How You May Help Rescue Organizations and Animal Shelters with Rehab!!

This is an exciting opportunity to help animal shelter and rescue rehabilitation to save money and pets!!

Dog in Blinds

This is a great way for you to get involved in rescue rehabilitation and rehab for animal shelters in the USA right now (and maybe around the globe later)!

WHAT?

If you read  >>> the reviews <<< on this site, you will see that several veterinarians and others have mentioned that this book ∨∨∨

should be available to more shelters and rescues for new caretakers of adopted pets, and we’d like to offset the expense to shelters of handing out these books to new pet adopters. (Note: if you have blocked Amazon, the book link will not show up above. If you are interested in searching for it on your own, you may use the ISBN 9780615900476 for more info.)

To donate to this program through me, you must use the PayPal link below for the discounted price. Otherwise, if you just want to purchase some and hand them out or use for yourself, then use the Amazon link, above ∧ ∧ by clicking the pic of the book.

HOW?

There is a drop-down menu associated with this PayPal button ∨ ∨ so that you may choose your donation amount…
check it out-


After Torn Knee Ligament Recovery Book
Message From You to Recipients



(This is a secure site & so is PayPal, just fyi)

WHY?

People want the book for dogs in rescue organizations and dogs in animal shelters so that the inexpensive and less-traumatic recovery options offered in the book may be followed instead of immediately pursuing surgery for torn knee ligaments.

IMPACTFUL CONSERVATION…

The other exciting part of this equation is that by following the rehab protocol outlined in the book, instead of first going to surgery, more funds could be made available for other newly admitted pets with much bigger medical problems! This is a very exciting effort toward overall conservation and community wellness.

MORE DEETS-

I am currently editing these original 4-week, foundation-building rehab books, and in the meantime, for every $5 donated, I am able to give one of these original books to an established city/county shelter or verified rescue organization in the contiguous United States.

These books will accompany new pet caretakers at adoption, and the new adoptors will be able to follow the directions while working with their veterinarian on follow-up for pain control, continued recovery, and additional wellness.

SO MUCH NEEDED HELP, IN MANY WAYS (AND THANK YOU ALL)!

I will be posting pics below this post as books are donated so that you will be able to see the benefits of your donations. I will also post pics and follow-up info from the new pet parents too, when they share it with me!

Thank you in advance for participating in this adventure!

Blessings-

Deborah

Q & A

May we buy books from you at this same discount for our clinic, to hand out to clients?

If you are a clinic owner or associate, you may also use this option to purchase books for your clinic. Many of you are already doing this though personal contact with me. If you have not previously ordered from me, be sure to include your clinic name and shipping information in the comments section of the Paypal purchase. Also, to make sure the info gets sent to me, fill out the short private contact form below.

When will this option be available for clinics and shelters in other areas besides the United States?

On the one hand, I could implement this option at any time. On the other hand, I’d need to first know shipping destination outside of the US. Then I would know how many books I could send for a particular donation amount. Currency exchange rates are a factor. Please contact me using the form below, and we will work out the details via email. Please include your clinic or shelter email where the contact box asks for it.  You may provide your personal email if you are a principle veterinarian at the facility. The info you put into the contact box goes directly to  my email, so no one else should see your information.

Arthritis

Physical Therapy as Effective as Surgery for Torn Meniscus and Arthritis of the Knee, (Human) Study Suggests

“Surgery may not always be the best first course of action. A physical therapist, in many cases, can help patients avoid the often unnecessary risks and expenses of surgery. This study should help change practice in the management of symptomatic meniscal tears in patients with knee osteoarthritis.” Mar. 21, 2013 — A New England Journal of Medicine (NEJM) study showing that physical therapy is just as effective as surgery in patients with meniscal tears and arthritis of the knee should encourage many health care providers to reconsider their practices in the management of this common injury, according to the American Physical Therapy Association (APTA).

The study, published March 19, showed no significant differences in functional improvement after 6 months between patients who underwent surgery with postoperative physical therapy and those who received standardized physical therapy alone.

