# Surgery for torn ligament or not???



## AllforRudy (May 23, 2010)

Hi,

I'm new to this forum and so glad I found it, because I need some advice!

My sweet Rudy, who just turned 6 this month, ruptured the ligament in one of his back knees. He's limping around a little and seems to be a little depressed and in mild pain. He still wants to run, jump, and play, and go for walks, though, but we've been trying to cut back on his activity.

The vet says he needs to have the new TPLO surgery to stabilize his knee joint. If he doesn't have the surgery, he will always have lameness in that leg and he will be more likely to develop arthritis in the joint. 

Rudy is still so young and active that we wanted to get him in for surgery right away and give him his life back. Even though it will cost $3600-$3900, we planned to go ahead with the surgery anyway, until we found out about the long and difficult recovery time.

The recovery time is 3 months. He would have to be kept quiet all that time. He would be allowed to go outside only for bathroom purposes at first, and then for short walks later. We'd probably have to keep him in a kennel to limit his movements, and he would not be allowed to play with our other dog during this time. He would not be allowed to climb the stairs. 

The problem with all of this is that Rudy is very emotional. He seemed like a normal German Shepherd dog until he was hit by a car at the age of 3 (thanks to the plumbers who carelessly left our gate open). One of his front legs was shattered by the accident, and he had to have reconstructive surgery. Ever since that time, his behavior has not been the same. He's been very nervous, and I've often wondered if he has post-traumatic stress disorder. If anyone in our house so much as raises their voice, he hides under the desk or gets on my lap.

I realize that his nervous problem probably stems from the accident and not the surgery, but the thought of putting him through major surgery with a long recovery period is frightening to me in view of his mental status. If he couldn't sleep upstairs every night like he's used to, if he couldn't play every day with our other dog, if he had to be kept in a kennel, I just don't know how he would survive. I'm worried that during those 3 months of recovery, his mental health would worsen, and his nervousness and depression would increase too much.

I want to do the right thing, the most loving thing, for my precious boy. But how do you choose between what's best for his physical health and what's best for his mental health? 

Any ideas or advice would be tremendously appreciated!!!

--- Holly


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## katieliz (Mar 29, 2007)

just had tplo surgery for my big white boy (18 months old) caesar. the recovery IS very hard and time consuming for the human, and very hard restriction-wise for the dog. gosh i have to say i honestly would not know what to do were i in your position. i would think it was an insurmountable problem if you were just plain UNABLE to keep the dog quiet and/or confined for the three months. but for the dog's mental health issues i just don't know. on one hand, he already has these issues, and maybe confinement in a safe place would not be so traumatic for him, on the other hand more surgery, more hospitalization, another change in his routine...i just don't know. afraid i've not been much help here, i hope/know others will post and give you their opinions. 

i will be thinking about you and rudy tho, and hoping for the best possible outcome for him. please post and let me/us know what you decide and the outcome.

http://caesar-the-road-pirate.blogspot.com


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## JakodaCD OA (May 14, 2000)

I've gone thru knee surgeries with two dogs, (and one husband!) I think it's more nerve wracking on US vs the dog.

My dogs also sleep upstairs every nite, and well, my husband carried them upstairs)

No, they didn't race around and play with the other dogs, but they seemed to realize their limitations, and were ok with that. 

Are you sure he tore the ligament?? If he's limping "a little", it may not be a complete tear..if the ligament is totally shot, he'd most likely be on 3 legs. 

How did the vet diagnose? Did he do an MRI? 

I think I'd go for a second opinion and seek out an ortho surgeon who are MUCH more qualified than most vets. 

My vet however, does knee surgeries atleast once a week, he's been doing them for years, so when my dogs were done, they were both done by him.. Cost was around 1200$, much cheaper than an ortho surgeon, and they both recovered just fine.

I guess the question only you can answer is this, Is NOT doing the surgery going to be better for him in the long run, vs 3 months of discomfort ?


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## katieliz (Mar 29, 2007)

yup diane, the c-monster was definitely on three legs. did your dogs actually have the tplo procedure, there were three or four or more procedures available when i researched it, some that could have been done locally that would have been less expensive, but the tplo was recommended because c was so young and so big. he did go to an ortho surgeon and the cost was a bit more than 4k, but it turned out that not only did c have a torn acl, he had a torn meniscus as well, and also had some post surgery complications.

i've been thinking about this since i originally posted and i do think, if this were my dog, i would have the surgery...thinking in terms of the long run -vs- three months of discomfort. 

our house involves stairs as well, my dh is sleeping next to c's crate, and using the sling was pretty hard on such a big dog. but i didn't feel like there was a choice, c could not bear weight at all. it did help that he is very adaptable and sound mentally, i don't envy the op, sounds like a hard call to make.


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## JakodaCD OA (May 14, 2000)

actually both dogs didn't blow the cruciate,,this was what kinda peeved me about the whole thing,,Vets just can't really tell, how exstensive the damage is unless they do an MRI, (which you might as well open them up it's so costly!) or open them up.

The first one, had smashed his knee cap, on ice, so that was repaired, plus his knee had what they called, "coagulated chicken fat substance",,surrounding,,so it was scraped out..

The second one, had OCD, which was not showing up on xrays (I have weird ailments with my weird dogs! LOL),,basically that surgery was a cleaning out, removing bone fragments,,arthritis build up...

So in the end, tho they ":thought" it was ligament/cruciate tears, those were fine!..

Go figure..

My first boy, he was a weenie, and hubby had to carry him upstairs every nite,,down was ok,,if we monitored.. My second, a female, she was one stoic bitch,,she did it on three legs, while I held my breath and monitored.

