Boca didn't get a very good gift for her Gotchaversary

[Adina P]

Today marks 6 years since baby Boca came home

Boca has been a wonderful family dog!  The unfortunate gift she got today finding out she has a torn CCL.  I've been looking at old DK discussions from others who have been through this and our experience with Boca seems similar to Jarka's with Monty insofar that at first we thought the minor limping was just over exertion after the occasional fetch (because we didn't run her hard often, we figured the consequent temporarily limping was just from not being used to the effort).  Then after the first day of the Walla Walla Romp it got much worse. This morning she got an xray and the vet gave us the results of a torn CCL. 

Sounds like no matter what procedure we choose for repair, the after care is critical and the chances of the other knee needing surgery later are fairly high.  I'd love to hear from those of you who have been through it and how things are going now and any recommendations you have. 

[Sheree Small]

Our Zoey had the TPLO at 18 months of age. Our process was almost identical to Lucy's. Down to the photos, as Zoey and Lucy look alike. We used the exercise pen instead of the crate and we just moved our lives into the room with the pen so we were were all together. Zoey slept in her crate in the bedroom the first 4 weeks I think and then she slept on her bed, because she is a good sleeper. Weeks 6-12 were tough because she is an energetic girl but we kept her on a short leash, progressing to long leash for walks around the yard and neighborhood. At 12 weeks I decided to let her free range the yard and immediately when she was off the leash she "zoomied" around the yard. Freaked me out, but she was fine. It's been a year since surgery and she is fine. Good luck to Boca. It's a hard process while you're in it, but after it's done doesn't seem so bad.

[Carolyn Shusterman]

Adina, My daughter crated her cockapoo 'Skip' for 8 weeks plus a high protein diet and 'Skip' is walking just fine now and living a normal life with no surgery and no more crating

[Lucy & AnnaBelle's Mom]

What I was told is that in smaller dogs you can sometimes get these to heel on their own.  However with larger dogs it is much more difficult because they just continue to re-injure them.  

[Maryann,Roo and Tigger]

Gentle Leader totally prevents Roo jumping up and HE IS A JUMPER, heart ailment, Addison's and all.

First week will be tough.  Then you will get into a routine and it will ease up.  Thinking kind supportive and healing thoughts for you and Bocca.

[Gail and Bailey]

Poor Boca. Hoping for an easy repair and recovery. Hugs!

[Laurie, Fudge, and Vern]

First of all, I cannot believe it has been six years since you got Boca. I remember it so clearly. Secondly, I am so sorry about her torn CCL. We have not gone through this...knock on wood....but wish Boca the best of luck and a speedy recovery.

[F, Calla & Luca]

So sorry to hear about Boca. She has had her share of troubles. I do hope she gets through this with relative ease.

[Adina P]

Thanks I think she will.  I'm amazed at how stoic dogs are about pain.  Limping is literally the only sign of pain.  Clark had tried several times to feel all along her leg and hip for some sign of pain to give us an idea of what might be wrong.  Nothing.  She's also great in the crate so I think her healing will go well.  I may move her crate into the living room so she's not relegated to the mud room all the time. 

Right now the closest hospital that does the more advanced TPLO surgery is booked out to mid August.  Shortly after that school starts.  I'm freaking out on how this will all work out.  I'm a worrier and someone who wants all facts and figures and how's and what's lined up and fully understood or I feel paralyzed yet my head is spinning. 

[Becka]

So sorry to hear this! Feel better, Boca! 