“This study demonstrates what physical therapists have long known,” explained APTA President Paul A. Rockar Jr, PT, DPT, MS. “Surgery may not always be the best first course of action. A physical therapist, in many cases, can help patients avoid the often unnecessary risks and expenses of surgery. This study should help change practice in the management of symptomatic meniscal tears in patients with knee osteoarthritis.” According to lead physical therapist for the trial and American Physical Therapy Association (APTA) member Clare Safran-Norton, PT, PhD, OCS, “our findings suggest that a course of physical therapy in this patient population may be a good first choice since there were no group differences at 6 months and 12 months in this trial. These findings should help surgeons, physicians, physical therapists, and patients in decision-making regarding their treatment options.” Researchers at 7 major universities and orthopedic surgery centers around the country studied 351 patients aged 45 years or older who had a meniscal tear and mild-to-moderate osteoarthritis of the knee. Patients were randomly assigned to groups who received either surgery and postoperative physical therapy or standardized physical therapy. Within 6-12 months, patients who had physical therapy alone showed similar improvement in functional status and pain as those who had undergone arthroscopic partial meniscectomy surgery. Patients who were given standardized physical therapy — individualized treatment and a progressive home exercise program — had the option of “crossing over” to surgery if substantial improvements were not achieved. Thirty percent of patients crossed over to surgery during the first 6 months. At 12 months these patients reported similar outcomes as those who initially had surgery. Seventy percent of patients remained with standardized physical therapy. According to an accompanying editorial in NEJM,”millions of people are being exposed to potential risks associated with a treatment [surgery] that may or may not offer specific benefit, and the costs are substantial.” Physical therapist and APTA member Mary Ann Wilmarth, PT, DPT, MS, OCS, MTC, Cert MDT, chief of physical therapy at Harvard University, said, “Physical therapists are experts in improving mobility and restoring motion. The individualized treatment approach is very important in the early phases of rehabilitation in order to achieve desired functional outcomes and avoid setbacks or complications.”

Story Source: The above story is reprinted from materials provided by American Physical Therapy Association. Note: Materials may be edited for content and length. For further information, please contact the source cited above.

Journal Reference:
Jeffrey N. Katz, Robert H. Brophy, Christine E. Chaisson, Leigh de Chaves, Brian J. Cole, Diane L. Dahm, Laurel A. Donnell-Fink, Ali Guermazi, Amanda K. Haas, Morgan H. Jones, Bruce A. Levy, Lisa A. Mandl, Scott D. Martin, Robert G. Marx, Anthony Miniaci, Matthew J. Matava, Joseph Palmisano, Emily K. Reinke, Brian E. Richardson, Benjamin N. Rome, Clare E. Safran-Norton, Debra J. Skoniecki, Daniel H. Solomon, Matthew V. Smith, Kurt P. Spindler, Michael J. Stuart, John Wright, Rick W. Wright, Elena Losina. Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis. New England Journal of Medicine, 2013; : 130318220107009 DOI:10.1056/NEJMoa1301408
Note: If no author is given, the source is cited instead.

Here is a second report of the same issue:

Medscape Medical News from the:

American Academy of Orthopaedic Surgeons (AAOS) 2013 Annual Meeting
This coverage is not sanctioned by, nor a part of, the American Academy of Orthopaedic Surgeons.

Medscape Medical News > Conference News
Physical Therapy as Effective as Surgery for Meniscal Tear

