Boxer Crazy

Boxer Health => Surgery and Orthopedics => Topic started by: whitepupzoe on June 18, 2013, 10:37:06 AM

Title: CCL UPDATE 9-4
Post by: whitepupzoe on June 18, 2013, 10:37:06 AM
I think Abby torn her CCL. She's been limping off and on for about a month, but now it's getting worse.

Here's my problem, my husband said no more surgery, he is absolutely against having her operated on. Abby had a really rough time when she had her shoulder operated on 2 years ago, problem with pain meds, etc. so ever since then he's been against any type of surgery.

How can I convince him...Abby is 7 years old, I can't let her limp for the next 5 years  ( :fingerscrossed: ) ...and rest and restriction is not working for her anymore.

Advice?
Title: Re: CCL and Husband Problem
Post by: RocketBoxer on June 18, 2013, 11:09:50 AM
Well, first off what have you tried so far? How much rest/crate restriction has she had? Is she on any supplements?
Title: Re: CCL and Husband Problem
Post by: whitepupzoe on June 18, 2013, 11:15:02 AM
She's on Dasaquin and has been for over a year. The vet said she has a combination of arthritis and a possible injury to her CCL. My husband won't even agree to take her to see a specialist to get a definite diagnosis.

We have just been restricting her activity, no playing, no jumping, no walks, no couch. Is there something else I should be doing for her or giving her?
Title: Re: CCL and Husband Problem
Post by: BoxerWB on June 18, 2013, 11:48:21 AM
Hmm... Have you already tried the "we learned from last time, we'll know what to avoid this time" angle with him?  We know our boys are big mushes about their pups, so maybe the general vet needs to make it clear how it is hurting her? Abby not fully using that leg will cause problems for other parts of her body as she adjusts how she does things to compensate.

It seems like everyone I know who has tried conservative management had ended up needing the surgery anyways - it only takes the dog getting in one "illegal" romp to undo all your careful restrictions.

I know it is tough, once they get their minds set, but I'm sure you can help him see reason.  :thumbsup:
Title: Re: CCL and Husband Problem
Post by: whitepupzoe on June 18, 2013, 12:02:35 PM
I think another trip to the vet might help him change his mind...he's always more receptive to what she says then me.  ::)
Title: Re: CCL and Husband Problem
Post by: Eilene on June 18, 2013, 02:49:37 PM
Hope he agrees to whatever will help her..I'll keep my fingers crossed
Title: Re: CCL and Husband Problem
Post by: whitepupzoe on June 18, 2013, 03:25:03 PM
We are going back to the vet tonight, I am hoping she can pursuade him into at least taking her to a specialist for evaluation. I will keep you posted!
Title: Re: CCL and Husband Problem
Post by: Boxermom,K on June 18, 2013, 04:38:24 PM
If he is completely against surgery then tell him you guys have to look into other options such as a brace to help stabilize the knee/leg for 6-8 weeks to give it time to heal.
Title: Re: CCL and Husband Problem
Post by: Rubidawg on June 18, 2013, 05:18:46 PM
When we decided to finally do Rubi's, she was in bad shape. Screaming. Writhing. Unable to stand. She'd hobble (nearly falling over) to go hide in the yard, she was in so much pain. Wet herself. I've never seen her that miserable. for years before, we had tried therapy. We had tried weeks, upon weeks, upon weeks of crate rest. We had tried massages, with daily ice packs. Eventually, she woke up in so much pain, we were scared we couldn't help her. It had just gotten too painful for her and we had no choice but to put her through surgery. She was 4yo, had been on supplements since she was diagnosed with HD at 6mos. She had more rimadyl, tramadol, aspirin, then I'd like to think about. Eventually, you have to weigh out what is quality for her? Is it a few more weeks of crating? Is it upping her pain meds? Is it worth trying physical therapy for a little while to see if that helps? Is it putting her through surgery and all of the aftercare?

Rubi went through bouts of going 3-legged, to back to normal, running and playing and chasing Grady for a long time. It was when the pain was so unbearable, she woke up screaming and falling over that we had looked into autoimmune diseases and other possibilities before we ended up with TPLO. She came out the day after surgery, walking on all fours, bright-eyed and wagging her tail. But.....it is a tough surgery and it's quite painful for them afterwards, which is why they send home "the patch" but even still....Rubi was very uncomfortable for many weeks. The first few days were extremely hard (on her and on us). Then add the exercises you had to do daily, walking her on leash every hour to get her out to potty using a towel sling until she was able to atleast toe-touch the leg enough to walk out herself (still on leash). Her recovery took about 8 weeks, then it was weeks of water therapy after that. So, just things to know/consider and ask about, so you know what you would be getting into.

