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Post date: Jan 13, 2010 6:26:1 AM
This is about my 93 pound, 3 or 4 year old Husky mix female, named Andi. She basically "blew out her knee" in mid December. With the torn ACL (or in dogs, the CCL - Cranial Cruciate Ligament, as in the one that faces the head of the animal) the knee joint is unsupported. It causes her to be walking on a joint that is not stable - it is like the leg gets all flexy in the middle, so she can't really trust it. Couple that with the fact that it lets the tibia slide forward and whack the patella (the lower leg hits the kneecap) and it makes an awful click/clack sound as she sort of wiggles her way around.
We ordered a brace from OrthoPets for her. It arrived today. The brace is made from plastic molded onto a plaster model of the dog's leg, that the prosthetist made from a fiberglass cast that I made of the dog and mailed off to the lab in Denver. The joints are the same ones used in human prosthesis - kind of a rubber that gives a little bit of spring. Velcro, padding, and medical grade foam line it for comfort. Lighter, better fit, and a MUCH better joint than the one I made from leather and aluminum. I should hope so - since it has added up to about $650 once you count the medical grade fiberglass material to make the cast (vet aisle at the farm and ranch supply store just outside Spokane.... rednecks do their own doctoring), shipping the cast out, the fed ex shipment back, as well as the actual device's cost. But, if it allows the joint to be stabilized without surgery, so that the scar tissue can grow. The surgery most commonly done (called "traditional repair" or "Lateral Suture Stabilization") does what the brace does - but with nylon fishing line inside the knee - it holds it while letting it move in the normal range of motion and you hope the scar tissue builds up around it to hold it all together. Like the vet said - her football career is over, but that doesn't mean I have to get her a little doggy wheelchair (OrthoPets makes those too). Took 7 days for them to make the thing, and I have had really good communication with them. I don't know how MANY of these they have going on at one time, but the quality and workmanship seems really good.
The dog doesn't like it, right off the bat. It makes the leg a little bit stiff and she has to get used to it. She also still makes a bit of the click/clack noise, but not quite as much, and she is not wiggling her way around on basically 3 and a fraction legs - she is using all 4 again, and actually walking around. She was following me around the upstairs begging for scraps (I had a turkey hotdog in my hands that I was giving her pieces of). Give her a few days and I think she will be much more mobile. We are supposed to ease her into wearing the brace - kind of like getting used to contacts. An hour at a time, a few times a day, and work up to longer. They included a suggested schedule in with the brace.
Attached is a close up shot - with the brace on her right stifle (rear knee joint on a dog is called a stifle - I don't know why). She is also wearing her soft harness - the harness allows me to lift her up with the handles on the top side so she is not putting strain on the legs going up and down the steps into the backyard. I don't think she likes the harness much, but she accepts the extra help going up the stairs. If we don't grab her she will go up the steps on her own.... but that is a sure way to let her undo any of the buildup of scar tissue in the joint that will eventually (we hope) stabilize the joint from the inside. There are other surgeries that cut and then reconnect the bone of the lower let in such a way that the joint doesn't NEED the cruciate ligaments to stabilize it - they change the angle of the top of the tibia and then screw a metal plate to hold the bone together. I don't want to do such an invasive process on the dog (nor spend $2,500 on the TPLO surgery), nor the cheaper ($1,200) fibular tie-back that the vet I took her to specializes in - it doesn't have as good a track record.IF the brace can stabilize the joint, and let scar tissue build up to help out, then the dog can get back to a normal life without surgery. I can always have surgery done later IF this does not work. As long as the joints are not sliding and banging around, there should not be pain. I'm a fan of not having to cut on an animal if it is not necessary. There is a slow period of recovery if you don't do surgery.... but there is a slow recovery if you hack the bones, put them back together in a configuration that is different, and hold them together with metal plates and screws.... If it was MY knee, I might try the brace only option for awhile, too.
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