9 1/2 yo Lab Mix Torn ACL/CCL no Surgery

Cathy
(originally submitted under comment section of “Anecdotal Progress” post)
Submitted on 2012/12/17 at 8:15 pm
I agree that exercise can help heal. My 9 1/2 yr old lab mix tore her ACL in September and we chose not to have surgery for many reasons. I found your site and we began the SLOW short walks 3 weeks after the injury. Other than that she was restricted to my bedroom and potty breaks outside. We began with 5 minute walks twice a day. It has been over 3 months now and we have progressively increased the duration of her walks. Today she walks about 20 minutes at a reserved pace twice a day. Her limp is barely noticeable. In the house we only restrict her (with a baby gate) to my carpeted bedroom when no one is home to prevent her from chasing the cat or freaking out at the doorbell, etc. and we bought cheap runners to put on the hardwoods to create no-slip paths for her. She takes Glucosamin/Chondroitin and Green Lipped Mussel supplements daily, and we cut her food back somewhat so she stays “skinny”—-no extra weight on the knee. She is on a no grain dry food mixed with canned. She was on Rimadyl for a month after the injury and Tramadol for 2 months. I took her off both now. I know she may never go back to unrestricted running and chasing the insane Papillion dog next door—- but she is getting better without surgery or drugs for now.
Here is my question: How can I find a vet who is supportive? My vet sent me to a surgeon and they weren’t positive about options or alternatives. I would also like to know if you recommend water therapy?

rehabdeb
Submitted on 2012/12/19 at 9:05 am | In reply to Cathy.
Hi, Cathy!

Thank you so much for your feedback, and commendations to you for being fastidious with the program 🙂
According to what I saw in my email feed from your post, you may be in North Carolina? I do know vets, specialists, and rehab practitioners in N.C., specifically Raleigh, however I will say you will likely, at this point, gain more support from a horse trainer and the horse racing community.
When I came into animal rehab at the end of 2004, I came from a varied and dynamic background in human sport science, to put it succinctly. I came to animal rehab expecting to find program protocol, functional program design based on dynamic neuro-muscular principles, and info of that nature. There wasn’t any I could find published on the web. I found some wonderful articles by Dr. Jan Steiss, Auburn, one of the first vocal practitioners of DVM-based animal rehab, but nothing along the lines of the very intense sport science journals I’d been reading and the coaching practices I knew. In the following months and years I began writing easy, land- and home-based programs, so that patients I was seeing even in a hospital clinic setting could benefit from applied and thoughtful homework. I now realize I have a lot more broad background in body wellness and functional program design than many people in veterinary medicine and veterinary rehab, and while it’s awesome to see info I take from centuries, really, of practice that began in human sport science and repair (long before I came on the scene…:)), being so very simply beneficial to the animals I work with, it’s complicated to gain an ear at times. Keep in mind that no professional can know everything, and since in a broad view, so many disciplines are and can be linked, it just takes time for mass acceptance. I have no staff, and until I take time to write and publish more of my anecdotal findings more formally, there will be nothing for others to note or contest. I hope that makes sense. It’s been like swimming up a waterfall, because I’ve been aware of a lot of the principles I use for muscle strengthening, bone strengthening, recovery from injury, etc…since the late 1970′s. I have seen that even if papers are published, the majority will remain hesitant, and that seems to be the way it is with so many things. I think that most often we/they/anyone has to have a dynamic personal experience to hop our thought and process over the ridge of the rut to begin traversing a different path. I can remember some of my light-bulb moments over time and my astonishment that what I now “knew” wasn’t broadly taught or widely accepted…several times this has happened over the past 30 years or so, in a variety of venues.
So, I don’t recommend water therapy for your case, based on what you have said in your note. I don’t see overall beneficial reason for it in over 95% of my cases. This is because a thoughtful, progressive, controlled, land-based, gravity-based, exercise protocol will do more to provide return to overall function, repair of hard and soft tissue, and be less expensive for the people while less disruptive to the animals. And the land-based protocol only work well in the environment of appropriate, lameness-duration-based pain management. I have come to the conclusion that so many animals are over-worked in the water treadmill without appropriate pain control and they are returning to function, slowly, painfully, and it’s not a miracle or even an awesome tool, in these cases. What is an awesome tool is appropriate pharmaceutical pain management coupled with the controlled, super slow, walking and then beyond-the-basics, return-to-function program.
The quick answer as to why/what works about the programs I’ve written is that it is slow and therefore not further concussive on the joint. Slow also means more equality in weight-bearing on all limbs…no cheating, which happens when they go faster. Slow means it will be more painful because we are asking for the injured or surgery limb to be used, but if we control it (use a harness, too!!), then we are not inducing damage…we are just asking for use. Pain meds take away the painful part and we get better use. Better use means muscle and supportive tissue builds. Surrounding soft tissue and supportive structures will, in turn, support the joint. Over time, many of my patients have rehabbed torn CCL knees without surgery to the point that their vets could no longer get drawer motion nor could they really differentiate between knees. None of the properly rehabbed ones have gone on to tear the opposite knee ligament. This is huge.
Lack of adequate pain control is a thorn in my practice, and I’m trusted by the vets in this area who use me frequently, so they understand when I send an animal back for review of meds. I cover pain issues in a Q&A post I think I entitled “Should my Dog Still be Limping…”. There are three main reasons I see pain and lameness, so check out that note, too, if you’d like.
I also think I have posted a note elsewhere on this site regarding water treadmill, and I go into more depth about it therein.
I’ve got to run to appointments.
I hope this is helpful, and I really appreciate your taking time to write!!
Blessings-
Deborah

rehabdeb
Submitted on 2012/12/19 at 9:10 am

…also, if you’re on Facebook, check out my FB rehab page:

https//www.facebook.com/animalrehabconditioning

and it sounds like you could use a phone consult from me, if you’d like. You could use a little more direction for the next steps, and I have dogs returning to agility competition, hunting, etc…without surgery, so more can usually be achieved than where you might be now.
ciao-

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