Found out my dog has a partial ACL tear. He is only lame on it when he is active. Trying to find alternatives to surgery and I found cold lazer and prolotherapy injections and I was wondering if others had any luck with them.
I looked into prolotherapy for my shepherd when he needed a TPLO on his second knee. It was going to be at least as expensive as the TPLO and the prognosis wasn’t as good. My vet said it was really only appropriate for dogs that were not good surgical candidates.
Check also on TTA vs TPLO. My Bouv had TTA. It is still bone invasive from a recovery perspective, much less painful IMO.
A partial tear may be healed with cold laser therapy and/or underwater treadmill therapy. See if you have a CCRP in the area.
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[QUOTE=SarahKing;7481397]
A partial tear may be healed with cold laser therapy and/or underwater treadmill therapy. See if you have a CCRP in the area.[/QUOTE]
thank you! the surgeon said that the laser therapy does not work and really pushed for surgery. I just cant justify surgery since my dog is 90% sound. Laser therapy seems to work good on horses and dogs. What is a CCRP?
You can’t actually “heal” a tear. What you can do is build up enough supporting muscle and scar tissue to make the knee stable again.
With that said, a partial tear almost always becomes a full tear, it may be tomorrow or it may be a year from now. But in the mean time the joint is having damage inflicted upon it. So when the full tear occurs surgery is not as successful due to the pre-existing arthritis and scar tissue.
** and I’m a big fan of both cold laser and rehabilitation techniques. I worked with a CCRP (Certified Canine Rehabilitation practitioner) for several years and some of the dogs we got back to 100% were amazing.
We see a LOT of dogs like yours through our hospital. Surgery generally does give you the best results (with the least chance of reinjury as well). However for dogs who are comfortable conservative management is often recommended first. Strict rest with eventual monitored rehab therapy is recommended. Cold laser can help with inflammation, but is not going to do anything with the actual tear in the ligament. It is important to keep inflammation down as much as possible, as the progression of arthritis in conservative vs. surgical patients is much higher as the inflammation process is more chronic.
FWIW, I have seen well over 2500 cruciate dogs, for the ones who choose conservative treatment (with mild signs like your dog), I would say about 50% return to almost normal function and 50% persue surgery at a later time (due to further strain or non-healing). I think its worth trying conservative for 12 weeks, if after 12 weeks with no significant improvement your dog is likely more a surgical candidate. Conservative management is tough, but usually worth it if you stick with it! I would also be in contact with a CCRP.
My bad anxiety dog tore both knees a year apart. She cannot be crated or confined for sx rehab or to go in for laser therapy. The surgeon had me put her on a short does of car proven for inflammation. He said to rest her…she would have good and bad days. Give her a little more exercise on the good days. I only took her out for short potty breaks and no stairs. She was also stared on Adequan, Traumeel, and Tramadol. Already on fish oil and a joint supplement. She is a bit bow legged, but he was thrilled with how she healed. Sx is elective. She is 13 and plays and wrestles with my younger dog nonstop.
I see this sx day in and day out as well and see dogs do great. I just knew that this dog couldn’t handle it.
well, it has been fairly chronic for 6 months. We did duramax for 4 weeks and he looked perfect while on it. He is now off the duramax and he is 90% sound, but if he runs around on it he is quite sore.
3 vets have seen him and gave me different opinions, so frustrating. My local vet recommended laser but said he is fine and the “drawer test” is normal (Keep in mind she is a very local yokel vet), the specialist orthopedic surgeon said he has a partial tear in one stifle and looks good in the other and recommended surgery. He said that laser and steroid injections are an option but they rarely work. The 3rd vet does orthopedic work only looked at his X-rays and said she sees changes in BOTH stifles and would have to examine him to advise a plan.
I don’t want to keep having him evaluated though bc every time a vet does the drawer test he is very sore.
well, it has been fairly chronic for 6 months. We did duramax for 4 weeks and he looked perfect while on it. He is now off the duramax and he is 90% sound, but if he runs around on it he is quite sore.
3 vets have seen him and gave me different opinions, so frustrating. My local vet recommended laser but said he is fine and the “drawer test” is normal (Keep in mind she is a very local yokel vet), the specialist orthopedic surgeon said he has a partial tear in one stifle and looks good in the other and recommended surgery. He said that laser and steroid injections are an option but they rarely work. The 3rd vet does orthopedic work only looked at his X-rays and said she sees changes in BOTH stifles and would have to examine him to advise a plan.
I don’t want to keep having him evaluated though bc every time a vet does the drawer test he is very sore.
If its chronic for 6 months, it doesn’t sound like the healing process you are using is getting him past this one final hump. NDAIDs are wonderful and can really help, but long term use can cause liver and kidney failure. However, if financially you just cant do surgery then NSAIDs might be a good option for your dog.
Board certified surgeons generally have far far more experience in evaluating cruciate ligament tears than regular vets. I personally would follow the advice of a boarded surgeon…but there are certainly other options and if you feel your dog isn’t painful it isn’t going to hurt to explore them. It would concern me that he was painful after the drawer test. A normal knee should not be painful after.
As for the third vets comments - radiographs will NOT show you a cruciate tear. They will show joint effusion. Its common with dogs who tear one knee, to have difficulties at some point with the other. However its also common for effusion to appear in the knee (stifle) of the healthy leg as it is taking a the brunt of the weight bearing.
