advice needed with torn ligament

[spiritwings1202]

Originally Posted by ladyjane

You know, it just hit me....you have a torn ACL and are walking on it? That is a pretty debilitating injury most times. Are you sure you are thinking of the same thing when youre thinking about your pup? Are you sure that you understand how debilitating this is? I honestly don't believe so because you seem so distant about it....perhaps you misunderstand this injury? Please at least take your baby to a boarded surgeon and totally understand what this is about before making a permanent decision.

or
Daisy has been to a surgeon and yes I am taking her back to make sure it is ok. I have a torn lateral and collateral ligament and I have not had surgery. my knee pops out of socket and is very painful and no I am not comparing it to Daisy. 2 weeks ago I was taken to the Er bc I tripped over the dog gate and my knee popped out of socket. which popped back in. This happens every now and then, but I deal with it bc I do not want surgery.
Which has nothing to do with Daisy's injury. I was just expressing that I too understand the pain she is in.

With that being said; If the vet and the surgeon told me that Daisy needed surgery I would do it as long as they thought that she could handle it with her health issues. I love my dogs like my children and I am of those dog moms that runs to the vet when there is any sign out of the normal. We were at the Emergency vets on Easter with a houseful of company. As soon as Daisy injured it we left for the emergency bc that is all that mattered to me.

We saw an orthopedic surgeon who was on call that day and we had to wait 1.5 hrs for her to get there, and she did not recommend surgery at that time. She she called me for a follow up Daisy was doing great walking and even at times running on it.She wanted to watch it over the next few weeks and see how she did.
Like I said we are going back to the vet tom and yes we will probably have to see the surgeon again too. I am doing what is best for Daisy!

[lynzy420]

Originally Posted by kjc

Ask the vet if swimming would be okay... if yes, then fill up your tub and wear her butt out!

[kjc]

This is probably not too popular of an opinion, lol, but here goes: I was a tech in the days before pain meds were made available to animals. One problem is that when animals feel pain, they limit their activity. When they don't feel pain, they tend to overdo and re-injure themselves. Personally, pain meds never did that much for me, lol.

That said, maybe decreasing her meds would help her to be less active, or some puppy downers to help keep her calm. And IDK if this is okay for this type of injury, but would some kind of splint or a support bandage be of any help? I would imagine it may take more therapy to get the leg fully functional after healing, but if it can prevent further injury it might be worth doing, if appropriate in this instance.

[107barney]

Originally Posted by spiritwings1202

Honestly I would do anything for my dogs, and I have. If you saw Daisy's health records you would understand that I have ALWAYS done what is best for her.
I will do what my Vet and the surgeon recommends considering her health issues! I don't think you completely understand the whole picture and I did not post this thread to be jumped on I was looking for suggestions to keep her busy while she recovered. ~~wow~~

Wow is right. You asked what you could to keep your dog busy while she "recovered" and "healed" ---and people wanted you to understand that torn ligaments don't heal. If you feel you've been "jumped on" then ask yourself why you're on the defensive because no one here jumped on you. We simply wanted you to know that in these situations, the joint is completely a mess and the dog lays down scar tissue and arthritis sets in. Arthritis is progressive and irreversible. Here is more on the ACVS website, link below -- This article specifically talks about conservative management of this and why it is not going to stabilize the knee. You are setting her up for more trouble -- torn meniscus, full tear, and most significantly, progressive arthritis. I am praying no xrays were done and this diagnosis was incorrect and she has a soft tissue injury. Then she might actually heal nicely. I'll pray for your pup and for you.

ACVS - Cranial Cruciate Ligament Disease

[yorkietalkjilly]

Originally Posted by kjc

This is probably not too popular of an opinion, lol, but here goes: I was a tech in the days before pain meds were made available to animals. One problem is that when animals feel pain, they limit their activity. When they don't feel pain, they tend to overdo and re-injure themselves. Personally, pain meds never did that much for me, lol.

