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.

Can Dogs Get Arthritis?

Did you know that dogs and cats can also develop arthritis in their joints?  Osteoarthritis is the most common type of disease in our pets and is frequently found in the hips, knees, shoulders, elbow and in the bones of the spine. Some arthritis can develop from a ligament rupture such as a torn cruciate in the knee or a knee cap that slips from the groove of the tibia. Hip dysplasia in dogs is the most common cause of arthritis of the hips. Early surgical correction of the knee and hips can help stave off the arthritis. Obesity, and congenital conditions can also contribute to arthritis formation. Old, large breed dogs, such as Labradors, can also get arthritis in their spine.

Rheumatoid arthritis is caused by a malfunction of the dog’s immune system. The antibodies that normally protect the dog from foreign invaders incorrectly attacks the joints of the dog causing severe cartilage and bone deterioration. Blood tests can help identify rheumatoid arthritis. Auto-immune arthritis is treated with corticosteroids to reduce the inflammation.

Arthritis can also be caused by infections, either bacterial, fungus or viral. Leptospirosis and Lyme disease are common invaders that can cause arthritis. Septic arthritis is ususually treated with antibiotics.

Some dogs may not exhibit symptoms of arthritis until the disease is well advanced. Lameness, limping, difficulty in getting up, reluctance to jump or resisting walking can be signs of developing arthritis. Sometimes a loss of appetite, lethargy or other signs may also develop.

A trip to your veterinarian for an exam, blood tests and radiographs (x-rays) can help identify the problem. Surgical intervention can help with some cases of arthritis, especially of the knee, and hip. Arthroscopic surgeries and joint replacements are now common place at larger referral hospitals or Veterinary Universities. Rehabilitation with water treadmills are now available for our pets, too.

Some arthritis can be managed with anti-inflammatories, such as Rimadyl or other NSAIDS. Diagnostic blood work is recommended to monitor for possible affects on the internal organs.

Glucosamine and chondroitin may also be effective with arthritis by providing the basic components cartilage needs to repair itself. These supplements can be given as a chewy treat  (Joint support) or can be in prescription diets such as Hill’s j/d diet.

Your veterinarian can help advise you in a treatment plan to alleviate the pain in your pet and have a better quality of life.

Feline Asthma

Feline AsthmaFeline asthma is a relatively common ailment, affecting about 1% of cats. The disease closely resembles the same condition in humans.

What Causes Asthma
Asthma is triggered in susceptible cats by exposure to allergens or irritants. Common culprits include pollens, cigarette or fireplace smoke, various sprays, perfumes, deodorizers, carpet cleaners, and dust from cat litter. In response to exposure, the smooth muscles surrounding the airways contract, narrowing the breathing passages. The airway lining may also become inflamed and produce excessive amounts of mucus.

Signs of Asthma
The most common sign of asthma is coughing. It is often mistaken for hairballs. Other signs include difficulty breathing, wheezing, and lethargy. Cats experiencing severe episodes of asthma may pant with their mouths open.

Diagnosis
Diagnosis begins with a thorough history and a physical examination. The veterinarian may detect wheezing sounds with the stethoscope. However, additional tests are usually needed. X-rays often show characteristic signs of lung inflammation. A tracheal wash, in which cells rinsed from the airways are examined microscopically, is sometimes recommended. Tests to rule out parasites, such as heartworms, may be necessary as well.

Treatment
As in humans, asthma is a condition that is treated but not truly cured. Many cats respond well to treatment with inhaled medications administered through a face mask. Corticosteroids help to control the inflammatory response in the lungs. Bronchodilators help keep the airways open during an attack. Some cats may need both types of medications. Oral medications are also used, but may be less effective or have greater side effects. Cats whose asthma is not completely controlled with inhalant medication are often prescribed oral corticosteroids as well.

Cats experiencing a severe, acute asthma attack require emergency treatment. They should be kept quiet and handled as little as possible on the way to the veterinary hospital. Once there, they will be treated with oxygen and fast acting corticosteroids. They may also receive bronchodilators. These severe attacks can be fatal.

Preventing Attacks
It is crucial to use inhalers and other prescribed medications exactly according to instructions. In addition, reducing exposure to potential irritants is beneficial. Choose a low-dust or non-clay cat litter. Avoid smoking in the house or using the fireplace. Choose products that do not contain heavy perfumes or deodorizers. When using hair sprays or cleaning sprays, make sure the cat is out of the area first. You may wish to consider an air purifier. Keeping a log of your cats asthma episodes can help you to identify some of the triggers so that they can be avoided.

Disc Disease in Dogs

iv discAs pet owners, we all hope that our dogs never have to experience disc disease. However, this is a fairly common condition in some breeds and in many geriatric pets. Discs are essentially cushions that help to absorb tension and pressure between the vertebrae. Humans have this same mechanism and can also suffer from disc disease. By acting as shock absorbers, discs help to protect the very delicate nerves found within a dogs spinal column.

