Wednesday, Sep. 12th 2018

Cruciate Ligament tears in dogs and upcoming events

Cranial Cruciate Ligament Tears in Dogs

 

 

Joint Health and Cranial Cruciate Tears

Quiz time!  What is the most common orthopedic (bone/joint) injury in dogs?  OK, you already had a clue in the title.  It’s a Cranial (or anterior) Cruciate ligament tear.  This is one of the two ligaments inside the knee joint that help keep the shin and femur bones from slipping against each other when the knee is bent.  You may hear it referred to as an ACL or CCL tear, and it’s a common sports injury in human athletes as well. 

Factors that may contribute to this injury are numerous.   Certainly, obesity and a straight leg conformation are common contributors.  Other factors can include poor diet which contributes to inflammation and “dryness” of the ligament in Chinese terms.  Genetics may play a role.  Many times, dogs receive this injury from jumping or falling from higher places like retaining walls or beds. Dogs that leap in the air after balls or frisbees and land on their hind legs may be prone to it as well.  Sometimes, though, a simple turn while running, hopping off a single step, or squatting to urinate will cause this injury. 

Diagnosis is commonly made during a physical exam by doing a “cranial drawer test”.  In this test, the doctor stabilizes the shin and thigh bones and tries to move the shin bone forward.  If it moves forward at all, this is an indication the ligament is torn.    In more chronic injuries, a “medial buttress” may be felt, which is thickening of the tibia on the inside of the joint as the body tries to stabilize the joint.  A common pattern seen in dogs with this injury is an initial severe lameness either carrying the hind leg or walking with the knee turned out and an obvious limp.  Without treatment, this lameness will seem to get better over a few weeks.  But then the arthritis begins to advance and a limp will return. 

Treatment has several possible levels. Pain medication is a must, of course, in addition to a good joint supplement.  Surgical repair is optimal, in order to rebuild the joint and keep it from slipping.  However, this is fairly expensive and the aftercare of 12 weeks or so of careful exercise restriction and physical therapy can be more than some families can handle.  If surgery is not an option, the second-best treatment is use of a high-quality splint to stabilize the joint.  Ideally, one that has been custom fit to the patient will be used.  These are still fairly expensive though much cheaper than surgery.  But, of course, if you don’t repair the joint with surgery, ongoing damage and advancing arthritis are a given.  In almost all patients who do not receive surgery, and ultimately in some that do, life-long pain management may be needed.  Options for this include medications and supplements, cold laser, acupuncture, and pulsed electro-magnetic field therapy.  Some patients may also benefit from occasional physical therapy such as a water treadmill to strengthen muscles in the legs.  Another benefit of physical therapy is to strengthen the other leg, as 60% or so of dogs that tear one CCL will likely tear the other one at a future point.  At our clinic, we also recommend life-long supplementation with a high-quality glucosamine/MSM product and chiropractic evaluations at least 3 times a year.

While we hope your pet never suffers this injury, it is so common that we diagnose at least one every 2-3 weeks in our clinic.  If your pet has a hind leg lameness that is obvious even at a walk, we recommend you make an appointment within 48 hours to have it evaluated.  Many dogs also will not sit straight, but will extend both hind legs to the side, usually with the injured one uppermost.  CCL lameness is usually at least a Grade 3 of 5, meaning the pet is unable to bear full weight on the leg and the stride is noticeably shortened. Grade 4 is considered “toe-touching” meaning they won’t even put the whole foot down.  Grade 5 is non-weight-bearing.  Any lameness with this severity needs attention promptly as it is rare for minor problems like pulled muscles to show this degree of severity. 

Here are a couple of videos that might interest you on the topic: 

https://www.youtube.com/watch?v=d12zCpjMpTo  (What it looks like)

https://www.youtube.com/watch?v=PYZv1hp48J8 (5 things you should know)

Events, Important Dates:

Dr Leonard will be out of the office Friday, 9/14 and from Wednesday, September 26 through Monday, October 1.  During this final week of the month, she will be attending an agility national championship out of state.  In order to serve our clients, Dr Tora Seals from the Springfield area will be filling in.  She is not a holistic medicine specialist but can provide all routine care such as vaccinations or titers, lab work, treatment of skin and ear problems, and diagnosis and treatment of illnesses. We will be scheduling holistic follow-ups with any patient needing this but encourage you to get your pet seen by Dr Seals if they are feeling unwell.  We also will have a chiropractor certified to work on animals here on Thursday afternoon.  If your pet requires regular acupuncture, please make sure we get you scheduled around these dates.  We ask that you be understanding of differences between Dr Leonard and our relief practitioners, and patient with any minor glitches that may occur as they familiarize themselves with our practice style. 

 


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Raymore, MO 64083
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