QuestionMy dog Max is 6 1/2 years old and as we say he lauched himself off the couch a couple of weeks ago and he immediately pulled his leg up and started walking on 3 legs. We took him to the vet who said he had a torn ligament and that he would have to have surgery. He said the ligament was not torn right thru but that it was torn and he put him on anti-inflammatory and pain killers and said lets watch it but he will most likely need surgery. I really don't want to put the little guy thru surgery again as he had a operation for bladder stones about a year and a half ago. He doesn't seem to be in pain he never, cries or yelps even if you press on it. The vet was really pressing on his leg during his examination and he commented how he was a tough little guy because he didn't yelp or try to nip at him. Max only reacted once and all he did was turned his head and leaned towards his leg. What would be your opinion on this. He never cries or yelps and after a nites sleep he's walking around on all fours. during the day he will walk around on 3 legs but not always. Should we wrap his leg? also what would his recovery be like? I would really appreciate it if you could answer my questions.
AnswerThe diagnosis of a ruptured cruciate ligament is made through observing abnormal movement of the joint. A veterinarian will place one hand around the femur and one around the tibia in a precise manner. By applying pressure on the knee, the veterinarian will feel the bones move abnormally in what is called a 'drawer sign.' It is called that because the movement of the femur in relation to the tibia is similar to pulling and pushing in the drawer of a cabinet. If an animal is in a lot of pain, or very nervous, the muscles near the knee may be so tense that they prevent the drawer movement from occurring. If a veterinarian suspects a ruptured cruciate ligament in a dog but cannot elicit the drawer sign, the dog may be heavily sedated to relax the muscles and then re-examined for the drawer sign.
A device, called the 'DGY2000,' has been developed by the University of Wisconsin School of Veterinary Medicine to detect stretched or partially torn ACLs. In these conditions there is often insufficient joint laxity to detect using the procedure described above. The DGY2000 consists of a platform with two moving pieces. The dog's leg is strapped onto the platform and the femur is held in place while a small force is applied to the front and then the back of the tibia while radiographs (x-rays) are taken. An exact measurement of the amount of laxity in the joint can then be determined from the two radiographs. Earlier diagnosis and a chance to stabilize the joint before total rupture of the ligament occurs has the potential to help prevent pain and arthritis in dogs.
Treatment of a ruptured cruciate ligament
If the ligament is completely torn, the dog (especially a large dog) is generally treated with surgery. There are several different methods used to repair the knee joint when an anterior ligament is torn. They all entail using synthetic suture material, or a portion of adjacent fibrous tissue to basically re-create the ligament. The suture or tissue is made to extend from the outside lower portion of the femur to the inside upper portion of the tibia. After the surgery, the dog must be strictly confined for 2 weeks. By day 10 after surgery, most dogs touch the toe of the affected leg to the ground and will start bearing minimal weight on the leg. Once the dog has reached this point, it is often very difficult to keep the dog quiet until complete healing has taken place. The dog generally has to be restricted to only leash walking for a minimum of 4-6 more weeks; the exact amount of time depends upon the extent of the injury and the corrective procedure performed. This exercise is extremely important to prevent the surgical correction from tearing. The veterinarian's instructions regarding exercise during the recovery period should be followed very carefully.
In some instances, if the cruciate ligament is only partially torn, the animal is older, has medical conditions which could affect healing, or the owners will not be able to keep the dog quiet for a number of weeks after surgery, medical treatment is used. This basically consists of controlling the dog's activity for 8-12 weeks. Swimming and low-impact exercise (walking) may be done on a controlled basis, as instructed by a veterinarian, to keep up muscle strength. If overweight, the dog should be placed on a reduced-calorie diet. Nonsteroidal anti-inflammatory drugs (NSAIDS) such as carprofen, etodolac, meloxicam, deracoxib, buffered aspirin, or other medications are often used to reduce inflammation in the joint and relieve pain. (Do NOT give your cat aspirin unless prescribed by your veterinarian.) Products containing glucosamine, chondroitin, perna mussel, polysulfated glycosaminoglycans, and other chondroprotective agents are often recommended, as well.
If a dog with a ruptured cruciate is not treated, severe degenerative joint disease (arthritis) usually occurs. In addition, because the dog favors the affected leg, he will generally put more weight on the unaffected leg. It is not unusual for the dog to rupture the anterior cruciate ligament on that leg as well because of the increased stress on the leg.
Prognosis
If the dog's exercise is restricted as instructed, and overweight dogs return to normal body weight, the prognosis is good. Depending on the amount of injury to the knee and length of time between the injury and correction of the problem, degenerative joint disease may occur as the pet ages.
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In my opinion if this is his injury he will be better to have surgery .