There are several reasons that may cause your dog to develop disc disease. In many cases, disc disease occurs due to a trauma, such as falling, jumping off of furniture, being struck by a car or even rough-play. Discs can also degenerate as a pet becomes geriatric. Obese dogs are very prone to developing disc disease as well due to the extra pressure on the back caused by the fat. Certain breeds, such as Dachshunds, Basset Hounds, Cocker Spaniels and other breeds with long backs can be more prone to developing disc disease especially if overweight.

The symptoms of disc disease are normally rather obvious. These signs will vary; however, depending on which disc is affected as this disease can occur anywhere on the spinal cord. For example, if your dog leaps from the bed and a disc in the middle back becomes slipped (known as a slipped disc), they will have greater pain in this area and the rear legs may be more affected. The abdomen may become rigid, the dog may tremble and in some cases they may even lose control of their bowel and bladder. In cases where a disc in the upper vertebrae around the neck is affected, the dog will likely have difficulty holding its neck and head up. In any case, the dog will be weakened and often lethargic. In severe cases, disc disease can also lead to paralysis.

As pet owners, we all hope that our dogs never have to experience disc disease. However, this is a fairly common condition in some breeds and in many geriatric pets. Discs are essentially cushions that help to absorb tension and pressure between the vertebrae. They can rupture applying pressure to the spinal cord and delicate nerves.

As pet owners, we all hope that our dogs never have to experience disc disease. However, this is a fairly common condition in some breeds and in many geriatric pets. Discs are essentially cushions that help to absorb tension and pressure between the vertebrae. They can rupture applying pressure to the spinal cord and delicate nerves.

As pet owners, we all hope that our dogs never have to experience disc disease. However, this is a fairly common condition in some breeds and in many geriatric pets. Discs are essentially cushions that help to absorb tension and pressure between the vertebrae. They can rupture applying pressure to the spinal cord and delicate nerves.

If you notice any of the above symptoms in your dog, you should seek immediate veterinary attention. Your veterinarian will perform a thorough exam and will likely need to take X-Rays to further assess the health of your dogs vertebral column. If caught early, disc disease can be successfully treated with medications. Anti-inflammatories, antibiotics, pain medications or a combination can be used to treat this condition. Be sure to closely follow your veterinarians instructions on how to administer these medications. Dogs with acute ruptures will need surgery to remove the debris in the spinal canal and relieve the pressure on the spinal cord. I had a disc rupture a few years ago which did need surgery to remove the debris and I must say that the surgery has given me great relief and I am now pain free.

Treatment does not just involve giving medications. Your pets activity may need to be restricted and jumping and rough-play are definitely prohibited. This means no more leaping from furniture! If your pet is overweight, it will also be very important to begin a high quality diet that promotes weight loss. Your veterinarian will recommend a diet that is right for your pet. Once your pet has been cleared for increased exercise by your veterinarian, regular walks will greatly benefit your dogs weight and overall health.

Urinary Problems in Cats

Bladder problems in cats

Problems of the bladder and urethra are all too common in pet cats. The lower urinary tract can be a site for inflammation, infection, stones, and obstructions. Together, these conditions are referred to as Feline Urological Syndrome (FUS) or Feline Lower Urinary Tract Disease (FLUTD). Signs that your cat may have lower urinary tract disease include difficulty urinating, blood in the urine, or urinating in inappropriate locations.

Feline Cystitis
Cystitis means inflammation of the bladder. In dogs, its often due to an infection. Although infection does occur in cats, up to 60% of cases of feline cystitis are idiopathic, meaning the cause is unknown. Possible causes such as viruses and stress are being researched by major veterinary colleges.

Cats with cystitis urinate frequently, producing small amounts of blood-tinged urine. They may cry or appear to be in pain when urinating. Cats with any of these signs should see the veterinarian for a physical examination and urinalysis. The urinalysis can detect infection and other problems. If an infection is found, a urine culture will help identify the best antibiotic to treat it. In cases of chronic or recurrent cystitis, x-rays may be taken to get more information about the condition of the bladder.

bladder

Infections of the bladder are treated with antibiotics. Unfortunately, there is no specific treatment for idiopathic cystitis. Changing the diet so that the cat takes in more water and alters the urine pH is often helpful. Reducing stress is also a good idea. Medications are often given to ease discomfort and manage secondary infections. Most cats recover from idiopathic cystitis within a week or so, but recurrence is common.

 

Urinary Stones
Urinary stones (uroliths) can be a serious, even life-threatening, problem. Uroliths are composed of crystallized minerals, such as struvite, oxalate, urate, or cystine. They can be found anywhere in the urinary tract. In the bladder, they cause irritation, increasing the likelihood of cystitis or bacterial infections. In the urethra, they can cause an obstruction, making urination impossible. The resulting accumulation of urine in the bladder prevents the kidneys from continuing to cleanse the blood. Death can result within days. Male and female cats get uroliths with equal frequency, but urethral obstruction is more common in males due to their narrower urethras.