While I can appreciate the surgery, I do try to go conservative as much as possible. Rubi can no longer sit because of all of the arthritis that has built up in her knee both pre and post surgery. So that is a downfall, otherwise - she does fairly well keeping up with Bauer on her own, despite Shawn and I hiding our eyes when we think she's going to blow it out again! There are pros and cons and a big risk is blowing out the OTHER knee - but that can happen with or without surgery.

My advice would be, take him along with you to the vet. Talk to them about seeing a specialist, but be forwarned...the specialist will want to do surgery - they just seem to go right towards that route, unless you find a specialist that also considers the pros and cons with conservative management as well. It's up to both of you to ask about all of the options and weigh them out evenly. I was against it at first, even when they told us she needed it - I felt there was something else going on based on all of the other tests - but was glad to see her up, walking, and happy again.
Title: Re: CCL and Husband Problem
Post by: Missy/Precious mom on June 18, 2013, 05:42:42 PM
Fingers crossed
Title: Re: CCL and Husband Problem
Post by: Christina on June 18, 2013, 06:49:25 PM
Star has bad arthritis in both knees,  but he had that prior to surgery because it took  over a year to get the prior diagnosis.   My reasoning with Star  was that I absolutely couldn't put him through the restrictions of conservative management and then turn around and have to do surgery anyway.  He was also almost 2 at the time.

 The thing with conservative management is that you're going to restrict her for 6-8 weeks,  then a slow return to normal activity,  and then there's no guarantee that she'll be 100%.  The entire time her knee is unstable and there's a greater possibility of arthritis forming.

 There are a lot of specialists that will do the traditional surgery on bigger,  active dogs.  As long as you are very careful in the beginning,  it has a good success rate.  You're regular vet should even be able to do it.

I know several people that have had dogs do well with just tramadol post op, I don't know what pain meds she had trouble with,  but I know Star had a horrible time  with the fentanyl  patch,  so the surgeon didn't use it the second time.  They're using different things like gabapentin now  for post op pain too.
Title: Re: CCL and Husband Problem
Post by: 3BOXERS on June 20, 2013, 07:28:21 PM
I tried the CM approach with Mic when he had a particle tear. He was almost healed and then he tore his acl completely. He did one stupid burst of speed or tried to jump to fast (i did not see the reinjury) and a year of rehab and crating when done the drain. He had tplo in April and is doing great. I do not think I realized how much pain he was in till after he had surgery and started to heal. He is back to being a really goofy guy instead of being so quite.

I think that the CM approach works best for older dogs that are not as active. The ones who do not like to jump a lot or have sudden bursts of speed. First you need to find out if it is a full tear or just a particle. I do not think that it will heal with just crating if is a complete tear.
Title: Re: CCL and Husband Problem
Post by: Rubidawg on June 20, 2013, 09:51:29 PM
Any updates, Kris? How did the appt go?
Title: Re: CCL and Husband Problem
Post by: whitepupzoe on June 21, 2013, 02:06:56 PM
Oops sorry, should have updated.  :blush:

My vet said that yes, there is arthritis in the knee and a injury to the CCL. She said 99% of the time the injury will not heal with just resting, etc.

Al is still not ready to have surgery done tho. I know if we go to a specialist they will say yes she needs surgery, but I think we need to know a definite diagnosis.  Will the speciliast be able to tell if it is a partial or complete tear?
Title: Re: CCL and Husband Problem
Post by: Rubidawg on June 21, 2013, 03:06:19 PM
Definitely go to the specialist. Even if you do go with surgery, I would not trust a regular vet to perform it.

They can't tell if it's a partial tear or a complete tear til they really get in there. They will perform the drawer test and depending on how much pain and movement in the joint there is, that can still be inconclusive. They thought Rubi's was a complete tear, but ended up only being a partial when they went in. It was all the arthritis causing a good part of the issue with immobility.
Title: Re: CCL and Husband Problem
Post by: Christina on June 21, 2013, 04:03:45 PM
The longer that the knee is unstable, the worse the arthritis will get.  That's why Star's knees are so bad.  Star only had partial tears, there was still enough instability in there for horrible arthritis to form. 

I would go to the specialist, there are several surgical options that will have her comfortable and well on the way to healing in no time.
Title: Re: CCL and Husband Problem
Post by: BoxerWB on June 21, 2013, 04:39:04 PM
I agree w/Dawn - they can't be 100% certain, but the specialist has a better "feel" for what is normal and could tell you with *more* certainty than a gen. vet.  Did the gen. vet already take X-rays? X-rays aren't great for seeing soft tissue, but they can help see how things are positioned.
Title: Re: CCL and Husband Problem
Post by: whitepupzoe on June 22, 2013, 12:44:17 PM
No my regular vet doesn't do the surgery, they will send you to a specialist. We could go to the same place we had her shoulder done for the diagnosis.  I think Al's real issue isn't with the surgery itself it is with the recovery. I know with her shoulder she had 8 weeks of strict rest.

