Dog. Repair or Write off?
Discussion
scdan4 said:
& others: Not so useful here - she's a young, very energetic dog and is already miserable from 3 months of rest. Her love of running and boundless energy is a chief reason this is an issue / question in the first place. To "manage it", or attempt to "holistically" repair it, whilst probably an option on a myriad of dogs, it won't be on this one.
For her, in this case, that degree and length of restriction would be cruel.
And this morning I got the girl up, she ran downstairs.
I appreciate that on a bigger, highly energetic dog you are going to struggle with conservative management but you are going to have to restrict her for at least a couple of months post op anyway. For her, in this case, that degree and length of restriction would be cruel.
And this morning I got the girl up, she ran downstairs.
You say it has been 3 months already but you let her run down stairs which is the worst thing she can do as it puts so much stress on the joint.
Restriction doesn't mean stopping all activity it just means you stop her running and jumping particularly on furniture and up and down stairs.
I didn't restrict my dog properly to start with as I didn't really understand the implications of allowing him to jump on and off furniture etc. Since putting the mattress on the floor and a stairgate on the stairs and carrying him onto the sofa, up the stairs and into the car, he has made amazing progress.
You need to get her on a joint care supplement such as Vetzyme high strength ASAP and an anti inflammatory, I use Yucca liquid.
Just think about trying PROPER restriction for 8 weeks to see if she starts to improve.
Good luck!
The problem with the above approach is the long term. She may heal and improve but her ligament will be severely weakened and at risk of going again when older, With good surgery the ligament will be stronger than before, the surgeon will remove any unwanted debris in the joint (which will otherwise increase pain and discomfort) and hopefully as a result provide a stronger joint incase the other ligament in the other leg goes.
Cruciate surgery is common surgery esp for a referral vet, there should be no complications more than any other surgery/anaesthetic so if cost can be covered I'd have to say that it should be done.
I do agree it's not the right move for all dogs (eg elderly, other health problems, small breeds etc)
Cruciate surgery is common surgery esp for a referral vet, there should be no complications more than any other surgery/anaesthetic so if cost can be covered I'd have to say that it should be done.
I do agree it's not the right move for all dogs (eg elderly, other health problems, small breeds etc)
- ****OP look into physiotherapy/hydrotherapy for your dog post surgery. I would very very strongly recommend hydrotherapy as soon as the initial wound has healed. Can't emphasise this enough. See if your vets know a good one. It'll be worth every penny for a quicker recovery!*****
Edited by bexVN on Thursday 22 November 14:29
bexVN said:
With good surgery the ligament will be stronger than before,
No matter what surgery she has the ligament will not heal. I have never heard of the type of surgery the OP's vet has described and belive you me I have done some research. I am led to believe that:Edited by bexVN on Thursday 22 November 14:29
There are basically two surgical strategies.
1) Hold the bones in position at the joint with a surgically installed restraint which will allow near-normal movement of the joint while preventing improper movement. Tough fibrous scar tissue will then build up around the joint. This scar tissue will provide long-term stability. These are called 'Conventional' or 'Traditional' surgeries.
2) Cut the bones and reposition sections of the bones using metal plates or implants to alter the relationship of the bones to each other, changing the tibeal plateau angle at the stifle joint. The procedures used to do this are TPLO and TTA.
-- Some vets will recommend TPLO or TTA for most or all dogs with ligament injuries. These very invasive bone altering procedures have much greater risk of serious complications than conventional surgery but do not have superior long-term outcomes.
There are dozens of intracapsular and extracapsular variations of conventional stabilization. 'Extracapsular' means outside the joint. 'Intracapsular' means inside the joint. Extracapsular procedures are generally recognized as the best choice among the various conventional procedures in most cases.
Extracapsular stabilizations usually use heavy suture similar to nylon fishing line attached to the bones outside the joint to hold the bones in place. The theory behind all conventional surgeries is that by holding the bones in place at the joint in a way that allows near-normal joint movement, the surgical stabilization will provide conditions under which the body can begin building up the permanent scar tissue stabilization.
For many years vets have used monofilament nylon orthosuture (similar to fishing line) drawn tight and secured, to stabilize the joint in most extracapsular procedures. There are now stronger materials available, but for most dogs the standard nylon orthosuture is still a good choice. For large high-energy dogs you will want to consider other orthosuture materials which are described lower on this page. The installed orthosuture strands will provide temporary stability while over a period of months the dog's body builds up tough fibrous scar tissue which will permanently support the joint. The surgically installed orthosuture will always stretch or break after several months. It is not meant to be a permanent stabilization. Its function is to give the body the temporary stability it needs to get started on establishing the permanent stabilizing scar tissue. Whether or not surgery is needed to get a start on re-stabilizing the joint, ultimately it is the dog's own healing process which provides the new scar tissue support for the joint.
