18 Month-Old Lab/Weimer With Dysplasia, Luxating Patellas, Torn CCL/ACL

From Leslie T:

We have an 18 month old lab/weimer shelter rescue. We found out around Thanksgiving that he has hip dysplasia, luxating patellas and on Jan 2, he tore his ACL in his right leg. We’ve been restricting his activity, he’s on meloxicam daily, dasuquin, and I give him Exclusive senior dog food that is very high in glucosamine and chondroitin. We had taken him to a chiropractic vet to check his hips after the initial diagnosis of dysplasia and he agreed with our regular vet that FHO surgery is in Jack’s future, but nothing we need to do right now.(Double hip replacement isn’t in our budget) My question is, is your rehab protocol something that I can do with Jack considering he’s such an ‘orthopedic train wreck’ as my vet described him? We have noticed that Jack’s front left leg is starting to turn in, almost like being pigeon toed, since he tore his ACL. Is this because of the additional strain he’s putting on that leg now? I’ve been impressed with what I’ve found on your website, but I don’t want to do something that could further injure Jack. He’s tentatively scheduled for surgery on 2/17, but we can always reschedule. I hadn’t scheduled it until this week because we were trying to put it off to see if we could work with him at home without surgery. It was going GREAT until he took off in the backyard after a bird. He limps on his back leg and when he’s standing and eating, he will put his tip-toe down. Before he took after the bird, he was beginning to put a little more weight on that leg. He still is very happy-go-lucky and wants to try and run. Other than the limping, he doesn’t appear to be uncomfortable most of the time. We do have tramadol if he seems to be uncomfortable and we have had to give it to him a couple of times. One problem we are running into is that he absolutely REFUSES to go to the bathroom while on a leash. What we had been doing is walking him on his leash out into the backyard and then letting him off. Since his leg was starting to feel better, as soon as we unleashed him, he would run. I don’t know how to stop this. There really isn’t a way to confine him in our yard. We have a pool and when it warms up, I do plan on getting him in the pool. Right now, it’s just WAY too cold for this Texas gal! 🙂
Submitted on 2014/02/03 at 5:48 pm | In reply to Leslie T.
Hi!
I’m going to move this conversation to the Q&A section after this response, so go ahead and find it there to respond more 🙂
Let’s see…My first thought it that you’re so close to Austin, we should work on getting together! I will come to your vet’s clinic in Houston if we can get together a couple of rehab clients and maybe do a lunch-n-learn with the clinic…but you’d have to set up all that 🙂 I would charge you for a consult but not for mileage ;O

Ok, some quick answers, and I apologize for taking a while to respond…just busy over here-
*Restricting like you have been doing is great.
*I have over 30 years experience in nutrition and supplements, for performance and for wellness and for chronic disease…and everything in-between. It is my preference that even when feeding a great food people supplement with specific amounts of additional fish oil (specific to EPA and DHA) and a glucosamine/msm/chondroitin/green lipped mussel supplement that is of the higher pharmaceutical quality available.
*I deal mostly with multiple-issue pets, train wrecks :), and very definitely the beginning course for everything you have listed is to start at the very beginning of one of the books I have out. The first four weeks are very much the same for all the issues you have named. The specifics come in the future and depending on lagging parts. Almost everyone thinks they don’t have to start at the very beginning, mostly because they have in mind what they have been already doing with their pet. Almost everyone really does need to start at week one of my protocol. Fact is that most of these pets are not taking enough pain relief for their complicated and compiled issues, and most of them have NOT been made to go very slowly on their sore parts. Slow is essential to get all parts back into the game. Pain meds are essential to help all those sore parts as we get them back on board.
*I will tell you I have successfully rehabbed dogs with the “worst” hips I’ve seen (and I do this a LOT, rehab bad hips, see bad hips) using exercise physiology and progressive sport training program design. These dogs are able to build muscle, pull the femur away from the cup, and not need surgery so long as whatever is needed to maintain their physical improvements is pursued.
*You are correct about the front leg (based on what you said and my experience with the same), and pain meds will help that discomfort and the altered carriage.
*Thank you for the kudos about the website!
*Most conservative recommendations, even those from vets who aren’t as familiar with exercise physiology return-to-function like I am, say to give the dog 6 weeks (as does Slatter’s Veterinary Surgery text) of time, and that without a specific program! In your case, if you get the post-op book, because it has the most info right now, then you’ll be ahead of the game, and if you follow it as exactly as possible, not cutting corners and not assuming that parts don’t pertain to you (start at the beginning, get 2-3 analgesics on board, restrict, do the massages, etc…), then you will be surprised (maybe…hopefully) at the outcome, and you’ll be ready for weeks 5-8. Then maybe we can figure out how to consult together.
*Give him the Tramadol 2-3 times per day (hopefully that’s the script your vet wrote), and if he can stand it, for now also give the nsaid. If he cannot take anti-inflammatory, then see if your vet will script Gabapentin to go with the Tramadol; that’s what we use in Austin to get weight-bearing accomplished if need be. Within a couple of days, I can work with a vet to get the right meds and along with home and leash restriction, take a dog that is 4/4 lame (not using injured leg) and get them to 1-2/4 lame…WITH the RIGHT amount of medication and restriction. THEN we can work on the best productive exercise to build the strength of the muscle and connective tissue.
*So, obviously no more bird chasing and no more off leash in the back yard. I’d say that about 1/3 of my client patients purportedly won’t go potty on the leash…but really I see all but less that 1% of those come around when they aren’t given a choice. They eventually figure out they aren’t going to outlast you, and they will go…it almost always works if you have patience, and in this case, Jack would be much worse off after surgery if you don’t get on top of this behavior, you know? You definitely cannot let him off leash to do whatever he says he wants to do while he’s tricking you if he has surgery. He will also (from the sound of personality) HAVE to wear an E-collar after surgery…I’ve seen some dogs do minimal licking, once or twice, and end up with a raging infection…MUCH worse to deal with than the E-collar 🙂
*And definitely don’t use the pool for his conditions until after 12 weeks of my rehab…longer for other protocol. Dogs don’t generally use their hind legs when swimming, and when they do, it’s at an odd angle that adds to the problems in the knee (simple answer). It doesn’t build the muscle we need to stabilize and support the knees and hips. So, the best exercise for Jack will be progressive, land-based, weight-bearing exercise 🙂
I think that answers all your questions for now. If you’d like more info, we should email and set up a paid phone consult that I put on the books at a specific appointment time in order to give you better attention for Jack!
Blessings-
Deborah

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