God forbid if either of them slept downstairs one nite !!


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## natalie559 (Feb 4, 2005)

Holly you cannot do nothing if you have a torn or partially torn ligament. The leg will continue to degenerate and the condition will worsen. But you have another option other than surgery that you could explore. It's termed conservative management and this approach has healed both of Penny's knees so I am a big believer. 

But it is not by any means a do nothing approach. You must restrict the dog for 8 weeks, no running, no jumping, no stairs, I covered slippery surfaces in my home and leashed her for potty breaks. After 8 weeks or so you slowly reintroduce activity and build from there. CM depends on the build up of scar tissue to restabilize the joint and this takes the initial 8 weeks for the fibrosis to form, then many more months for the tissue to harden and strengthen.

The process quickly becomes second nature for the dog, it is us humans that struggle with the new routine.

There is a wonderful yahoo group that deals with this very issue and has been so very helpful to me and Penny for both advice and support,

ConservativeManagement : Canine Conservative Management

A CM supporting website with info, Dog Ligament Injury-- Is Surgery Really Needed?

The great thing about CM is that you can take the 8 weeks and if properly restricted there won't be in increased chance of arthritis forming, you can explore surgical options and if there is no improvement then you can chose surgery then. There have been great advancements in the tightrope surgery and it is much much less invasive than tplo. If surgery is your choice maybe consider that as an option.


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## AllforRudy (May 23, 2010)

Wow, thanks for the great input! I am so grateful to all of you who took the time to read my message and respond! Rudy is grateful, too! 

Natalie, I will definitely study the sites you recommended. It is good to know that someone else tried an alternative to surgery with their GSD and it was successful. I hope I can do the same thing for Rudy. The less trauma for him, the better.

Holly


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## ZAYDA (Apr 22, 2010)

My 6 year old just had ACL surgery and it cost $2000 for everything, meds, follow up, everything. She was kept very quiet for about 4-6 weeks but at 2 months you wouldn't even know she had surgery. It was rough the first 2-3 weeks but after that it was my job to make sure she didn't do anything to injure the surgery but that was not really a big a deal we just had to keep her from jumping on the bed that was the biggest issue, but we did fine. I don't think it is as bad as they tell you and now that it is nice out you could take him swimming as thats the best therapy you can do.


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## natalie559 (Feb 4, 2005)

Keep in touch with what you decide for Rudy. All the best to you both!


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## katieliz (Mar 29, 2007)

zayda, the cost depends on which surgery you have. there are several different types. i'm thinking that for 2k it was not what's called tplo surgery, which also has a more difficult and longer recovery time because it is more extensive surgery. but it's also sometimes recommended for big, young dogs because it can be more effective for a longer period of time. as i understand it anyway.


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## Brighthorizondogs (May 31, 2010)

I'm in the same boat. I have a dog that was diagnosed last week with a torn CCL at Tufts. I'm very wary of the TPLO and TTA. The vet didn't discuss all the various surgeries? There is TPLO which is where they break the tibia and rotate the piece before securing it with a metal plate and screws. I have been told it can take an entire yr for the dog to fully recover from it. Then there is the new TTA which also involves breaking the tibia and altering the joint, probably the same recovery time as it is very invasive. My worry with both these surgeries is that they can put additional stress on the other ligaments and have heard of dogs occasionally needing more surgery later to fix that. Then there is tightrope which is where they drill holes in the bones and thread through a piece of strong nylon cord and secure it firmly so it doesn't loosen and is supposed to be strong enough not to break, it acts like the torn ligament. Restriction for the first 8 weeks is pretty much the same but after the recover to full function is faster. Some don't recommend it for large breeds but the materials now are supposed to be strong enough. Then there is traditional which I think they attach the bones together with a thick suture then after a while the suture breaks and the scar tissue keeps everything stable. This is not recommended for large breeds.

I'm looking into tightrope. Has anyone had that done? My dog weighs 70lbs and is almost 3yrs old. She already has really bad elbows so I'm nervous about waiting and not doing anything. I don't want her knee gone too. I just really don't like the idea of TPLO or TTA. From what I have read no surgery is better than the other in the long run and of course the vets are going to recommend the most expensive, TPLO and TTA. 

For the moment while I research more into the surgeries and figuring out how the heck to afford the surgery, I'm trying to get a brace for her. I should have the money next week but I might be $200 short. I'll find a way to get it. For the surgery I'm going to need serious help as I'm on disability and had a part time job until last week when it was completed. I don't have any way to afford it. She already wants to return to her normal activities. She's walking on it but constantly limping. She's getting a little stir crazy though. I'm going to take her for a short swim tomorrow and see how she does, it has been 6-7 weeks since the injury but it was misdiagnosed at first so she was only rested for 4 weeks then resumed activity. The vet said there looks to be some degenerative changes in the joint so I don't think we will be able to take a chance an avoid surgery. My 18 month old poodle really misses playing with her friend and her coming with us on the nightly walks to the center of town to sit and chat with my friend and her GSD boy. My poor girl can't play with her boyfriend anymore. Anyways the brace can be used before and after surgery to prevent her from reinjuring the knee while it heals. This should help her get around after as there is no way she can avoid having to go over at least one step every time she needs to go out. To bring her in the main house with me, she will need to climb 3-4 steps. There is one step in the basement. I also cannot keep her from jumping onto my bed. At least it is only about 12" or so off the floor and the mattress is memory foam. I tried to put up a ramp but she wanted no part of it. She is on rimadyl but she's been on that for months anyways for her elbows and she's on a glucosamine/msm supplement.


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