Unlike human ligament surgeries, dog ligament surgeries do not re-attach or permanently replace the ligaments. Some vets will fail to make this clear to their clients, leading people to believe that the surgery is a 'repair' in the sense that the damaged ligaments will be restored to function or permanently replaced. Ironically, a statement that some vets use in recommending surgery is "Those ligaments won't repair themselves." It's true that ruptured ligaments don't repair themselves, but it's also true that the surgery the vet wants to do isn't going to repair the ligaments either. Ligament repair or replacement with surgery is just not an option for dogs.* The ligaments, once fully torn, are gone forever. Anyone who tries to tell you otherwise is either mistaken or being deceitful. Permanent stabilization of the joint depends on the tough new fibrous scar tissue described above
Sorry one rushed reply lead to an unnecessary lengthy reply!
I'd meant the replacement for the ligament (whatever method is used) will be stronger than before though I also have not heard of the OP described method and did not realise they were talking about using the original ligament. Picked up on that when re reading, will have to ask at work maybe even email our referral orthopaedic surgeon.
Many years ago they did use the ligament though (obviously along with suture materials). It was effective but modern techniques are better.
Non referral surgery usually involves using very strong nylon (we nickname if the fishing line!) also a good and successful technique as long as the appropriate size used. As usually use the next strength up (ie use material designed for 20kg dog for a 10kg dog)
I still think surgery would be better than conservative, I'd probably want to ck the method out more first
I'd meant the replacement for the ligament (whatever method is used) will be stronger than before though I also have not heard of the OP described method and did not realise they were talking about using the original ligament. Picked up on that when re reading, will have to ask at work maybe even email our referral orthopaedic surgeon.
Many years ago they did use the ligament though (obviously along with suture materials). It was effective but modern techniques are better.
Non referral surgery usually involves using very strong nylon (we nickname if the fishing line!) also a good and successful technique as long as the appropriate size used. As usually use the next strength up (ie use material designed for 20kg dog for a 10kg dog)
I still think surgery would be better than conservative, I'd probably want to ck the method out more first
Edited by bexVN on Thursday 22 November 17:11
Edited by bexVN on Thursday 22 November 17:14
bexVN said:
Sorry one rushed reply lead to an unnecessary lengthy reply!
I meant the replacement for the ligament (whatever method is used) will be stronger than before)
Many years ago they did use the ligament though (obviously along with suture materials). It was effective but modern techniques are better.
Non referral surgery usually involves using very strong nylon (we nickname if the fishing line!) also a good and successful technique as long as the appropriate size used. As usually use the next strength up (ie use material designed for 20kg dog for a 10kg dog)
The point I was making is that I am led to believe that the "artificial ligament" usually breaks and it is the scar tissue that holds the joint stable. With conservative management the scar tissue builds naturally not round an "artificial ligament". It may take longer but is less invasive than surgery and in time, once hardened is just as strong.I meant the replacement for the ligament (whatever method is used) will be stronger than before)
Many years ago they did use the ligament though (obviously along with suture materials). It was effective but modern techniques are better.
Non referral surgery usually involves using very strong nylon (we nickname if the fishing line!) also a good and successful technique as long as the appropriate size used. As usually use the next strength up (ie use material designed for 20kg dog for a 10kg dog)
Yes but scar tissue is unpredictable and there is no guarantee it will actually develop in the right place the suture would help this. However the method I know best does not rely on the suture breaking that I'm aware of, however that would make sense.. Plus the debris that forms in the joint when the damage occurs can and does cause an inflammatory response that reaccurs. Cleaning up a ruptured joint can reduce the pain considerably.
Arthritis will inevitably be a factor long term no matter what method but it should be significantly reduced/ slowed down with surgery (as long as it's done well)
I'm not against conservative management but I do believe surgery is better for most ad long as it's done well (over 22yrs I've seen both approaches many times) and if my whippet had cruciate damage I would use surgucal not conservative, if my vets advised it.
Arthritis will inevitably be a factor long term no matter what method but it should be significantly reduced/ slowed down with surgery (as long as it's done well)
I'm not against conservative management but I do believe surgery is better for most ad long as it's done well (over 22yrs I've seen both approaches many times) and if my whippet had cruciate damage I would use surgucal not conservative, if my vets advised it.
