Orthopedic problem- knee injury

[StarfishSaving]

My girl Sally injured her ACL a couple years ago. *The vet did not catch it.* We took her several times over the course of a year for a limp, but never got a definitive answer. I read and read and researched Sally's symptoms, and kept going back to the vet with things that I came up with- asking for radiographs, Lyme test, anything I could think of that would cause her limping. He only half-heartedly did the tests but when he took x-rays, it was only her hips, which are okay. He never did anything with her legs, then he decided to write it off as "maybe she sprained something..." and kept reinjuring it.

Well, upon taking her in to a new vet for a second opinion, we found that she had torn her ACL probably close to a year and a halfish before. I do not need to tell you that I was devastated by this. The ligament is probably way beyond repair now and she has suffered what I can only hope is not irreversable stress to her knee. X-rays in May/June showed definite arthritis and probably bone spurs, we've been back and forth to the new vet trying different meds, but it's all just pain management mostly. He offers little hope of us being able to do anything but manage Sally from here on out. I asked about surgery, he did say that there's an option to put her under and scrape some of the spurs and arthritis away but he doesn't really want to do it and thinks it would be merely a temporary fix.

He pushed for management, but over the last 6 months, nothing has made enough of an impact for me to be comfortable with just leaving it. That's how we got into this mess- assuming there was nothing we could do. We'd been using Rimadyl sporadically over the summer, and he has now given us Deramaxx to try. I have been giving her Gluco/Chondroitin, MSM, Fish oil, and Vitamin E; the vet said to continue.

Since we've reached a dead end, though, my husband and I want to try taking Sally to an orthopedic specialist to make sure that there's nothing we can do to improve her health and make sure she has a long, happy life without this injury crippling her more progressively.

Sally is a border collie(probably golden) mix and will be turning 7 around February. She should have many years left with us and I want them to be as high quality as possible!

Does anyone have any experiences with injuries and problems like this? No matter what, I'm looking for a specialist in the area, but some insight on what we might be up against would be good.

Has anyone had this issue? Or know anything about this surgery or other options, ACL issues, and things like that? I don't know what I'm looking for here. I just would love... to not be in this completely alone, I guess.



A dirty dog is a happy dog, right?

[Traci]

Actually, both vets should have referred you to an orthopedic vet surgeon at the moment either suspected a problem.

You cannot actually know the extent of damage until surgery, and I would NOT just settle for the second vet going in on a guess. See only a board-certified orthopedic vet surgeon, you might have to get a consultation first, and you'll want ALL of Sally's health records faxed to him, including all xrays and other diagnostics so he can review them and make a qualified judgement combined with initial evaluation/exam before recommending surgery. Also tell him all of the medications and supplements you've been giving Sally, (including Rx noted in her health records)....He MUST know the types of meds she's been on, any accompanying bloodwork, and the brands or formulas of the glucosamine/chondroitin etc.

I don't think it's too late for surgery, but again, you don't know the extent of injury/damage until surgery. Sometimes xrays can be quite revealing, but surgery allows the vet to determine the full extent and the ability to repair as much as possible.

Due to her age, and especially since she's been on rimadyl and dermax, you must get a full blood profile done on her prior to surgery, discuss that in full with the surgeon.

[Amandasmom]

Has anyone mentioned TPLO surgery? I've been through that 3 times with great success.

[StarfishSaving]

Has anyone mentioned TPLO surgery? I've been through that 3 times with great success.

Nobody has mentioned this as an option until you! I've been reading up on it since, though, and it sounds like an option. Of course we won't know what our possibilities are until an ortho doc has seen Sally. Traci, do you have experience with dogs and this surgery?

It bothers me that this vet (who I really do have a lot of respect for) never suggested taking it to a specialist when he knows we'll go as far as we need to in order to help make her life better.

Thanks for the insight, guys. You've rekindled some hope that we can reclaim more comfortable quality of life for Sally, after I was starting to think there wasn't much hope for improvement. I'll be calling Monday and asking to speak to the vet, and requesting a referral to a board certified ortho surgeon. In the meantime, I'm researching specialists on my own and will make a decision with as much info as I can collect.

