Just like humans, pets are prone to injury and disease of their bones, muscles, and ligaments. I see limping dogs on a daily basis. Cats, however, are much less prone to orthopedic problems, maybe that “always landing on their feet” ability comes in handy. I am not a horse vet, but I own horses, where lameness is a constant concern. I remember a quote from an orthopedic surgeon back in my vet school days, “Horses are always on a precipice between soundness and lameness.” I’m sure many of you horse owners can relate! I’ll leave horse lameness to the equine veterinarians, and let’s talk about dogs (mostly) and cats.
In my practice, the number one cause of lameness in dogs is an injury to the knee ligaments. Any of you that have been involved in sports know about knee injuries. Knee anatomy in dogs is similar to the human knee. The anterior cruciate ligament (ACL) is the most commonly injured ligament in dogs. It’s usually secondary to stress and torsion on the joint during vigorous activity in young active dogs, but overweight, inactive dogs are also at risk, simply because of the increased stress placed on their joints secondary to being overweight. Some dogs weighing less than twenty pounds may stabilize the joint with scar tissue just with six to eight weeks of confinement and rest, depending on their lifestyle. But the best treatment option for ACL rupture in dogs is surgical stabilization of the joint. There are multiple surgical techniques available including; extracapsular repair, Tibial Tuberosity Advancement (TTA) and Tibial Plateau Leveling Osteotomy (TPLO). The extracapsular repair uses a heavy gauge suture to help stabilize the joint. This procedure doesn’t require any special instrumentation and is fairly quick. This is the procedure that is most commonly done in general practices, such as mine. The extracapsular technique does have limitations and isn’t appropriate for large dogs. The TTA and TPLO techniques both require special equipment and expertise and are usually done by board-certified veterinary surgeons. An advantage to these repair techniques is they are more appropriate for larger and/or very active dogs. A disadvantage is there is a price difference because of the expertise of the boarded surgeon and the equipment and special training required.
Let’s talk a little about post-operative care. I always tell people that my job is easy. I have their pet under anesthesia, do the procedure and monitor them for the day. The pet owner’s job is difficult. They have to keep their pet quiet and inactive. Nothing is more difficult than orthopedic post-op home care. As a rule of thumb, EIGHT WEEKS of confinement/restricted activity is required for appropriate healing. What exactly is confinement? For bones and ligaments to heal, movement in the affected area needs to be restricted. So locking a pet in a room where they can still move around a lot and even jump up and down on furniture is not confinement. Confinement means a kennel or large cage. Leash walking your pet outside to use the bathroom, not setting him free is also important. Happily, with knee surgery, pets rarely have to wear a bandage or cast. Bandage and cast care is even more difficult, especially in cats. Trying to keep the pet from chewing at the bandage, keeping the bandage dry and clean (dogs when you walk them outside, cats after they use the litter box) and severe restriction of activity to help prevent sores secondary to the bandage all increase the difficulty level from a 5 to a 10! I have had broken bones, and I could rationalize in my head, 8 weeks of inconvenience and then I am healed. Our pets can’t do this, but I assure you, you can live through 8 weeks confining your pet. The better job you do at home care, the better the result your pet will have.
After healing comes rehabilitation. For years that simply meant let them off the leash and out of the carrier and everything would work itself out. However, post-operative physical rehabilitation has shown to significantly improve the short and long-term outcome for our patients. Physical rehabilitation includes exercises you can learn to do at home with your pet, like the simple passive range of motion exercises and low-stress exercises to strengthen the appropriate muscles. More advanced rehabilitation therapy includes an underwater treadmill, swimming, and therapeutic laser therapy. In fact, there are dog specific swimming facilities as close as Auburn and Enumclaw (most cats don’t really enjoy the pools!)
No matter what the injury, orthopedic injuries always require a thorough discussion with your veterinarian to decide what the best options for you and your pet. Make sure you ask what your responsibilities will be in the healing process. It’s important to be prepared.