Edited by bexVN on Thursday 22 November 17:27
Edited by bexVN on Thursday 22 November 17:34
scdan4 said:
However, all seen recently have been driving very nice cars. Vet 1 went off on a 3 week trip to Goa, and my suspicions are heightened when a consultation starts with "she is insured, yes?"
<puts away sweeping generalisations>
Sadly, most people seem to have a fit when told how much some operations/procedures cost, hence why we ask if insured, it also means we are more likely to be paid, no matter how genuine owners seem, so many decide to leave without paying. You should try dealing with the running of a practice where a lot of the clientele assume you should be a charity because you care about animals, it would open your eyes. As for new cars, after 25 years of being a vet, I'm getting my 1st brand new car ever next year, albeit a commercial vehicle. If the economic climate was better, I might have had a foreign holiday in the last 3 years, although most of my staff seem to travel more easily than me. Obviously, some big city practices may have a better profit margin than me, but I would expect many vets to be working as hard as I do, which is often more than most of the grumpy owners who don't want to pay. Thankfully many of our pet owners are brilliant to deal with, although almost all of our farm clients are better still. <puts away sweeping generalisations>
It is perfectly acceptable for different values to be expressed about pets, and I would welcome more open debate about what is the correct course of action in the wide variety if situations that we face. Above all what I cannot stand is the wilfull neglect of innocent animals. For example, on Wednesday, we had a pit bull b
h brought in, had been found running around the countryside with a new born pup in her mouth, she weighed 18kg, should have been 35kg, she didn't show any distrust or fear of us, some bd had abandoned her either before or after she whelped, leaving her to starve. Thankfully, she is now safe, and if she can't be found a home, we'll take her home. I don't want another dog, nor can I really afford one having taken on a rescue earlier this year, but animals such as this deserve a good home. OP I am glad you are not having your dog disposed of, surgery should be very successful and I am sure it will be grateful with years of friendship. I hope it goes better than expected and you feel you have got value for money from the moneygrabbing veterinary fraternity.
She is beautiful
Me again.
Thanks for the kind words. Have not tried to be a homocidal maniac, have tried to do the right (not necessarily the easy) thing. Your experiences and opinions have ALL been useful. (Never learnt nowt from someone that agreed with me)
A bit of correction on the details of the planned op.
Currently she limps constantly, but the severity depends on how rested it has been. A short, on lead walk round the block (no more than 15 mins) will have her refuse to put her back right paw on the ground for the following 2 days, (unless in overexcited / fight / flight mode, when stupidity takes over, and I assume lots of damage is done.) This is a dog who would run non stop for 3 hours with her friend and instantly be ready to do it all again. Twice.
She can't swim for toffee. Her weekly swimming lesson / throw in the lake is clearly not her favourite passtime. I had been considering a trip to the local endless doggy pool with her anyway, to try and teach her to swim properly, so that's the proverbial 2 birds with one stone!
Thanks for the kind words. Have not tried to be a homocidal maniac, have tried to do the right (not necessarily the easy) thing. Your experiences and opinions have ALL been useful. (Never learnt nowt from someone that agreed with me)
A bit of correction on the details of the planned op.
The Wife said:
"The vet will reposition the point at which the top bone meets the tibia so that then cannot keep sliding forward/around (causing pain and instability). They will then backfill with titanium foam, which is porous so the bone can grow through creating a strong, stable joint. The vet definately said she would be able to run once recovered and that this method is far stronger than the cheaper nylon chord method that would work well on a smaller or shorter legged, or older or less boisterous dog. She would snap the nylon (in his opinion) way before the scar tissue and muscles had adapted, and would still cost 1200 quid.
His quote is 2200, we have a little left on the insurance so would need to pay out 1700"
His quote is 2200, we have a little left on the insurance so would need to pay out 1700"
anonymous said:
[redacted]
Would be a pleasure! Currently she limps constantly, but the severity depends on how rested it has been. A short, on lead walk round the block (no more than 15 mins) will have her refuse to put her back right paw on the ground for the following 2 days, (unless in overexcited / fight / flight mode, when stupidity takes over, and I assume lots of damage is done.) This is a dog who would run non stop for 3 hours with her friend and instantly be ready to do it all again. Twice.
S6 Devil said:
I appreciate that on a bigger, highly energetic dog you are going to struggle with conservative management but you are going to have to restrict her for at least a couple of months post op anyway.
You say it has been 3 months already but you let her run down stairs which is the worst thing she can do as it puts so much stress on the joint.