[Stella]

Hey Adina, sorry to hear about Boca's injury. I am a canine rehab professional, so thought I'd throw my two cents your way! Surgery or no surgery, she will still develop arthritis in that joint, it will just happen later with surgery. TTA and TPLO both change the bony anatomy of the knee (stifle) joint to create stability. Both of these can lead to secondary problems - patella tendinopathy, hip joint problems etc etc because other joints have to work differently to compensate for the altered knee anatomy. The suture method preserves the natural anatomy of the knee joint, but historically hasn't been successful in larger dogs. There is a stronger suture material available that does work in larger dogs, you just have to find a surgeon that uses it. With the suture method I would also recommend she has a stifle brace to provide extra stability to the joint as it heals. Please please do not restrict her activity prior to surgery, with the exception of avoiding crazy things (!!) you want her leg to be as strong as possible going into surgery so she will recovery quicker afterwards. If you have a rehab professional in your area I would try to see them at least once pre-op (if you go that route - more about that in a minute!) to be shown home exercises to maintain her strength. A forward thinking surgeon will restrict activity post-op, but not for six weeks that is too long, and you should be able to begin rehab within the first couple of weeks :)

To keep her entertained the Nina Ottoson games are excellent, also when she is more mobile you can do leashed 'find-it' games where you hide treats around the house and she has to find them. Brain exercise can be just as tiring as physical exercise.

Surgery - it is not time dependent, what I mean by that is you could try rehab first. Some dogs do great with rehab alone. If after two to three months of rehab she isn't improving, then surgery is he way to go.

Hope this helps, feel free to ask questions :)

[Adina P]

Thank you for your input Stella. 

You said the suture method hasn't been successful in larger dogs, can you say more about that?  Studies or experience help.  In what way is "successful" defined?  It seems to be still widely done, so I wonder what that means for the average dog.  I will ask about a brace. 

You said to not limit activity.  My worry is causing pain.  She is at least 80% non weight bearing on the affected leg.  So isn't that essentially no activity even if she hops around?  Also I worry that the weight bearing back leg will be adversely affected if she puts extra weight on there...especially since there is a high chance her other knee CCL will go bad later. 

I don't believe there are any rehab pros locally (though I don't know for sure, I doubt our small town would have one).  Even if we did the TPLO, I would not be able to go back to that city for rehab.  It would be solely for the surgery and we'd have to do the rehab/healing at home on our own.

Would rehab first be at all affected if the ligament is completely torn and she puts no weight on it presently?  She already shows signs of arthritis on the joint the vet said. 

My biggest post-op concern is the hopping/jumping.  I can't put a leash on her without her taking the first 30 seconds to hop around like a crazy dog.  Maybe that is where the brace will come in.  Thanks again for any insight!

[Stella]

Hey Adina

In larger dogs the sutures often break before the joint has formed enough scar tissue to become stable, this is why the TTA or TPLO is often preferred in larger dogs. I guess everyone has their own definition of successful, for the surgeon it is that the joint is stabilized and remains stable. For me as a therapist it is that the dog regains full range of motion and strength, walks and runs without limping and can return to recreational activities (within the recommendations of the surgeon, I do know of dogs that have had surgery and returned to agility, but this is a bit more exceptional!).

You are right, if one CCL has gone it is highly likely the other one will go too. I didn't realize she is currently 'hopping lame'. What I meant is that if you really limit her activity, crate rest etc, she will lose a tonne of muscle which can prolong post-op recovery. Ideally you want her to try to use the leg as normally as possible, is she on any pain relief meds? Bracing preoperatively can help her to use the leg more too. Stifle braces, and rehab are covered by some pet insurance plans.

Finding a therapist - in the USA you are looking for someone with CCRT or CCRP qualifications,
http://www.caninerehabinstitute.com/Find_A_Therapist.html
http://ccrp.utvetce.com/practitioners.asp

There are also rehab professionals that do online distance consults, let me know if you need to find someone and I can find some names for you!

A good rehab practitioner should be able to help her to use the leg and weight bear on it. Closed chain activity (where the foot is on the floor) actually creates stability in the joint through cocontraction of the quads and hamstring muscles, so walking/ weightbearing is actually good for the joint, even if the ligament is completely torn. It is twisting motions that you want to avoid, this is where the joint is usually unstable, or when decelerating suddenly.

Does this help? Or did I just create more questions?!!