Looking for advice on old dog with torn ACL please

[Lisa Loves Shiny]

Hi guys. I'm back asking for dog advice again.

My dog is 13 years old and has sleep apnea. She has done poorly under anesthesia in the past. Thursday she injured her knee. We didn't see the event, just that she couldn't bear weight on it. Vet told us to watch her and bring her in on Friday.

Friday was X-rays and exam. Vet said she believed our dog has a torn ACL but sent the images to be reviewed by a radiologist who was supposed to call us Saturday. He never did. The belief is that while they can't see a torn ligament on an X-ray the radiologist might be able to see if the bones are not quite in their normal position. The vet said our dog would need TPLO surgery and the surgery would take about an hour and a half. She put the dog on Gabapentin and Rimadyl. We carry the dog down the steps because she slides out of the sling.

Today our dog is not limping and walking normally.

Has anyone experienced anything similar? I'm hoping that she has a knee sprain or a partial tear that may not require extensive surgery. Everything I read (Google) recommends surgery for even partial tears.

Thank you kindly in advance for any suggestions.

 

[tyty333]

Just wondering if she can stay on Gabapentin and Rimadyl long term? I don't know anything about either drug (or anything
about dog's ACLs either).

 

[Lisa Loves Shiny]

Just wondering if she can stay on Gabapentin and Rimadyl long term? I don't know anything about either drug (or anything
about dog's ACLs either).

That's a good question and thank you for taking the time to help me think this out. I think if she heals enough for the inflammation to go down to normal she might not need them long term. I'm not sure if she continues to do well if we won't be faced with her needing surgery if the knee joint continues to be unstable. Or if she favors one knee and is putting additional stress on the other that she won't end up with both ACLs ruptured. Or maybe she heals enough and scar tissue forms allowing the joint to become more stable. So many questions but the vets here always push surgery.

I had a 16 year old dog with a huge spleen tumor and grade 3 heart murmur. They pushed surgery so hard and would not give me any information on surviving the surgery or survival rates. We did home hospice instead and she died two weeks later. Only after she died did the vet tell me she would not have survived the surgery. It was a very hard time and so much unnecessary pain and angst regarding if we were doing the right thing.

 

[Ally T]

I agree that if she is now walking normally, given her age & intolerance to general anaesthetic, I would ask about long term pain relief. I hope she is feeling much better soon.

 

[elizat]

I was in the same spot with my dog that passed at Christmas at almost 16.

When he was about 12, he did the same. They thought it could be a torn meniscus (I think?)or cruciate ligament but couldn't see on a scan. Given his age, my vet was conservative and said to do steroids and pain meds to see what happens, plus rest. He actually sorted on his own. Give him a chance. If it's truly torn all the way, it will require surgery.

My other dog tore his cruciate in half and the difference was night and day. He had the surgery as he was younger about 1.5 years ago. He has an artificial ligament now.

So having had two dogs with this issue give rest and meds a chance if your dog is now walking normal and get it rechecked. With my old man, his ended up basically healing up on its own and scar tissue developed around it.

With an old dog and a big surgery, if the dog seems ok I'd give it a chance to see if maybe there is no tear of if scar tissue developed around a partial tear.

 

[elizat]

Also, if it's a total tear they just can't walk on it. No weight, it atrophies, etc. Oliver had that so we did the surgery and he was hobbling while he waited for weeks for surgery.

He takes rimadyl and gabapentin even 2 years out. They can be long term meds but require blood work yearly due to liver issues. Lmk if you have more questions. I have had a clear rupture dog and a dog that they never could see it.

 

[elizat]

Oh- your dog's size matters. They do a tplo for bigger dogs and they can just do an artificial ligament for smaller. The artificial ligament tends not to take after a certain weight with the wear and tear post surgery. Oliver is 24 or so pounds and has lost weight post surgery.

 

[mom2dolls]

Our boy Max had something similar. We opted for the medication, due to his age and other health issues. He was on the medication about four months. I hope your baby feels better soon

 

[Piper70]

Our 5 yo pitbull had a CCL tear ( probably partial ) in 2021 and we did have the TPLO surgery on her because she was so young and very active. It’s a looong difficult recovery. I don’t think I would put an older dog through that unless it was definitely a full tear and was unable to walk. I would wait and see if it can be managed with the pain medication.

 

[Lisa Loves Shiny]

Thank you everyone for sharing your thoughts and experiences. It means so much to me.

Still waiting for the vet to call back and I called this morning to remind them that I am not going away. Vet care here is not very good because we have very few private vets and mostly clinics in which you pay for a wellness plan and any issues such as orthopedic injuries or cancer gets referred to a specialist with lengthy wait times.

