Caring for a Three Legged Dog or Cat
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So Travis came up lame 3 weeks ago. We thought it was in his front end but, as it didn't get better we took him in to a vet that happens to be a surgeon last Tuesday. Turns out it is his hind end that is hurting. He has a painful hip (dysplasia and arthritis) and a painful knee in his remaining back leg .... OUCH!!! My poor baby boy! There was "mild" effusion around the knee and the vet dx "early partial CCL tear" and recommended a TPLO right off the bat.
We said whoa! And consulted Dr. Google ... Turns out there is a fair amount of controversy over how to treat a CCL. And that there are some people (vets included) that think that TPLO's are over prescribed (huge money maker) and that conservative management should be the first line of action, then go to surgery if that does not work.
We are leaning towards conservative management to start. We understand that this path may work best for smaller dogs (but it has also worked for larger dogs eg Briards) but it is really hard to consider going straight to a major invasive surgery involving metal implants (potential OA and OSA) when we don't even really know for sure if he has a partial CCL tear! The surgeon we took him to said there was no instability in the knee at this point. This seems like a critical point. She advised that a full rupture was inevitable, even with a brace (we immediately thought of Ortho Pets) and because he is a tripawd he can't afford to have a full rupture bc he would not be able to walk at all (well, OK, it would be really hard but we know not impossible to deal with) We have an appt with a rehab vet on Wednesday and are looking forward to getting her input. If she agrees that conservative management is a viable option then we will get a cast made for a custom brace from Ortho Pets. She is one of their partners and received training directly from OP so we feel really good about having her do it
Travis is a 7 yo 80lb GSD who has been a left rear amp since he was 10 months old. He is a big dog and we consider him a little overweight given that he is a tripawd and we are working on taking a few pounds off. Until he came up lame I called him my beast. He has been really healthy and fit for years. He was taking 1-2 mile walks daily and loving it. Since he came up lame we have been gradually reducing his walks. After his CCL dx last week we gave him several days total rest and are now gradually working him back up to 1-2 very short walks a day.
We have read alot of the historical tripawds forum threads on this subject but were hoping for an updated take on this controversial subject. Is it reasonable to go with conservative management first given Travis' history, size, and age?? Is a full rupture really inevitable????? If we go with surgery should we go with TPLO or an alternative, such as the Tightrope procedure that does not involve metal implants?
Any and all input is welcome!
xoxo,
Martha, Travis Ray, and the Oaktown Pack
Woohoo! Tripawds Rule!
Regulator of the Oaktown Pack, Sheriff of the Oaktown Pawsse, Founding member and President of the Tripawd Girldogs With 2 Names ROCK Club, and ... Tripawd Girldog Extraordinaire!
Oh boy I am sorry to hear this about Travis. I don't have much to add about the procedures you are talking about. I do know one of my quadpaws that we had did have a tear but my vet at the time was an old farm vet so not sure what procedure he did to allow him to walk again but he wasn't a Tripawd either. I will send up some healing prayers and hope you can get some good advice
Hugs xoxoxoxo
Michelle & Angel Sassy
Sassy is a proud member of the Winter Warriors. Live long, & strong Winter Warriors.
sassysugarbear.tripawds.com
07/26/2006 - Sassy earned her wings 08/20/2013
05/04/2006 - Bosch, Sassy's pal, earned his wings 03/29/19 fought cancer for 4 months.
"You aren't doing it TO her, you are doing it FOR her. Give her a chance at life."
Doggone itTravis Rae! Tripawds just don't need this kind of hassle! Well, I guess it's really your humans who don't need this kind of hassle! You could care less!
Travis Rae, just like all the OP family, couldn't be in any better hands. You'll do your research and you'll figure out the best path for this crazy boy.
I'm sure Pam will jave some really good input for you Martha.
Sending lots of love and a bucket of watermelon for your Pack! And most here are sayin', "Watermelon???"
Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!
Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!
Awwww, thanks so much for the support Michelle and Sally. Sally, watermelon is a little hard to come by this time of year since we don't buy fruit and veg from the Southern hemisphere (well maybe except for another OP fave -- bananas!!) but the thought is totally appreciated!
I forgot to say that Travis is currently on Rimadyl and tramadol and appears to be doing better between the pain meds and the reduced activity. His limping is greatly reduced. In fact, most of the time it is not even apparent. Another good reason to stick with conservative management??
xoxo,
Martha
Woohoo! Tripawds Rule!
Regulator of the Oaktown Pack, Sheriff of the Oaktown Pawsse, Founding member and President of the Tripawd Girldogs With 2 Names ROCK Club, and ... Tripawd Girldog Extraordinaire!
That sounds like a good sign for conservative management to me!
Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!
Martha!!!! Travis Ray!!!!
Not good Mr. Beast!