[Amandasmom]

Some older vets think that TPLO is not needed (davet). But having seen the results in 2 of my dogs, one had both knees done and the other just one knee, its well worth it.. BUT... I had a great surgeon from Tufts. He does these procedures all the time and also teaches. Check out the University of Pennsylvania ( noticed you live in PA). They may have info on finding a good ortho person in your area.

If you end up going that route, I can help with tidbits of info I learned during recovery.

The other alternative is a knee brace. Yes they do make knee braces for dogs. They have to be fitted by a vet but from what I've read, they seem to work well. That's if all else fails.

[Traci]

If your current primary vet doesn't give you a referral, or doesn't know of a proper referral, call an emergency vet facility (one that is established, has a good reputation), you can usually ask for references to a good orthopedic surgeon this way, even your emergency vet facility might have a board-certified surgeon available.

I've assisted in a few (Davet might be able to weigh in here too), most are brought in very soon after injury, which of course, affords the best results, as opposed to more than a year after an injury of this type. It might be possible the injury isn't as old as the vet assumes, some ways to try to gauge exactly when some forced injury occured, how she is reacting to or coping with the injury/pain, (is she inactive? vocalizing/yelping? Reluctant for walks?) how she is holding her leg/knee, and how she's responding to current meds (obviously the meds are basically placating, if surgery is indicated, a bit more could be done to stabilize the joint and address cartilage, etc). I'm assuming your current vet is experienced enough to accurately diagnose ACL, (most often by use of the "drawer" motion test and xrays) but by not referring you to an orthopedic surgeon right away, I kinda question his direction. He should have done so immediately when you asked for options.

Here is a good site that explains ACL and the TPLO surgery, it's worth it to talk to a board-certified surgeon and see if this is a good option for Sally. Again, be prepared that it really depends on the extent of damage (and the surgeon's ability/technique), but a good surgeon has that experience and can tell you everything you know to expect. If surgery, even TPLO surgery is an option, go for it, and be sure you understand what is required for recovery (strict limiting of exercise at first, then initiating a physical therapy protocol to strengthen the leg/joint etc, with or without the aid of antiinflammatory meds or supplements).

[StarfishSaving]

I am fortunate to have a board accredited orthopedic surgeon in Pittsburgh, about an hour and a half from here. Now, here's hoping that we can get our vet to give us the referral. He's usually pretty accommodating but I hope he's not going to give me a hard time about wanting to see a specialist. It took a long time to find a vet I'm happy with, and now that trust hangs in the balance.

Anyway, I do think that her injury happened a good while ago. She's never really yelped or whined but she has limped for a long time. She manages herself really well now but I worry about what she's doing to her body by overcompensating for the bad leg. For instance, going up stairs mostly involves PULLING herself up with her front legs instead of using her back legs to help push off, and I worry about her shoulders. She also uses her other back leg to compensate a lot where she should be using both and I don't want that leg or her hips to suffer for it.

Monday, we head down the path to getting her to a specialist.

[Traci]

You don't have to explain yourself to your vet, simply ask for a referral, he is obligated to do so, and it is actually incumbent upon him to do so. It doesn't mean you are leaving him, you are simply getting a more qualified opinion from a specialist for this issue.

Let us know how this goes, ok?

[Amandasmom]

Davet broke his computer again. Don't know when he'll be back. With my first TPLO, he suggested injecting something into the joint to turn it into a solid mass. He thought the modern way was a waste of money.

Let us know what happens, we are here for you. Best of luck.

I see from the football game that its snowing in Pittsburg...

[StarfishSaving]

It sure is, Amanda'smom, but it's a good thing that I LOVE snow!

Sally is our little snow dog, she loves it so much! But we've been keeping her out of it so as not to aggravate her arthritis.





NOTHING that might make my Sally's life better is a waste of money. I don't know if we'll end up doing TPLO but I'm glad to know that you're happy with the results! (times three!)