ACL or Ruptured Cruciate Ligament Knee Injuries in Pets

Meet Jack…an English Bulldog with a great job and an exciting story to tell. Sadly, Jack’s career was almost derailed due to an unexpected injury. Like so many NBA stars and skiers, Jack messed up his knee and was sidelined for many weeks. Thankfully, prompt care and a great surgery team got Jack “back on the road again!”

Just one look at Jack and you can tell that this is a dog meant for bigger things. From blogging about his travels as New Mexico’s Canine Travel Reporter to his awards from the governor, Jack oozes confidence and excitement. So, when Jack ruptured his cruciate ligament, neither he nor his human partner, Jill, were going to let anything stand in the way of his speedy return to the spotlight.

Normal Stifle x-ray

Like people, dogs have two cruciate ligaments to help provide support for the knee. Their presence keeps the femur and tibia from sliding around and destabilizing the joint. According to veterinary surgeon, Dr. Phil Zeltzman, repairing torn cruciates is the most common surgery at veterinary surgery centers. He adds that certain breeds (Labradors and Rottweilers) show up with this injury more frequently than other pets.

Dogs can rupture these ligaments with sudden twisting movements while running or even from slipping on ice. In Jack’s case, a sudden meeting with a child’s snow sled was enough to cause the injury. After seeing Jack limp into the house that snowy day, Jill knew an appointment with his veterinarian was needed.

In most cases, diagnosing a cruciate tear simply requires a veterinarian’s examination and, if the patient is not cooperative, a touch of sedation. Palpation of the knee joint is the key to the diagnosis although it is also a good idea to take x-rays of both knees to look for any other problems.

The next step is surgery. According to industry experts, pet owners spend more than $1 billion dollars on cruciate surgeries for their pets each year. A variety of procedures exist to help stabilize the knee, but most surgeons will utilize one of three procedures. Because of Jack’s anatomy, breed and size, surgeons at the New Mexico Veterinary Surgery Center determined that the Tibial Tuberosity Advancement surgery would be the most effective solution.

Radiographs to the left show a ruptured ACL ligament in one of my patients, Luna. Compare it to the normal knee and you can see at the 90 degree angle of the x-ray on the left, the femur or the big thigh bone sits almost behind the tibia or the lower leg bone. The cruciate ligament stabilizes the knee. Luna had a TPLO surgery (Tibial Plateau Leveling Osteotomy) performed by Dr. Payne of North Houston Veterinary Specialists. Dr. Payne is a veterinary orthopedic surgeon and travels to the veterinary clinic that requires his services.

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The surgery requires very special instruments and surgical skills for a successful outcome and at Luna’s 6 week check up, she was walking great.

As with any pet surgery, cost certainly is an issue. It is not unusual for these cruciate surgeries to range in cost from $1200 to more than $3000. David Goodnight, CEO of PurinaCare pet insurance says that nationwide, the average cost for this type of surgery is $2500.

Some pet owners will question the need for surgery as fibrous tissue in the dog’s body will eventually stabilize the joint. Sadly, this could lead to bigger problems, including severe osteoarthritis or even a rupture of the ligaments in the other knee. Certainly this route only increases the pet’s discomfort.

After surgery, most dogs feel much better. In fact, it’s a challenge for owners to keep their pets rested during the recovery. Jill recalls her experience with Jack, “Luckily I remembered to always keep him on a leash outside…by day three after surgery, I could see him wanting to run!”

This 8-10 week recovery period is crucial. Too much activity can delay healing at the site or even cause enough damage that a second surgery might be needed! The doggie patients need to stay in a crate when they can’t be supervised, go outside ONLY on a leash and only for bathroom breaks until the surgeon says short walks are ok. Running, jumping and stairs should be avoided.

Jack has made a complete recovery and is now back educating people about the wonders of New Mexico. But he is not out of the woods yet. About half of dogs who rupture one cruciate will tear the opposite knee’s ligaments. Along the course of his recovery, Jack’s veterinarians have made several recommendations to help him avoid this fate.

First, weight control! Excess weight creates additional stress on joints and can lead to ligament tears.

Next, daily exercise is important. Spending about an hour each day engaged in moderate exercise is not only a good way to keep your dog healthy and limber…it will probably help you too!

Finally, don’t overdo it! You wouldn’t run a marathon without training, so don’t expect your dog to hike 4-5 miles with you immediately.

Your veterinarian will also have some helpful ideas to protect your pet’s joints. Nutraceuticals, like glucosamine or rehabilitation exercises can help strengthen and support the knees. Canine Dasaflex contains a blend of ingredients to help with joint health and pain.

What are “Hot Spots” in Dogs?

The dog’s skin is the largest organ of the body, yet there is a very restricted number of ways in which it responds to trauma. “Hot Spots” or acute moist dermatitis are locations on the dog’s skin due to your dog’s itching, biting and scratching and may often arise quite suddenly. These places may become very large and may develop just about anywhere on the dog. I see it sometimes in the spring time once the temperatures are warmer as well as the humidity is high. The dogs with the thick undercoat, such as Labs, golden retrievers and rottweilers are susceptible to getting these spots on their face and neck. Typically, spots located at the base of the tail are very likely resulting from fleas simply because fleas choose to congregate in these areas. Quite a few dogs happen to be so hypersensitive to fleas, the bite of one flea is sufficient to induce the dog to itch all over. Almost any injury can begin the process which the dog then exacerbates by continual chewing and licking which in turn results in a vicious cycle and will cause the hot spot to spread.