That said, maybe decreasing her meds would help her to be less active, or some puppy downers to help keep her calm. And IDK if this is okay for this type of injury, but would some kind of splint or a support bandage be of any help? I would imagine it may take more therapy to get the leg fully functional after healing, but if it can prevent further injury it might be worth doing, if appropriate in this instance.

May I just disagree a little bit with you, Kathy? Just for consideration - it's up to everyone to decide for themselves for sure but just look at the other side of it from the dog's point of view. I've heard that position of restrict pain meds so much from older vets all of my life and always thought it so easy for them to talk - they weren't the ones walking on torn ligaments, newly reduced fractures or freshly post-op with inadequate relief so as to keep them quiescent. It can be like walking with glass with a torn ligament in your leg, especially early on. And let me tell you, a fresh surgical incision hurts like the very devil - even those little less than 1 inch ones from scopes! Cut skin and torn body parts hurt in dogs just like humans but they can't moan and groan and call the doctor every 5 minutes as we do. And they are genetically programmed not to show pain except when sudden or surprised. They just shake and become agitated and restless, often isolating to suffer unseen if possible. Younger vets don't tend to agree with that under-medicating pain thinking much.

It may be harder with animals, but just like humans, they deserve as much relief from bad pain as we do. No dog should have to hurt and suffer in order to help it heal better unless its life could be in jeopardy from the pain medication. We just have to work hard to keep them corralled and quiet as they heal, as tough as that is on the dog and on us! Many pain meds tend to sedate and that can help a dog be less lively but the vet should help the owner manage his dog's pain as he heals and the rest is up to us owners to restrict their access to play with other dogs, prevent all jumps, running and stop the romp with toys, etc. It can be done. Of course with CCL, I've always read that the tear often keeps tearing until the last bit eventually fails and in the meantime, the contralateral limb is sustaining immense stress to its CCL, especially in very active, jumping dogs. Most Yorkies jump a whole lot to get to be near us on furniture, etc.

But in this little dog, apparently they have to give consideration to other medical conditions that she has that could contraindicate surgical repair. It's heartbreaking when there are no easy answers.

Here's another article on it with a slightly different take than the one in an earlier post.

Category - Faqs - Animal Medical Center - Los Angeles, California

Working for a sports medicine orthopedic surgeon who surgically treated high-performing college and professional athletes and had to find ways to keep them highly functional, I found that the surgeon in the field is often light-years ahead of the "establishment" in current thinking about surgical treatments, new techniques and possibilities, often doing the previously-thought impossible and that eventually the old thinking eventually does catch up. It seems to be the same with dogs these days in many veterinary practices as more vets work to repair things earlier and try to give the dog a more high degree of function where possible.

If this little girl can't somehow have surgery, I'm sure they will find a way to keep her at least comfortable. I know her mommie is dead set on doing what's best for her.

[bobohyde]

Columbo had LP/ACL surgery on both knees last year by an orthopedic surgeon. I remember the surgeon telling me that most ACLs don't require surgery. Columbo had complete tears AND luxating patella, so he definitely needed surgery. We are in the surgeons office all the time now to see the internists for his PLE and there are frequently dogs there getting their ACLs repaired by the surgeons. Our surgeon has done THOUSANDS of these and people come from out of town and neighboring states to see them. They are very, very good and I completely trust them. So if he told me most don't require surgery, I believe him. However, I DID NOT ask any questions about why most don't need surgery since we definitely needed it. I'm guessing those that don't are not complete tears and most dogs don't also have LP (unless they are yorkies!). He was also talking about all breeds of dogs. If Daisy has consulted with an orthopedic surgeon who did not recommend surgery, I assume that recommendation is based on Daisy's specific injury, combined with her age and health history and if her mom trusts the surgeon, she should feel comfortable with that recommendation. That being said, Columbo's LP is what led to the ACL tear. We did not even know he had LP until it happened at age 8.5. If Daisy has any level of LP (so many yorkies do), it is likely she will re-injure the knee at some point even after recovered and eventually, there could be an event that will tear it completely. Now that Columbo has recovered, we still limit his jumping as much as possible. We don't allow him to jump up steps, jump up or down from the couch, etc. He'd sure like to and occasionally does before we have a chance to pick him up, but that is rare. He has been cleared to do those things now, we are just paranoid to prevent any additional vet bills since we have spent a new car on him in the past year LOL. I would definitely, permanently, prevent Daisy from jumping down from anything, along with any jarring, explosive type of activity. We had to remove his ottoman from the window for squirrel watching. He is allowed back on it now, but we bought a 6" thick cushion from the fabric store to put in front of it to cushion his jump down from the ottoman.

