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Cruciate Ligament Disease in Dogs Advice Sheet

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Cruciate Ligament Disease in Dogs Advice Sheet Cruciate Ligament Disease in Dogs Advice Sheet What is it? How is cranial cruciate ligament The canine stifle (knee) joint consists of disease diagnosed? an articulation between the femur (thigh Your dog will have an orthopaedic bone) and tibia (shin bone). There are two examination, which usually reveal signs of cruciate ligaments within the stifle joint a joint effusion (an increase in the amount called the cranial and caudal cruciate of fluid within the stifle), thickening of the ligaments which are fibrous bands that joint and muscle wastage. Manipulation provide stability to the joint during weight of the joint also allows the identification bearing and twisting movements, and of instability. Following orthopaedic resisting movement between the femur assessment, your dog will need to have and tibia during weight bearing. Cranial a sedation or short general anaesthetic cruciate ligament disease is a common for examination of the stifle joint to further condition that affects dogs. This ligament assess joint instability and for x-rays to be may degenerate with age, weaken and performed of the stifle joint, which can then then eventually rupture. Once stretched or be used to plan surgery. ruptured (torn) the stifle becomes painful and unstable for the dog. Sometimes we What are the treatment options for see traumatic ruptures, but in most dogs Cranial Cruciate Ligament Disease? the rupture occurs in a ligament with pre- existing degenerative changes, often Surgical Treatment following minimal trauma. Surgical treatment for cruciate rupture is We see complete or partial ruptures. Partial commonly recommended as it typically cruciate ruptures are unlikely to heal and offers a superior outcome. At the time of may cause ongoing lameness or progress surgery, the joint is inspected to assess to complete ruptures. Degenerative the menisci and any injury is addressed. changes may occur in the cruciate There are a number of surgical options ligaments of both stifles, leading to each with individual advantages and simultaneous or successive rupture. disadvantages which will be discussed where appropriate. What are the clinical signs of cruciate disease in dogs? Extra-capsular Repair: Lateral Fabellotibial Suture Clinical signs of cruciate disease include hindlimb lameness, stifle swelling, pain and This is a traditional treatment commonly instability of the joint. Owners also often employed, however, it has in recent notice that dogs tend to sit ‘wonky’ or with publications, been demonstrated to offer not such a good outcome as TPLO (see the affected leg held out to the side. Thigh Osteotomy Procedures) surgery particularly muscle loss may also occur. on medium to large breed dogs. In some cases, particularly where the Complications are rare and the surgery meniscus is also injured (a shock absorber is not as expensive as some of the other pad between the tibia and the femur), a techniques. Surgery involves placement of clicking sound may be heard. a nylon implant on the outside of the joint to act as a temporary artificial cruciate Cruciate Ligament Disease in Dogs Advice Sheet ligament. The implant increases the stability position while healing occurs. The implants of the stifle joint while tissue scarring occurs remain in place once healing has occurred to further stabilise the joint. Failure of the unless there is a problem (e.g. infection implant before sufficient scarring is a necessitating their removal. common occurrence and may result in a prolonged or poor recovery. During the TPLO procedure a curved Osteotomy Procedures incision is made in the tibia which enables Osteotomy procedures typically involve rotation and levelling of the tibial plateau. cutting the shin bone to flatten the slope This is then secured in the new position of the tibia (top of the shin), thereby using a bone plate and screws. The TPLO removing the need to have a cruciate changes the shape of the joint so that the ligament to prevent movement of the femur is less prone to slide down the tibial femur (thigh bone) relative to the tibia. plateau when weight-bearing forces are The cut bone is then stabilised with metal applied; therefore improving the stability of implants which hold the bone in the new the stifle joint. X-rays after TPLO surgery Cruciate Ligament Disease in Dogs Advice Sheet Recent publications have demonstrated Exercise restriction: that TPLO surgery offers the potential for a Unless instructed otherwise your dog should slightly superior outcome. be rested in a crate, pen or small room for 6 to 8 weeks following surgery and should be walked on a short lead, four to five times What could go wrong? daily for toileting only, then rested. Potential complications will be discussed with you at consultation and include Your dog should be consistently using the wound swelling or infection, surgical site operated limb one week after surgery, infection, implant failure, fracture, ongoing and this should improve further over the lameness, late meniscal (cartilage joint coming weeks. Physiotherapy can be pad) injury, patella tendon inflammation, very beneficial for recovery following osteoarthritis and ongoing lameness. cruciate ligament surgery. Your pet may be discharged with a physiotherapy plan. What is the likely Outcome for my Follow up appointments dog? Unless advised otherwise, a revisit There is a good to excellent outcome for appointment with Langford Vets will be the majority of dogs following surgery recommended in six to eight weeks for after cruciate rupture. In a recent study, a check-up and postoperative x-rays to limb function of the operated leg of dogs assess bone healing. receiving TPLO surgery was comparable in both walk and trot to the limb function of Returning your pet to exercise healthy dogs within 6-12 months of surgery. Following your six week revisit and assuming This was superior to the other techniques your pet is making satisfactory progress, included in the study. Even though it is exercise can gradually be reintroduced. It is rarely clinically relevant, osteoarthritis keeps developing into the joint after surgery. important to remember that the operated Hence, for all dogs management relating leg will still need to strengthen, and so to the treatment of osteoarthritis is advised. failure to return to exercise gradually may This includes dietary management, as result in complications. Hydrotherapy and / obesity increases the risk of contralateral or physiotherapy can also be considered at cruciate disease occurring, osteoarthritis this point if not already started. progression and surgical complications. Aftercare: It is very important that you follow the post operative instructions carefully as failure to do so could result in the repair failing or the bone breaking, which potentially could result in further surgery being required and a prolonged recovery. Contact Us T: 0117 394 0513 / 0514 E: [email protected] langfordvets.co.uk.
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