The dog normally has bacteria that lives on their skin and so long as the skin is healthy, the microorganisms almost never result in any issues. However when something occurs, such as a fleabite, cut or allergies, the dog begins to lick, bite, chew and scratch which in turn disrupts the defensive layer of the skin. As soon as that takes place, the bacteria on the skin, as well as the germs in the mouth, set up housekeeping in the skin. This creates a swiftly spreading infection which may be quite painful. The area on the skin is red, raw and seems moist because the wound oozes serum and pus. The hair then mats down over the wound and the infection then spreads beneath the hair.

A visit to the veterinarian is usually called for. In many cases the fur must be clipped off to stop the spread of the infection. Sometimes, these hot spots are so painful, the dog may need to be sedated in order to have the region cleansed and shaved. Antibiotics are prescribed to take care of the infection and follow-up antibiotics are sent home. Sprays, ointments and medicated shampoos can also be prescribed to continue treatment at home.. For some dogs, a special collar may be used that can help deter the dog from chewing at the places.

The particular underlying reason for the insult should likewise be tackled. If fleas can be found, then year round flea control may be prescribed.(over-the-counter flea control is not recommended) Pollen, food, and other allergens can also precipitate an attack. Sometimes specific diets with essential fatty acids and a novel protein source for example salmon, lamb or venison may be recommended to help heal the skin. Blood and skin tests can be preformed to help discover what the dog is allergic to and special allergy injections or prescription diets is often given.

Check your dog daily for itchy spots and use flea control suggested by your veterinarian year round to help avert hot spots as a result of flea allergies. Daily grooming and brushing can keep mats from developing. If your dog is itching continuously, take him to the veterinarian to handle the itching before the infection can progress.

Canine Parvovirus

Puppy Vet Visit

Canine Parvovirus is a serious, highly contagious disease that affects the digestive system. It is most common in puppies.

How Dogs Get Parvovirus
Susceptible dogs are infected by swallowing the virus, which is found in the droppings of infected dogs. The virus is difficult to kill with ordinary disinfectants and can survive in the environment for years. People can inadvertently spread it on their hands, shoes, or inanimate objects.

Not every dog exposed to Parvovirus will get sick. Puppies, especially those that have not completed their vaccine series, are most vulnerable. Those born to mothers that were not vaccinated are at extremely high risk. Other factors that influence susceptibility include stress, genetics, parasite infection, and general health. Some breeds, such as Doberman Pinschers and Rottweilers, seem to be more likely to become seriously ill.

What the Disease Does
Parvovirus infects the bone marrow and lymph system, weakening the dogs immunity. It simultaneously destroys the lining of the intestinal tract, preventing absorption of water and nutrients. The damaged intestine can leak bacteria into the body. In newborns the virus also damages the heart. Signs of Parvovirus include fever, lethargy, loss of appetite, vomiting, bloody diarrhea, and dehydration. Dogs can die from dehydration or from bacteria in the bloodstream.

How Parvovirus is Diagnosed
Diagnosis begins with a physical exam but also includes laboratory testing of the feces. Other tests that can help the veterinarian treat the disease more effectively include a blood panel and a fecal test for parasites.

Treatment for Parvovirus
There is no specific treatment that kills the virus, but sick dogs are treated for secondary infections and to reduce the symptoms. Hospitalization is usually required. Treatment may include IV fluids to help with dehydration, IV electrolytes and nutrients, antibiotic injections, medications to control vomiting, and drugs that stimulate immunity. Up to 90% of puppies recover with treatment.

Preventing Canine Parvovirus
The key to preventing Canine Parvovirus is a good vaccination program. Puppies are vaccinated starting at 6-8 weeks of age and boostered every 3-4 weeks until the puppy is at least 16 weeks old. In highly susceptible breeds, boosters are given as old as 22 weeks of age. After that, vaccinations are given every 1-3 years depending on the type of vaccine. Its especially important for female dogs intended for breeding to be vaccinated. This allows them to provide immunity that protects their puppies until they are old enough to receive vaccinations.

Puppies

Adult dogs that have never been vaccinated before are given one or two vaccinations initially, followed by re-vaccination every 1-3 years. Ask your veterinarian about the best vaccination protocol for your dog.

Dogs with Parvovirus should be isolated from other dogs since the disease is highly contagious. Contaminated objects should be disinfected with a dilute bleach solution.

Because puppies that have not yet received their entire vaccination series are susceptible to Parvovirus, veterinarians recommend minimizing their likelihood of exposure. Avoid taking them to parks or other public, outdoor areas where soil may harbor the virus. If possible, choose puppy socialization and training classes that require the puppies to have started their vaccines. The classes should be held in places that are disinfected regularly. It is also preferable to avoid boarding very young pups.

Keeping your puppy healthy will reduce his susceptibility to Parvovirus. Be sure he receives regular veterinary checkups, gets all recommended vaccines on time, is treated to control parasites, and enjoys a healthy diet.