ACL/CCL Injury Question

[Where_sMyWhite]

I know physically what the difference is; I had it explained to me before my dog had her TTA. My girl had her TTA at 4 and lived another 7 years after that without another problem.

I liked the TTA better as it is a tich less invasive to the tibia.

Was wondering more why the surgeons might recommend TPLO over TTA unless it is because TTA is maybe slightly more difficult a surgery?

The surgeon that did mine felt, at the time, that the post surgical pain in the dog was less with TTA than TPLO. TTA does require the same type of post surgical confinement and care as TPLO.

[Horsegal984]

One of the advantages of TPLO over TTA is that if the implant becomes a problem it is easier to remover the TPLO hardware.

Other things that factor in are surgeons experience and preference, as well as the dogs anatomy to begin with.

[SquishTheBunny]

Both Tplo and tta are similar types of procedures. Most consider less “risk” with a Tplo because plates can easily be removed should the implant fail or infection occur. Tta revisions are far more complicated than Tplo revisions. However both have low failure rates in general and qualified surgeons and medical staff can greatly reduce the chance of infection…however it can happen regardless of precautions.

[pharmgirl]

My almost 12 month old pup just had TPLO surgery two weeks ago (she actually tore it as a ~15 week old pup lawn darting across the deck, but we had to wait until she finished growing to to the surgery).

I went to a specialist that from what I have read is one of the best, and I love him (and I am picky). I went to Dr. Sherman Canapp at VOSM http://vosm.com/. I know of others that have gone here and been very pleased, as well as others that went elsewhere and did not get the follow-up communication and care they needed from the first vet and went to VOSM for their rehab and follow-up care.

I discussed with him TPLO vs. TTA, etc, and he said that he still preferred TPLO b/c long term outcome was still better in TPLO patients (and he does lots of agility dogs, police dogs, field trial, etc, so I know returning to peak performance is important to him). FWIW I did find this about long term outcome (maybe not enough of a difference to matter, but still): http://www.ncbi.nlm.nih.gov/pubmed/23432511

I would definitely say that some type of surgery is needed for your dog. It’s like with humans when they tear their ACLs- everyone I know that has hurt theirs has been told to get surgery if they expect to do anything remotely physical. And, of course, rehab is going to be extremely important to returning to the previous level of function. From what I have heard from others that had it done on their dogs, and from what I’ve read, water therapy is extremely beneficial to building back the strength and muscle after surgery. And, it has the benefit of strengthening the other leg decreasing the chances of the CCL in the other leg tearing.

[asb_own_me]

Regardless of the procedure you end up choosing, you DO need to choose a specialist and you need to do it now.

Waiting will ultimately increase the effects and severity of the arthritis your dog will suffer down the road.

Your groomer is not a veterinary surgeon, nor was she privy to surgery details or post-operative care and rehab details of any of the dogs she said she felt “weren’t right”. I call bullshit.

Get your obviously loved and well-trained (your competition partner!) to a specialist ASAP. Schedule the surgery to fix this and follow all post-op care and rehab instructions TO THE LETTER. You will not regret it.

Signed,
Someone who has been through four ACL surgeries and a cervical spine surgery with her dogs - successfully.

[knightrider]

Thanks all… this has been quite the learning experience. Surgery is scheduled for Tuesday…I’m a nervous wreck although she is in the hands of one of the top surgeons in our area.

I actually contacted VOSM and loved their office. Seriously considered going there but already had this set up and its a lot closer to me.

My mobile vet who originally saw her stopped by last night and he thought she had about 12% atrophy already and encouraged me not to wait too long if i waited. She is using the leg and is putting weight on it when walking, but from everything i’ve learned her leg will be a lot worse off with arthritis issues and such if I leave it alone…that and if it gets weaker she will have a longer recovery.

Really appreciate the advice here. I was doing everythign I could to figure out a way to not do surgery. Not just because of the money but because I wrongly thought with time it would be ok…

I called the surgeon last night and left a voicemail asking him to switch over to TPLO. The vet at the office who did the xrays actually encouraged me to do that surgery over TTA and she contacted probably the best surgeon locally who does agility and he would only suggest TPLO for his own dogs…so that is our path…

Surgery is in the morning and then I will be home on Wed with her… Wondering if I should stay home on Thurs and/or Fri… what have you all done? Is it necessary? I think I can get away with being home on Thursday, but not sure about Friday…

[MsM]

Ask your vet first. If it may be an issue, they might keep her an extra day and then you could just take off Friday if necessary.

If you have a secure, small spot for her recuperation, she should be fine being alone for 8 hrs or so as long as you can manage her medications. You want her to rest anyway! Just make sure she is okay with her cone and you have really made sure she can’t get stuck or try to get up on anything. If at all possible, come home at lunch for a potty break.

[knightrider]

I have a crate for her, but did not want to put her in the crate until I’m sure she can get up on her own without assistance. I’m sure she will be able to, but in case she can’t i have a plan to block some furniture in with a section of carpet in a small box area. I can easily move the couch if I need to get in but she shouldn’t be able to get out.

Once I’m satisfied that getting up is not an issue, I will put her in the crate during the day…so I’m hoping she will be able to get up/down without assistance after Wed or Thursday…

[pharmgirl]

How big is her crate, and is there something in there (like a dog bed) that she has to give her traction? Mine could get up ok pretty well but not on very slick surfaces at first.

