ligament problem...

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ligament problem...

Postby julien_sti » Sat Oct 22, 2011 2:23 pm

hey guys its been a while since ive logged in, I'm in a chocolate situation right now...Xena as a partial ligament tear in her left knee and i dont know what to do...the surgery is pricey as hell! does anyone know of any other ways to fix that? I see so many reviews on internet about people who did it and it dint change anything theyre dogs would still suffer and most of them also say they add to do the other leg too the vet also said it happens alot that the second leg needs to be done too...some even say they add to redo surgery...I seriously dont know what to do im not in a good economic situation right now...she's only 10 month old she cant pass the rest of her life suffering and not be able to take walks and play...what to do???
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Re: ligament problem...

Postby I<3mypit » Sat Oct 22, 2011 2:33 pm

When my dog shattered her foot I was in a bind too. I ended up applying for the Care Credit credit card.

I don't know what your credit situation is like but Care Credit will give you 6-months with 0% APR. You can use it for doctors, dental, vets, etc...
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Re: ligament problem...

Postby mtlu » Sat Oct 22, 2011 3:24 pm

You are Quebec? Maybe some other Canadian members can chime in if there is something similar to CareCredit that you can look into.

My dog tore her left CCL and and a year later tore her right CCL. We opted for surgical repairs both times and I think a lot of factors need to go into the decision-making process.

Since Xena is only 10 months old, I think you should you try to find a vet/orthopedic specialist who will work with you on a non-surgical solution. A member here, lilangel, has used an orthopedic brace for one of his dogs – I think it has to be custom fitted so it's still not a cheap option but definitely less than surgery. You might want to try PMing him for more info.

For now, I would keep her to leashed walks and don't let her run or jump too much. Definitely no fetch because dogs often start in a position facing you and then pivot around to chase after the ball – that pivoting/twisting can exacerbate problems in her knee joints.
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Re: ligament problem...

Postby AllisonPitbullLvr » Sat Oct 22, 2011 5:03 pm

No carecredit...at least not in Ontario :(

julien, seach PBF for threads on ACL tears...there have been TONS of them over the years with people discussing which options they chose and whether it worked for them.

If it was my own, young, happy, vibrant dog I would find the money. As it is, my 12 year old lady with multiple other joint issues has a chronically torn ACL. I would have fixed it years ago if I had had her then because it would have helped her shoulder issues to have a stable leg in the rear.
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Re: ligament problem...

Postby lilangel » Sun Oct 23, 2011 1:59 pm

Yep. Here is a video of my dog on day 1 in her Orthopets knee brace. She has bi-lateral FULL CCL RUPTURES. The first knee (without the brace) was surgically repaired and bothers her every day, even 3 years later. The braced knee is in great shape so far and she never wears the brace anymore.

About 10 minutes before the video was taken she was putting zero weight on her leg, it was tucked up into her rib cage and she was barely able to hop around on her surgically repaired knee. We put the brace on and after 60 seconds or so of testing it, she began walking with full weight bearing on the leg. It takes getting used to and she was not exactly graceful in it for a few days but this is the immediate result of a properly fitted brace.

Her section starts at :45 seconds and runs for about a minute...

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Re: ligament problem...

Postby Kingsgurl » Mon Oct 24, 2011 1:41 am

Vin, how long did she need to wear the brace? It seems as if the brace would be a non-surgical equivalent to an extra-capsular repair, with the difference being the joint was stabilized externally instead of internally while the scar tissue built up and stabilized the joint. Very interesting.
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Re: ligament problem...

Postby nic » Mon Oct 24, 2011 2:36 am

That's interesting.I just saw an advert for the type of braces in a pet dog magazine here in the UK.
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Re: ligament problem...

Postby julien_sti » Mon Oct 24, 2011 10:18 am

thats actually what I was thinking of doing, it looks safer...and since my dog only as partial tear I think it would be much better it would help her heal and be back to normal without risky surgery...shes at the vet right now for her radios so i'm gonna talk about this with the vet when they call me to come pick her up, now what sacres me is, I tough that kind of problem is a old dog problem, now if my dog as this thing at such a young age does that mean she as weak joints and that its probably gonna happen on the other leg sooner or later?
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Re: ligament problem...

