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anterior cruciate ligament tear


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My 6 year old McNab tore his ACL. He was chasing a squirrel in the backyard when he just went down, so I don't think it's the slow degenerative form of ACL. I was told I had time to decide on surgery and he is being forced to rest and on anti-inflamatory medicine.

 

My vet wants to do the intra ligament repair (over the top repair) but I googled it and saw a low (15%) percentage success rate and a lot of complications.

 

I need opinons on WHICH treatment, and any experiences others have had.

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I agree with Liz that the best option is a consult with an orthopedic surgeon. Our Celt had a completely torn ACL (apparently began as an injury but progressively deteriorated over time). We opted for a TPLO on the advice of his ortho surgeon (with over 20 years of experience). With surgery at 9 1/2 years of age and follow-up rehab therapy, he is completely sound and working cattle at almost 11 years of age.

 

There is an overly-lengthy topic about our experience in the Health and Genetics section. You can find it under my content or with a search on "Celt ACL". I don't have access to a computer or would provide the link.

 

Very best wishes with treating this!

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PS - Yes, you can wait with crate rest and anti-inflammatories but in my experience, waiting unnecessarily will just prolong the recovery period as your dog will rapidly lose muscle tone not only in the affected leg but also in the other legs, which will tend to slow down recovery and also make it harder on him to be mobile when necessary while recovering.

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My 6 year old McNab tore his ACL. He was chasing a squirrel in the backyard when he just went down, so I don't think it's the slow degenerative form of ACL. I was told I had time to decide on surgery and he is being forced to rest and on anti-inflamatory medicine.

 

My vet wants to do the intra ligament repair (over the top repair) but I googled it and saw a low (15%) percentage success rate and a lot of complications.

 

I need opinons on WHICH treatment, and any experiences others have had.

 

Performed properly on a suitable candidate and with a correct rehab regime the sort of extra capsular repair you mention has a success rate that is not much different from TPLO or its variants according to my orthopaedic specialist.

 

However, the larger and more active the dog the lower the likely success rate.

 

It was fine for my 12 year old collie cross but if he had been half the age I would have gone for a TPLO.

 

Cage rest is most successful for small dogs but even then is hit and miss and wastes potential recovery time as Sue says.

 

I echo the advice to get a referral to a specialist.

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In my experience, which is limited to my one dog, responses from others, and talking with vets, the ortho surgeon, and the rehab therapist, I would say that crate rest is only going to be "successful" in the case of an ACL sprain or strain, or a minor tear, where the formation of scar tissue can help stabilize the joint. In addition, it would be most likely to be successful (as Pam said) in the case of a smaller and less-active sort of dog. Apparently, torn fibers do not heal and if enough of them are torn and/or if the dog is very active (or larger), rest and medication will not result in anything but a temporary "fix".

 

This was Celt's case. While the vet diagnosed a tear, the ortho surgeon that we saw (when the injury was recent and he was 6 1/2 years old) diagnosed a strain or sprain. She had him on crate rest and meds, and following that, he remained sound for several years. But, in that time, apparently the initial injury/damage of a limited number of fibers became a total tear - and the symptoms were subtle. He was not lame. He was not appearing unsound. But he was "toe-touching" or standing with that leg extended and his weight on his toes and not the sole of his foot. Looking at his paw pad, you could see (if you knew enough to look for this, and I didn't until the rehab therapist pointed it out to me afterwards) that there was only wear on the tips of the toes and not evenly throughout the pad. He was not sound, he was not moving sound, but he appeared quite sound to the untutored eye.

 

Surgery at this time (and we did try another round of crate rest and meds, even though the vet was convinced the tear was significant if not total at this point) by the ortho vet showed that the tear was not only total but that it had been totally torn long enough that the ends of the fibers had "retreated" (think of a bunch of fibers in a nylon rope - torn, they are like fiber optics, rather fluffy and poofy - when you use a match or lighter to seal and consolidate them, they melt and "retreat" into a solid-looking ball of material).

 

These dogs are very stoic - Celt had been running, playing, and working for some months or longer without the stabilizing support of a functional ACL in his joint, and he was not appearing lame to the concerned eye, except for maybe an occasional "did I see something not quite right" step. He did, eventually, show obvious signs of lameness when he was startled and wound up using his leg in an unexpected maneuver. However, this did not happen until after he was diagnosed and his surgery was scheduled - we had to wait some weeks for an available surgical appointment.

 

I can't minimize my feeling that a consult with an experienced canine orthopedic surgeon is the best option. And, the sooner you can deal with this, the more quickly I believe he will be able to heal and recover. Celt's rehab took a little extra time as he was very unfit when he finally had surgery and so not only did we have to deal with his "bad" leg but also with rebuilding muscle and balance throughout his body. I wish, in retrospect, that I had been able to have him treated much, much sooner but we were trying a conservative approach again.