I think I will push for at least a specialist visit and go from there. I hate to see her limp for the rest of her life. I would rather deal with 8 weeks of recovery and then have her be fine. Her shoulder is completely healed and she has full use of it now. I imagine the knee would be the same.  :confused:
Title: Re: CCL UPDATE 9-4
Post by: whitepupzoe on September 04, 2013, 08:37:18 AM
Ok so we FINALLY have an appointment with the specialist next week to look at Abby's back leg. I know he is going to say we need surgery....and Al is finally on board with it.

Any advice on what I need to ask the specialist?
Title: Re: CCL UPDATE 9-4
Post by: Missy/Precious mom on September 04, 2013, 10:27:30 AM
Fingers crossed
Title: Re: CCL UPDATE 9-4
Post by: Eilene on September 04, 2013, 12:04:37 PM
Good luck
Title: Re: CCL UPDATE 9-4
Post by: Christina on September 06, 2013, 06:43:40 PM
They should do a drawer test too check for stability of the knee,  probably more xrays as well.  Ask what surgical options are available, why they recommend one over the others.  You don't have to go with the bone cutting surgeries   like TPLO  or TTA,  the traditional surgery can work very well with active dogs,  you just have to be more careful in the beginning.

I knew I couldn't keep Star that calm for the traditional surgery, I went with the TPLO,  it's pretty stable from the beginning.  He jumped his xpen 4 days post op and didn't do any damage. 

I hope it goes well.
Title: Re: CCL UPDATE 9-4
Post by: 3BOXERS on September 07, 2013, 02:47:05 AM
I really think that which surgery you choose depends on the age of the dog and how active they are. If she is at the point where she is mostly a couch potato and really does not tear off across the yard to get to things. Then you may want to considered something other them tplo. If she is really activate and likes to jump then I would go for tplo. I would ask if they cast after surgery. The rehab vet I have been going to thinks it is a good idea if they are casted for a week after. Mic was and it was ruff, but it really kept the knee stable.
Title: Re: CCL UPDATE 9-4
Post by: whitepupzoe on September 13, 2013, 02:51:29 PM
Ok, back from the specialist and he didn't seem to think it was torn...or even partially torn. Said both knees were "crunchy" due to arthritis, but he did the drawer test and said she didn't show the signs of having a tear. He gave us some options...3 types or surgery to consider... Extracapsular repair, TPLO and TTA. He recommeded strict restrictions for a month along with rimadyl twice a day and see if she shows improvement. If no improvement then back for xrays and then discuss surgery options.

Abby still has alot of spunk, she is 7 years old...I mean lately she is a couch potato but mainly because of her leg bothering her I think. So I am not sure what we will decide if the restriction of activity doesn't help. This vet does the extracapsular surgery himself, but we would have to see a specialist for the TPLO or TTA.

Thoughts?
Title: Re: CCL UPDATE 9-4
Post by: Eilene on September 13, 2013, 02:59:00 PM
Sorry i have no experiece with this
Title: Re: CCL UPDATE 9-4
Post by: whitepupzoe on September 13, 2013, 03:04:18 PM
Sorry i have no experiece with this

You're lucky! LOL I wish I didn't either!
Title: Re: CCL UPDATE 9-4
Post by: Rubidawg on September 13, 2013, 03:09:03 PM
Personally, restrict her - VERY tough restriction. It's hard to go through, but so important and then see how she does. I would not opt for surgery if she's just "slowing down" from the pain. Pain meds and restriction may be all she needs. If it were my dog, I'd look into conservative management and treat that way. If she's not getting anything with the drawer test, surgery isn't worth it.

