Is surgery the only option to treat your dog’s cruciate ligament tear?
Are there non-surgical solutions to your dog’s knee injury?
Thank you, Mandie, for sharing your conservative management experience and success the second time around.
Tucker’s story
Tucker is my (almost) 6-year-old American Bulldog.
From our first meeting in the shelter, I should have known it would be a wild ride. Tucker jumped a waist-high gate to greet us. Yet, Tucker never ceases to amaze me with his antics. He is one of those dogs that can look at you and make you giggle uncontrollably. He’s part dog, part cow, and 100% lummox.
Some of what makes Tucker so goofy is also what makes him so prone to injuries. He is front-heavy with a giant head and chest. However, his tiny back legs did not follow suit making his knees vulnerable. Over the years, he has experienced damage to both of his knees. Some breeds are susceptible to cruciate ligament injury due to the conformation of their legs. Tucker is also at a disadvantage in this regard. His back legs somewhat turn in, making them a lot less stable than other dogs with similar weight.
Tucker’s diagnosis
When Tucker was diagnosed with a full CCL tear, and our veterinarian recommended a TPLO right away. Without knowing anything about the surgery or what it entailed, we decided to research it first. We learned about an alternative to a surgery called Conservative Management (CM).
Conservative Management for dogs is a somewhat loosely defined term. It entails rest, anti-inflammatory medications, and supporting the natural healing process over a period of 4-8 weeks.
Reducing the load on the knee gives the joint a chance to build up muscle and scar tissue to compensate for the ligament’s loss.
Our treatment decision
We felt we owed it to Tucker to try to heal him using a more natural approach. Therefore we gave CM a “go” for a few months.
The measures we tried the first time around included:
- restricting him to leash walking only for bathroom breaks
- confining him to a small, carpeted area of the house while we were gone
- using Rimadyl to help with inflammation,
- and trying a dog knee brace.
Despite all of our best efforts, we were unable to see the results we wanted. After a few months, we opted to go with surgery. We picked the Traditional Repair surgery even though our vet preferred the TPLO. The surgery was successful, and Tucker has healed completely.
Lameness returns
A year later, Tucker once again became intermittently lame in his other hind leg. At first, it started that he would only limp in the morning. However, it gradually progressed to toe touching every other day. We decided to take him to the veterinarian to have the drawer sign test performed and get a definitive diagnosis.
Positive drawer sign
As expected, Tucker tested positive for the drawer sign. Although the veterinarian did not think it was a full tear yet. Tucker was not toe-touching regularly.
Despite not believing it was a full tear, he recommended a TPLO or TTA be done within the next month. I explained that I wanted to try Conservative Management. He wished me luck, informing me that generally, only dogs under 30 pounds have success without surgery.
After leaving the office that day, we began a strict Conservative Management regimen. Remembering the trials, tribulations of the surgery, I wanted to make CM work this time.
Conservative management the second time around
Luckily, my husband and I both work from home. One of us could stay with Tucker at all times to make sure he was staying calm, quiet and resting.
This second time around, I did things a bit differently. I still kept him confined to controlled leash walking when he needed to use the bathroom. However, I also made it a point to walk half a block each time we went out. I felt it was important to keep the leg strong and moving while his body worked to build up scar tissue and muscle around the torn ligament.
I made sure he did not get overly excited, jump and/or run. Any strenuous activity or quick motion could tear the ligament and set us back.
Along with the short leash walks, Tucker was confined to a small, carpeted space in the home at all times.
That was a new measure. It prevented him from quickly running to the door if he heard something or sliding on the non-carpeted areas of the house. I felt terrible confining him like that but I knew I was doing what was best for him.
Weight management
Of great importance for any dog with CCL issues is proper weight management.
Leading up to his second CCL injury, Tucker was getting one too many handouts while visiting our relatives in Pennsylvania. As a result, he gained a significant amount of weight.
As part of the plan, I cut back on his food intake and switched him to a higher quality, protein-rich food. Over the first month of CM, he lost about 5 pounds. He dropped a total of 12 pounds during the entire CM period. Since then, we worked hard to keep the weight off. It is an important part of maintaining his joint health.
Managing inflammation
The inflammatory process can be very damaging to the body in both humans and dogs. Managing inflammation is an integral part of any successful round of Conservative Management.
This time I really wanted to go as natural a route as possible. However, seeing how much pain Tucker was in initially, I started him on a round of Rimadyl to make him more comfortable.
The only downside to the Rimadyl is that it makes him forget he is hurting! Therefore, I adjusted the dosage. Concerned about the effects of NSAIDs’ long-term use on the liver, I wanted to transition to a more natural approach as soon as possible.
Supplements
After about the first month of the Rimadyl, I found information on using Yucca Root to help ease inflammation. I gave it a try. I transitioned from one to the other over the period of about two weeks while realizing that I would keep him on the Rimadyl if I noticed a decline in the way he was feeling. After that period, Yucca seemed to be doing just fine. I have stuck with the Yucca Root extract ever since. Tucker’s dosage is 9-10 drops of yucca extract in his food with a bit of water to dilute it.
In addition to the Yucca, we began giving 1000 mg of Omega-3 Fish Oils twice per day during Conservative Management. The idea behind the Omega 3 fatty acids is that it helps to lubricate the joints and reduce inflammation. We’ve had nothing but positive results from using this supplement, and it is another one we continue to use. We also had always been doing the Glucosamine/Chondroitin supplements and continue to use these as well. Cosequin seems to be the most palatable as well as a vet favorite. However, we’ve tried many brands with similar amounts of success.
After about 8 weeks of CM, Tucker improved significantly. He was no longer limping or toe touching as he once had been. It was a long 8 weeks, but it was worth avoiding the cost, risk, and recovery process associated with surgery.
We are aware that CM is not defined as a “fix” for an injured cranial cruciate ligament (CCL). But with the use of supplements and an alternative, holistic anti-inflammatory medication like Yucca, we have seen great results. Over time, Tucker’s leg will build up the scar tissue necessary to stabilize the joint. Hopefully, that will happen without any major arthritic consequences.
Our CCL Injury conservative management overview
- Weight Management – We cut down on treats and snacks while transitioning to a higher quality food which we fed less.
- Inflammation – We started with Rimadyl and Omega 3 Fish Oil (1000 mg capsules, twice per day). After 1 month of the Rimadyl, I transitioned to Yucca Intensive, and give 9-10 drops diluted in food.
- Joint Support – Glucosamine and Chondroitin supplements are good to support joint health in any dog.
- Rest – Make sure your dog stays in a confined area without distraction. Carpets are preferable, avoid steps, jumping, running or rough play during this time. Toys such as frozen Kongs filled with peanut butter or bully sticks are a good way to help them alleviate boredom.
- Controlled Exercise – Take a few, short, leash walks per day under controlled conditions to ensure your dog maintains muscle, and to also encourage the growth of scar tissue around the injured ligament.
- Pay Attention to Your Dog – Your best friend will tell you how they’re doing. Go at their pace, and avoid doing too much, too soon!
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Mandie Shaner is the founder of Dog Knee Injury, an owner resource dedicated to helping people facing CCL injuries in their pets. She also is active in Pit Bull advocacy/animal rescue through Save A Bull.
Related articles:
Talk To Me About Dog ACL/CCL Injuries: My Dog Ruptured Their Cruciate Ligament
Conservative Management
Regenerative Medicine
Evaluating PRP Treatment for Dogs: Platelet-Rich Plasma Treatment (PRP) for Partial Cranial Cruciate Ligament (CCL) Tears—Would I Do It Again?
Further reading:
Conservative treatment options for partial and complete CCL tears in dogs