[ladyjane]

Originally Posted by bobohyde

Columbo had LP/ACL surgery on both knees last year by an orthopedic surgeon. I remember the surgeon telling me that most ACLs don't require surgery. Columbo had complete tears AND luxating patella, so he definitely needed surgery. We are in the surgeons office all the time now to see the internists for his PLE and there are frequently dogs there getting their ACLs repaired by the surgeons. Our surgeon has done THOUSANDS of these and people come from out of town and neighboring states to see them. They are very, very good and I completely trust them. So if he told me most don't require surgery, I believe him. However, I DID NOT ask any questions about why most don't need surgery since we definitely needed it. I'm guessing those that don't are not complete tears and most dogs don't also have LP (unless they are yorkies!). He was also talking about all breeds of dogs. If Daisy has consulted with an orthopedic surgeon who did not recommend surgery, I assume that recommendation is based on Daisy's specific injury, combined with her age and health history and if her mom trusts the surgeon, she should feel comfortable with that recommendation. That being said, Columbo's LP is what led to the ACL tear. We did not even know he had LP until it happened at age 8.5. If Daisy has any level of LP (so many yorkies do), it is likely she will re-injure the knee at some point even after recovered and eventually, there could be an event that will tear it completely. Now that Columbo has recovered, we still limit his jumping as much as possible. We don't allow him to jump up steps, jump up or down from the couch, etc. He'd sure like to and occasionally does before we have a chance to pick him up, but that is rare. He has been cleared to do those things now, we are just paranoid to prevent any additional vet bills since we have spent a new car on him in the past year LOL. I would definitely, permanently, prevent Daisy from jumping down from anything, along with any jarring, explosive type of activity. We had to remove his ottoman from the window for squirrel watching. He is allowed back on it now, but we bought a 6" thick cushion from the fabric store to put in front of it to cushion his jump down from the ottoman.

Was this a board certified surgeon? I never heard of such a thing! Ligament tears are horrible and if left untreated the dog ends up with horrible arthritis.

[bobohyde]

Originally Posted by ladyjane

Was this a board certified surgeon? I never heard of such a thing! Ligament tears are horrible and if left untreated the dog ends up with horrible arthritis.

Yes, he is a board certified surgeon. There are 4 specialists in the practice, 2 are board certified surgeons and 2 are board certified internists. To say they are passionate about what they do is an understatement. The enthusiasm and professionalism they exhibit is inspiring. We are so very lucky to have them here since people drive quite a distance to see them. We have seen 3 of the 4 of them due to Columbo's issues. I am not disputing tears can end up with arthritis (although when we asked if Columbo would experience arthritis anyway after having had the surgery, we were told yes. I assume not to the same extent as without surgery). I said I did not know any details as to why most of the injuries Columbo's surgeon sees do not require surgery, only that he said that. I also asked him how many surgeries like Columbo's he has done and he said "thousands", which I believe since there is frequently a dog with an ACL injury in the waiting room. Obviously, a very common injury with dogs. My point was that Daisy has seen a surgeon (not just a regular vet), has other health issues, her owner trusts her vets and said she would do whatever is needed for Daisy whom she loves like a child and the surgeon still did not advise surgery. I was merely adding support for Daisy's mom to her confidence in that recommendation by repeating what I was told by Columbo's surgeon since others here did not feel it was the correct advice. There are obviously many dogs who don't required surgery based on the severity of the injury and the overall health of the dog. That being said, it doesn't mean they will not injure the leg worse at some point which will then require surgery if their health allows it.

