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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 14566
Experience:  Over 20 years of experience as a veterinarian.
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She is a JR and her back leg has just started to be not able

Customer Question

She is a JR and her back leg has just started to be not able to put pressure on
JA: I'm sorry to hear that. Have you looked to see if there is a wound on their foot?
Customer: the vet thinks its cruciate but I just can't see how, shes so light, activ, shows no pain and we can move and pull her leg around.
JA: What is the dog's name and age?
Customer: Missy she's 6
JA: Is there anything else the Veterinarian should be aware of about Missy?
Customer: She's been on anti inflamatried for 5 weeks, You Move vet strength joint tablets and absolutely no improvment, she has been on cage rest for 4 weeks, then yesterday she came on a walk, was putting wirght down, she can swim but around the house she lifts it up all the time i've had her x-rayed and it shows nothing in her back legs but the ligament cant be seen, no nothing wrong with her otherwise
Submitted: 2 months ago.
Category: Dog Veterinary
Expert:  Dr. Kara replied 2 months ago.

Hello, my name is***** and I have over 20 years of experience as a veterinarian. I'm sorry to hear about Missy's rear leg non-weight bearing lameness for the past 5 weeks.

I understand that she is slim and active, which makes a cruciate ligament injury seem unlikely but with her history that injury would make the most sense, especially because on radiographs there is no sign of bone disease. Although she is strong and athletic even professional athletes that train with appropriate professional guidance can suffer cruciate ligament injuries. While it is true we see more cruciate injuries in overweight, poorly conditioned dogs even the best athletes can suffer cruciate ligament damage if they are unlucky and slip or twist the knee just the wrong way during activity. Her short legs and her particular conformation, the angle her knee is set at, can predispose her to a cruciate strain/tear.

Dogs are non-weight bearing lame for a few reasons:

1) It hurts too much to bear weight on the leg

2) neurologic disease such that the pup cannot feel the leg or control the muscles in the leg

3) instability of one of the joints such that the leg either cannot support the pups weight or the dog feels the instability and doesn't feel confident using the leg.

Over time when a dog doesn't bear weight on a leg and learns that she can move quickly on 3 legs it may become a habit to not use the injured leg. So even if healing takes place the loss of muscle while the ligament is healing, and her habit of not needing to use that leg, may interfere with her doing so now.

I am glad to hear that she was weight bearing some yesterday on her walk, that is a positive sign. It may take a while for her to learn to use the leg consistently again. It is important to not push her though to return to full activity before she is ready. Healing can take months. If she resumes full activity too soon she can reinjure herself and lose all of the healing that has taken place.

It may help to have her evaluated by a veterinary physical therapist and learn some exercises that you can do at home with her to help maintain muscle mass and flexibility so she will hopefully be able to get back to normal function eventually.

Some dogs with cruciate ligament tears also suffer meniscal damage. The meniscus is a cartilage cushion in the knee joint. It cannot be seen on radiographs and if it tears it can fold in the joint. This makes bearing weight on the joint painful (like walking on a pebble). This won't heal even with strict rest and anti-inflammatories and will require surgical intervention.

So if she continues to be lame then surgery to remove a damaged meniscus may be needed.

Please let me know if you have any further questions.

Customer: replied 2 months ago.
Would the vet have been able to see from the X-rays if it was a lixating patella?
After short excercise or walking missy rests her leg more than usual and her bad leg does feel more squishy than her good I assume from loss of use. She can jump and walk I just do not know if surgery is the only or best option or if we should just wait and train her to use it again, is she doing harm by walking on it?
Customer: replied 2 months ago.
Here are the the X-rays can you see anything?
Customer: replied 2 months ago.
how long is too long for us to say ok it's not healed lets go for surgery..
Expert:  Dr. Kara replied 2 months ago.

A luxating patella is something we can normally palpate on examination.

But we can also see a luxated patella on radiographs (if it is luxated when the radiograph is taken) and we can see the signs of the damage a luxating patella will do to the knee joint over time as well. They include a shallow groove, and secondary arthritis, both on the patella itself and the distal femur.

In her case neither patellas is luxated on the radiographs and there aren't any bony changes indicating a fracture or chronic patellar instability.

Frankly if she is not much better after 5 weeks then she probably would benefit from surgery.