OK, Obie is little and a quad, but he had partial tears in both of his CCLs. I chose surgery both times because after research and getting several opinions (including Dr. Pam by PM) I came to the conclusion that Obie's knees would not get better without intervention.
On the first knee we tried conservative treatment, rest and an anti-inflammatory, but there was no improvement. His was not a catastrophic injury and in fact he never even limped. One day I noticed that his right hip and upper leg was smaller than his left. Obie's problem was luxating patellas which caused a structural problem in his leg, the bones got out of alignment and the rotation made the CCL start to tear.
Seems to me that if there is not a structural problem like Obie's then conservative treatment might work, and it is certainly worth a consult.
Karen
Tri-pug Maggie survived a 4.5 year mast cell cancer battle only to be lost to oral melanoma.
1999 to 2010
Sending healing thoughts and prayers to Mr Travis Ray!
Linda, Ollie, Riley & Spirit Mighty Max
Oh wow.... Travis!!!! You poor guy....
I don't have any advice but definitely wanted to send love and lots of healing energy your way. Keep us posted!!! We will all be keeping you in our thoughts!!!
Hugs!
alison with spirit shelby in her heart (and little jasper too)
Shelby Lynne; Jack Russell/Shiba Inu mix. Proud member of the April Angels of 2014.
October 15, 2000 to April 8, 2014
Our story: Broke rear leg in June 2013 - non-conclusive results for cancer so leg was plated and pinned. Enlarged spleen in September 2013 and had it removed and was diagnosed with Hemangiosarcoma and started chemotherapy. Became a Tripawd January 8th, 2014 and definitive Hemangiosarcoma diagnosis. Three major surgeries in 7 months and Shelby took them all like a champ only to lose her battle to cancer in her brain. We had 8 amazing extra months together and no regrets. #shelbystrong #loveofmylife
DUDE! I'd give my spare leg if I had one. I hope you feel better and dont need surgery.
Wyatt Ray Dawg . . . The Tripawds Leg-A-Cy Continues!
Read all about my adventures at my Tripawds Blog
Did your vet sedate your dog to feel the knee? They need to be fully relaxed to differentiate a full vs partial ACL injury. If the knee is not very loose you can try the brace. If it is fairly loose or totally ruptured then I would pursue a lateral suture repair rather than a TPLO but that is just my personal preference.
Pam
Hey everyone, thanks for all your support. It means the world to us!
Dr. Pam, thanks for responding so quickly! My vet manipulated his leg without sedation so we could see for ourselves where he was painful. But Travis was sedated for xrays and I assume that she also manipulated his leg under sedation (he was really sore the next day!). I am pretty sure that she said there is little to no instability in the knee at this time. There is effusion in the knee but she said it was mild and in fact the radiologist she sent the xrays to said the knee looked normal. She then had her in-house radiologist look and he thought there was effusion. So apparently her diagnosis of an "early, partial CCL" was based on his pain when she manipulated the knee and on mild effusion at the knee joint. During a follow up call she was talking about the possibility that just a "few fibers" of the CCL were torn. Travis also has dysplasia and arthritis in his hip and that seemed to be even more painful than the knee so it seems to me that his limping could be from a combination of things. And he is doing better so far with rest, severely restricted activity and pain management .
Is it true that it is inevitable that a partial tear becomes a full rupture, even with conservative management and a brace? Our vet made it sound like it was.
Woohoo! Tripawds Rule!
Regulator of the Oaktown Pack, Sheriff of the Oaktown Pawsse, Founding member and President of the Tripawd Girldogs With 2 Names ROCK Club, and ... Tripawd Girldog Extraordinaire!
I don't know much about knees, except my own 2 that need replaced. I was wondering if you could look into a wheelcart for him. Don't know if there are any places that rent them versus buying one as they are a tad expensive. I think I have seen them for a few hundred $. Just thinking, it would give his knee total rest? Just a thought. Sending hugs and healing prayers your way. Lori, Ty & Gang
TY GUY, Best Black Lab ever! Diagnosed and had amp in January, 2014. Kicked MRSA's butt. Earned his angel wings on April 16, 2014. Run Free my boy and don't forget a shoe. Ty is a proud member of the " April Angels". Ty sent us Daryl, a Tripawd rescue in Sept. of 2016. Daryl is 5 +or -. We are also Pawrents to Chandler, a Border Collie mix who is 15 and 1/2, Lucy, a Corgi who is 7, 2 minis, 2 horses, and a feisty cat named Zoe. Zoe had a non skeletal Osteosarcoma removed in July 2015. No Chemo, she was at least 16. She is going strong although she is now completely blind. She is now close to 20 and her hobbies are eating and sleeping in front of her personal heater.
No it will not always progress. I have had clients with large dogs with a partial tear use rest and rehab and completely heal and never fully rupture the knee. As a tripawd he probably does put more stress on it but I would not put him through a big surgery if he does not need it.
I would try the brace and consider Adequan injections to help the knee heal faster.
Pam
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