Partially torn ACL-Traumeel injections? Traditional or TPLO surgery?

[LMH]

Has anyone tried Traumeel injections for a dog with a partially torn ACL?

Success?

Adding in:

11yo Aussie, otherwise healthy. 45-50 lbs.

75% tear on LH.

How do you decide which surgery?

I am literally ill-I keep reading about repeated surgeries, high chance of second ACL tearing, painful recovery.

I am reading that conservative management is NOT an option for us.

The cost seems incredible-especially when the likelihood exists for multiple surgeries.

How bad IS the pain after surgery.

I am totally ill.

[Sansena]

No. But have recently had Traumeel injections surrounding some slow-to-heal wounds on my dog’s elbows. Two weeks later, and elbow is nearly all healed. Scabbed over and beautiful, new granulated tissue.

I’ll be following other’s posts as they answer your specific question.

[S1969]

One of my dogs had a medial collateral tear and had a “traditional” surgery since I don’t think TPLO would fix that injury…he had 2 metal plates installed and an artificial ligament formed out of suture material (if I recall correctly).

He was in quite a bit of pain for several days. It was very sad to watch, and the combination of the pain meds and antibiotics made him sick so we had to take him off the pain meds for a short while and that was terrible (but at least he wasn’t puking too).

Same dog then had a cruciate tear in the same leg (perhaps in part due to having the 1st surgery?) and had to have a TTA, which is similar to a TPLO but somewhat different. But the same idea of reshaping the bone.

He was hardly in any pain. Seriously…we called the vet and asked if we could reduce his pain meds in an effort to make him a little less exuberant!

I would do the TPLO in a heartbeat over the traditional surgery. It’s more expensive, but should be a much more reliable fix, and honestly, not very painful.

[Mao]

What is TPLO and TTA?

[LMH]

@Sansena;5850296

No. But have recently had Traumeel injections surrounding some slow-to-heal wounds on my dog’s elbows. Two weeks later, and elbow is nearly all healed. Scabbed over and beautiful, new granulated tissue.

I’ll be following other’s posts as they answer your specific question.

Did you have to go through a vet to get the injections?

[Where_sMyWhite]

Mao,

Google TPLO and TTA.

I can only speak to the Tibial Tuberosity Advancement (TTA) surgery.

Newer technique than TPLO (don’t recall what is stands for). TTA is less invasive to the bone than TPLO. Post surgical pain is less with TTA. Because TTA is newer, not as many surgeons do the procedure.

My Bouv had a TTA. Has not needed any additional surgery on that leg or the other leg. She does have some arthritis in the hock on the leg with the TTA but I think no way to know if they are related or not.

[SquishTheBunny]

“Traditional” is generally a lateral suture technique, that a lot of GP vets feel comfortable performing. TPLO’s and TTA’s are newer techniques, as well as Tightropes.

Lateral sutures are common to break down over time, especially in a younger more active dog, or a dog that is slightly (or more) overweight. TPLO and TTA are both good techniques that have a much higher success rate. Tightropes are the least invasive to the bone (pretty much a glorified lateral suture) but can only be done for dogs with certain bone angles and as a much newer technique, many hospitals are not offering this yet.

In my honest opinion, whether you choose a TTA or TPLO, you are going to get great results with a very short recovery time. There are really no studies to say which one is better, has a faster recovery or has better results, it just depends on which way your surgeon prefers. Either way you choose (TTA or TPLO) You will be impressed with the recovery time!

Best to do your research and if possible go to a board certified surgeon - or one that has had years of TPLO/TTA experience. A good practice will do pre and post op radiographs, post ops are looked at before waking the dog up and if there is ANY chance of pin misalignment or an unproductive angle they will go right back in to fix it. Also,the good surgeons are going to take a look at the meniscus to debride or “release” depending on the injury (if any). Pre-op antibiotics are necessary (20 minutes to 30 minutes before cutting) to ensure maximal antibiotic effect (extremely important when going into the joint). If you are at a good practice that uses careful sterile procedures, the chances of infection are slim. Plate rejection CAN happen, and that is a risk with any surgery. Often in these situations, after bone healing the plate is removed. This happens very rarely.

[SquishTheBunny]

Tibial Plateau Leveling Osteotomy

[Marshfield]

Lateral suture may be a good option

[SquishTheBunny]

[QUOTE=Marshfield;5852412]
Lateral suture may be a good option[/QUOTE]

Usually at least $1000 cheaper, but unfortunatley 50% of them breakdown. However, I agree that due to the age and weight of your dog (pending hes not overweight and has good angles) a lateral suture may be a cheap quick fix.

[allintexas]

If the surgeon is saying that either surgery would be ok for your dog, I would go with the one they have more experience with, and make sure that they are a board certified vet surgeon with plenty of experience, for optimal results.

I have a medium size dog, who was diagnosed with partial acl tears in both knees about 4 years ago. With conservative treatment (Rimadyl) she recovered more or less completely (she went from not wanting to walk to 3 legged to getting around fine) in 3-4 weeks. She does have some arthritis in her knees now, and she is maintained on low-dose rimadyl. I believe that the vet told us that partial acl tears can heal pretty well with rest and anti-inflammatory therapy.