I will say this, on the drawer test - they couldn't get much movement from Rubi's knee either. However, her screaming in pain, unable to walk, hiding in spaces, peeing herself....they knew something was wrong. Test, upon test, upon test came up with nothing. An ortho looked at how she was attempting to walk, looked at her knee, felt around and said...yep, it's torn or atleast partial...and surgery was the only option. She felt there was so much arthritis built up in her knee and degenerative disease, that the knee was staying in it's place, for lack of a better term, but still needed to be repaired to the point she wasn't screaming in pain anymore - and it was a constant scream, not like she was getting up and it hurt. She wouldn't move. They thought autoimmune disease, among other things. We considered letting her go because she could not move at all. We hesitated with the surgery, but decided to go with it and are relieved that she's no longer hurting. They did find only a partial tear, but it was enough for her. So, sometimes, the drawer test is not always going to tell the story of what's going on. However, I really don't think this is the case with Abby. She may have a slight partial tear, that with some rest and medication, will heal up on it's own. Well worth the shot rather than putting her through surgery. IMO
Title: Re: CCL UPDATE 9-4
Post by: whitepupzoe on September 13, 2013, 03:18:50 PM
I hope so Dawn. We haven't really been strict with the restrictions...so it's kinda our fault. I don't want to put her thru surgery unless it's absolutely necessary, the doctor also said he could sedate her and do more extensive xrays and manipulate the joint to get better answers if she doesn't improve.
Title: Re: CCL UPDATE 9-4
Post by: 3BOXERS on September 14, 2013, 12:03:11 AM
With Mic I tried to go the crate rest route. He had only a partial tear at the time. I did lots of rehab and at about 10 months the pet sitter let him have to much time in the yard by himself and he tore his acl completely. All it takes is one quick turn or jump and it can undo all the progress. If she is still really active I would go for TPLO. It is the most stable. Right now I would also consider getting her on Adaquin. I will help with the pain and inflammation.  I hope it is not a tear and the she feels better with some crate rest.
Title: Re: CCL UPDATE 9-4
Post by: Christina on September 15, 2013, 12:19:48 PM
Star's  knee was always stable with the drawer test,  both with him awake and sedated,  he still had a partial tear that was causing enough instability for him to have significant arthritis in both knees by the time we finally found the specialist who checked the drew the fluid off his knees and found it indicated a tear.  Star was a special case with his odd presentation and his age.

 Since her knee appears to be stable, I would go with the strict rest and rimadyl,  but if has to  be very strict restrictions.  Hopefully she'll get better,  but if it is torn,  the chances of conservative management working aren't great. 
Title: Re: CCL UPDATE 9-4
Post by: BoxerWB on September 18, 2013, 11:54:13 AM
Is she already on joint supplement? Maybe if the "crunch" is arthritis, you could ease some discomfort by lubing the joint. This is what I'm using for Dash as a preventative: http://www.pupsup.com/Canine-HylaSport.htm (I bought it for Xena to assist the Adequan, but we weren't very far into the treatment before she died, so I don't know for sure that it works well on tough cases).  It has Glucosamine, Chondrotin, MSM, and Hyaluronic Acid. The Hyaluronic Acid is starting to gain popularity in supplements because it is included in the natural fluid of joints, so the goal is to add to that natural lubrication. There is a form of it in the injections Aaron gets in his knees (he's missing half his cartilage).
Title: Re: CCL UPDATE 9-4
Post by: whitepupzoe on September 18, 2013, 02:50:21 PM
She has been on Dasaquin for a couple years now.
Title: Re: CCL UPDATE 9-4
Post by: BoxerWB on September 20, 2013, 12:37:44 PM
Looks like there are a couple of version of that brand - does it have hyaluronic acid?
Title: Re: CCL UPDATE 9-4
Post by: whitepupzoe on September 20, 2013, 01:48:00 PM
Hmmm...I'm not sure. I would have to look at the bottle. If not, I will get something that does have the acid in it when the Dasaquin runs out.  :thumbsup:
Title: Re: CCL UPDATE 9-4
Post by: AandWBoxers on August 02, 2014, 06:10:21 PM
Hi~
My Mugs (5.8 yr old) has been diagnosed with CCL.  She's been limping for a year on her knee, and started a little whimpering last week, trying to get comfy for bed. 

I've read through a few threads in here about this and, of course, seem to get more questions than answers!

First question:  How does a specialist make this diagnosis and surgery better for dogs than a general vet? 

Why give supplements for years if it doesn't really make the problem go away??

How much more does a specialist usually charge for these surgeries vs a regular vet?? 

My husband was against the surgery, also, and wanted me to look into this forum and others to get more answers.  I hope you guys will be able to help us out! 

Thank you! 
Title: Re: CCL UPDATE 9-4
Post by: Christina on August 03, 2014, 10:17:37 PM
The specialist and general vet will make the diagnosis in the same way, they do the drawer test and tibial thrust test, movement with either indicates an unstable knee. The difference comes with the type of training and the experience with different surgeries. Your regular vet may not be comfortable doing the surgeries, so he refers everyone to a specialist. If you want the TPLO or TTA done, a specialist is the only way to go. The general vet may be able to the the traditional, or commonly referred to as fishing line surgery, but for a more active dog, it should be done with stronger line and some vets make a few modifications like extra connections to make it more stable during the recovery.