Postby lilangel » Mon Oct 24, 2011 2:30 pm

Kingsgurl wrote:Vin, how long did she need to wear the brace? It seems as if the brace would be a non-surgical equivalent to an extra-capsular repair, with the difference being the joint was stabilized externally instead of internally while the scar tissue built up and stabilized the joint. Very interesting.


All told, she wore the brace very day for something like 5-6 months. Yes, I suppose it is the equivalent to the extra cap except it is 100% non-invasive and nothing is drilled or added to the joint. There is no human monkeying around with joint laxity and sutures. No weeks of being crated or tethered without movement thus no muscle atrophy, no extraordinary rehab, no debilitating chronic pain, no further unnecessary discomfort. It facilitates a natural and immediate healing process, which a better option in this case IMHO.

The dog in the video was 11 years old when the footage was shot. She is now 13 and doing well. She can walk a mile at one time all by herself. If she had not had the extracap on her other previous knee injury who knows how much better off she'd be.

The first 2 weeks using the brace are an intro period wherein you use the brace for successively longer periods of time per day. The first day she wore it for the video, that is all, a minute give or take, then we took it off and she went to lay on her bed for the rest of the day. Every day is like that for a couple of weeks adding time each day because your dog needs that period to adjust to the brace. You have to be patient enough to give your dog enough time to be comfortable wearing the brace for 16 hours a day. When she is wearing it from wake to sleepy time, then it is a no brainer except for checking your dog for sore spots. There is a good amount of soft dense foam padding, (1/4 inch,)but you can always add more in the form of strategically placed mole skin if it gets too compressed. We did this and never had any problems with pressure sores or anything of the sort. You just have to monitor your dog for that kind of thing.

The brace does and is meant to limit mobility to some extent so while your dog will be able to walk and run around, go up and down stairs like normal, when she sits, she will sit funny because the brace limits the motion of the knee and it will stick out a bit funny. She will probably choose to lie down instead.
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Re: ligament problem...

Postby lilangel » Mon Oct 24, 2011 2:41 pm

julien_sti wrote:thats actually what I was thinking of doing, it looks safer...and since my dog only as partial tear I think it would be much better it would help her heal and be back to normal without risky surgery...shes at the vet right now for her radios so i'm gonna talk about this with the vet when they call me to come pick her up, now what sacres me is, I tough that kind of problem is a old dog problem, now if my dog as this thing at such a young age does that mean she as weak joints and that its probably gonna happen on the other leg sooner or later?


The only problem I see here is the age of your dog. He will grow a lot in the next 6 months so a brace may not be a a viable option. I would opt for conservative management for several months which entails having your dog do very little. This give the leg time to heal itself. I have done this with another dog that was the same age as yours the first time her knee went out and then 8 months later it went out again and she has pulled through without any issues. I could have the ages mixed up since I don't think of her in months of age but rather turning points of development. She is now 28 months and she hasn't had any problems at all and she was never cut into. Some people will vehemently disagree, maybe your vet will disagree. Those opinions are all valid. My own vet agrees with everything I have done, so as far I'm concerned I did the right things and avoided a lot of potential irreversible consequences. There is just no way of knowing how a surgery will heal. Some are fine, others are not and the options are much narrower after surgery has been done. If you do not opt for an unnecessary surgery in the first place, the surgical option is always there when you need it and then it is a last resort, rather than having something worse as a last resort.

JMHO
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Re: ligament problem...

Postby julien_sti » Mon Oct 24, 2011 4:24 pm

ok so GOOD NEWS!!! no tear was shown on the radios its jsut swollen, the vet said its like a twisted ankle but for the knee!!! so no operation and no brace needed, she only needs a couple weeks of rest with anti-inflamatory and then back to exercising slowly, the vet said shes young shes strong and since theres no tear she will heal by herself! so yeah it cost me around 500$ (I sold my car to have the money) to get told she only needs rest but yeah at least now I know!
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Re: ligament problem...

Postby Kingsgurl » Mon Oct 24, 2011 11:24 pm

Whew! That is good news!
Thanks for the info on the brace, Vin! I hate un needed surgery, went with the extra-capsular because the TPLO freaked me out quite a bit, all that sawing of bone and redoing angles, plates, screws, rejection of said plates.. I'm a firm believer in doing as little harm as possible while trying to 'fix' things. I will hit you up next time cruciate issues come up as to where you got yours.
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Re: ligament problem...

