Vet advice please -cruciate ligament in a Schnauzer

[S6 Devil]

I have a 5 year old miniature Schnauzer (Mutley) who suddenly became lame in his rear right leg after trying to mount a Staffy. My initial thought, on doing some research was cruciate ligament. He wasn't putting any weight on it but didn't show any obvious signs of being in pain (apart from not putting weight on it).

I took him to the vet who examined him. He advised that the drawer sign for a a cruciate tear was inconclusive. He gave some anti inflammatories, even though there was no sign of inflammation and advised restricted activity for a week and to come back for x-rays if there is no improvement.

If it is a partial tear in the cruciate ligament, I have read that the ligament won't repair but the scar tissue that eventually develops will stabilise the joint.

In the week after the visit to the vet, he seemed to be making progress and was weight bearing on our short leaded walks but still carrying the leg at times. I carried him up the stairs and lifted him onto the sofa, bed and into the car to reduce any stress to the joint. Luckily I was on 2 weeks annual leave so was with him nearly 24/7. The anti inlammatories/pain killers may have made a lot of the difference.

I didn't go back to the vet as I decided to try conservative managemnt (restrictive activity) rather than the anticipated advice of surgery. There is a lot of split opinion on the internet about surgery/conservative management which is where my quandry lies.

Now, 4 weeks later Mutley seems to have improved a little but not as much as I had hoped. He walks fairly normally on it during the day. He gets 3 x 5-10 minute walks a day mostly on grass. He can stand on the leg whilst having a pee. He isn't allowed to run, jump, climb stairs etc. However in the evening he isn't comfortable and can't put weight on the leg. There is some muscle atrophy which I guess is to be expected.

I do massage the leg and use a hot water bottle on it at night. I am waiting to speak to a local hydrotherapy centre tomorrow as this could well help with the atrophy. Some non weight bearing exercise seems a good idea.

Is there anything else I can do? Am I walking him too much? I know it can be a long healing process and conservative management may not work. I really don't want to go down the surgery route if I can help it. I hate seeing him struggle.

Any thoughts or advice?

Here he is:

Edited by S6 Devil on Monday 8th October 00:04

[Bradgate]

Poor little chap .

A proper diagnosis is essential before treatment decisions can be made. At the moment, no-one knows whether or not surgery is required because the necessary investigation has not been done. When you have all the information, you can then decide what course of action is best for the dog. If your own vet is not experienced or confident in orthopaedic surgery, she should be able to refer you to a specialist. I hope you are insured.

Cruciate surgery is usually very successful in dogs, my Lurcher had his fixed and was as good as new after his recuperation period. He didn't enjoy the enforced rest, though.

[bexVN]

I'm sorry to criticise your decision but you should have gone back to your vet when they asked you to.

Healing by itself is usually only suggested if surgery is too risky for other reasons such as age, other health issues etc. Otherwise there is a higher chance of chronic lameness and more arthritis at an earlier age.

It is still possible to have surgical repair but the scar tissue may add to the difficulty so you need to chat to your vet about the best option now.

It may be that hydrotherapy/ physiotherapy will benefit for the healing process.

Sorry the leg hasn't healed so well I hope it's ok soon.

[S6 Devil]

bexVN said:

I'm sorry to criticise your decision but you should have gone back to your vet when they asked you to.

Thanks for the reply. The vet advised that I come back for x-rays

S6 Devil said:

if there is no improvement.

There has been improvement hence I haven't gone back...yet!

Bradgate is right, no conclusive diagnosis has been made, as yet. I think I need to get him X-rayed to get a definitive diagnosis.

If it is a cruciate ligament tear, there seem to be so many conflicting views on approaches to treatment. Many advise conservative management (restrictive activity) particularly for small dogs, 25-30lbs which Mutley is. Others advise that surgery is the only option.

I would rather try the non surgical method first.

Correct me if I'm wrong but by the look of TPLO and TTA, the bone has to be broken, so any scar tissue that has built up in the period of conservative management (restrictive activity) is likely to be removed anyway.

CCL replacement surgery looks like it relies on the scar tissue that forms around the artificial ligament.

I will make an appointment for X-rays tomorrow and discuss the options with the vet.

And no,unfortunately I don't have insurance but will find the money for whatever is needed.

Edited by S6 Devil on Monday 8th October 04:00

[bexVN]

There are several methods for cruciate surgery, orthopaedic surgeons would probably cringe at the thought of the nylon suture technique but I' ve seen it work very well in many different breeds and is more reasonable cost wise.

Yes small dogs can still need the surgery, they don't always respond to rest etc.

I think you are right, xrays first. After that discuss options with your vet.

I do highly recommend your ideas on hydro etc, a good place will know what to do whatever the presentation of injury.

All the best

[S6 Devil]

Thanks Becky.

I've just taken him for his morning walk. There doesn't seem to be any stiffness and no limp whatsoever. His stifle seems stable and he is putting full weight on it when having a pee (and he can pee for England).

I just don't understand why he seems fine throughout the day but at night limps, holds the leg up and doesn't put weight on it.

[bexVN]

Probably because he's had chance to rest it overnight but as the day goes on more and more pressure has been put on it so it becomes sore.

Doing the best for our four legged friends is hard isn't it, they don't make it easy!

[S6 Devil]

I spoke to the vet today. He advised that as he is making progress, to continue with the restriction and start him back on some anti inflammatories. He gave me 2 weeks worth twice daily. I am going to just give him one a day in the evening for a month and see how he is.

The vet advised that if he still isn't right in 3-4 weeks then to go back to see him and he will do the x-rays and we can discuss the next step. Not cheap though at bt £250-350.

He advised hydrotherapy would be a good idea so that is on the cards.

Mutley has put on some weight(600 grammes) so I am going to cut his treats right back.

Fingers crossed for the next month.

Thanks for your advice!

[bexVN]

Sounds promising. I didn't think to ask you about pain relief. I assumed the vet would've prescribed some last time.

I hope he can miss out on surgery but if it doesn't respond then it's the best option for long term.

All the best to you both (lovely looking dog btw )

[S6 Devil]

Just a quick update.

After 5 or so months of restricted activity, he has made great progress and is back to his old form. No limp, full range of movement, muscle mass back to normal and all excess weight gone. He is now walking miles, running, jumping and generally enjoying life to the full.

I finally got to sleep in a complete bed, remove the stairgate and allow Mutley to jump up on the sofa and into the car.

What a relief!

Thanks for all the advice.

[bexVN]

Aww that's a great result. Hope he doesn't cause you any more concerns with his legs, they can be such a worry to us!!