Rottweilers, like other large-breed dogs, have increased predisposition to CCL/ACL injuries.
Morpheus: What happened, happened and couldn’t have happened any other way.
The Matrix Reloaded
Neo: How do you know?
Morpheus: We are still alive.
Jasmine’s story
When Jasmine started limping that summer, we didn’t think too much of it. It wasn’t the first time it happened. Jasmine had injured her hind leg three times before that.
After an exam and x-rays, we were always told it was probably just soft tissue injury and sent home with the recommendation of restricted exercise. Each time it did seem to have resolved on its own eventually.
This time it was different.
Jasmine’s lameness persists
With passing weeks I started to feel that perhaps we should take her to the vet again after all. Things weren’t getting worse, but they weren’t improving either, and Jasmine was showing less enthusiasm for exercise. This hasn’t happened before and wasn’t like her at all–we always had a hard time holding her back.
At the beginning of September, we took her to her vet at the time. He couldn’t elicit the drawer sign but suggested an appointment with an orthopedic specialist just to be sure.
He mentioned the words ACL injury and that was the first time we ever heard about such a thing. After I researched what an ACL tear was I really wished it was something else!
Jasmine was putting some weight on the leg even though she was limping heavily, particularly after rest following exercise. She wasn’t holding her knee up as would be typical either.
Confirming the diagnosis
However, after a visit with the specialist, and a set of x-rays, the diagnosis was in and it was breaking my heart.
Yes, Jasmine did indeed have a partial ACL tear in her left leg. And if that wasn’t enough, her right knee didn’t look so great either. The recommendation was to do a TPLO surgery on the left knee immediately, with a prospect of another surgery once that heals. When I’ve learned what TPLO was I didn’t like it the least bit.
To Jasmine, her legs were the most important part of her body! They took her places!
Our reaction
Such invasive surgery and recovery … taking almost a whole year out of her life … I really didn’t want to do that if I could help it.
I spent endless hours researching and looking high and low for other options. We considered conservative management with a knee brace. But Jasmine was only 5 years at the time and she was a very active dog.
Brace didn’t sound like a good solution for her.
Alternative options
I was talking to many people; anybody who was willing to discuss it. One vet from Australia mentioned that prolotherapy might be a solution for a partial ACL tear.
It sounded hopeful, and certainly better than surgery. I found a vet in our region and discussed that with her. She said that it could be an option.
Before we booked a consultation with her I brought it up to Jasmine’s vet. He didn’t know much about it—looked it up quickly and figured it was a terrible idea. He started saying things such as bone infection and amputation scared the living daylights out of me.
I did talk to some vets who successfully use this technique. However, the word amputation eclipsed all the positive things I read and heard.
I called the consulting vet immediately and told her what Jasmine’s vet thought. She was trying to explain that while there is some degree of risk they take precautions and it is very safe.
As she noticed I wasn’t really hearing her, she said there was a new treatment out there which we could consider—stem cell regenerative therapy. It really is a shortcut to what the prolotherapy is designed to achieve.”
Stem cell therapy? Ok, a new idea that didn’t have the word amputation tied to it. I asked her how it worked—this certainly sounded interesting!
So back to research. The more I was reading about what the stem cells were, the more exciting the whole idea sounded. We discussed it with my husband and he also felt good about it.
So back on the phone with Jasmine’s vet.
“Stem cells? From bone marrow?” he asked. “And what about rejection issues?”
“No,” I said, “stem cells from Jasmine’s own fat tissue”.
This time he didn’t even bother looking it up. “Sounds like a scam,” he said.
Getting a second opinion
Well, it didn’t sound like a scam to us.
I went back online to see if I could find any testimonials about this treatment in dogs. Didn’t find many, but found some. And more importantly, this felt right.
I made a list of vets in our area certified for the procedure and start calling them. Ideally, we wanted to find one who already had experience with this.
It turned out that nobody in Canada—or in Ontario anyway—had actually done it yet. As we really wanted somebody who did, we decided to call around the south of the border. Couldn’t find anybody either.
Ok, this was pretty new stuff, huh?
Still, though, it did feel right. So back to calling vets nearby. One of them spent at least forty minutes discussing things with me on the phone. He did feel that surgery might be the best option but was open to the stem cell idea. “Knees love being operated on,” he said.
Well, knees might … but what about the dog?
We discussed it all again with my husband and figured that we do want to see where the stem cell route might take us. So we booked a consultation with this new vet.
When we brought Jasmine in, he started examining her head to toes.
“Hey, doc, the knees are over here in case you can’t find them,” we thought. But he explained how the bad knees would affect other things.
“I want to treat the whole dog,” he said.
Our jaws dropped. “Wow, now there is a novel concept!”
Skipping through a series of events that included:
- additional abdominal exam the vet did while he had Jasmine under to take his own x-rays
- a cancer scare
- and an exploratory abdominal surgery …
Several weeks later we were all set to go ahead with the treatment.
As destiny would have it though, a week before the planned treatment, Jasmine came home limping really badly, not using her left leg at all.
From partial to full tear
We took her in immediately and our fear was confirmed, her ligament was now totally gone.
So there we were, back to the drawing board. Do we have to do the TPLO after all? (Personally, I’d like the TTA better, but there was no surgeon in Ontario doing that.)
Her new vet brought up the option of an extracapsular repair as less invasive.
That confused things further, because we have already discarded this option at the beginning, after reading many articles on how bad this option is for large breed dogs.
However, this new vet already got a lot of our trust in the meantime. And he has done this surgery successfully on large dogs many times in the past.
I asked him the main question: “Is this what you would do if it was your dog?”
He said that all things considered yes, he would. I was still a bit uneasy about the potential failure of the repair, but it was substantially less invasive…
With that decided we didn’t feel like abandoning the stem cell therapy idea though. Perhaps it could save her other knee? And while at it, it could maybe help the operated knee heal better?
And so it was all set.
The surgery and treatment
The first day her vet did the extracapsular repair and extracted a bit of Jasmine’s fat tissue. The fat tissue went to VetStem to be processed to extract the stem cells.
Two days later he injected the stem cells into both of Jasmine’s knees, shoulders (which developed arthritis as she was compensating for her bad hind legs) and gave her one IV dose of stem cells also to help our areas that couldn’t be injected).
The first month post treatment he seemed rather disappointed. He couldn’t see any difference the stem cell treatment would have been making.
By the second month though, he started to get really excited.
We couldn’t really tell, because we had nothing to compare it with. All along we were just praying that her right leg would hold up through all that.
At the end of the second month Jasmine was hardly limping at all, and the third month she had the bounce back into her gait. Now it started to get really exciting!
The other knee goes
So of course, as a number of times before, just when we were so happy how well things were going, three months after the first surgery, Jasmine’s right knee just went.
She didn’t do anything crazy or out of the ordinary. Just boom and there it was. That was really disappointing.
So back on the operating table.
Looking back, I believe that the treatments we chose were the best option for Jasmine. She is living her life as if none of that ever happened and I wouldn’t have done anything differently.
As much as I hate that she had to have gone through all that, it seems that it had to happen and couldn’t have happened any other way.
If it wasn’t for her injured knee and our reluctance to put her through invasive surgery, we wouldn’t have found her new vet and her other health issues might have never been diagnosed and treated.
All that also taught me the importance of being involved in my dog’s health care decisions, research, and second opinions.