Postby lilangel » Tue Oct 25, 2011 1:47 am

julien_sti wrote:ok so GOOD NEWS!!! no tear was shown on the radios its jsut swollen, the vet said its like a twisted ankle but for the knee!!! so no operation and no brace needed, she only needs a couple weeks of rest with anti-inflamatory and then back to exercising slowly, the vet said shes young shes strong and since theres no tear she will heal by herself! so yeah it cost me around 500$ (I sold my car to have the money) to get told she only needs rest but yeah at least now I know!


FYI, cruciate injury is often misdiagnosed or under diagnosed if that is even a term. Someone can correct me if I am wrong but I don't think you can even see cruciate injury by radiograph. I would personally, if she were my dog, treat her as if she had a cruciate tear and start conservative management immediately. Keep her doing nothing active for at least 8 weeks and then ease into a normal schedule over 4-8 more weeks, even if the dog seems fine at week 2! Often people think it is just a sprain and do maybe 2-4 weeks of no activity besides short leash walks. Then they go back to a normal routine and things are great until... bam... full rupture down the line because the leg never fully healed. Conservative management is a pain but very doable and worth the effort to save your dog from a lifetime of trouble with the leg. Then again, the leg could go at anytime for a whole bunch of reasons you have no control over.
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Re: ligament problem...

Postby julien_sti » Tue Oct 25, 2011 6:55 am

vet said 2 - 3 weeks of zero activity, then start with 10 minutes walks for a week, then next week 15 minutes, then 20 etc...so yeah about 6-8 weeks before letting her play with the other dogs and stuff like that, for now I just give her small walks like 5 minutes and really slowly I just let her sniff everything she wants and take her time so its a slow walk, its better then nothing I guess! it sucks but I guess we dont have the choice, if anybody as ANY idea what kind of activity I can do with her inside that will not risk to hurt her knee please tell me!
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Re: ligament problem...

Postby mtlu » Tue Oct 25, 2011 10:16 pm

lilangel wrote: Someone can correct me if I am wrong but I don't think you can even see cruciate injury by radiograph.

From what I understand, the ligament tear does not show up on x-rays but it is still useful to rule out any underlying structural issues. One of the orthopedic specialists we went to pointed out how the meniscus showed swelling/extra fluid in her knee and that is often indicative of a tear also. The majority of his diagnosis was done by manipulation of her legs/body and watching her gait at various speeds while I walked her outside on leash.

lilangel wrote: I would personally, if she were my dog, treat her as if she had a cruciate tear and start conservative management immediately. Keep her doing nothing active for at least 8 weeks and then ease into a normal schedule over 4-8 more weeks, even if the dog seems fine at week 2! Often people think it is just a sprain and do maybe 2-4 weeks of no activity besides short leash walks. Then they go back to a normal routine and things are great until... bam... full rupture down the line because the leg never fully healed. Conservative management is a pain but very doable and worth the effort to save your dog from a lifetime of trouble with the leg. Then again, the leg could go at anytime for a whole bunch of reasons you have no control over.

I think this is excellent advice. Conservative management is hard, especially when the dog is "acting fine" after a couple of weeks – and the same is true in recovery from surgery also and the dog is allowed to much freedom of movement suddenly when muscles have not built back up yet.

OP: Try searching for "101 things to do with a box" – I know it's been posted on this forum a few times. You can also do things like feed her by scattering her kibble all over the house so she has to search for her food – this will help work her brain a little bit.

We did box work, you can also do a search for that or "nosework" and also look in the sport section of the forum. I would hide a treat bag inside of one of five cardboard boxes and have Molly search for the food. In the beginning, you start off super easy – it almost looks too easy but it's important to slowly build up the difficulty so that your dog *always* gets rewarded (with food :) ) and looks forward to doing searches. It doesn't take too long to do a session and is also a way to feed her breakfast and/or dinner while also providing some good mental stimulation that will tire her out.

Short clicker training sessions, 5 or 10 minutes at a time a couple times a day can help tire her out mentally. It's different from physical exercise but people often underestimate how much mental stimulation can tire a dog out.
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