Cats suffering from uroliths have signs similar to cystitis. However, cats that are obstructed also strain to urinate, without producing urine. It may appear as though the cat is constipated. As time goes on, the cat may vomit, have a tender abdomen, and become comatose. A cat straining to urinate but producing no urine should be seen by your veterinarian immediately.

Diagnosis of urolithiasis is based on a physical exam and urinalysis. X-rays, ultrasound and blood tests may also be beneficial. For proper treatment, the veterinarian must identify the mineral content of the stones, either by finding crystals on the urinalysis or by collecting stones via urinary catheterization or surgery.

big cat

Some stones can be dissolved with special diets or flushed out of the bladder through a urinary catheter, but others require surgical removal. Urethral obstruction is an emergency condition requiring hospitalization. A surgery called a perineal urethrostomy is sometimes recommended for male cats that become obstructed repeatedly. This surgery widens the cats urethra, making blockage less likely.

Around 60% of uroliths in cats are composed of struvite. Cats with a history of struvite urolithiasis should be fed diets that are low in magnesium and that create urine with an acid pH. No other foods or treats should be given. The second most common type of urolith is calcium oxalate. Cats with a history of oxalate urolithiasis are fed diets with reduced levels of protein and oxalate. These diets create urine that is less acidic.

It is also a good idea to encourage cats to urinate regularly by providing adequate numbers of clean litter box.

For the Nutritional Management of Cats with Feline Lower Urinary Tract Disease (FLUTD) caused by struvite uroliths or urethral plugs, calcium oxalate uroliths, or feline idiopathic cystitis (FIC).

FLUTD is often associated with inflammation of the urinary bladder and urethra. It is characterized by clinical signs such as urinating outside the litter box, frequent attempts to urinate, and/or straining to urinate. Prescription Diet® c/d® Multicare Feline is formulated to provide nutritional management of cats with the 3 most common causes of FLUTD including FIC, struvite uroliths or urethral plugs, and calcium oxalate uroliths.

Feline c/d Prescription Diet® c/d® Multicare Feline pet food contains controlled levels of magnesium, calcium, phosphorus, and oxalate to reduce building blocks of crystals and uroliths, as well as enhanced vitamin B6 to help decrease oxalate formation and excretion in the urine. c/d® Multicare Feline also generates an environment that is unfavorable for the development of uroliths due to the addition of antioxidants, Vitamin E and beta-carotene. c/d® Multicare Feline is formulated to avoid excess sodium and has high levels of omega-3 fatty acids from fish oil that help break the inflammatory cycle associated with the most common causes of FLUTD.

Dr. Debra Garrison

Dr. Debra Garrison

Bladder Stones in Dogs

The occurrence of bladder stones is not uncommon in our canine friends and can lead to serious discomfort and even secondary problems if not treated. These stones are rock-like minerals that form in your dogs urinary bladder. There can be several small gravel-sized stones or large single stones in the bladder. In this handout, we will discuss the symptoms, treatment, and prevention of bladder stones in dogs.

It is normally not difficult to detect that your dog is experiencing discomfort related to their urinary tract. The two most common signs of bladder stones are hematuria and dysuria. The former symptom involved the presence of blood in your dogs urine while dysuria is a term to describe when your dog is straining to urinate. If you notice that your dog is having difficulty urinating, do not hesitate to contact your veterinarian. If possible, try to collect a fresh urine sample in a clean plastic cup to bring with you to the veterinary practice. Although these symptoms are good indicators, dogs with bladder infections (without stones) can exhibit hematuria and dysuria.

The build up of bladder stones can lead to serious pain and your pet may even cry out when trying to urinate. It is important to catch this condition early, so that surgery or secondary infections can be avoided and additional stones will not form. Your veterinarian will want to perform a laboratory evaluation of your dogs urine and will also palpate the urinary bladder to see if stones can be felt. In many cases, your veterinarian may want to take x-rays or ultrasound your dog to search for bladder stones.

If it is determined that your pet has bladder stones, your veterinarian will recommend the appropriate treatment. In serious cases where larger stones are involved, or stones that are unlikely to dissolve with other therapies, surgery may be necessary. Removing bladder stones involves opening the abdomen and urinary bladder and it will take your dog several days to recover. Certain types of bladder stones can be dissolved with special prescription diets and your veterinarian will notify you if this is an option. If diet therapy is chosen, it is very important that you follow the exact diet regiment as outlined by the veterinary staff. It can take several weeks to months to fully dissolve bladder stones and your veterinarian will want to follow-up with your dogs treatment until the stones are eliminated.

Once you have eliminated your dogs bladder stones, there are steps that can be taken to prevent future occurrence. Maintaining your dog on a special diet may be indicated and your veterinarian may want to perform follow-up urinalysis, x-rays or ultrasound to detect recurrence. Non invasive investigation and careful monitoring can detect this problem early helping to avoid surgery!