Surgery for Torn Anterior Cruciate Ligament

[balkis]

Hi Mike,

My girl Kaila (about 68lbs) has a torn acl in both legs. For right now though, I can only afford to have surgery performed on one leg. However the problem is, I CAN"T MAKE A DECISION on which surgery she should have done. I have done extensive research on my own and am currently scheduled for a visit with another vet to get a THIRD opinion.

I have learned about:

TPLO
TTA
Fibular Head Transpostion
Lateral Suture Repair

Kaila is 11 years old and at a medium activity level. I orignally was going to have the FHT done by Dr. Martin DeAngelis (he's been doing it for about 25 years). But then I went to get the second opionion and I was told that the FHT isn't really all that common any more.

I was told that with the FHT method a lot more arthritis could develop BUT I was also told that no matter which surgery was done ultimately arthritis will develop.

I was also told that any of the surgeries aren't really "wrong" but that it more or less depends on what the owner's expectations after surgery are and what type of method the surgeon's preference is.

I also know that much depends on the competancy of the surgeon and the after care that's given.

My goal is to make Kaila more comfortable, make it easier for her getting up the stairs and going out for a little bit longer walks.

All that being said.... do you have any experience with a dog that's had any surgery for a torn ACL? If so, what type of surgery did they have?

Have you heard anything (good/bad) about any of these surgeries?

Any advice you can give me would be appreciated.

thanks
Linda and Kaila

[abndogos]

HI. Are you going to be able to keep her quiet while one of the legs heals? How much "torture" is it going to be to keep her/him quiet while it heals? My breeder had a MUCH younger dogo male have the surgery, he tore one ACL, got it fixed, and then tore the other, got it fixed, and then tore the first one again. Inevitably, she had to put him to sleep, she could not bear seeing him 1) in pain and 2) him having to be confined to a crate when he was such an active dog (as most dogos are)....hence, why I ask how much "torture" it will be to keep him/her confined while it heals. How active is she now, how much do the torn ACL's limit her mobility life right now, how much pain is she in? Being an RN, I always have to think of the quality of life vs quantity. Good luck!

[Mike D'Abruzzo]

Hi Linda,

Sounds like you have done more research than me and I'm definitely not an expert on what to do once the ACL tears - although I have seen plenty of dogs that have a good quality of life once the healing process is complete. I have assisted in handful of TPLOs as a tech but that is about it.

I have heard good things about Dr. DeAngelis but have never personally met him. There is also a surgeon named Dr. Steckle (sp?) that comes to Peekskill Animal Hospital that I know for sure first hand is amazing and gets called in for all the specialty surgeries. A lot of animal hospitals use him - a great guy and very honest.

The only advice that I really have to offer is as a preventative for your other dogs or maintenance once the healing is complete.

The two most important things I have found is weight and a high quality joint supplement - because issues with the joints are such a common problem with dogs I make this like a religion even for privately owned dogs that are kenneled at the facility because a joint injury will obviously affect the training.

I prefer to keep dogs as thin as possible without looking like they are unhealthy.

As far as joint supplements they are definitely not all created equal, and when you see it on a dog food label it is usually in such small amounts and such a small piece of what the dog really needs it might as well be ignored.

I SWEAR by the "agility" supplement I use on all the dogs. You can read about it here: Agility. I have seen close to miracles with it - and any dog in my care immediately goes on it. That I have delivered to the kennel.

Although I have never used it personally, Glycoflex 3, has a very similar formula, so I'm assuming that it might have similar results as a preventative and repair nutriceutical.

I have used Cosequin in the past and didnt get nearly the same results - I think because the agility has a better combination that includes the sea mussels which are great for the ligaments/tendons.

If anyone else has seen good results with other supplements I would be interested to know since there are a lot out there and can be difficult to know which are good options. So far the Agility is the only one that I have used large scale on enough dogs to know that what I was seeing wasn't a coincidence.

Good luck with this!

[balkis]

Hi Mike,

Thanks for your input. After a considerable amount of thought I've decided to have Dr. Brett Wood at the Animal ER (RT9 - Wappingers) do the Lateral Suture Repair for Kaila.

Thanks too for the thoughts on after care. I'm in total agreement with you regarding their weight and the supplements. All 3 of my dogs are at their ideal weight and have been on the Glycoflex 3 for about 2 years now.

Just so you know, the Agility and the Glycoflex have almost the same exact ingredients. As for the glucosamine, MSM and the Green Lipped Mussel they are exactly the same. However, the crazy thing is the Agility is about $42 for 60 tabs and the Glycoflex is about $45 (online) for 180 soft chews. Not sure why that is but I go for the Glycoflex to save a few dollars.