This is Columbo's surgeon:

Kevin Stiffler, DVM, Diplomate ACVS

http://vavetspecialists.com/wp-conte...-1-200x300.jpgDr. Kevin Stiffler is a Virginia native, having grown up in Williamsburg. He received both his Bachelor of Science and Doctor of Veterinary Medicine degrees from North Carolina State University. Dr. Stiffler then went on to complete a general rotating internship at the University of Georgia (UGA) College of Veterinary Medicine. Following his general internship, Dr. Stiffler completed a surgical internship at the Dallas Veterinary Surgical CEnter in Texas and then returned to the University of Georgia to complete a three year residency in small animal surgery. In 2004, Dr. Stiffler was honored as UGA’s resident of the year. That year he also received the national resident clinical presentation of the year award from the American College of Veterinary Surgeons for his research on urinary tract infections following spinal surgery.
Dr. Stiffler has been practicing in Richmond, Virginia since 2004 and he became a diplomate of the American College of Veterinary Surgeons in 2005. Dr. Stiffler is married to Dr. Katie Stiffler (a graduate of UVA and UGA) who is a small animal veterinarian practicing at Wellesley Animal Hospital in the Short Pump area of Richmond. The Dr.’s Stiffler are the proud and busy parents of twins Charlie and Abby who were born in 2007.
Dr. Stiffler has a special interest in minimally invasive surgery including arthroscopy and laparoscopy. He also has a strong interest in surgical correction of cranial cruciate ligament instability and fracture repair. Having always wanted to live in Charlottesville joined with a desire to work with other dedicated and compassionate specialists, he happily joined VVS in 2011.

[ladyjane]

Originally Posted by bobohyde

Yes, he is a board certified surgeon. There are 4 specialists in the practice, 2 are board certified surgeons and 2 are board certified internists. To say they are passionate about what they do is an understatement. The enthusiasm and professionalism they exhibit is inspiring. We are so very lucky to have them here since people drive quite a distance to see them. We have seen 3 of the 4 of them due to Columbo's issues. I am not disputing tears can end up with arthritis (although when we asked if Columbo would experience arthritis anyway after having had the surgery, we were told yes. I assume not to the same extent as without surgery). I said I did not know any details as to why most of the injuries Columbo's surgeon sees do not require surgery, only that he said that. I also asked him how many surgeries like Columbo's he has done and he said "thousands", which I believe since there is frequently a dog with an ACL injury in the waiting room. Obviously, a very common injury with dogs. My point was that Daisy has seen a surgeon (not just a regular vet), has other health issues, her owner trusts her vets and said she would do whatever is needed for Daisy whom she loves like a child and the surgeon still did not advise surgery. I was merely adding support for Daisy's mom to her confidence in that recommendation by repeating what I was told by Columbo's surgeon since others here did not feel it was the correct advice. There are obviously many dogs who don't required surgery based on the severity of the injury and the overall health of the dog. That being said, it doesn't mean they will not injure the leg worse at some point which will then require surgery if their health allows it.

This is Columbo's surgeon:

Kevin Stiffler, DVM, Diplomate ACVS

http://vavetspecialists.com/wp-conte...-1-200x300.jpgDr. Kevin Stiffler is a Virginia native, having grown up in Williamsburg. He received both his Bachelor of Science and Doctor of Veterinary Medicine degrees from North Carolina State University. Dr. Stiffler then went on to complete a general rotating internship at the University of Georgia (UGA) College of Veterinary Medicine. Following his general internship, Dr. Stiffler completed a surgical internship at the Dallas Veterinary Surgical CEnter in Texas and then returned to the University of Georgia to complete a three year residency in small animal surgery. In 2004, Dr. Stiffler was honored as UGA’s resident of the year. That year he also received the national resident clinical presentation of the year award from the American College of Veterinary Surgeons for his research on urinary tract infections following spinal surgery.
Dr. Stiffler has been practicing in Richmond, Virginia since 2004 and he became a diplomate of the American College of Veterinary Surgeons in 2005. Dr. Stiffler is married to Dr. Katie Stiffler (a graduate of UVA and UGA) who is a small animal veterinarian practicing at Wellesley Animal Hospital in the Short Pump area of Richmond. The Dr.’s Stiffler are the proud and busy parents of twins Charlie and Abby who were born in 2007.
Dr. Stiffler has a special interest in minimally invasive surgery including arthroscopy and laparoscopy. He also has a strong interest in surgical correction of cranial cruciate ligament instability and fracture repair. Having always wanted to live in Charlottesville joined with a desire to work with other dedicated and compassionate specialists, he happily joined VVS in 2011.

