Rose’s CCL Injury Part2

Rose’s knee showed great improvement on the anti-inflammatories. Her limp decreased greatly. The swelling in her knee went way down. We weren’t fooling ourselves, she was on an anti-inflammatory, and since it may have been be a partial tear of the CCL, rather than a full tear, but we knew a partial tear of the CCL can go complete in the bat of an eye, but at least we had improvement, which gave us hope that she had only sprained her knee.

Her follow-up Vet. exam dashed hopes of a sprain. With a considerable amount of swelling down, he now could feel significant drawer sign. He confirmed great suspicion of a CCL tear. We decided that rather than have our regular vet do the fix, that we’d go to a surgical specialist in Spokane, WA, to which he was in full agreement.

Her appointment with the Specialist was just shy of a week later.  Rose had been on strict crate rest for over 2 weeks.  That’s pretty hard on a 7 month old puppy.   The Orthopedist examined Rose, and scratching his head, stated that there was a little drawer sign, but not much more than on her good knee (normal “puppy drawer”). She has a grade 2-ish limp. No pain on exam, the patella is rock solid, and he gets no “pop” from the meniscus. Not completely sure, we agreed to more x-rays to see what it looks like now that the swelling is down.

   
Rose, patiently waiting for her exam at the surgical specialist’s office.

At worst, it would be a early CCL partial tear. At best, a grade 3 sprain. While we waited for x-ray results, we weighed our options for repair should it be a partial. We know darned well, it will become a full eventually if it is, but the question is conservative vs dynamic repair (anterior suture vs TPLO). Exploratory surgery for diagnostics was not an option as it just introduces other potentials in the joint that nobody wants, related to unnecessarily risk.

She was sedated for her x-ray, and x-rays of both of her knees (for comparison) were taken.  While she was sedated he manipulated her knee again, and now that she could not resist, he could clearly feel drawer sign.  She had a tear.  We suspected it was partial, but partial is like a frayed rubber band, just ready to go.  Full rupture would be inevitable, or she would develop a great deal of scar tissue to protect the joint.  With her being only 7 months old, we believed the only option was full dynamic repair (a TPLO – TIBIAL PLATEU LEVELING OSTIOTOMY)

We signed the consents and left our baby in their care, to have surgery that day.  The cost including the x-rays that day would be just short of $3,500.  We went home to await word.  We knew she would be staying at the office until the next morning.

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