Cruciate Ligament conservative management tips Took my boy to the vet today after he came up lame yesterday. The vet examined him (no xray) and diagnosed CCL tear. Recommended surgery and sent us to a surgeon. Being the skeptic that I am, I researched this and found many sources saying conservative mgmt can be just as effective if not more. My boy is a 9 year old Yorkie weighing 10lbs. We decided to go conservative mgmt route. Any info, tips, comments, suggestions are welcomed! Not ruling surgery out, but would like to avoid general anesthesia + the knife if possible. Thank you wonderful people!! :) |
I would do anything to avoid the surgery. I pray you will find the cure without the knife. Poor little fella, I hope it heals up on its own. |
Sorry but conservative management can lead to arthritis. I would do the surgery for best quality of life. |
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OP, here is an articlewritten by the board certified surgeon I use. Hopefully it will help you in your decision making. Yorkie Haven Rescue - Cranial Cruciate Ligament Tear Info A quote from the article: Treatment Strategy Some veterinarians and pet enthusiasts recommend conservative treatment of CrCL tears for a period of time, but this is rarely successful and is not a good course of action to follow. Conservative treatment leaves the knee unstable for a long period of time allowing the onset of progression of osteoarthritis and meniscal tears. Osteoarthritis can progress very insidiously in the early stages, giving the impression that the dog is improving. This is because the lameness may appear to improve as the acute inflammation inside the knee joint subsides. However, as the arthritis progresses over the months and years to follow, lameness and stiffness ensue. Many pet owners have difficulty recognizing this and believe their dog has recovered. An orthopedic specialist can alert owners to the decreased function and pain the dog is actually experiencing. Dogs are very clever at modifying their posture, gait and activity level to lessen the pain and functional deficit they are experiencing. These clinical signs become more obvious when arthritis becomes severe. Unfortunately, surgical treatment of the CrCL may be less successful at this time due to the presence of irreversible arthritis and fibrosis of the joint. The best recommendation is surgical stabilization of the joint as soon as possible. It has been shown that early treatment of partial tears leads to preservation of the CrCL, minimal to no arthritis and a very low chance of future meniscal tears. |
Oh, and I have to add that anesthesia in this day and age is rarely a problem. Certainly there are always risks to everything, but the anesthesia protocols for small dogs today is so much better than it was many years ago. And, if using board certified surgeons I cannot imagine they would not be using the most up to date methods. |
My Jezebel has the same injury, and she is having surgery on Tuesday. You have a window of opportunity, if you wait too long your dog will be in pain for the rest of his life. I hear you loud and clear regarding the wish to avoid the knife, but sometimes it can't be avoided. Did you actually see the surgeon, and what did they say? Did they take x-rays? When I saw Jezebel's x-rays, there was no question what needed to be done. The tibia and fibula were completely shifted over and not directly under the femur like they should have been, and the patella was over to the side and not up front. It was easy to see just how unstable the joint really is when that ligament is ruptured. Within a couple of months with all of that instability, all of the cushioning structures would be worn away and she would be in pain -- and lame -- for the rest of her life. There is no way I could do that to her. |
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:thumbup::thumbup: Great informative post! |
Thanks for the replies! There seems to be a lot of conflicting evidence and differing opinions on this. For everyone that swears surgery is a must there's someone screaming DON'T DO IT! I am really confused because I clearly want to do only what's best for my best friend. I have not yet seen the surgeon, but let's be honest folks, surgeon's need to perform surgery to make their money. Of course he/she will recommend the knife. That's why I am trying to get the unbiased opinion of people in the know. |