Restriction doesn't mean stopping all activity it just means you stop her running and jumping particularly on furniture and up and down stairs.
poor posting on my behalf. The toddler runs down the stairs. The dog lives on the ground floor on the floor, is not allowed on furniture, is not allowed upstairs at all (that's where the cat lives) and is normally restricted to the garden, kitchen and living room - all flat. You say it has been 3 months already but you let her run down stairs which is the worst thing she can do as it puts so much stress on the joint.
Restriction doesn't mean stopping all activity it just means you stop her running and jumping particularly on furniture and up and down stairs.
S6 Devil said:
Just think about trying PROPER restriction for 8 weeks to see if she starts to improve.
Good luck!
I think she thinks she's in a POW camp. She's been off lead once in 3 months (before diagnosis, to see what happened.) She gets a slow trot round the block maybe once or twice a week. Before this she had at least 2, often 3 walks a day, one of which would be at least 1.5 hours long and would involve most of that off lead and running. She's not happy.Good luck!
bexVN said:
- ****OP look into physiotherapy/hydrotherapy for your dog post surgery. I would very very strongly recommend hydrotherapy as soon as the initial wound has healed. Can't emphasise this enough. See if your vets know a good one. It'll be worth every penny for a quicker recovery!*****
Karyn said:
Very definitely going to need (more) pictures of the cause of this mental anguish and exertion! 
glad to oblige! (as the man in the park said "oooo, they're interesting markings". No, they're gloss, she's been "helping"Thevet said:
lots of true, good stuff.
I also said"I am sure that a vet surgery costs an awful lot to run, the knowledge costs a lot to acquire and their time should be rewarded."
Which I am, and is true, and I don't begrudge.
I am also currently miffed at the wonky x-ray vision / canine mind reading ability of the vetinary profession.
And f
k me the bills make your eyes water.
A proper hydrotherapy unit for pets has qualified staff very used to dogs that don't like water. They will often be able to work on that. But it's more than just a swim in the pool, there will be specific exercise regimes etc aswell as physiotherapy plans, they will prob have a treadmill (in a water tank) aswell.
I'm glad you're getting the dog sorted OP but I must say that I was also shocked at your original post.
I can't see how putting the dog to sleep would even be an option to cross your mind, if you couldn't afford to get the operation done then the sane thing would have been to seek help from one of the dog charities. They would have taken the dog, had th operation and rehomed the dog.
Definitely worth sorting your insurance as you obviously need a higher limit too.
I can't see how putting the dog to sleep would even be an option to cross your mind, if you couldn't afford to get the operation done then the sane thing would have been to seek help from one of the dog charities. They would have taken the dog, had th operation and rehomed the dog.
Definitely worth sorting your insurance as you obviously need a higher limit too.
essexplumber said:
Sorry to be a bit righteous but just the way that you are talking about her makes me think that you shouldn't have a dog in the first place.
I don't want to be confrontational at all, but phrases like "reasonable return on my investment" and a "cheap boggo mutt" if she was worth £2K would you have the op then?
If she is only 2 and as you say a lovely dog is £1700 worth seeing her life over? I have no idea about your personal situation and it is a lot of money but there must be a way around it. My friends Staffy bh had her cruciate go at a young age and she has been perfect ever since so its in no way a life changing injury.
If she has the op you may have to reign her in a bit in future to prevent a reoccourance of the injury.
Again OP, I appologise for seeming so blunt and I hope a way can be found.
Bang on. I don't want to be confrontational at all, but phrases like "reasonable return on my investment" and a "cheap boggo mutt" if she was worth £2K would you have the op then?
If she is only 2 and as you say a lovely dog is £1700 worth seeing her life over? I have no idea about your personal situation and it is a lot of money but there must be a way around it. My friends Staffy b
h had her cruciate go at a young age and she has been perfect ever since so its in no way a life changing injury.If she has the op you may have to reign her in a bit in future to prevent a reoccourance of the injury.
Again OP, I appologise for seeming so blunt and I hope a way can be found.
I didn't read the thread yesterday because I thought it was going to be this but then thought no one could be so cold.
Repair? It's a dog and not an object.
Both my dogs are cross breed and both rescue dogs. Jess has cost over £6000 due to mange but she's a member of our family.
Maybe you should see if there's a charity that would assist to have the operation done at a lower cost, find another owner for the dog and never get another pet again.
falkster said:
Bang on.
I didn't read the thread yesterday because I thought it was going to be this but then thought no one could be so cold.
Repair? It's a dog and not an object.
Both my dogs are cross breed and both rescue dogs. Jess has cost over £6000 due to mange but she's a member of our family.
Maybe you should see if there's a charity that would assist to have the operation done at a lower cost, find another owner for the dog and never get another pet again.
£6k for mange ............ unbelievable!I didn't read the thread yesterday because I thought it was going to be this but then thought no one could be so cold.
