Thoughts/opinions on ACL surgery

[TheRedQueen]

We have a real dilemma here...and I'd like some opinions please.

Xander (almost 9 yo Australian Shepherd) needs his ACL repaired. He also has a grade 3 heart murmur. He was diagnosed in November, and put on strict crate rest "to see if helped". He was on 3 legs all through the holidays. Now we have him out and about in the rest of the house, as he was losing too much muscle mass everywhere. So now he's restricted to walking...(no running, jumping, etc) and he's on 4 legs again...I'm assuming scar tissue is building up now.

The problem is, we have NO money for an expensive surgery...none. We're gonna have to scrape this up somehow. The ortho specialists are quoting $95 for the initial exam, and $3,000 for the surgery. (plus the hour long drive each way) Our regular vet will not touch him, and I wouldn't want them to...as they're more large-animal that does small animal stuff. But Sawyer (another Aussie) uses a different vet (he gives discounts to Service Dogs...and Sawyer is a SD...as is Xander). This other vet can do ortho surgeries and the receptionist said that the exam would be $35 (regular office visit) and the surgery would be under $2,000. Now this sounds better for us, but maybe not for Xander. We haven't gotten details from this local vet as to what kind of surgery it would be, or if they can monitor his heart (I think they said they can).

Has anyone gone a cheaper route with the ACL surgery...any thoughts, experiences?

[katiek0417]

I can't speak from experience, Erin, but I have a good friend who had to get both ACL's repaired on her mix. They went with a real expensive, state of the art facility for the first one; and a smaller vet for the second. The dog never fully recovered from the first, but was very successful with the second.

So, just speaking from her experiences, expensive isn't always better.

I think the main concern is if the cheaper vet can really monitor Xander hear murmur both during and after the surgery...(I mean, is he set up for it, etc).

Good luck, and give Xander a butt scratch for me!

[TheRedQueen]

I can't speak from experience, Erin, but I have a good friend who had to get both ACL's repaired on her mix. They went with a real expensive, state of the art facility for the first one; and a smaller vet for the second. The dog never fully recovered from the first, but was very successful with the second.

So, just speaking from her experiences, expensive isn't always better.

I think the main concern is if the cheaper vet can really monitor Xander hear murmur both during and after the surgery...(I mean, is he set up for it, etc).

Good luck, and give Xander a butt scratch for me!

Thanks Katrina! I'm pretty sure John asked about the murmur when he called the smaller vet...he called yesterday to check back in to double check the price and get more details, but they were already closed by the time he called. So that's on his to-do list for tomorrow!

[BullyLady]

Does Xander play any sports? Are you concerned about him competing?

Here in town many of the GP-type veterinarians will do ACL repairs, but we also have a veterinary orthopedic surgeon as well. Obviously the board certified surgeon charges more, so this is a question that I heard a bazillion times when I was working in the clinics. The answer that our vets always gave was that they could do the repair and they could do it well, as far as your average pet/housedog was concerned, but that if you were wanting your dog to do any sort of high-level competition or sports that you would be better off paying extra and having the surgeon do it.

I don't have any personal experience, this is just what I heard repeatedly while working with vets.

[TheRedQueen]

Does Xander play any sports? Are you concerned about him competing?

Here in town many of the GP-type veterinarians will do ACL repairs, but we also have a veterinary orthopedic surgeon as well. Obviously the board certified surgeon charges more, so this is a question that I heard a bazillion times when I was working in the clinics. The answer that our vets always gave was that they could do the repair and they could do it well, as far as your average pet/housedog was concerned, but that if you were wanting your dog to do any sort of high-level competition or sports that you would be better off paying extra and having the surgeon do it.

I don't have any personal experience, this is just what I heard repeatedly while working with vets.

Yeah, he plays flyball...though I keep hearing..."they can do flyball again, IF they have a good box turn". He does not have a good box turn, and I'm concerned that even if he had the expensive surgery, that he'd just ruin the knee because of his lousy turn. (the rest all have fantastic box turns, for this reason).

So now I'm trying to figure out if he'd be competitive anyways, with either surgery...or if I'd just retire him and allow him to do what he loves most, be a dog and play ball in the yard. I dunno. He is 9, so it's not like he's a spring chicken in the sports world. So much to think about!

[BullyLady]

Yeah, he plays flyball...though I keep hearing..."they can do flyball again, IF they have a good box turn". He does not have a good box turn, and I'm concerned that even if he had the expensive surgery, that he'd just ruin the knee because of his lousy turn. (the rest all have fantastic box turns, for this reason).

So now I'm trying to figure out if he'd be competitive anyways, with either surgery...or if I'd just retire him and allow him to do what he loves most, be a dog and play ball in the yard. I dunno. He is 9, so it's not like he's a spring chicken in the sports world. So much to think about!

Well, I'll tell you, that sort of sounds like the answer to your question to me. If you know that either way he probably shouldn't continue playing flyball, because of the possibility of reinjury, then I would just retire him and do the less expensive but still effective one.

[maberi]

I think the biggest question is what type of repair are you planning on having? A TPLO or TTA where they have to actually cut the femur and reposition it is much more involved than a conventional ACL surgery. That would play a huge role in who I took my dog to. When Earl had his I saw several vets and one of the biggest determinates for me was the amount of surgeries they had done. The vet who did Earl's surgery had done thousands of TPLO surgeries but the TTA was so new at the time and they wanted to do this on Earl at a very reduced price.