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I totally agree with this. Additionally, I will add this: Recently we took three pups to the boarded surgeon who we use in Houston. One of them had been seen by a vet who said she needed both knees and hips operated on. She would occasionally fall down. In the end, after he saw these three pups, he did not recommend surgery for ANY of them, including the one who had been seen by the other general practice vet who actually had offered to repair the hips and knees at a low price (first clue to run away). So...NOT true about surgeons. If you have not taken your pup to a board certified surgeon for an evaluation, I suggest that you do and voice your concerns with him/her. If your pup does indeed have a torn CCL and you don't do surgery, there is enough written out there about the ramifications. Up to you whether you want to heed these warnings. I thought you wanted actual good feedback...sounds to me like you want everyone to say it is ok to leave it go without surgery. I hope for your pup's sake I am misreading this. Oh...and BTW, those of us who are posting about surgery are not biased! We are not vets...simply pet owners who have been in your shoes. :) |
At the very least, you should go see the surgeon and get x-rays done. Until then, you really don't know what you are dealing with and you are making a decision without all the facts. I know what you are going through. I don't want to put my pup through surgery, either, but now that I know what is going on inside of the joint I know there isn't any choice.:( Mine started limping over the weekend, and I was able to get her in to see the surgeon on Wednesday. By that time, she seemed to be doing SO much better. She even managed to bolt out of the exam room with the surgeon chasing behind her and he didn't catch up with her for a good ways. I really thought that I would hear that it wasn't that serious and it would be a "wait and see, rest the joint" diagnosis, but I went anyway so that I would definitely know what was going on. Was I ever wrong, and the x-rays proved it. That ligament just isn't there anymore, and the joint is all out of whack. It's incredible what they can put up with. At least go get the x-rays done, so that you aren't making a decision blindly. |
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Honestly, I think the tone of some of the responses here have been a little aggressive. I wasn't trying to be mean to anyone and talk down or anything like that. This is a horrible situation and I'm trying to make the best decision. I don't think just jumping into to surgery without researching the facts is as bad as some people are making it out to be. I'm going to get a second opinion tomorrow from another vet. Obviously not leaving it like it is. Wish people would be a little more understanding. I'm heartbroken for my boy. :( |
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THANK YOU! Had surgery yesterday and now recovering! Saw another vet and then consulted a surgeon. MPL + ACL fixed. |
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Best wishes for a perfect recovery. There are two of us here that are just a little bit ahead of you. Eddie had the same surgery on Monday (http://www.yorkietalk.com/forums/sic...-luck-vet.html) and my Jezebel had hers on Tuesday. This was Eddie's second surgery, so Alaskayorkie knew what to expect. This is the first time I've ever dealt with anything like this, so the territory is unfamiliar to me. If you have non-medical questions about recovery (for instance, "when did she start to bear weight on the leg," etc.), feel free to ask. |
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How did you handle the crate thing? In all day and night? When were you able to stop using the crate? Also, how long before removing sutures and the cone? I appreciate the info! |
Right now she's in an ex-pen that is large enough for her bed, a pee-pad, and a water bowl. She's been pretty good about the confinement. She stays in almost all day and all night. She is allowed to leave it to go to the bathroom and at times when she is going to be heavily supervised. I will let her lay next to me on the sofa (in her bed) when I'm watching TV, but I have her tethered to my arm so that she can't suddenly jump off. This morning she was crying, which is so unlike her, so I took her for a bathroom break and then brought her to bed with me for a while (tethered also). She only had surgery on Tuesday, so we are nowhere near getting rid of the crate. Until it heals completely (6-8 weeks), she has to be prevented from running and jumping. The bandage will be removed after 5 days, then the stitches come out on day 10 - 14. When the stitches come out, I'm assuming the cone can come off. The cone stays on, but the doctor said it could come off when she out to use the bathroom, I guess because during that time you must have them on a leash and you will be keeping a very close eye on them and can stop them from licking if they look like they might try. She has adjusted to wearing the cone very well. Other than that, it took 2 days after her surgery to finally poop, and today (3 days after surgery) she started bearing some weight on the limb and walking a little better when she goes out to potty. She was pretty unsure of herself on Wednesday and Thursday. |
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