The Editorial TeamOwner and Editor: Paul Alexander Editor: Shadow and Bobbi Contributing Writers: various members of dogpawfile
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Anterior Cruciate Ligament: Angie’s Knee Replacement
By: Marjorie Myles- Bilous
On a typical late autumn Sunday evening, the dogs wanted out into the yard to play. They were safe in a fenced yard with squirrels to chase, leaves to rummage through, and lots of open space to wrestle and have a ball. It was when it was time to call them in that things weren’t so typical! Five dogs had gone bounding out. Four came bounding in. The fifth dog was limping and refusing to put any weight on her left back leg. Little did we know, this in itself is the typical tell-tale sign of a torn ligament in the knee, or more correctly , a torn anterior cruciate ligament.
Angie, a head strong, feisty Cairn Terrier, had somehow in that short time damaged her knee so badly she required surgery. According to her vet, Dr. Ian Webb, “Aside from Spay and Neuter, ACL surgery is becoming perhaps the leading procedure preformed in veterinary offices”. It is more common in larger more athletic breeds. What often happens is that as the dog is exercising, it lands wrong, gets its foot in a hole, or shifts its weight the wrong way, and tears the ligament. “Years ago, they would never have operated on these dogs,” Dr. Webb explained. “The ligaments would not heal, and dogs would go lame, and/or develop arthritis in the joint.”
Angie’s humans had some knowledge of this sort of injury and the surgery as their own daughter’s dog, Jema, had both of her knees done. Jema’s surgery and recovery has spanned nearly two years. She is a very athletic dog; as a result, once the first knee was healing, she damaged the second. The expense of the surgery is daunting, compounded by a long and committed recovery period required to get optimum results for the dog. Having looked after Jema on occasion for their daughter during her rehabilitation, Angie’s folks were aware of what was to be expected. They were also keenly aware of how they felt about their own dog and wanted to do everything in their power to make it right.
In assessing Angie, Dr. Webb made the following suggestions: Angie would require surgery, needed to loose at least 6 lbs, and have at least 5 months of rehabilitation. If these things were all done, she would likely have a positive outcome and make a full recovery. Jema’s surgery was more intensive than the one considered for Angie, and her recovery time longer than that anticipated for Angie. There was much debate between Angie’s folks and their one daughter as to who should preform the surgery, and how her recovery should be handled. The daughter wanted to take Angie to live with her and see her vet, as she was experienced with the situation and well suited to taking care of Angie. In the end, Angie’s folks went with their own vet, and he preformed the surgery. It was unimaginable to them to not have her at home and in her familiar surrounding during this time.
Two metal plates were secured to either side of the upper portion of the knee joint and connected with wire to the bone below, essentially creating a new ligament to replace the damaged one. In the course of healing, new sinuous ligament material would eventually over grow the metal and replace the torn ACL. Angie’s leg was shaved bald for the surgery, and she was sedated for many hours after the procedure was complete. The first hurdle to be crossed would be if she would stand after surgery. After five hours, when her folks called to see how she was, the news was positive. Angie was one her feet and looking for love from the staff at the clinic. She would have to be carried to the car to come home and carried to her crate, and only allowed a few small steps at first. There would be no weight bearing for several weeks, and she was to be confined to a crate until she could put her foot down. Angie was to be walked on leash every time she went outdoors to toilet, and most definitely could not navigate the stairs.
This meant that Angie’s companion, Farley, had to leave his home for several weeks while she convalesced. Angie was miserable in her crate. She whined from hunger as her meals had been dramatically reduced due to her lack of exercise, and the vet’s instructions that she shed six pounds. After about three weeks, Angie was allowed out of the crate while her people supervised her. Still, Farley couldn’t be with her. She whined and looked for him. She rested a good deal, and dutifully took her pain relief medicine, Meticam. Time passed for her, and by the fifth week, she was actually putting her foot down and tentatively putting weight on it.
Angie was supposed to do stretching exercises to strength the leg and these started to be done at this time. Finally, she was in a place in her recovery where her buddy could come home and be with her. She was very excited to have Farley home. When her owner took her for a walk, she slipped her collar and ran! This was not a good thing. She suffered for her exertion and did not repeat this behavior for sometime. She quickly realized her limitations. Angie played with Farley, but never to the point where she allowed herself to be hurt.
There was some discussion as to whether she would go south with her humans or stay at her second home for the winter. She eventually stayed at her second home where her recovery continued. She shared this space with three other dogs plus Farley. It was not easy being on leash to go outside when the others were free to run. Dutifully, at 6 in the morning in Pj’s at sub zero temps, Angie was taken for her constitutional. Every time she had to go outside for over a month in freezing temperatures, she was walked. She was stretched, flexed and exercised as per her physiotherapy. Each day, she was walked with the other dogs, till she could do a mile and half without discomfort. She got to the point where she was trying to break off lead on walks to run, so a special harness had to be purchased.
After four long months of recovery, Angie showed that she was stronger and healthier than she had ever been, and was finally allowed off leash in the yard to be with the other dogs. She was reluctant at first to push herself, but she has found her footing. She still requires a small amount of Meticam for pain relief when she exerts herself too much. She is on Glucosamine daily and will continue this for her lifetime.
Perhaps the toughest decision to make was to spend the money on the surgery. Angie is a remarkable dog, and one would hate to see her lame at such a young age. Thank goodness there is an option. Angie’s story proves that with will, determination, and lots of loving human support a dog can flourish.