[LMH]

Has anyone had any luck with conservative management?

[SquishTheBunny]

Absolutley, we see quite a few that go for conservative management route. Chances are better for a decent recovery on a PARTIAL tear, if a.) dog is not overweight and b.) dog is not overly active. Most dogs that are treated with conservative treatment do end up developing arthritis, but considering your dogs age I wouldnt be concerned about that. Usually you will see some response within two weeks if conservative management is going to work without complications. By week 4-6 your dog should be nearly back to normal…if not, then the partial tear may have developed into a full tear with meniscal injury that would require surgery.

[LMH]

Zack is definitely a good candidate. His weight ranges from 48-52.

I have cut back his food to get him to the 48 range (also knowing his activity is almost zero). He was 52 at the last vet visit.

He is a really mellow aussie so that is with us.

It is just really really hard watching him ache and struggle. It is also so hard confining him as I walk off with my other aussie.

He seems to know he is hurt-he is not fighting the rest. Thankfully.

We are only on day 3 of “CM” and I am still reining things in-it is so new figuring out what trips us up…for example, he now has to go outside through a different door (only 2 steps as opposed to 4)…things like that.

[fivehorses]

Two torn cruciates here, and two tplo surgeries.

I opted for that since my dog is a lab, very active, a bit overweight, and first one was when she was one, and then she blew the other at 3. She is now 5.

I did not feel I had a choice, since the fishing line surgery most likely would not last as long due to her age, and she’d need another.

TPLO surgery is not fun. After the surgery, the dog is given meds to combat the pain, and needs to be confined to a crate. For the first, I was very hyper vigilant with her. I did it all by the book.

For the second one, she was no longer use to being crated, so in her mind, she thought she was bad. It was awful.
I resorted to sleeping downstairs on the couch, so she would not do steps.
However, she did jump on the couch with me(a no no for surgery) and I just wasn’t as nuts and she healed well.
She was careful, she knew to keep her knee very still jumping on or off the couch. Not that I recommend it.
I did not let her off leash for the 2 months or whatever timeframe it was. That I was strict about, since when she runs, she bolts. On and off the couch, she is better at controlling.

I feel badly for the dog, and worry about arthritis. She has been on cosequin since her first tplo.
Would I do it again, yes, although it would make me sick to think of it.

[LMH]

Thank you for sharing your experience fivehorses.

Were he younger I WOULD do surgery-no doubt.

I just don’t see how he would manage at 11yo.

With both legs torn, he would need two surgeries-and then recovery for each.

No way could he handle dual surgeries.

I hate this-I hate every moment of it. He has to be stalled and left behind-and he has NEVER had to be confined because he is so well-behaved.

Your story is one reason I am doing my best to avoid surgery for him. I can’t imagine the pain and recovery on an older body.

Today was the tiniest bit better-he had no 3 legged steps-just weak 4 legged ones.

It is a learning curve. I am very aware when he needs to get up and assist him as best I can. That helps.

I think avoiding the 4 steps was another big help.

The bed and sofa are still issues but he will allow me to lift him. If he no longer will, I will likely find a way to sleep low to be with him. :sadsmile:

[fivehorses]

I don’t want to scare you off the surgery.

As I tried to explain, for the first one, the vets had me a basket case about not letting her run, jump, crate all the time, etc.
For the second one, like kids, I wasn’t so anxious, and although she didn’t come for walks with me for a couple of weeks, eventually, I let her walk when she started to bear weight. The whole thing was not letting her bolt, as she will do when she sees someone or hears someone(Miss Greeting committee).

It was 2 months to total recovery, probably 2 weeks of serious restraint, and then slowly increasing it, but she was always leashed during the first month or so.

I would look into the suture surgery given her age.
In all truth, if the conservative approach doesn’t work, or she can’t go on walks ever again, etc, then I would opt for the suture or tplo or taa.

Would I do it for my lab at 11, you betcha. My dogs usually live till they are 14 or so, and I’d want those years.
I hope your dog responds to the conservative approach, but remember, life is about quality, not quantity.
I make my decisions mostly based on that, not on how old they are, etc.
Good luck.

[LMH]

Thanks again-I will give this a couple of weeks and reevaluate.

This morning is a wee bit better than yesterday. So long as that trend continues we will hang on.

[MsM]

Slightly different issue, since I had a young dog with luxating patellas, but similar surgical options.
With mine, I tried rest when his first stifle started to go out, but his other then went out and I knew we needed a fix. He ended up having the TPLO on one side and the suture surgery on the other (at the same time).
Based on my experience of one :winkgrin:, the TPLO was a pretty big deal. He was confined pretty strictly for six weeks and then leash-walked only for another month. He did need physical therapy to regain strength. I would try other options first with an older dog.
The suture sugery, OTOH was a fairly minor procedure. He was immediately weightbearing (Good thing considering the state of his other leg!). I have heard similar stories of this being a much easier recovery. This could easily be a good choice for your dog. I would be much less concerned about the surgery and recovery with this procedure.
Wishing you good healing!

[LMH]

Thank you MsM-

I appreciate any information just to gather information.