 

Very best wishes!

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I agree with Liz that the best option is a consult with an orthopedic surgeon. Our Celt had a completely torn ACL (apparently began as an injury but progressively deteriorated over time). We opted for a TPLO on the advice of his ortho surgeon (with over 20 years of experience). With surgery at 9 1/2 years of age and follow-up rehab therapy, he is completely sound and working cattle at almost 11 years of age.

 

There is an overly-lengthy topic about our experience in the Health and Genetics section. You can find it under my content or with a search on "Celt ACL". I don't have access to a computer or would provide the link.

 

Very best wishes with treating this!

Thank you!!!..I found your post and have been reading it. I'm at least the one person you have helped.

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In my experience, which is limited to my one dog, responses from others, and talking with vets, the ortho surgeon, and the rehab therapist, I would say that crate rest is only going to be "successful" in the case of an ACL sprain or strain, or a minor tear, where the formation of scar tissue can help stabilize the joint. In addition, it would be most likely to be successful (as Pam said) in the case of a smaller and less-active sort of dog. Apparently, torn fibers do not heal and if enough of them are torn and/or if the dog is very active (or larger), rest and medication will not result in anything but a temporary "fix".

 

This was Celt's case. While the vet diagnosed a tear, the ortho surgeon that we saw (when the injury was recent and he was 6 1/2 years old) diagnosed a strain or sprain. She had him on crate rest and meds, and following that, he remained sound for several years. But, in that time, apparently the initial injury/damage of a limited number of fibers became a total tear - and the symptoms were subtle. He was not lame. He was not appearing unsound. But he was "toe-touching" or standing with that leg extended and his weight on his toes and not the sole of his foot. Looking at his paw pad, you could see (if you knew enough to look for this, and I didn't until the rehab therapist pointed it out to me afterwards) that there was only wear on the tips of the toes and not evenly throughout the pad. He was not sound, he was not moving sound, but he appeared quite sound to the untutored eye.

 

Surgery at this time (and we did try another round of crate rest and meds, even though the vet was convinced the tear was significant if not total at this point) by the ortho vet showed that the tear was not only total but that it had been totally torn long enough that the ends of the fibers had "retreated" (think of a bunch of fibers in a nylon rope - torn, they are like fiber optics, rather fluffy and poofy - when you use a match or lighter to seal and consolidate them, they melt and "retreat" into a solid-looking ball of material).

 

These dogs are very stoic - Celt had been running, playing, and working for some months or longer without the stabilizing support of a functional ACL in his joint, and he was not appearing lame to the concerned eye, except for maybe an occasional "did I see something not quite right" step. He did, eventually, show obvious signs of lameness when he was startled and wound up using his leg in an unexpected maneuver. However, this did not happen until after he was diagnosed and his surgery was scheduled - we had to wait some weeks for an available surgical appointment.

 

I can't minimize my feeling that a consult with an experienced canine orthopedic surgeon is the best option. And, the sooner you can deal with this, the more quickly I believe he will be able to heal and recover. Celt's rehab took a little extra time as he was very unfit when he finally had surgery and so not only did we have to deal with his "bad" leg but also with rebuilding muscle and balance throughout his body. I wish, in retrospect, that I had been able to have him treated much, much sooner but we were trying a conservative approach again.

 

Very best wishes!

I just checked his pads and there is all over wear and he is in excellent health and 56 lbs. My vet (not board certified) only does the lateral suture which I feel is for less active or older, or smaller dogs. The board certified surgeon only wants to do the over the top intra ligament replacement which is very invasive. They take a ligament from the hocks and pull it down under the tibula and loop it through the knee cap and sew it back onto the hock. With this technique I'm concerned with repercussions of the missing femor ligament.

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As for the all-over wear, this a recent injury, right? You may not notice a wear pattern difference if the injury is recent enough but with time, even if you don't notice a gait anomaly, it may still be there. Some top-flight sports med canine orthopedists have a gait analysis device - like a runway, the dog walks or trots along this and it measures the weight each leg bears and so reveals almost imperceptible irregularities in gait.

 

You would not have known Celt had a long-standing (some months at a very minimum) totally-torn ACL. He ran, he played, he worked and did not show visible lameness - but the unsoundness was there and he wasexcellent at compensating by using his other hind leg and diagonal foreleg. I wonder just how many hard-working, lean and fit dogs, have continued on for months or years through stoicism and compensation?

 

I think that I know a couple of people who have had sevrral dogs with the procedure you mention and have found it very successful and their dogs have recovered quickly and without incident. But I can't say that for certain. I could try and contact them next week and ask.

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