so much, and there are always small children.
RosiesDad
@bystander: Barclay Slocum worked on your dog? Very cool. He was a brilliant surgeon who sadly left this life way too young.
TrishB
@RosiesDad: Sorry, I do have one comment to a vet since I’m the caretaker of a diabetic dog, and it almost kills me to say – Walmart. Pepper’s first insulin was Vetsulin, long since pulled off the market, but her endocrinologist/internist then switched her to Novolin N when the Vetsulin was no longer available( (and the then atypical Cushing’s started making thing more interesting.) I paid about $75/month for 2 years of the Novolin, until one day I happened to walk in Wallyworld here in Boofoo, Ohio where they had a sign at the entrance about pet prescription prices. Novolin N was $25 damned dollars there. Still is, and at for at least a little while Pepper costs less per month than the car payment. Not all of her stuff is available there and I hate patronizing the place, but $50 month is huge for me, and insurmountable for many people I know. I was stuck out of town last month and was stunned that Target was charging $91 for the stuff and the pharmacist told me it costs them $80. Decent generic syringes are $12/100 instead of the lousy CVS brand ones for $25 and the BDs for $30+. Truly, sorry for the rant. You may not even be able to relay this kind of info for your patients’ owners, but I was floored. I love my vets and they work with me on keeping Ms Pepper going, but I never know whether this stuff is not known, or if they’re prohibited from telling by law/practice. I just never want to see lack of $50 in a monthly budget cause an animal to be put down. Pepper is still pretty spry for an old wench.
RosiesDad
@TrishB: In other news, Vetsulin returned to the market a couple of months ago. I think we get about $40/bottle for it.
As to Walmart: their pharmacy gives some meds away below cost as a means of getting people in the front door. I cannot buy Humulin N (or any of its generics, of which Novolin N is one) for what Walmart charges and even the local Costco pharmacy charges much more than $25 for this insulin. That said, their prices are not consistent and I have heard from clients that they can vary from week to week.
And it isn’t that this is unknown to vets, it’s just that we can’t keep track of it. When sending clients out with prescriptions for meds I don’t stock, I advise them to call pharmacies before they go to have them filled and check prices because what is $25 in one place might be $125 somewhere else. For no rhyme or reason.
Sometimes we just scratch our heads.
Gus
Late to the story, here, so you probably won’t read this, but my 35 lb. cockapoo had both rear knees done (extra capsular repair). He rebounded quickly and well.