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ACL Repair for Older Dog


skybarker

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Luke had a TPLO when he was five and now at nine he has a tear on the other leg. I am not sure I want him to go through that again. I am considering either the string repair or leaving it alone. I am just not sure what is the best option for an older dog (and, this time the cost is an issue, too).

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When my Matty (9 year old 65 lb lab mix) tore her cruciate ligament, I went the conservative management route. She tore hers in February 2009 and by September she was nearly back to normal.

 

The Conservative Management group was a big help in making the decision on whether to do surgery or not. http://pets.groups.yahoo.com/group/ConservativeManagement/

My vet was also understanding and helpful.

 

(Simplified explanation here)

The idea behind the conservative management route is to let scar tissue build up and harden around the joint to stabilize it. In order for that to happen, you have to confine the dog for a while and gradually re-introduce activity. The end result is much like the traditional surgery (where they basically tie the bones together with surgical "fishing" line)...its not really the 'fishing line' that stabilizes the joint long term, its the scar tissue that builds up around it. The line just helps keep it a bit tighter while the tissue forms and strengthens.

 

My plan from the beginning was to see how Matty did without surgery and if after 4 months I didn't see improvement, we'd reconsider surgery. Matty was doing well for the first few months and I was seeing improvement, then she decided to run one day (my fault for not having her on-leash) and set us back to nearly the beginning. She was tired of being couped up, especially when it started getting warm and sunny outside. I ended up getting the A-Trac brace for her (http://www.woundwear.com/home.cfm). She only wore it on walks...short ones to the mail box at first, gradually building up to 2 mile walks. I can not see leaving this brace on a dog all the time and definitely not while unsupervised. Its not custom shaped to fit the dog and can shift when they lay down. With that said, I was very happy with it for walks and Matty was just happy to be out and about that she didn't pay any attention to it and looked forward to putting it on. By the end of August we started walking without the brace and by late September she was running through the fields with Bear.

 

Unfortunately, I can not tell you how things worked out for Matty long term. In Feb. 2010 she started limping again. At first I thought she re-injured herself, but the vet said the joint was still tight. New x-rays showed she had bone cancer on her hip and we had to say good bye to her in April.

 

I'm glad I chose not to do surgery. Matty's recovery time from surgery would have probably taken about the same amount of time as conservative management did (apart from our set back). She had 5 months of running with her brother before the cancer appeared.

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I think it really depends on what you do with your dog. My acd had TPLO at 7 yrs and 9yrs. She is pretty darn active and needs to be active so we chose to do the surgery.

 

If the dog is less active and doesn't compete in things, I would probably think about conservative mgmt or a less expensive surgery.

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#1 - I'm not a vet - not even close.

 

But I have taken care of (I'm a petsitter) two older dogs with tears. One was a 10 year old lab that tore his ligament when he took off after a deer and fell on the ice. The other one was about a 10 year old boxer and he tore his ligament that same winter - we had a lot of ice that year.

 

The lab had a surgical repair which cost about $2500 out a Mission Med Vet. I think it lasted maybe 6 months and then he was limping again. He died this year from something else and I don't think he ever had a problem with his other back leg.

 

The owners of the boxer decided not to do surgery. His leg did get better for a while. For about a year he didn't have problems with either leg. And then both of his back lets went. That was really hard. His poor back legs just kind of windmilled out there until he could manage to get himself up and stabilized. And he had to kind of drag his feet when he walked. It was so painful to watch but he still had pretty good quality of life. He got himself around and was still so happy to be with the children and his family. But his condition worsened steadily - he also had severe eye problems in one eye. First he had an ulcerated cornea and then he developed glaucoma in that eye. He was such a wonderful family dog so it was really hard when they had to have him put down.

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My BC is 12.5 now. If she ruptured her cruciate now, I would get it repaired. She is as active as she was when she was 2 and I'm still doing agility with her. She has a bit of arthritis in her front toes and thats it. If she acted or looked old, I may not do surgery - but no one believes she's senior.

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Thanks to all for the feedback. After consultation with our regular vet, too, we are going to try conservative management this time. I think he will be OK. His second injury probably started some time ago and he has some measure of stability which hopefully will improve a bit over time.

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