My sweetie is still looking better and so sweet to go into her new kennel to keep her from jumping on the couches. I tell her "kennel" and she ignores me. I tell her sternly "kennel" and she puts her head down and goes in. She gets a tasty treat for being such a good girl.

I put her harness on and let her go down the steps with me holding it instead of carrying her outside today because she acts like she is having a seizure when I carry her down the steps and that seems to be more damaging to her than letting her navigate the steps with help.

I remain hopeful and thank you all for your warm thoughts and prayers. Please keep them coming because I think they are helping. {{{Hugs}}}.

 

[Lisa Loves Shiny]

Updating this post to say the vet still has not called but puppers seems to be doing very well. She keeps trying to run and dance. She does what I call the Rottie dance when excited. I am going to tackle the vet tomorrow because today I was busy with mom and my sweet dog seems to be doing well. Thank you all for your prayers and warm thoughts- they mean everything!!!


My sweet is missing her walks but I think we need to wait at least another week for that and I am cutting her calories due to her decreased activity. She probably hates me for that, but she is so loving she still loves me. Has anyone ever met a sweeter or more forgiving spirit than a dog?

Thank you everyone. I feel that this forum has some of the sweetest and kind hearted people on the planet. Hugs

 

[CMN]

Hi there,

My dog has had two TPLO surgeries on his back legs. For a while even with the surgery he would sometime get a flare up where he would lightly limp (not as severe as before the surgery). On those occasions the vet prescribed some anti inflammatory medication and he tended to get better in a few days. However, subsequently we have also (on the vet‘s recommendation) changed his diet to a special anti inflammatory food: Royal Canin Veterinary Mobility Support C2p Plus Dry Dog Food

i Am in Australia so whilst the product name might not be the same there is likely to be something similar available. I note this because ever since changing him onto that diet his instances of a flare up have reduced by about 85% Of course correlation does not mean causation but I thought it significant enough to mention it to you.

 

[Scon_ce]

My 9 yr old 55 lb dog tore her ACL in Aug 2022. She could not put any weight on that leg but was not in too much pain and only required rimadyl for the first few days after it happened. The wait for TPLO was about a month.
Rimadyl again for the week or two after surgery. Recovery went well, she still demanded her walks several times a day! Most stressful was wearing the cone and having the leg in a splint. And loading/ unloading for the 3 hr round trip to vet for all the checkups. But really, once she learned how to lie down and get up with the splint things went pretty smoothly. Now 13 months post surgery , if you didn’t know you wouldn’t know. No limp and no meds required. She is not an athletic dog but has always been walked regularly. She is maybe not as as strong as before but that’s ok because she used to be a leash-puller but since the surgery not so much!

 

[Lisa Loves Shiny]

Another update and request for opinions and advice please. Please keep in mind my dog is 13 years old and almost died under anesthesia 4 years ago while getting her teeth cleaned. The vet has not wanted to clean her teeth since due to anesthesia risk.

I am going to admit that recent events in my life have left me very insecure about making decisions. I feel somewhat paralyzed in decision making. I like to do the math, weigh the pros and cons but I am not getting meaningful input from the vets. Surgery is the 'gold standard' and I don't believe they are considering the risks like I am. It reminds me of the old saying 'the surgery was a success but the patient died' and I do not want that. I also don't want my dog to blow out her other ACL/CCL because of the stress on her good knee. I don't know what to do.

Sweet dog is walking well, dancing and jumping, no issues that I can see but she is still on Rimadyl and has not taken her daily walk for 2 weeks. I scheduled a follow-up with the vet that was supposed to occur yesterday. I got a call from the vet right before leaving to not come. My dog's regular vet is on vacation, but she recommended surgery before she left when the dog was lame on her leg. I scheduled a follow-up with her partner. The dog is walking on her leg just fine now. I wanted to talk about treatment options, activity levels, when we can wean the dog off her medications. So no face to face as I hoped. I was told via the tech who put me on hold to talk to the vet that since I was not considering surgery, there was nothing to discuss. ???????

I did get some clarification that the vet believed they saw a complete CC rupture on the X-ray. This is something I did not know.

I think my dog has always had the CC rupture. When I got our sweet dog 5 years ago I asked her to X-ray her hips because I worried she had something wrong with them. Sweet pup did not want to sit and when she did she sat sideways. Vet told me there was nothing wrong with her hips.

After researching ACL/CCL tears in dogs there are videos of the "sit test" in which you can see a dog sit the exact way my dog has done since I have had her when they have an ACL/CCL tear. Has she always had this? It looks like she has.

Hubby says 'no surgery' but we talk things out so that is not written in stone.

Vet refilled another 2 weeks of Rimadyl and Gabepentin. Those meds can't be good on an elderly dog's kidneys but I think we will do another 2 weeks.