The fact that she worsens after even a short walk concerns me and indicates that there may indeed be meniscal damage.

Customer: replied 2 months ago.
Ok thank you very much, I know it will be a vague answer but this is not covered on my accident only insurance I don't know if my vets are being expensive what's a rough price of the cost of this treatment?
Will missy recover fully and be able to run and walk exactly as before?
Without surgery, what will happen?
Expert:  Dr. Kara replied 2 months ago.

Insurance policies vary, and will depend upon whether you bought a preventative medicine policy or a more comprehensive policy. I would call the insurance office and check. Many policies do cover cruciate surgery, if the injury occurred after the policy was purchased. The sticky point is often whether there was a previous injury that led to a stressed/stretched ligament that now has completely torn.

You are in the UK so I don't know prices there but in the US it can range from $1500 (small dog, simple surgery, not entering the joint) to $3500++ (for more extensive surgeries that require entering the joint and removing the meniscus).

Recovery often depends upon the dog's willingness to learn to use the leg again, whether meniscal damage is present too, whether complications occur (infection, suture reaction), and whether you choose to go through physical therapy with her after surgery. Physical therapy is very helpful in maintaining muscle.

After any injury a dog can never return to normal, as he or she was before surgery. But with surgery she will have better stability, less arthritis, and it may help prevent injury to the opposite leg. Most dogs do very well after surgery and owners consider them much closer to their original state compared to dogs that don't have surgery.

If you choose not to have surgery with very strict rest the knee will form scar tissue and gain some stability with time but it won't ever be normal and it will be more arthritic as time goes on compared to a dog that had surgery.

Whether you choose surgery or not long term for joint pain and to keep arthritis formation as little as possible I do recommend using a combination of a glucosamine/chondroitin product (examples are Dasuquin or Cosequin) and an omega 3 fatty acid (like 3V Caps or Derm Caps). These work synergistically and improve cartilage health and joint fluid quality and quantity as well as reducing inflammation. They can take several weeks to see full effects. They are available over the counter.

Another option is a product called Duralactin. This is an anti-inflammatory product derived from milk proteins and it also has omega 3 fatty acids incorporated into it which can be very helpful. See this link for further information:

Expert:  Dr. Kara replied 2 months ago.
I'm just following up on our conversation about your pet. How is everything going?
Dr. Kara
Expert:  Dr. Kara replied 2 months ago.

Hello, I wanted to make sure that you didn't have any further questions for me, and I'd like to know how things turned out for your pup. If you could give me an update that would be great, thank you, ***** *****

Customer: replied 2 months ago.
Well, I went back to the vet now you made me accept it was probably cruciaye ligament, the vet said he was sure and looked at the x Ray's again, he said surgery was not the answer due to her size but if she hadn't recovererd in another 3 months then we should. Having surgery would almost guarantee arthritis in later life.
He said to lead walk her every day, not to cage her or stop her jumping on sofa but make sure she rests and doesn't race around.
I took her swimming yesterday and she really deteriorated, she can hardly walk today.
She's on anti inflammatory from the vet and joint supplements. The vet didn't seem surprised she wasn't showing signs of improvement said this would take months. She's been like it since 3rd June each day she looks the same except when she's excercised and she looks worse until the next day.
Expert:  Dr. Kara replied 2 months ago.

I too believe that this is a cruciate ligament injury but your veterinarian and I have a difference in opinion on management of these cases.

All dogs with cruciate ligament injuries will develop arthritis at some point because they have damaged the joint and caused inflammation and instability. Dogs that have surgery have instability for a shorter period of time and because the torn fragments are removed they tend to have less inflammation and for both of these reasons they will less arthritis in the long run.

My belief is that if a dog isn't improving at all over the first 2-3 weeks with strict rest then surgery is best. It is true the full extent of scar tissue and stability won't take place for months, but there should be some improvement.

If she is exercised on an unstable leg the movement will slow the body's natural process of forming scar tissue around the joint which is the only thing that makes the leg stable in the long run if surgery isn't done. I am puzzled by your veterinarian encouraging exercise. Perhaps there was a miscommunication?

I am very concerned about her worsening so much after nonweight-bearing exercise like swimming and perhaps a second opinion with a veterinary orthopedic surgeon is best. I am worried that she has meniscal damage too.