Medscape Medical News from the: American Academy of Orthopaedic Surgeons (AAOS) 2013 Annual Meeting Physical Therapy as Effective as Surgery for Meniscal Tear Kathleen Louden Mar 20, 2013 CHICAGO, Illinois — Patients with knee osteoarthritis and a meniscal tear who received physical therapy without surgery had good functional improvement 6 months later, and outcomes did not differ significantly from patients who underwent arthroscopic partial meniscectomy, a new clinical trial shows. In the Meniscal Tear in Osteoarthritis Research (METEOR) trial, both groups of patients improved substantially in function and pain. This finding, presented here at the American Academy of Orthopaedic Surgeons 2013 Annual Meeting and published online simultaneously in the New England Journal of Medicine, provides “considerable reassurance regarding an initial nonoperative strategy,” the investigators report. Patients with a meniscal tear and osteoarthritis pose a treatment challenge because it is not clear which condition is causing their symptoms,” principal investigator Jeffrey Katz, MD, from Brigham and Women’s Hospital in Boston, Massachusetts, told Medscape Medical News. “These data suggest that there are 2 reasonable pathways for patients with knee arthritis and meniscal tear,” Dr. Katz explained. “We hope physicians will use these data to help patients understand their choices.” In an accompanying editorial, clinical epidemiologist Rachelle Buchbinder, PhD, from the Monash University School of Public Health and Preventive Medicine in Victoria, Australia, said that “these results should change practice. Currently, millions of people are being exposed to potential risks associated with a [surgical] treatment that may or may not offer specific benefit, and the costs are substantial.” These results should change practice. The METEOR trial enrolled 351 patients from 7 medical centers in the United States. Eligible patients were older than 45 years, had osteoarthritic cartilage change documented with magnetic resonance imaging, and had at least 1 symptom of meniscal tear, such as knee clicking or giving way, that lasted at least 1 month despite drug treatment, physical therapy, or limited activity. In this intent-to-treat analysis, investigators randomly assigned 174 patients to arthroscopic partial meniscectomy plus postoperative physical therapy and 177 to physical therapy alone. The physical therapy in both regimens was a standardized 3-stage program that allowed patients to advance to the next intensity level at their own pace, Dr. Katz explained. The program involved 1 or 2 sessions a week for about 6 weeks and home exercises. The average number of physical therapy visits was 7 in the surgery group and 8 in the nonsurgery group. Investigators evaluated patients 6 and 12 months after randomization. The primary outcome was the between-group difference in change in physical function score from baseline to 6 months, assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). At baseline, demographic characteristics and WOMAC physical function scores were similar in the 2 groups. At 6 months, improvement in the WOMAC function score was comparable in the 2 groups. The mean between-group difference of 2.4 points was not statistically significant after analysis of covariance. There was also no significant difference between groups in pain improvement or frequency of adverse events. METEOR: Mean Improvement in Osteoarthritis Index at 6 Months Treatment Group Mean Improvement (Points) 95% Confidence Interval Surgery plus physical therapy 20.9 17.9–23.9 Physical therapy 18.5 15.6–21.5 There was 1 death in each group, and 8 patients in the nonsurgery group and 13 in the surgery group withdrew in the first 6 months of the study. Patients in the nonsurgery group were allowed to cross over to the surgical group at any time. Within 6 months, 30% of patients did so. “They were not doing very well,” Dr. Katz said. His team is still analyzing the reasons these patients did not benefit from intensive physical therapy. The 12-month results were similar to the 6-month results. In addition, by 12 months, outcomes for the crossover patients and for those in the original surgery group were similar. Meeting delegate John Mays, MD, an orthopaedic surgeon practicing in Bossier City, Louisiana, who was asked by Medscape Medical News to comment on the findings, said most patients don’t choose physical therapy. “In the real world, most people want a quick fix” and choose surgery, he noted. Dr. Mays said he would have liked to have seen a group of patients who underwent surgery but did not receive postoperative physical therapy. He explained that his patients with osteoarthritis and meniscal tear rarely get physical therapy after arthroscopic meniscectomy; they most often do home-based exercises. He added that “most insurance plans have limits on the number of physical therapy sessions they allow.” This study is funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Katz, Dr. Buchbinder, and Dr. Mays have disclosed no relevant financial relationships. N Engl J Med. Published online March 19, 2013. Abstract, Editorial American Academy of Orthopaedic Surgeons (AAOS) 2013 Annual Meeting: Abstract SE67. Presented March 19, 2013.

More Than Half of All ACL Reconstructions Could Be Avoided, Five-Year Follow-Up Study Shows

(From RehabDeb: This report is from human medical research, however animal studies are currently being conducted at Colorado State University. When I began animal rehab in 2005, I developed some protocol for people to use to benefit their animals if they did not want surgery for their pet, even though I was working at the time in a surgery specialty hospital. When I began independent practice in 2007, I took years of accumulated research, experience, and knowledge and created some simple functional exercise and drill protocol that has benefited hundreds of my canine patients whose people opted to not pursue surgery. That protocol and some other papers citing surgery text recommendations may be found elsewhere on this site-see the index to the right. In every case where my protocol has been followed (and there are no extenuating circumstances), the pets have stabilized the joint with muscle and scar tissue, and they have functioned very well. This work is all done in the home environment with no dependence on specialized equipment…no need when we are drawing from centuries of known exercise physiology and dynamic principles of body function. Blessings-)

Jan. 30, 2013 — In the summer of 2010, researchers from Lund University in Sweden reported that 60 per cent of all anterior cruciate ligament (ACL) reconstructions could be avoided in favour of rehabilitation. The results made waves around the world, and were met with concerns that the results would not hold up in the long term. Now the researchers have published a follow-up study that confirms the results from 2010 and also show that the risk of osteoarthritis and meniscal surgery is no higher for those treated with physiotherapy alone.

