Homework After Surgery or Instead of Surgery for Luxating Patellas (Loose Kneecaps)

First and foremost:  pay attention to the discharge instructions your veterinarian has given you if your pet just had surgery or has received instruction regarding an injury.  Please pay special attention to the part about no running, jumping, or playing. 

If your veterinarian did not say so, please note there should not be any flying over couches, galloping stairs, jumping into or out of cars and trucks,  jumping onto couches or your bed, jumping off of couches or beds, twisting very fast in tight circles, sliding on ice, or freedom in and out of doggie doors.  No owner jumping out from behind things to scare the dog into running crazy funny around the house like you sometimes like to do.   No running really means no running to the door when the doorbell rings, no running away from Halloween costumes, no running from one end of the house to the kitchen every time the fridge or a plastic bag is opened, no running to you when you yell to ask the dog if it wants to go outside, and no running inside after the ball, which is very similar to no running outside after the ball.  No, no swimming until at least 8 weeks after surgery and no lameness is present.

For further instructions, please see the additional links on this page about steps to follow after surgery.

and please see my related books (on Amazon.com. If these links don’t work for you, please search the titles, because I’ve made them available in all the countries Amazon has available…it just may be a different link for you than the one I posted here).

The first four weeks of information are the same for non-surgical and surgical treatment of luxating patellas, as they are for my rehab homework for torn knee ligament. Soon I will have a specific title available that deals with more specifics of luxating patellas.

Guidelines for Home Rehabilitation of Your Dog: Instead of Surgery for Torn Knee Ligament: The First Four Weeks, Basic Edition (Volume 1)

 

Guidelines for Home Rehabilitation of Your Dog: After Surgery for Torn Knee Ligament: The First Four Weeks, Basic Edition

Many cases of luxating patellas do not actually require surgery for correction; your veterinarian and I are able to work together in most cases to devise a plan that immediately reduces pain using medical pain control and gradually reduces pain while increasing thigh muscle & strength with rehabilitation protocol. There are many adjunctive therapies that are also helpful at this time, and they are discussed further in the book noted above. Also, please follow this link https://rehabdeb.com/pet-massage/ for some info on massage.

In some cases the patella ceases to luxate (flip off groove) when greater thigh muscle is created through strengthening exercises.  In some cases the increased exercise and specific exercise protocol for individual animals does not completely eliminate luxation, however in those rehab cases, luxation is often reduced and pain is either eliminated or greatly reduced.  These exercises are designed on a case-by-case basis and may include general walking, hill walking, sand walking, sand pile climbing, stairs, and a variety of other exercise physiology-based activities.

For animals with grades 1 and 2 luxation, rehabilitation protocol has worked successfully to reduce pain and/or luxation as well.  Grade 3 luxations are often similarly aided, however depending on the size and lifestyle of the animal or the severity of lameness, your vet may yet recommend surgery.  Grade 4 luxations almost always require surgery to hopefully improve quality of life, especially as your pet ages, and post-op rehab protocol should be advised (a notation of which follows this outline).

Rehabilitation should continue for at least six to eight weeks. Often owners relax around week 4, especially if things seem to be going very well.  If a rehab consult is not possible for an owner at week 5, then restrictions and exercises as per week 4 should be continued until an evaluation is made and new exercises are given or for the duration of the post-op restriction period suggested by your veterinarian.

copyright 2007, Deborah Carroll

How to Use The Homework Guides for Rehab After Dog Knee Injury or Surgery

Intro to the books, found on Amazon here:

 and here…

and elsewhere from a variety of booksellers.

Read the Preface.

Read the Prologue.

Read the whole booklet before beginning the work.

Thank you! Now continue to read this chapter. The above three bullet point sentences were for people who really want bullet points. Both the Preface and the Prologue contain beneficial information, and I think the following contents will answer several questions you might not even know you have!

This homework covers guidelines that may be used after any invasive procedure performed for surgical repair of your pet’s knee after a torn ligament, whether any of the bones were cut or not. Right now it does not matter so much that you know exactly which surgery was performed; the restrictions and care are equally beneficial.

These guidelines are also very beneficial for recovery after surgery for torn meniscus and after surgical intervention for osteochondritis dissecans (OCD) (yes, really, but different from psych OCD) of the stifle (knee) joint. Whichever method of surgery was used, this homework is an excellent place to continue the healing journey!

As I stated earlier, written programs like this were not readily available, if at all, when I first began working officially in small animal veterinary medicine rehab in 2004. I knew from working with athletes and others, as well as from reading related research for several decades, that very slowly progressing, return-to-function programs were needed for our pets, as well.

In light of what I knew, I began using simple post-surgical protocol I developed. The larger discussion, continually, is among varieties of veterinarians who have come to believe in a particular method or methods of surgery to be used to stabilize the knee after ruptured cranial cruciate ligament. Regardless of method used, this intro protocol should be very beneficial toward accustoming the joint to greater amounts of use again, toward improving bone healing, and toward improving bone and muscle strength.

