Cranial Cruciate Ligament Rupture

[Bella's Mom]

We have a 2yo pit bull/rhodesian ridgeback mix (65lbs.) who came up lame after a run on Friday night. The vet did 2 views of X ray but wasn't sure if it was a tear or complete rupture of the CCL They are quoting us $4000 for surgery which is beyond our means. Is there any way to 1) tell if it is a tear and 2) treat it without surgery. Everything I've read so far says that she'll be lame for life if we don't have the surgery. We want what is best for her to have a healthy life.
Any suggestions?
Thank you!

[Daveyo]

Hi I am Daveyo

I do agree that when you see your pet walking lame and favoring the injured leg. It is cause for concern. Since your VET is not sure which is which here, I do suggest you get an MRI done on that area, which can be more precise and pinpoint the problem

Secondly, people tend to forget we also get muscle tears too, like athletes get hamstring pulls etc, which mimic ligament tears. Therefore you must first rule out the ligament tear first before determining it is a muscle tear OK. Since animals cannot speak directly this is our only recourse.

Having a ligament tear is your worse case scenario since these two operation procedures is so debatable. Humans have 4 ligaments wic by the way is much stronger than having only two ligaments.

I have seen the ligaments on animals and it is quite small and very difficult to repair since it wraps around the knee joint. Example it is like a rubber band if I may say so. You break that rubber band and bingo it snaps away. Same for your hand, or elbow or any joint that has to move. It must have a ligament to move it. Once such surgery is done on that area, you MUST keep that dog off of that leg and not move it around. I strongly do suggest a CAST be put on that leg area, like a body cast to secure it all. Easy to tear the suture that is holding together the tear area. The body needs time to rebridge it and secure the ligament again. Same like you fracture a bone.

The other suggestion I would like to make is Shop around for a specialist in that field of expertise. This kind of case does require a specialist indeed. I know the ones in Texas are pretty darn good, and the cost is lower.

Estimated range is between 1800 to 2500 for such operation. 4,000 is way too much and that is overcharging and gouging the customer.

You need to also study up and read about the two procedures, and get as much of an idea what is involved.

I can provide you this so study up on it OK

Here are the links for you.

Extracapsular Stabilization Method

http://www.cvmbs.colostate.edu/ivapm/professionals/members/current_articles/budsberg.htm
http://scholar.lib.vt.edu/theses/available/etd-04302003-201619/
http://www.ejbjs.org/cgi/content/abstract/86/5/988

Tibial Plateau Leveling Osteolomy (TPLO).

http://vetsurgerycentral.com/tplo.htm
http://www.fvarc.com/PAGES/ARTICLES/images/fall-2004.pdf


You need to have an MRI done on the dog besides an X-ray to determine just exactly what got damaged. From there you can determine the best method of treatment. Both methods are OK but the second one is lesser chance of arthritis. That is about the only plus that it has over the other one.



I have a link for you to read which is good for lay people to understand about these ruptures. First there are 4 named ligaments in a human being and there are only two named ligaments on Dogs. Funny how I can say this but it is true.

Here is the link http://www.marvistavet.com/html/body_ruptured_anterior_cruciate_lig.html



Alternate method called the wait and see method.
http://home.earthlink.net/~tiggerpoz/index.html

In the meantime have a VET secure that leg completely to avoid any further damage until you decide to have this operation if it is needed and confirmed from the MRI and X-rays combined.

The other option is to have that area scoped of which a VET can insert the tiny camera inside and the VET can see from the monitor himself. Does not cost much and this is> in my opinion a sure fire way to confirm tear or no tear. Does no damage to the animal. All the VET is doing is taking a peek inside the affected area. If the VET does this kind of surgery I hope it is a micro surgery method. This means it is done with a micron scope to assist the VET and get a much better view and the VET can see where that needle is going as it is being sewed back together to ensure the best success.

You may have to deal with arthritis as it sort of comes with the territory to that injury. However it is known, that speed is of essence. Once the injury is determine surgey should be performed immediately without delay. In doing so, this minimizes the potential of getting arthritis.

Now for me to explain about the arthritis is too much, and if you click on the links provided, it will also tell you in greater detail of why and its speed and potentials etc.

If you have any questions feel free to drop in a line

Daveyo

[audreyhwallace]

I read on a website about Conservative Management. My dog has the same problem as yours. I know your post was from February... Did you ever get the surgery? How is your dog?

The website I found is: http://home.earthlink.net/~tiggerpoz/index.html

I am considering Conservative Manangement as opposed to the surgery simply for price reasons.

[Daveyo]

Hi

You have to understand if that ligament is not wrapped around the knee joint, you will still need to get that surgery done. If it just a partial tear meaning the ligament is still attached then still get the surgery done because it is much easier to save that ligament and prevent it from completely being torn apart.

In either case then you can do the conservative method and have the leg in a cast to prevent the leg being moved about for a minimum of 2-3 months. After this time period, then you can put on the elastic wrap and keep it around the knee joint area to secure it as it continues to heal. You can then let the dog walk around inside the house and not outside, and no steps or jumping. This is another 2-3 months. After this period continue to use the elastic wrap (the same stuff you use on your wrist when you get a sprain or a muscle pull) and you can bring your dog outside for brief spells to get sunshine etc, but do not let it run around and keep it on a leash.

Gradually you can let it more outside, but always keep the elastic wrap when going outside to protect it. Now you can take it off inside, and let it walk inside the house. No problem. By this time after 8 months from its surgery, the ligament should have healed and tighten up at the scar area to prevent it tearing apart.

It takes a long time for a ligament to re-adjust and to get supple again after a surgery is performed on it.

After about a year you should be out of the woods and just treat for arthritis if any exists.

And the elastic wrap has to be on the dog always when you let it outside and before you let it run around in your yard, do check for any holes on the ground. Just you walk around and scan the ground area and make sure no holes are around, and if possible set up a fence area to keep the dog inside a nice well spaced area for it to move about. This way it will not wonder past your allowed space area.

Everything inside that fence area is to be checked and should be clear and now you can let the dog out in this area to roam about and do whatever it wants. Just keep its running down to a minimum OK and don't ever forget that elastic wrap on the knee joint. This is for life on the dog, because that ligament is considered weak and it is stretched too. Don't risk it again ever.

If you follow this physical and medical suggestion then you will do just fine and this will not happen again. Never allow that dog to run freely in open space like a beach or park. You will risk another tear and more financial costs if it happens again. Keep this in mind always.
The dog should be fine then as long as that wrap is around the knee joint when doing limited runs around your own home area.

To clarify runs, a jog pace is fine, or a slow bycycle pace is fine with occassional stops in between as it exercises > NOT FULL TILT TOP SPEED RUNNING OR QUICK TAKE OFFS going after a stick or ball or other unwanted visitors etc. Never let that dog go that fast on a weak leg that had ligament surgery even after it is fully healed. It will rip that weak ligament completely.

The rest up to you and I gave you my scientific medical advice

Daveyo