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.

Rose’s CCL Injury part1

This is intended to document a CCL (Cranial Cruciate Ligament) injury and its treatment in real time,  as the dog progresses through her injury and treatment.  The decisions we made may not be the decisions others will make for their dog.  Every owner and every dog differs in their needs, abilities, and expectations.  This only documents ours.
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We finally had a nice day after a hard winter.  We had four feet of snow on the ground, and a lot of ice.  My three young dogs were getting cabin fever, and we thought we’d let them run a bit on our first sunny day.  It would prove to be a fateful decision for our 7 1/2 month old puppy, Rose.   Poor little Rose hurt her knee playing with her sister, Dahlia, and older kennel-mate, Luna.  The three puppies shot from the kennel with a purpose.  In a full run, body slamming, slipping and sliding.  Rose got caught in a frenzy of Labrador energy, and paid the price.  She came up on three legs.  We knew immediately we were looking at a cranial cruciate ligament injury.  Immediately, plans for a wonderful show career for this girl evaporated.  We crated her, and called the vet.

Rose: Note the swelling in her left knee:

Our poor baby!  It breaks my heart to see her hurting.

She saw the vet a few  days later. Her diagnosis at the vet was inconclusive, where she is swollen and lame, x-ray and manipulation diagnostic for ligament injury didn’t reveal anything positive, and there is no fracture, so, the vet wants strict joint rest for the next 10 days.  He could not feel “drawer sign” in the knee, but the knee was quite swollen, and likely the swelling itself was splinting the knee from providing him with exam clues.  X-ray showed a great deal of effusion (swelling).  Rose will be living in a crate for the duration – rather like strict bedrest.   Since I’m sitting in the den, I lifted her into the couch with me (no jumping up or down allowed), as a seven month old needs physical contact, especially Rose, who is a lovebug!   He put her on an anti-inflammatory, and suggested we keep her on that for 10 days, then re-eval the knee.  In the meantime, she would be on strict crate rest.

We went home, suspecting that we were looking at knee surgery for our girl, and had decisions to make with respect to the type of surgery we wished to do.

Click here for a Description of CCL injury and treatment

This is Rose on day two of her CCL Injury treatment with anti-inflammatories and crate rest only.   She is trying to use the leg, but clearly it is swollen and painful.