I don’t have the money to fund a large study or the time to ask for it at this point or in recent years. I do, however, have the validation of many veterinarians who have seen the progress of the pets whose caretakers have fastidiously followed my instruction for at least 8 weeks.

Often people see such notable improvement after only 4 weeks that they don’t understand the need to continue to follow through with progressive rehab. In well-established human rehabilitation protocol for ACL surgery, patients are progressed through criteria-based functional activities and evaluations for discharge from rehab are targeted between 4 and 6 months after surgery.*

Is this happening with your pet?

My preference is that people follow at least 12 weeks of rehab protocol for their pets in almost every case. The feedback from situations of which I am aware where this has occurred has been entirely positive.  This homework is an excellent place to continue the healing journey, so take a deep breath and move forward confidently!

Also, as noted, my practice and protocol are based on using the home or a standard vet clinic environment to accomplish functional rehabilitation. I prefer land-based exercise because I find it very practical for most pets and their caretakers after this surgery. You may put your internet researching skills to good use by looking for research data which encourages the use of weight-bearing exercise, where possible, to bring about greatest changes toward healing, including bone strengthening and the strengthening of soft tissue, as well as muscle hypertrophy. The latter is often the reason animals are referred to me; people want to see the muscle rebuilt where it has diminished over time due to injury and subsequent lameness (muscle atrophy).

Some people will want to utilize a clinic and a water treadmill in addition to the instructions in this booklet, possibly because the clinic option is available and their veterinarian has recommended it. Most people do not have the option of a rehabilitation facility for their pet, and that’s okay, because it’s not necessary to have that in order for your pet to recover…so don’t fret!

Regardless, I find that people are really in need of instructions that outline steps they may take to assist the healing and improved return to function of their pet in the home environment. Caretakers usually just don’t know what to do that is proactive and practical at home after pet surgery (or injury!).

I also emphasize over and over that pain control is important to my rehab protocol. If you are not going to use enough pain control to help your pet bear weight on the injured leg, then you should consider using the water treadmill..

It is extremely important for pet caretakers to learn how to control and care for their companions at home after this surgery whether or not they also entrust this aftercare to a clinic for a few hours a week as well. Do collaborate with your vet clinic, yet also learn how to do your part, hopefully aided by the ideas in this booklet.

*You may find out more about the topic of clinic-based human rehabilitation from books like Postsurgical Rehabilitation Guidelines for the Orthopedic Clinician, Hospital for Special Surgery, Department of Rehabilitation, Copyright 2006, Elsevier, Inc.

Cavaletti (Obstacle) Photos

Some Examples of Cavaletti Equipment my Clients Have Used in their Home Environments –

Since my practice is mobile, I look around the client’s home or workout environment to find cavaletti equipment or tools to get the (obstacle) work done. These drills are for proprioceptive benefit as well as range of motion and isometric strength building.

Cavalettis should technically and scientifically be done only after establishing a base with this program.

First…

I look around the home environment to help people with ideas that are inexpensive and easy to set up the right size and spacing of cavalettis for their pet. Finding options for the right kind of obstacles in the home environment makes it easier for the people and the pets to be compliant with the work. Less time demand and easier access makes for greater compliance. Even if people have to buy stuff to use for these drills, sometimes pool noodles or something from the home supply store, these tools are inexpensive.

Cavalettis Original Design 2-27-14I lined up these bricks along a house to make range of motion and isometric drills for a mid-sized herding dog with non-surgical rehab of torn cruciate ligament.

Cavalettis 3 Cavalettis 4

Later, her person caretaker raised the bar by raising the bar and building a more elaborate brick-scapade across the back yard!

Second –

10-11-14 Cavalettis

This was the cavaletti path for a large Pit/Lab X doing non-surgical rehab for torn cruciate ligament and torn meniscus. She also had a tarsal (ankle) injury that I discovered at the same time!

This client was unable to work her large, happy, strong dog outside with much success. She had great success doing all the advanced drills inside the home.

She also didn’t have the right size and type of items for the drills lying around the home, so she spent a little bit of money on wood. After doing the introductory drills at this height, the client then placed flat 2×4 blocks under the ends of the boards to raise them.

After several successful sessions at an introductory level, pets need to continue the drill at increasingly higher bar levels. For videos of cavaletti instructions, click here!

This client bought wood, nails, and pvc –

Cavalettis 2-27-14

This was level 2 cavaletti height for a Goldendoodle doing non-surgical rehab for torn meniscus and torn cruciate ligament. She also had hip pain issues that after muscle atrophy from the knee injury. This resolved after she started my program for muscle-building and received the proper pain medications from her veterinarian.

The next level for her was to put 2 x 4 blocks under the pvc. You already see that in the picture.

Cavs 2 7-11-14Cavs 7-11-14 These were from the woodpile out front at this mid-sized dogs home. I set them up to help her recover from her neurological event, an FCE (fibrocartilaginous embolism). I directed them to begin this work only after completing my base work of fitness and muscle strength.