Mine normally go in there when we’re not home, but her regular one didn’t let her truly stretch out as much so we got the next size up for during this time (and for her to sleep in b/c she likes to jump up onto the bed at night and that is a big No-No so she must be confined for sleeping as well). Is she inclined to jump onto any couches? If so, I do not suggest using furniture as blockades- it’s amazing how motivated they can be at times… (ask me how I know).

BTW, if she is a higher energy type (and my guess is that she is due to the whole agility thing), then you will want to make sure you have sedative meds handy to use when she starts feeling better (we’re using trazodone and it works great). This may be of special importance if you have another pet in the house that she may want to play with. If she’s by herself, she may stay a bit more calm, but my pup wants to play with her older brother (and he doesn’t help ). When we picked ours up after surgery, I asked for it and they said it was only as “last resort” (she’s a freakin’ puppy, what do you think?!). Luckily I had some from pre-op time (she’s an 11 month old puppy, we were trying to prevent her from damaging anything else before surgery!) and I needed it by day 4 post-op. And then I had to increase the dose by day 6…

[sockmonkey]

I just want to add a couple of things. 1) your dog WILL get arthritis. It is inevitable. But keep working your dog, use joint supplements, keep the weight down, do what the vet says, and you can prolong the time before it gets bad. 2) why on God’s green earth do people listen to their groomer’s for veterinary advice? I know that when I’m feeling ill I do not go and ask my hairdresser what she thinks I should do and she’s seen lots of people. It never made sense to me. People come in to see me and tell me that the groomer says their dog has this and that. The same with breeders. My colleague and I both want to retire and become breeders so that when we sell a dog and tell the new owner what to do and their vet says “What vet school did your breeder go to?” they can say “University of Pennsylvania.” What a kick that would be. I’m not being snarky. I’m just trying to be funny about it. Please don’t be offended.:D. Good luck with your dog.

[SquishTheBunny]

Good choice. We have done several general purpose police dogs with the TPLO method and all jabs returned to full service. It WILL be a minimum 12 week rehab but in the long run your dog should regain very close to normal function

[knightrider]

Thanks for the responses… Tomorrow is the big day.

To answer the question about the crate, I do have a big dog bed in there so she will be able to get up…it should have some traction. But before she goes in there, I’ll be setting up a spot in the house today for her to be comfortable.

Why do I listen to the groomer? Can’t speak for others and I agree she’s not a vet. I am one to typically treat my animals ailments conservatively if they can be comfortable first before jumping into things…usually. In my dogs case, I’ve been questioning things.

I’m questioning this not only because its a lot of money but also, she’s improved soooo dramatically. And she feels good. The past week or so she’s been putting more and more weight on this leg. And the average person looking at her doesn’t see the limp I see. I know that if I don’t treat this, it will probably get worse and tear completely, but there is that sliver of doubt in my head that sees so much improvement that its hard to see her doing really pretty good for week 5 (or 6?) and then know that tomorrow night when I bring her home she’s going to be in rough shape. Thats why I"m doubting it right now! Realistically I know that the sooner i get it done better off we will be and I know the percentages of blowing the other one… but, but, but… she’s doing so so well now.

Its tough to rationalize at times. There is a part of me hoping that I’ll take her in tomorrow and they will say I should give her more time… but realistically i know that is not going to happen.

What I’d like to know is what happened to all those dogs before surgery like TPLO was invented? How bad were they? And the other niggling thought is are the vets just trying to make money? I know I know, that is not really the case, but I question everything…thats my nature. So of course all these thoughts come into play…

I’m still doing this though! Tomorrow she goes in at 8am

[SarahKing]

She should be weight-bearing the day after surgery. Are they sending home a sling? Do you have access to a CCRP?

[knightrider]

That I don’t know…shoot didn’t think to ask about the sling…I do have access to a couple rehab places but think I’ll go to one that I’ve already talked to

[S1969]

[QUOTE=knightrider;8164003]
What I’d like to know is what happened to all those dogs before surgery like TPLO was invented? How bad were they? And the other niggling thought is are the vets just trying to make money? I know I know, that is not really the case, but I question everything…thats my nature. So of course all these thoughts come into play…

I’m still doing this though! Tomorrow she goes in at 8am[/QUOTE]

Well, they have a repair surgery, but I don’t believe it is as effective as TPLO- especially on larger dogs. So my guess is that many of the dogs before TPLO never fully recovered even with surgery, and were arthritic at an early age. Those that don’t have surgery are atrophied and arthritic.

Having been through the TTA surgery - it was amazing. I never felt like it was a money maker by vets - it turned my limping dog into a running machine again. And, very little pain (actually, be careful about this) - we had to really really really try hard to keep him from jumping - even out of the car after surgery. He felt great compared to his pre-surgical knee.

Definitely discuss rehab – especially the non-injured one. Find out what you can do to protect that one while the repaired one heals…and then look into rehab options for both knees so that they stay strong and healthy.

Good luck!!

[knightrider]

well thank god I took her anyway and over rode my doubts and the negative comments. Surgeon examined her under sedation and said 100% tear. She should be getting done soon so hopefully all is well. He thought that once the swelling subsided she started using it again…and compensating/making do.