“We have continued with our study and for the first time are able to present a five-year follow-up on the need for and results of ACL surgery as compared with physiotherapy. The findings have been published in the British Medical Journal and are basically unchanged from 2010. This will no doubt surprise many people, as we have not seen any difference in the incidence of osteoarthritis,” says Richard Frobell, one of the researchers behind the study, who is an associate professor at Lund University and a clinician at the orthopaedic department, Helsingborg Hospital.

Richard Frobell explains that the research group’s results from 2010, which were published in the New England Journal of Medicine, caused a stir and questions were raised as to whether it was possible to say that an operation would not be needed in the long term.

Half of the patients who were randomly assigned not to undergo reconstructive surgery have had an operation in the five years since, after experiencing symptoms of instability.

“In this study, there was no increased risk of osteoarthritis or meniscal surgery if the ACL injury was treated with physiotherapy alone compared with if it was treated with surgery. Neither was there any difference in patients’ experiences of function, activity level, quality of life, pain, symptoms or general health,” says Richard Frobell.

“The new report shows that there was no difference in any outcome between those who were operated on straight away, those who were operated on later and those who did not have an operation at all. The message to the medical experts who are treating young, active patients with ACL injuries is that it may be better to start by considering rehabilitation rather than operating straight away.”

In Sweden, over 5 000 people every year suffer an anterior cruciate ligament injury — mainly young people involved in sport. There are different schools of treatment and Sweden stands out with treatment that is in line with the results of the study.

“On an international front, almost all of those with ACL injuries are operated on. In Sweden, just over half are operated on, but in southern Sweden we have been working for many years to use advanced rehabilitation training as the first method of treatment. Our research so far has confirmed that we are right in not choosing to operate on these injuries immediately. Longer-term follow-up is important, however, if we are to look more closely at the development of osteoarthritis in particular,” says Richard Frobell.

The research group, whose study is called KANON, Knee ACL NON-operative versus operative treatment, is now moving on to the next stage. This year, the third part of the study will begin, following up the patients ten years after anterior cruciate ligament injury.

Richard Frobell has also entered into a collaboration with researchers at the School of Economics and Management at Lund University to evaluate the health economics aspects of different treatment methods for ACL injury.

Journal References:

  1. R. B. Frobell, H. P. Roos, E. M. Roos, F. W. Roemer, J. Ranstam, L. S. Lohmander. Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trialBMJ, 2013; 346 (jan24 1): f232 DOI:10.1136/bmj.f232
  2. Richard B. Frobell, Ewa M. Roos, Harald P. Roos, Jonas Ranstam, L. Stefan Lohmander. A Randomized Trial of Treatment for Acute Anterior Cruciate Ligament Tears.New England Journal of Medicine, 2010; 363 (4): 331 DOI:10.1056/NEJMoa0907797

From ScienceDaily

Fat is Pro-Inflammatory! Weight Loss Helps Relieve Pain From Arthritis (among other things!)

Copied from a recent post on the IVAPM*:

“…I would be looking for some of the non-pharmacologic strategies. You have already mentioned an important one, getting the weight off. Adipose tissue is the body’s largest endocrine organ, and it secretes, especially when in excess, a slew of nasty cytokines that essentially bathes the body – including the synovia and joints – in a soup of pro-inflammatory mediators. We have increasingly strong evidence in dogs that nothing more than weight loss will improve comfort and mobility in this species, including excellent one this year where the authors conclude “results indicate that body weight reduction causes a significant decrease in lameness from a weight loss of 6.10% onwards. Kinetic gait analysis supported the results from a body weight reduction of 8.85% onwards. These results confirm that weight loss should be presented as an important treatment modality to owners of obese dogs with OA and that noticeable improvement may be seen after modest weight loss in the region of 6.10 – 8.85% body weight”.”

