Vets/Animal experts - torn ACL options?

KiKiMe · May 2011

Good afternoon-

We recently found out that our vet thinks our 4 year old pitbull mix (66lbs) has a torn ACL. She was limping occassionally on it and other times running full force. The vet performed the drawer (?) test and said there was "a little" movement there. He also noticed some swelling. He gave us 20 days of pain meds and told us she would need surgery and we should decide between conventional surgery (about $1500) or TTA (between $2500-$3500). I have a few questions:

1) Is surgery our only option?

2) Which surgery would you recommend?

3) Do those seem like reasonable prices?

Thank you very much!

tiffanysbride · May 2011

Get a second opinion. My dog growing up had a torn ACL and my mom's pitbull also torn his playing in the yard. The vet in both cases told her that surgery is not 100% affective, it can be re-injured, etc. In both cases (these were 2 different vets) she was give pain meds, glucosamine and 4 weeks rest/no physical activity. Childhood dog had some favoritism in the winter when he got old (like 14+ years). Pitbull is doing great.

Anyway not saying your dogs injury is the same but I always get a second opinion when dealing with surgery. The outcome with and w/o is very important IMO. Perhaps look for a vet that specializes in joint/muscle injuries.

Clerk9 · May 2011

I'm sorry that your poor girl hurt her knee.

When it comes to orthopedic injuries, no surgery is going to "fix" them 100% back to where they used to be. The goal is to minimize the severity of arthritis/discomfort & lengthen the amount of time before it sets in. In other words, surgery is the best option to ultimately make her feel as good as possible for as long as possible. I think this is important to know before going into it because knowing that it's not going to be a total long-term "cure" may make a big difference to some people!

Having said that, I've seen some pretty impressive recoveries post-op from cruciate surgeries. (Where it gets to the point that keeping them from using the leg too MUCH becomes a bigger issue!) As far as I know, there hasn't been a ton of evidence that one of the types of surgery has a much better outcome than the others; an orthopedic surgeon would likely have the most up-to-date stats on that, though. And if you're going to go through surgery, I'd highly recommend physical therapy/rehab afterwards (the clinic where I used to work actually packaged a number of sessions in with the surgery to make sure it got done). It can make a HUGE difference!

If you decided against doing the surgery, you certainly could try to manage her injury with rest, joint supplements & pain medications (like PP mentioned). Some dogs do better than others with this approach, & there's no way to know how an individual will respond ahead of time, so it's a bit of a craps shoot, but it's definitely another option. With long-term anti-inflammatories, you should have her bloodwork monitored (we'd do it every 6 months) just to make sure that her liver & kidneys are healthy enough to continue to process the meds. Sometimes, usually after a number of years, it can get to the point where you need to add more & more medications for pain management & start running out of options for relief/comfort. (In certain cases, acupuncture can really help with arthritis management, especially once you're maxed out on drugs & don't have many other options.) So this would be the downside to managing the injury conservatively. (Like I said, it may never get to that point, but there's no way to tell.)

One last thing: MOST of the patients who injure one cruciate ligament WILL injure the opposite one within +/- a year. Unfortunately, you may very well be faced with this situation again fairly soon. That may or may not influence what you want to do now, but it's important to keep in mind regardless.

I'm sorry for all of the rambling, but I hope this information has been helpful. And, FWIW, the prices you were quoted for the surgeries sound about right to me. I hope that you & your family are able to figure out the best plan for everyone & that your little girl is on the mend ASAP no matter what you decide to do. GL & let us know if you have any more questions!

P.S. Other vets, please feel free to chime in & offer your $0.02 & your own recommendations/experiences!

KiKiMe · May 2011

Thank you so very much for your lengthy response; I greatly appreciate it!!

We surely want to do what is best for her...no doubt about it...she is a part of the family! At the same time, I want to make sure we are clear headed about this and realize that we do have a child on the way and many more expenses for him and I in the near future.

The vet did say that he hasn't necessarily seen better results with the more advanced surgery and since Mya isn't a working dog and isn't a huge dog she should be fine with the less advanced surgery. I guess the next step would be a consult with the surgeon.

Thank you again!

KiKiMe · May 2011

tiffanysbride:

Get a second opinion. My dog growing up had a torn ACL and my mom's pitbull also torn his playing in the yard. The vet in both cases told her that surgery is not 100% affective, it can be re-injured, etc. In both cases (these were 2 different vets) she was give pain meds, glucosamine and 4 weeks rest/no physical activity. Childhood dog had some favoritism in the winter when he got old (like 14+ years). Pitbull is doing great.

Anyway not saying your dogs injury is the same but I always get a second opinion when dealing with surgery. The outcome with and w/o is very important IMO. Perhaps look for a vet that specializes in joint/muscle injuries.

Thank you so much for your input! This is a difficult decision! Unfortunately, the timing is causing the biggest issue for us. It is a lot of money to spend when we are expecting. Not to say she is any less important with a baby on the way, we just have to think a little differently! Thanks again

julesjb · May 2011

I came to give my advice but Clerk9 covered it all and I agree completely!! I have had some patients do well with rest and meds but a good degree of them down the line require surgery as reinjury to the knee is common. I do feel strongly toward the TPLO and TTA as they are most effective and less likely to break down! I hope your furbaby has a speedy recovery!!

KiKiMe · May 2011

julesjb:
I came to give my advice but Clerk9 covered it all and I agree completely!! I have had some patients do well with rest and meds but a good degree of them down the line require surgery as reinjury to the knee is common. I do feel strongly toward the TPLO and TTA as they are most effective and less likely to break down! I hope your furbaby has a speedy recovery!!

Thank you!!

erpetdoc · May 2011

julesjb:
I came to give my advice but Clerk9 covered it all and I agree completely!! I have had some patients do well with rest and meds but a good degree of them down the line require surgery as reinjury to the knee is common. I do feel strongly toward the TPLO and TTA as they are most effective and less likely to break down! I hope your furbaby has a speedy recovery!!

I agree here. I'm in ER practice now, but formerly did day practice, and worked alongside a board certified surgeon (who did TPLOs all the time). I still work with a board certified surgeon, and he prefers TPLO too.

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Vets/Animal experts - torn ACL options?

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