We ended up going with the TPLO because I wasn't comfortable with Earl being a ginny pig

[maberi]

PS - Many people will agrue this with me but once they have a TPLO or TTA there really is no re-injuring the knee once it is healed. When they do either of those there really is no need for their ACL anymore (they change the angle of the knee so the acl is no longer needed).

I would be more concerned with him injuring his other knee as this is extremely common (usually within the first year) when one goes out

[BullyLady]

I would be more concerned with him injuring his other knee as this is extremely common (usually within the first year) when one goes out

Yup, that's the biggie to watch for. Since they are putting so much weight on the other leg to keep weight off the injured leg they stress the ligaments in the as yet uninjured knee, making it more susceptible to injury.

[TheRedQueen]

I would be more concerned with him injuring his other knee as this is extremely common (usually within the first year) when one goes out

Yeah, that's my other concern...

Especially with his crappy box turn.

[blabsforbullies]

PS - Many people will agrue this with me but once they have a TPLO or TTA there really is no re-injuring the knee once it is healed. When they do either of those there really is no need for their ACL anymore (they change the angle of the knee so the acl is no longer needed).

I would be more concerned with him injuring his other knee as this is extremely common (usually within the first year) when one goes out

I agree with you 100% about the TPLO. Also, I worry more about the other knee if a TPLO was performed.

More than cost, you need to pick a surgeon that is comfortable with whatever procedure they do. Ask for numbers of repairs they have done.

[maberi]

It's definitely a tough call Erin

I know with Earl I continued to let him do flyball and agility after his surgery because he was so young at the time (2.5 yrs old). He is such an active dog and lives to run so I couldn't deny that for him. I felt that I would rather risk him tearing his other knee than keeping him from doing the activities he loved so much. I still worry all the time when he goes nuts running around the yard like a crazed beast with Karma and Kayden but then I see the joy in his eyes and realize I would rather have him enjoy his life to the fullest.

I wish so many dogs didn't have this problem but it seems like it is such a common problem.

[TheRedQueen]

I agree with you 100% about the TPLO. Also, I worry more about the other knee if a TPLO was performed.

More than cost, you need to pick a surgeon that is comfortable with whatever procedure they do. Ask for numbers of repairs they have done.

Don't worry, I'm not going to find a vet who hasn't done a lot of these (that's why I'm not using my regular vet)...but unfortunately, cost is a big issue also. I'm trying to figure out if I can pay my mortage for next month...

Does the surgery get more complicated the longer the dog is walking around on the bad leg?

[maberi]

Again I am not a vet and am just going off of my experiences and the research I did on my own at the time of Earl's injury.

I was told the only risks you leave by letting the dog continue to walk on the bad knee is further injuring the knee (if it is a partial tear they can completely tear through it, if they haven't torn through the meniscus this is a possibility as well as an increased risk of arthritis setting in)

[iluvk9]

When I went through it with 2 dogs/4 knees, my Vet said it was VERY painful when they continuously start to hold the leg up.

[maberi]

Do they have Xander on any anti-inflammatories?

[TheRedQueen]

He's got Rimadyl, which I'm only giving him if he seems painful.

Right now, he bears weight on the leg...(it was a partial tear)...and barely limps. When he was on crate rest, he was holding it up completely...and everything was out of whack on him. Now he puts weight on it, walks around, and the muscle mass is better. He was just so depressed and losing muscle that I couldn't confine him anymore. Since the surgery wasn't on the horizon, I went with restricted activity, not crate rest.

[blabsforbullies]

Don't worry, I'm not going to find a vet who hasn't done a lot of these (that's why I'm not using my regular vet)...but unfortunately, cost is a big issue also. I'm trying to figure out if I can pay my mortage for next month...

Does the surgery get more complicated the longer the dog is walking around on the bad leg?

I understand that completely. Have you looked into Care Credit? They have some pretty reasonable deals... just a thought.

What was said above is true... it is possible to make an exisiting injury worse if left untreated for a longer period of time. It does make the surgery more complicated only in that the longer is goes on, the more scar tissue and possible ostearthritis occurs. But, having said that, it is NOT an emergency as long as you addressing his pain (ie: Rimadyl).

[TheRedQueen]

Don't worry, I'm not going to find a vet who hasn't done a lot of these (that's why I'm not using my regular vet)...but unfortunately, cost is a big issue also. I'm trying to figure out if I can pay my mortage for next month...

Does the surgery get more complicated the longer the dog is walking around on the bad leg?

I understand that completely. Have you looked into Care Credit? They have some pretty reasonable deals... just a thought.

What was said above is true... it is possible to make an exisiting injury worse if left untreated for a longer period of time. It does make the surgery more complicated only in that the longer is goes on, the more scar tissue and possible ostearthritis occurs. But, having said that, it is NOT an emergency as long as you addressing his pain (ie: Rimadyl).

We've looked into Care Credit...but we don't think we can swing it, with the interest rate and payments. We've looked into grants...but groups are going under...Ortho Dogs Silver Lining has no funds, and other we looked at have gone under due to lack of funds also. We're looking also to find vets that will take payment plans...not all of them will. It's been an on-going process this past month or so.

Thanks for the confirmation that I'm not crippling him for life! He's pretty wimpy...not stoic at all...so he's pretty easy to read on the pain-front.

[blabsforbullies]

Well, I know you are doing what you can. And if I think of anything, I will certainly let you know.