BJ Cavs 1 8-8-14

BJ Cavs 8-8-14

Yes, these ARE speaker stands inserted into milk crates. Only in Austin, TX (and maybe Nashville…)

Cavalettis

I DO work with many cats. This one is Kacey, and there’s a vid on this site of her doing cavaletti repeats…

Chile R 6-26-13 Cavs Happy

And this guy is getting a start using his own standard cavaletti equipment he usually uses for agility training. Recovery cavaletti drills are much different than agility training work with jumps. There is no jumping in recovery cavaletti drills.  He was working on this drill to help with his disk disease and degenerative myelopathy.

 

(Original Post November 3, 2014. Updated March 27, 2018)

After Surgery for Torn Knee Ligament (TPLO, TTA, CBLO, Lateral Suture) (CCL ACL Tear or Rupture)

Guidelines for Home Rehabilitation of Your Dog: After Surgery for Torn Knee Ligament: The First Four Weeks, Basic Edition

Preface to the Book of Instructions for Rehab After Surgery for Dog Torn Knee Ligament:

“Some of the information contained in this volume has been published previously by me on my websites beginning in January, 2007. Until this particular current publication, I have had available on my various sites (and on some sites that co-opted my material) a general outline for the first four weeks of post-surgical or post-injury rehab because the demand for this information has been so great.

The updated content of this volume is not available on any of my sites, nor has the full content been previously available, and most of the definitive information regarding exercise protocol that is contained in this volume has been removed from my websites and personal social media pages as of this publication.

When I first began publishing a simple home-based plan to the internet it was only a four-week, progressive walking exercise plan, useful for a variety of rehab situations. An expanded version of that is what is contained in this booklet.

What has happened though over time is that I have encountered many situations wherein people have interpreted these basic instructions in contrary ways, often omitting bits they thought they could and often in a way that has been detrimental to the pet.

Therefore, what this booklet also contains is a more thorough explanation of how to enact the plan well …and enact it simply. There is no “bullet point” version, because bullet points will not describe the details of functional rehab so that the animal receives more benefit while receiving less harm or discomfort.

As it is, I continually want to add to or modify bits of this edition, and I have to stop somewhere! This is the basic edition, the closest you may come to bullet points outside of my professional website.  Thank you, on behalf of your pet, for taking this time to learn more about the healing methods available for them.”

If you would like advanced or personalized exercises, then please contact me for a consult. There is a contact form at the bottom of this page <<Click on link . Use this form if you would like to schedule a paid phone or in-person consult with me for rehabilitation for your pet.

Blessings – Rehabdeb

Reviewed July, 2019

Instead of Surgery for Torn Knee Ligament in Dogs

Guidelines for Home Rehabilitation of Your Dog: Instead of Surgery for Torn Knee Ligament: The First Four Weeks, Basic Edition (Volume 1)

Here is the link to the Amazon.com site for my booklet of instructions for you to follow after a diagnosis of torn CCL (cranial cruciate ligament, like ACL in people, in the knee) in your dog. Follow these guidelines whether you have decided not to pursue surgery for your dog or you are doing some rehab prior to surgery, “pre-hab”.

These instructions cover four weeks from when you begin to tackle the lameness and injury issues…regardless of when the injury occurred; I sometimes get to work with a dog that has been lame for a year or more after injury, so go by functional rehab time and not necessarily time from injury.

My books should also be available on worldwide Amazon sites, as well as other distribution sites, like Barnes & Noble.

On all other Amazon sites around the world, and on other distribution sites, please search this title and ISBN:

Guidelines for Home Rehabilitation of Your Dog: Instead of Surgery for Torn Knee Ligament: The First Four Weeks, Basic Edition

  • ISBN-13: 978-0615900476

Thank you, and here’s an excerpt!

Preface

Some of the information contained in this volume has been published previously by me on my websites beginning in January, 2007. Until this particular current publication, I have had available on my various sites (and on some sites that co-opted the material) a general outline for the first four weeks of post-surgical or post-injury rehab because the demand for this information has been so great.

The updated content of this volume is not available on any of my sites, nor has the full content been previously available, and most of the definitive information regarding exercise protocol that is contained in this volume has been removed from my websites and personal social media pages as of this publication.

When I first began publishing a simple home-based plan to the internet, it was only a four-week, progressive walking exercise plan, useful for a variety of rehab situations. A version of that is what is contained in this booklet. What has happened though over time is that I have encountered many situations wherein people have interpreted these basic instructions in contrary ways, often omitting bits they thought they could while still hoping for success and often in a way that has been detrimental to the pet.

Therefore, what this booklet also contains is a more thorough explanation of how to enact the plan well …and enact it simply. There is no “bullet point” version, because bullet points will not describe the details of functional rehab so that the animal receives more benefit while receiving less harm or discomfort. As it is, I continually want to add to or modify bits of this edition, and I have to stop somewhere!

This is the basic edition, the closest you may come to bullet points outside of my professional website.

There is also an expanded edition, which contains more in-depth looks at potential pitfalls and additional remedies, along with greater explanation as to why I believe some therapies are better than others, especially for wellness and healing complementary to a home environment.

Thank you, on behalf of your pet, for taking this time to learn more about the healing methods available for them.

Thanks!

Blessings-