Supplements won't make the problem go away, they can help with arthritis, but they won't heal a torn ligament.

I've been through two TPLOs with boy Star, I'd do it again in an instant.
Title: Re: CCL UPDATE 9-4
Post by: whitepupzoe on August 05, 2014, 08:35:27 AM
Ditto everything Christina said.  ;D  My husband was against surgery for Abby at first, until we saw the specialist then he was convinced. My vet doesn't do the surgery so we had to go to the specialist for it...he was great and Abby's recovery was pretty easy.  I have heard the cost difference is $2200 for a vet vs. $5000 for a specialist.

Abby is still on supplements for her arthritis, the surgery didn't get rid of that, that will always be there, but the supplements help her...plus I give her a Rimadyl when she is having a tough day.

I don't regret having the surgery for her, she will never be able to run like she used to, but she can have a normal life...she's 8 now, so her running and jumping days were probably over even if she didn't tear her CCL.  ;)

Good luck and keep us posted!!
Title: Re: CCL UPDATE 9-4
Post by: Bumpy on December 26, 2014, 10:10:48 PM
This thread is very helpful as we suspect Keanu may have a torn ccl. Poor guy actually moves pretty well but after resting comes up lame in the right rear knee. Will be exploring options after his corneal ulcer has cleared up. Poor guy, breaks my heart when he is limping about as he is such a athletic strong guy. Ugh.


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Title: Re: CCL UPDATE 9-4
Post by: Boxermom,K on December 27, 2014, 11:56:09 PM
Poor guy. Do you have a clinic that does physical therapy in your area? I've also heard that is very helpful.
Title: Re: CCL UPDATE 9-4
Post by: Bumpy on December 28, 2014, 07:03:19 PM
Within a few hours yes but not real close. I was recommended to look into them by a friend as an ortho will always want to cut. The odd thing is some times he seams perfectly fine and then seemingly out of no where you catch him limping. Weird.


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Title: Re: CCL UPDATE 9-4
Post by: whitepupzoe on January 04, 2015, 04:07:06 PM
E any updates? Did Keanu have the surgery or did rest help?
Title: Re: CCL UPDATE 9-4
Post by: Bumpy on January 21, 2015, 10:07:39 PM
Sorry did not notice this.
  We have been back and forth to the optometrist for a corneal ulser. Treatments, time, and money had me concentrating on that first. Good news the eye is all healed up.
  We have been trying to limit his crazy running ( we all know how hard to impossible that is). He gets out of hand and usually limps that night or longer. Recovers though.
  Next up is Fiona's spay in two weeks, hope to get him in to get some opinions after that. Some of the things he is able to do etc, make me wonder if it is a tear. Who knows. I hate seeing him limp though..... He just loves to burn!
Title: Re: CCL UPDATE 9-4
Post by: Christina on January 22, 2015, 09:34:19 AM
It does sound like a tear. Star would run like crazy, play, jump, all the crazy thing a boxer does, but he had bilateral partial tears. He ended up with significant arthritis in both knees because it took so long for him to be diagnosed properly and to have the surgery
Title: Re: CCL UPDATE 9-4
Post by: Bumpy on January 22, 2015, 08:59:51 PM
How long are we talking. That is what I am afraid of but so many thing at once, I have to prioritize.
Title: Re: CCL UPDATE 9-4
Post by: Christina on January 23, 2015, 06:01:48 PM
It took almost a year before Star got his diagnosis. The main thing is you have to keep them calm before surgery, and then after surgery too. I know it's hard, especially with a boxer that doesn't think they are hurt. They are VERY stoic dogs. The surgeries aren't created equal, the traditional surgery is fragile and while it can be successful on large dogs, they cannot have explosive movements for at least 8 weeks. The TPLO is more expensive, but very forgiving. Star jumped a 4 foot xpen three or four days after surgery and he was fine. It of course gave me a heart attack, but his knee was ok. It takes 6-8 weeks for the bone to heal, but during that time you slowly build up the exercise. I completely understand prioritizing. There are two groups on Facebook, TPLO treatment for canines, and Orthodogs. Both are good resources.
Title: Re: CCL UPDATE 9-4
Post by: BoxerWB on January 23, 2015, 09:30:33 PM
Xena's arthritis required supplementation by the time she was two, not horrible but it was making noise. She needed Adequan every 3 weeks by the time she was 8. It took her a month to get diagnosed and I think 6 weeks until surgery.

Physical Therapy after healing is key. Even though he probably looks like he's using both legs, he's likely losing muscle mass in the injured leg and you'll have to work to get it back.