Some of the hip issues we see involve joint laxity, hip luxation, osteoarthritis, fractures of bones comprising the hip, hip dysplasia, and complications of total hip replacement. Our team will provide appropriate diagnostics and develop a treatment plan to address your pet's needs. Superior quality of life and the best outcomes are always our goal. We will work with you to ensure all concerns are addressed and that you feel well informed and confident as we proceed.
The canine knee joint, known as the stifle joint, is similar to a human’s knee. The joint is made up of the femur (thigh bone), tibia (shin bone), and the patella (kneecap) that are firmly held together by ligaments. Ligaments are strong, dense structures consisting of connective tissues that connect the ends of two bones across a joint. The function of ligaments is to stabilize the joint.
The stifle has two very important ligaments called the cranial (CrCL) and caudal (CaCL) cruciate ligaments (cruciate means a cross or crucifix) that cross in the center of the joint. The CrCL (known as the ACL in humans) restrains the backward and forward motion of the joint, in addition to inward twisting and hyperextension of the joint. It is the structure that is most commonly injured in dogs. In fact, more than 600,000 dogs in the U.S. have surgery for this problem every year.
Clinical Signs and Diagnosis Most dogs with a complete CrCL tear show an immediate onset of lameness. While there may be some initial improvement over several days, there usually is a dramatic decline in limb function over time. Dogs that have a partial CrCL tear may have persistent lameness on the affected limb; yet others have stiffness or lameness on the limb after taking a nap or while exercising.
Your veterinarian may detect swelling in the knee and instability in the stifle upon examination of the joint. Dogs that have a partially torn CrCL may not have any detectable instability of the joint, and X-rays of the joint may be needed to support the diagnosis.
Treatment The surgery that is recommended for medium and large breed dogs that have CrCL tears is the tibial plateau leveling osteotomy (TPLO). The X-ray of a dog's knee surgeryTPLO levels the slope of the tibia by cutting the bone and rotating it. A plate is fastened onto the side of the bone with a set of screws to hold the tibia together during the healing process. The TPLO keeps the femur bone from shifting backward during weight-bearing activities and allows other supporting structures of the stifle to stabilize the joint.
Results The TPLO procedure offer multiple benefits in comparison to older techniques including faster recovery; earlier use of the limb after surgery; better chance to return to athletic activity; and better range of motion of the joint.
The TPLO procedure is currently the best method available for stabilizing a dog’s knee. With good rehabilitation, 90% of dogs undergoing this surgery can expect to return to athletic activity within six months.
For more information on this subject, speak to the veterinarian who is treating your pet.
Belle is a young, active golden retriever who loves to swim, go on walks with her owners, and pal around with her canine friends. But, when she was just a year old, she tore her CCL. She was chasing after a ball in the house, and in her exuberance, slid into the wall at an odd angle. She let out one yelp and limped over to a rug to rest. Within a few days she seemed back to normal.
Belle continued to go on walks, but often after long hikes she would lay around the house more than usual. “She also stopped jumping on the couch, even when we gave her permission to join us,” her owner Ely Yakley explains. The turning point came on a hot summer day after Belle had spent hours swimming and jumping in and out of the pool. By evening, she couldn’t bear weight on her right rear leg.
Ms. Yakley took Belle to her family veterinarian in the morning who diagnosed a possible torn cruciate and made a referral to one of our board-certified veterinary surgeons.
Belle visits BluePearl
Surgeon, Dr. Alan Cross, confirmed the diagnosis. In humans, the anterior cruciate ligament (ACL) helps hold the knee in place. In canines, it is the cranial cruciate ligament (CCL) that performs the same job. Although occasionally it is a traumatic injury, or a sudden twisting motion of the dog’s rear legs that leads to a rupture or tear, in most dogs it is due to a degenerative process.
“The typical patient has had a three month or more history of occasional lameness,” explains Dr. Cross. “During this time, the cranial cruciate ligament is fraying, resulting in inflammation and pain. Once it tears completely, the knee is unstable and quite painful resulting in an obvious lameness.”
Treatment Options Treatment options are either conservative management, which includes activity restriction, anti-inflammatory medications and pain management therapies, or surgery. “Some dogs will improve without surgery, but in my experience they never will do as well as they do with surgery,” Dr. Cross reports.
If left untreated, meniscal tears can develop (menisci are the cartilages that provide load sharing function in the knee) as well as severe arthritis. However, according to Dr. Cross, “Most dogs return to excellent functioning following surgery.”
Get Expert Advice Many factors like the dog’s age, size, behavior and expected activity level are taken into consideration when determining the best treatment for a torn CCL. It’s important to weigh the options with the expert advice of your family veterinarian and a veterinary surgeon.
Belle’s owners decided that the tibial plateau leveling osteotomy (TPLO) surgery, considered the gold standard for CCL repair – would be best for her. After her surgery, Belle’s owners also opted for her to receive physical rehabilitation (the equivalent of physical therapy in human medicine) which is recommended to achieve the best results. During rehabilitation sessions, pet owners learn exercises, techniques and lifestyle changes that help their dogs recover more quickly from surgery and can be used throughout their lives to keep them at optimum health.
Belle is More Active Than Ever
Three months after her surgery, Belle was running and jumping again. “She was actually more active than she’d ever been in her life. Here we thought we just had a calm dog, but what we didn’t realize was that she had knee problems,” says Ms. Yakley. “In hindsight, I realized that Belle was really good at hiding her pain. My only regret was that I didn’t realize earlier that something was wrong.”
Dr. Justin Payne is a board-certified veterinary surgeon who has provided exceptional care for pets in the Houston area for the past 15 years. Dr. Payne has a particular passion for orthopedic surgery; however, is here to help any pet in need.
