But My Dog Doesn't Play Football!!!

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Google Maps location for Riverport Veterinary Hospital

Riverport Veterinary Hospital
1 Avoca Street
Goolwa
SA 5214

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Phone:
08 8555 5690

Victor Central Veterinary Clinic
35 Crozier Road
Victor Harbor
SA 5211

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Phone:
08 7522 4300

Let’s get straight into it…knee “injuries” are the second most common orthopaedic problem (that means bone and joint problems) that we see in dogs.  The most common orthopaedic problem is Hip Dysplasia but we still see at least 3 or 4 dogs every week with knee problems.  Specifically the problem we are discussing today is cruciate ligament disease.

Is that the same injury that footy players get?

Sort of…It’s certainly the same ligament that causes the problem but the process is different; let me explain:

  • Footy players (or netball players, or snowboarders, or whatever athlete takes your fancy) are generally highly trained athletes that put too much strain on their Anterior Cruciate Ligament (ACL) by hyperextending or twisting their knee.  This ruptures the ligament causing a whole lot of pain, the necessity for a knee reconstruction and generally 12ish months out of their chosen sport.

If you don't know who this is you clearly don't follow the AFL!

  • 99% of the time dogs have a degenerative cruciate ligament condition.  It’s the same ligament, the ACL, but instead of being perfectly healthy and then snapping, the ligament tends to whither and fray over time, until it is weak enough that even a relatively minor insult (eg. Jumping off the bed) causes it to rupture.  Quite commonly the knee starts to get sore before the ligament has even ruptured and in these cases proactive management can significantly affect the outcome.

Ah so that’s why you wrote “injuries” instead of injuries earlier on

Spot on.  While we do occasionally see a footy player style acutely ruptured ACL, in the vast majority of doggy cases the problem has been building up for some time.

I’m worried about my dog’s knee now – how do you diagnose this problem?

We can actually tell a fair bit just from talking to you and looking at your dog.  If he/she has been limping on and off for a while on a back leg, cruciate disease is most likely until proven otherwise.  When we examine the patient, we are looking for telltale signs such as swelling in and around the joint, as well as abnormal movement (cranial drawer) that would indicate the cruciate ligament is not doing it’s job.

 

Looking for Cranial Drawer

 

 

We will then generally sedate the patient to again check for any abnormalities as well as take some x-rays of the knees.  We always x-ray both knees in case the “good” one has any problems (more about that later).

Once we have our diagnosis we can discuss the treatment options.

Which are?

The vast majority of patients require surgery (call it a “knee reconstruction” if you like) to give them the best outcome.  However, we have to take into account the patient’s age, size, weight, activity level and attitude to best formulate a treatment plan.  In general terms here are the 3 options:

  • Medical Management – For some older, small or inactive patients we may recommend treating medically rather than surgically.  This basically involves managing the pain and arthritis that we know will develop, as well as making some lifestyle changes (think weight loss, exercise control etc.) to keep the pain levels to a minimum. 
  • Surgery Type 1 – EXTRACAPSULAR REPAIR – Essentially this involves gaining stability in the joint by placing a synthetic ligament around the outside of the joint.  Remember that we are dealing with a diseased ligament so primary repair (like is often done in people) just doesn’t work very well in dogs.  This is usually the surgery of choice for dogs weighing less than about 20kg.

 

Extracapsular Repair

  • Surgery Type 2 TIBIAL PLATEAU LEVELLING – This is not an easy concept to grasp but is the best option in larger patients.  The actual surgery that we perform is called a Triple Tibial Osteotomy and aims to rearrange the angles of the knee joint so that the cruciate ligament is no longer necessary.  It involves cutting the tibia (shin bone) in 3 places and putting it back together with stainless steel plate and screws.  If you want any more detail send me an email!

 

Triple Tibial Osteotomy

  •  
    1. The aim of surgery is to end up with a functional, pain free joint.  Not a perfect joint.  Any time a joint has been damaged in this way arthritis will develop, so part of the treatment is life-long arthritis management to ensure the best long term outcome.
    2. Around 50% of dogs that rupture one ACL will rupture the other at some stage.  Yep…50%.  You remember I said we always x-ray both knees?  Well that’s why…we know that around 50% of dogs will rupture their other ACL and often we can predict that likelihood based on the x-rays.  There are also other factors; for example if I see a 2 year old Rottweiler with a ruptured cruciate I can almost guarantee that the other ACL will rupture within a year or 2.
  • So If we go for surgery what sort of recovery can I expect?

    While every patient is different, I always advise owners to expect around a 12 week recovery/rehab period.  The surgery is the easy part…it’s often the recovery period that causes more headaches for patient and owner.  Don’t worry though, we guide you through it as best we can.

    Then What…Is Fluffy fixed?

    There are 2 things we always discuss when we make a diagnosis of cruciate ligament disease:

    I’ve waffled on beyond my word count now so thanks for reading and if you need any further information send us an email to enquiry@vetsfirst.com.au or simply give us a buzz at your preferred clinic.  Don’t forget to ask for the free e-book on cruciate ligament disease too!

    Until next time…


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