I think I should schedule an appointment with a rehab vet and there is one an hour away who uses cold laser and other treatments. I just don't want to be turned away again if that vet also believes surgery is the only option.

 

[elizat]

Hi, I think that going to another vet to get a second opinion is the best option. If your dog is doing all the normal activities without being in pain, I would be thinking about the same process as you. Also if they don't even want to put her under anesthesia to clean her teeth, but they are saying she needs this even when she's acting normally, I would be concerned as well. As someone that recently lost an older dog, I would have been devastated if I would have booked him for a type of surgery when it wasn't truly necessary and he died under anesthesia even if it was the textbook treatment.

I think get your second opinion and go from there. I would focus on someone that treats elderly pets. There are lots of dogs that are on the pain medication and rimadyl daily, or just PRN, and they just have to have blood work. To me, it would seem like the risk of medication management might be less than surgery. For what it's worth because we had the lesser surgery in my household, my vet has told me with either surgery. It is common for pets to be on both rimadyl and or gabapentin sometimes for the rest of their life prn. That's normal at least based on what they tell me.

It would be an easy choice if the dog was not acting normally, could not walk, or move. I would also try to start doing short walks to see how your dog does. Glucosamine supplements and weight management become really important even if they don't have surgery. Just like people really!

I would be dealing with this very conservatively given your dog's age and the fact that they do not want to even do anesthesia for a teeth cleaning.

The procedure they want to do is also a hard recovery for the dog. Even the lesser version that my dog had because he is a smaller dog with the artificial ligament had a recovery period of probably 6 months before he wasn't in pain every day. But he was like eight at the time. I would have never put my old man through that. Ever.

You are doing the right things. Get that second opinion. Talk to someone that treats elderly pets as a focus if you can. It's clear you want to make the best decision and are weighing it all out.

 

[CMN]

I agree with @elizat. The age of the dog, symptoms, management options, and quality of life are all factors that need to be considered holistically. This may include water therapy (I should mention that my dog has done very well with his legs by doing a lot of swimming).

Do not second guess yourself here. I think you are absolutely asking the right questions. Quite frankly I do not see how a vet can recommend surgery without taking into account all aspects of the dog’s health and age and treatment options. If they are doing their job properly they should be more than willing to discuss this with you.

 

[OneFifty]

I'm sorry you are going through this.

My 13 year old dog is on Rimadyl and has been for a year due to arthritis. He was only on Gabapentin when we were getting the initial inflammation down. Our vet said that he could be on this medication for the rest of his life.

His quality of life is really important to us. He is a very active lab and loves to hunt. Since we put him on this medication, he is still showing his age, but he is more like his old self.

 

[winnietucker]

We had this with both dogs. One we did surgery because it’s what was recommended. Our second dog’s knee didn’t seem too bad so the vet recommended 2 different pain killers, fish oil, and cosequin - he’s on that. The dog who didn’t have surgery also hasn’t handled anesthesia well in the past but I can’t remember if that was a factor in the vet’s recommendation because it’s been a while at this point.

 

[Garnetgirl]

Because if your dog’s age and previous anesthesia problems, I would be inclined to leave well enough alone. Best wishes to you and your pup!

 

[Piper70]

One thing I can add from our experience is we cut down on anything that includes jumping or cutting/pivoting. So no more fetching tennis balls, limiting jumping on and off furniture etc. Coco still gets zoomies outside which I can’t control but I’m not adding to any further issues to the surgically repaired leg or the “still good so far” leg. They told me at the time of the first surgery that dogs who have one CCL tear have a 50% higher chance of having the second leg tear.

 

[Lisa Loves Shiny]

Thank you everyone! I took a break from the Internet to help with my anxiety so sorry for taking so long to thank everyone for their help. It means so much to me.

Doggie is doing well so far. Today she had her appointment with the rehab vet. The examination was very thorough. She went through everything from a gait test where the dog walks on a mat that measures the pressure she places on each leg, a physical exam and she measured her range of motion at the knee joint. This took over an hour.

I did get answers and a treatment plan. Long story short- the rehab vet gave me evidence that our dog does not have a complete CCL rupture. And she pointed out that despite our vet verbalizing a complete CCL rupture, the vet only noted joint effusion when reading the X-Ray.

The rehab vet does not believe our dog needs surgery at this point. She told me if it was her dog she would hold off and see if the dog continues to do as well as she is. We did do a shock wave treatment and will do another in 2 weeks and one more 2 weeks later.

We will wean our dog off her Rimadyl in the next week and she told me to just allow her to walk through the house and go outside to potty. No walks, no jumping. Then we will see if we can increase her activity in two weeks.

Thanks again for the advice, prayers and well wishes!

 

[Garnetgirl]

This sounds like very good news, and so encouraging. Good luck @Lisa Loves Shiny