I believe you may have misunderstood him. There is no way I believe that he said that most don't require it. Maybe many owners won't do it for one reason or another...but to say that most torn ACLs will end up with severe arthritis if not repaired and then to go on and say they don't recommend the surgery for most? Kind of a stretch for my mind.

I would be very puzzled. Might be interesting to write to him and ask him for clarification.

[107barney]

Just wanted to add that dogs with medical problems can and do have surgery. My 12.65 year old dog daisy has more problems than most other dogs and she has surgery when she needs it. My dog has a bum liver and a protein losing kidney disease and IBD and allergies and is lucky to be alive. Can't take most drugs, including metacam. Despite her 300+ page medical history, she can have anesthesia. So can almost every other dog.

[Wylie's Mom]

I can't add to the debate but I just wanted to drop of some support, good thoughts, positive healing thoughts, and lotsa hugs for you and your baby. Wishing for the very best outcome and hope everything goes well. HUGS !

[Ellie May]

I don't have an answer for you except listen to the surgeon.

It is best for the knee to fix it. That may or may not be best for the pup in all cases though. I'd be fixing it in a young dog.
in an older, unhealthy, small, inactive dog I'd think long ad hard about a partial tear. Let your boarded surgeon weigh the options.

[yorkietalkjilly]

Hoping to hear how she's feeling today when you get back from the vet and settle down, get a deep breath!

[lynzy420]

Originally Posted by yorkietalkjilly

Hoping to hear how she's feeling today when you get back from the vet and settle down, get a deep breath!

Me too!

[spiritwings1202]

[QUOTE=kjc;4205257]This is probably not too popular of an opinion, lol, but here goes: I was a tech in the days before pain meds were made available to animals. One problem is that when animals feel pain, they limit their activity. When they don't feel pain, they tend to overdo and re-injure themselves. Personally, pain meds never did that much for me, lol.

That said, maybe decreasing her meds would help her to be less active, or some puppy downers to help keep her calm. And IDK if this is okay for this type of injury, but would some kind of splint or a support bandage be of any help? I would imagine it ma hy take more therapy to get the leg fully functional after healing, but if it can prevent further injury it might be worth doing, if appropriate in this instance.[/QUOTE ]


I agree with u 100% about a week after the injury she had me take her off the pain med and see how she did and she wanted to see her for a follow up. At that time Daisy was doing great walking on it and no limiping what so ever. She was impressed how well she was doing. But she had to go and romp with Pixie and that is when she started limping again. We took her to the vet today and this is what she said. It was hard to find any slipping in the joint and that bc the orthopedic did not do an ultra sound there was no way to confirm that it was a partial tear. She was suspicious that it was a stretched out ligament.
The orthopedic did take xrays to make sure there was no damage to the bones or arthritus. She did do the drawer test and the tibia did not slip which was a good thing but she said that she thought it was a partial tear. She did the tibia compression test but it was hard to tell bc Daisy was nervous. She explained that the only way to tell for sure the extent of her injury was an ultra sound under sedation. I am very afraid to do this bc of Daisy's health issues.

My Vet today told me that she really feels it is a stretched out ligament not a partial tear but again she said the only way to tell for sure is an ultra sound with sedation bc she needs to be very still and calm for the procedure.

The other option is to do physical therapy 3 times a week for 6-8 weeks.