Gold standard repair is TPLO, TTA or Tightrope with arthroscopic evaluation of the joint and the meniscus (often will need releasing!). Cheaper surgical alternatives are lateral sutures, which often are recommended in smaller or lean/less active dogs. Continued physiotherapy could help as well, I would go to an assessment with a CCRP if you do not choose to persue surgery, as they can give you their opinions on whether they feel they can help your dog. Considering its been 6 months already, and your dog isn’t terribly sore, and if finances for surgery are tight, starting with the CCRP may be the best option 
Don’t forget you have a young/healthy dog with a full life of (hopefully!) running around ahead of him in time. 
Thumbs up for laser
My 12 yr old Mastiff had a slip on some ice on the 10th. The next day she slipped two more times. Then she was unable to rise or walk herself. We took her to the ortho surgeon for evaluation, as she could not walk on that paw - kept knuckling over on it. (Happily she has a Blue Dog, Help Em-up harness so DH was able to practically carry her to her appointment.)
She pulled a groin muscle and partially tore the cruciate on the RH. She also has IBD and a history of ulcers, so medicating her is tricky. Due to her age, she is not a surgical candidate.
She went to the ortho for laser twice last week, and once so far this week. We have only gotten 5 Rimadyl, (which are not full doses for her size), plus some amantidine, and tramadol into her, and obviously rested her. I believe the laser is helping the most.
She will also go back to rehab when she is stable enough. She has gone already, due to arthritis in her back and loss of muscle in her hind end. There she gets massage, laser, range of motion exercises, and water treadmill.
Today she is driving me crazy. She still sometimes needs help getting up, but once up, is getting around fine. She wants to go for a walk-about around the farm and I have to keep denying her request.
Two years ago she pulled a bicept tendon. We did I think 6 laser sessions for that and then she was sound on it.
What Squish said. In those 6 months, was there very strict crate rest?
actually, he started off lame on the right 6 months ago, healed and then recently in the last 6 weeks has been lame on the other leg. I cant keep him in a crate. He goes crazy! I do keep him quiet, off the couches and I carry him(hes 75lbs) down the steps.
He is on Pentosan, but I wonder if he should be on anything else for inflammation. He looks totally sound walking but when he is still you can see that he takes the weight off the bad leg.
Im not against surgery for financial reasons, it just sounds so drastic to break a bone and put a plate and screws in and also my friend had a terrible with her dogs recovery.
I have seen two dogs heal without surgery, one was given a supporting brace, the other healed on it’s own, crated during day and night (with breaks of course), carried his leg quite a bit and was given a kibble with glucosamine and chondroitin.
I thought you were saying 6 months lame on one leg, not one then the other. If he hasn’t been on NDAIDs for leg #2, I would give that a try + physio (including laser, it can be useful for decreasing inflammation). Your #1 goal is to decrease inflammation. If THAT doesn’t solve the lameness, then its likely a chronic cruciate injury.
okay, I will. THANK YOU:) A million times
Six months ago I was completely pro-surgery for cruciate repair. Now, having a young Boxer experiencing complications in the repair of her second knee, I would encourage anyone to really consider the pros and cons of surgery. The end of our tunnel is not in sight and the ultimate result may be a second surgery to go in and remove her implant. Not any particular thing to blame - she developed an infection at the surgical site. Yes, we were religious about oral antibiotics and no, she did not lick, chew, or otherwise investigate her incision. Somehow a “bug” got in there. This procedure was done by an orthopedic vet who only does knees and he is also a family friend. I don’t question his protocols in any way and she even had a platelet rich plasma procedure to aide healing. The surgeon is as frustrated as I am that this happened.
Lesson learned: out of our four repaired knees, one had complications. You know the waiver you sign prior to surgery that talks about rare instances that probably won’t happen but you have to sign it anyway? Yeah. Those rare instances do happen to someone sometimes - just ask my dog!
[QUOTE=Lizrd;7485767]
Six months ago I was completely pro-surgery for cruciate repair. Now, having a young Boxer experiencing complications in the repair of her second knee, I would encourage anyone to really consider the pros and cons of surgery. The end of our tunnel is not in sight and the ultimate result may be a second surgery to go in and remove her implant. Not any particular thing to blame - she developed an infection at the surgical site. Yes, we were religious about oral antibiotics and no, she did not lick, chew, or otherwise investigate her incision. Somehow a “bug” got in there. This procedure was done by an orthopedic vet who only does knees and he is also a family friend. I don’t question his protocols in any way and she even had a platelet rich plasma procedure to aide healing. The surgeon is as frustrated as I am that this happened.
Lesson learned: out of our four repaired knees, one had complications. You know the waiver you sign prior to surgery that talks about rare instances that probably won’t happen but you have to sign it anyway? Yeah. Those rare instances do happen to someone sometimes - just ask my dog![/QUOTE]
oh my gosh, Im so sorry Lizrd! My friend had a very bad experience with her boxer’s surgery as well. He ended up needed 3 separate surgeries. THanks for sharing
there are other methods out there besides TPLO for surgically repairing CCL tears in dogs. Personally, I’d stay very far away from TPLO, because it is, as you say, incredibly invasive- cutting bones, inserting metal plates- and it has NEVER been proven to give better results than more simple surgical repairs. Plus it has the potential to have some very horrible adverse events.
The surgical method that is currently looking the best in the literature is called “tightrope”. If you can’t find anyone that does that, I’d opt for a simple fish-line repair followed by physical therapy.
the longer you let the dog run around on an unstable knee the more likely the dog will develop serious arthritis in the joint later. “conservative management” generally involves bracing or externally stabilizing the joint in some other way (look up CCL braces for dogs, maybe you could try one) and strict rest for some weeks.