Ok - that's about it for now. I am hopeful that this surgery will help Kaila be more comfortable.

thanks
Linda

[Mike D'Abruzzo]

The difference is in how many chews you need for the dose. The glycoflex 3 you have to give 2-3 times the amount for a dog of the same weight. For instance I give 1 1/2 tabs for most my dogs that are in the 60-100 lb range where with the glycoflex 3 I would have to give 4 tabs. I get the agility on autoship for $33.25 and get an additional 10% off if I order by the dozen (since have a kennel of dogs) and also no shipping cost because I do big orders (over $500 no shipping). So it all kind of breaks out even depending on the individual situation.

Keep us posted on how everything goes with the surgery.

[Mike D'Abruzzo]

Woops, I was looking at the loading dose of glyoflex 3. The amounts are about the same per pill for the main ingredients with other slight variations such as the amount of vitamin C etc..

You were right. Interesting that Kaila still tore two ACLs at a good weight and on supplements. Did she already have issues before you started her on it? Have you noticed positive changes with the other dogs on it? I might try the glycoflex 3 if there is enough positive feedback. the price is right.

[balkis]

Hi Mike,

Sorry just getting back to you now. I've been off the site for a bit.

Hmmm - in answer to your one question, I can't really say I've noticed positive changes in my other 2 dogs. Only because they really don't have any issues that I've noticed. I can tell you that Milo (9 1/2 yrs) and Stitch (6 yrs) are in good shape and are both active. I play lots of catch games with Stitch and Milo goes for lots of bike rides with me.

Like I mentioned before all 3 dogs have been on the glycoflex for about 2 - 3 years (can't remember exactly) now. Did Kaila already have some damage before that - MOST LIKELY. Since we adopted her (about 9 years ago) she has always been high energy when it came to being out in the yard. She used to go crazy jumping up and down at the fence when someone past our house. (Don't worry - we MANAGE that now!) From all the research I've done on this subject, the damage to the ACL is done in small increments over time. So it is definitely possible there was damage before having her on the glycoflex. Now, would she be in worse condition if she weren't on the glyco? Would she be in even better condition if she were on the Agility? I can't say for sure. But:

What I think I'll do - and it will be a good experiment - is I will put Kaila on the Agility. For just the one dog it won't be too expensive and then we can see if there is a difference.

Once again, thanks for your input,

Linda

[SteveKesslerCFDT]

Hi Mike and Linda,
I am in the UK and because I was unable to get Agility delivered here I am using a joint supplement called Lupo San from Germany. It too has Glucosamine derived from green lip sea mussels. It comes in powder, and dissolvable tablet form, with the tablet cointaining 40% sea mussel and the powder 30%. I'll keep all up to date on the results as I have two dogs with joint problems currently on the supplement.

Hope all works out for you.

Best,
Steven Kessler
CFDT

[balkis]

Hi Mike,

I just wanted to give an update on Kaila's progress. She is doing GREAT! She had her surgery on 6/23 and the staples were removed on 7/3. Her surgeon told me that she was healing about ONE MONTH ahead of the average time for dogs who had the same type of surgery.

Just to recap, I ended up having the "Imbrication" or "Lateral Suture" surgery done for her. I decided on this type of surgery vs. the TPLO because of two things: 1. Kaila's age - she is about 10 1/2 years old and 2. her activity level - she was never a hiker but more of a short walk type of girl.

Like I mentioned before, she had been on the Glycoflex III for a couple of years. Around the first week of June I switched her over to the Agility. I would like to point out that Kaila's other ACL is also torn but at this time that knee seems to be holding up quite well. However, for the time being we are keeping her activity level to a bare minimum (per the vet) because she needs to build scar tissue around the wound site. It may only be the other knee looks better than it really is because she isn't using it to full capacity. Once we start to increase her exercise and movement (in another 3-4 weeks) I will be able to see how BOTH knees are doing.

I will keep her on the Agility for another couple of months. Then I'd like to switch her back to the Glycoflex III and monitor her closely to see if there is any change - especially in the knee that did not have the surgery. If I don't see any negative changes I will keep her on the Glycoflex since it is about 1/3 less the cost of the Agility. Of course, if there is any negative change I will put her back on the Agility.

That's the closest I can come to doing an experiment - Agility vs. Glycoflex - (sorry Mike)
but I guess that's why I'm an accountant and not a scientist.

I'll keep you posted. And all kidding aside, even though I was nervous about having the surgery done I am soooo glad I did. Kaila is really looking great and she is already reaping the rewards of the surgery.


Take care,
Linda

PS - thanks for the good wishes Steve - hope this info is helpful to you.