Repair? It's a dog and not an object.
Both my dogs are cross breed and both rescue dogs. Jess has cost over £6000 due to mange but she's a member of our family.
Maybe you should see if there's a charity that would assist to have the operation done at a lower cost, find another owner for the dog and never get another pet again.
Sorry to upset all you on here but much as I love my dogs (working dogs) common sense prevails and not sentimentality. The fees charged by vets for small animals are, in my opinion, frankly obscene.
Longwool said:
falkster said:
Bang on.
I didn't read the thread yesterday because I thought it was going to be this but then thought no one could be so cold.
Repair? It's a dog and not an object.
Both my dogs are cross breed and both rescue dogs. Jess has cost over £6000 due to mange but she's a member of our family.
Maybe you should see if there's a charity that would assist to have the operation done at a lower cost, find another owner for the dog and never get another pet again.
£6k for mange ............ unbelievable!I didn't read the thread yesterday because I thought it was going to be this but then thought no one could be so cold.
Repair? It's a dog and not an object.
Both my dogs are cross breed and both rescue dogs. Jess has cost over £6000 due to mange but she's a member of our family.
Maybe you should see if there's a charity that would assist to have the operation done at a lower cost, find another owner for the dog and never get another pet again.
Sorry to upset all you on here but much as I love my dogs (working dogs) common sense prevails and not sentimentality. The fees charged by vets for small animals are, in my opinion, frankly obscene.
I know his dog is still enjoying a good quality of life, if the owner wants to then who are we to say 6k is too much.
Veterinary fees aren't cheap but neither are the overheads of a practice.
bexVN said:
I think (if I remember correctly) he's referring to demodectic mange not sarcoptic mange as you may be thinking. A much harder mite to control and clear up. The costs were due to unusual presentation of the condition and now on going and probably lifelong tx. All of which has involved months of care.
I know his dog is still enjoying a good quality of life, if the owner wants to then who are we to say 6k is too much.
Veterinary fees aren't cheap but neither are the overheads of a practice.
Good memory Bex. I know his dog is still enjoying a good quality of life, if the owner wants to then who are we to say 6k is too much.
Veterinary fees aren't cheap but neither are the overheads of a practice.
Off topic
Jess has been medication free for the last two weeks which is the first time in almost two years. The final attempt to cure was Panomec cattle scabies treatment and, as the vet said, it was a bit like tapping a nail in with a cannon.
Fingers crossed its worked but even if it hasn't we'd already decided to use the Panomec on alternate days or even 1/3 days. So far she's got a full fluffy coat with no slight bald patches, no scaly cheeks and she's so happy - if she's happy we are.
To the OP. I have not read the whole thread, only your post so I apologise if I repeat someone else. Firstly, it is a tough decision and I applaud you for trying to do the right thing for the dog.
Vets bills can be serious money (mine has had over 3k in a few weeks, thankfully covered by the rescue charity and their insurance as they knew she was unwell when I took her on and no insurance company would even quote me for her.
The vet I think discounts his time to the charity and I know some vets will try to give people time to pay. As I understand it, the blue cross will give free treatments to animals but I am not sure what criteria they use if any so perhaps a quick call to them might be a way forward.
Hope it all works out and sorry for not reading the whole thread but been terribly busy and wanted to suggest blue cross ASAP in case they can assist.
Vets bills can be serious money (mine has had over 3k in a few weeks, thankfully covered by the rescue charity and their insurance as they knew she was unwell when I took her on and no insurance company would even quote me for her.
The vet I think discounts his time to the charity and I know some vets will try to give people time to pay. As I understand it, the blue cross will give free treatments to animals but I am not sure what criteria they use if any so perhaps a quick call to them might be a way forward.
Hope it all works out and sorry for not reading the whole thread but been terribly busy and wanted to suggest blue cross ASAP in case they can assist.
We had just lost our dog (had her 12 years) when the cat came home limping, his rear hip socket ball had been snapped off (on his leg), the choices were, PTS, remove the leg, or operate (remove the broken ball, smooth the end of the thigh bone over and fit into the hip socket), we paid £300, the RSPCA paid £200 and the cat was fine after some time recovery
the OP should ask the PDSA and RSPCA if any help is available sooner rather than later, for the sake of the dog
ooops, just realised the OP took the operation route
good luck, the dog looks great
the OP should ask the PDSA and RSPCA if any help is available sooner rather than later, for the sake of the dog
ooops, just realised the OP took the operation route
good luck, the dog looks great
Edited by Upatdawn on Tuesday 27th November 13:59
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