Weight loss. There is no substitute. • Lago R, Gomez R, et al A new player in cartilage homeostasis: adiponectin induces nitric oxide synthase type II and pro-inflammatory cytokines in chondrocytes. Osteoarthritis Cartilage. 2008 Sep;16(9):1101-9. • Impellizeri JA, Tetrick MA, Muir P. Effect of weight reduction on clinical signs of lameness in dogs with hip osteoarthritis. JAVMA 2000 Apr 1;216(7):1089-91 • Burkholder, 2001 • Mlacnik E, Bockstahler BA, Muller M, et al. Effects of caloric restriction and a moderate or intense physiotherapy program for treatment of lameness in overweight dogs with osteoarthritis. J Am Vet Med Assoc. 2006 Dec 1;229(11):1756-60. • Marshall WG, Hazewinkel, HA, Mullen D, et al. Vet Res Commun. The effect of weight loss on lameness in obese dogs with osteoarthritis. 2010 Mar;34(3):241-53

*International Veterinary Association of Pain Management

Intestinal Bacteria Linked to Rheumatoid Arthritis

From ScienceDaily. com Nov. 5, 2013 — Researchers have linked a species of intestinal bacteria known as Prevotella copri to the onset of rheumatoid arthritis, the first demonstration in humans that the chronic inflammatory joint disease may be mediated in part by specific intestinal bacteria. The new findings by laboratory scientists and clinical researchers in rheumatology at NYU School of Medicine add to the growing evidence that the trillions of microbes in our body play an important role in regulating our health.

Using sophisticated DNA analysis to compare gut bacteria from fecal samples of patients with rheumatoid arthritis and healthy individuals, the researchers found that P. copri was more abundant in patients newly diagnosed with rheumatoid arthritis than in healthy individuals or patients with chronic, treated rheumatoid arthritis. Moreover, the overgrowth of P. copri was associated with fewer beneficial gut bacteria belonging to the genera Bacteroides.

“Studies in rodent models have clearly shown that the intestinal microbiota contribute significantly to the causation of systemic autoimmune diseases,” says Dan R. Littman, MD, PhD, the Helen L. and Martin S. Kimmel Professor of Pathology and Microbiology and a Howard Hughes Medical Institute investigator.
“Our own results in mouse studies encouraged us to take a closer look at patients with rheumatoid arthritis, and we found this remarkable and surprising association,” says Dr. Littman, whose basic science laboratory at NYU School of Medicine’s Skirball Institute of Biomolecular Medicine collaborated with clinical investigators led by Steven Abramson, MD, senior vice president and vice dean for education, faculty, and academic affairs; the Frederick H. King Professor of Internal Medicine; chair of the Department of Medicine; and professor of medicine and pathology at NYU School of Medicine.

“At this stage, however, we cannot conclude that there is a causal link between the abundance of P. copri and the onset of rheumatoid arthritis,” Dr. Littman says. “We are developing new tools that will hopefully allow us to ask if this is indeed the case.”

The new findings, reported today in the open-access journal eLife, were inspired by previous research in Dr. Littman’s laboratory, collaborating with Harvard Medical School investigators, using mice genetically predisposed to rheumatoid arthritis, which resist the disease if kept in sterile environments, but show signs of joint inflammation when exposed to otherwise benign gut bacteria known as segmented filamentous bacteria.

Rheumatoid arthritis, an autoimmune disease that attacks joint tissue and causes painful, often debilitating stiffness and swelling, affects 1.3 million Americans. It strikes twice as many women as men and its cause remains unknown although genetic and environmental factors are thought to play a role.

The human gut is home to hundreds of species of beneficial bacteria, including P. copri, which ferment undigested carbohydrates to fuel the body and keep harmful bacteria in check. The immune system, primed to attack foreign microbes, possesses the extraordinary ability to distinguish benign or beneficial bacteria from pathogenic bacteria. This ability may be compromised, however, when the gut’s microbial ecosystem is thrown off balance.

“Expansion of P. copri in the intestinal microbiota exacerbates colonic inflammation in mouse models and may offer insight into the systemic autoimmune response seen in rheumatoid arthritis,” says Randy S. Longman, MD, PhD, a post-doctoral fellow in Dr. Littman’s laboratory and a gastroenterologist at Weill-Cornell, and an author on the new study. Exactly how this expansion relates to disease remains unclear even in animal models, he says.

Why P. copri growth seems to take off in newly diagnosed patients with rheumatoid arthritis is also unclear, the researchers say. Both environmental influences, such as diet and genetic factors can shift bacterial populations within the gut, which may set off a systemic autoimmune attack. Adding to the mystery, P. copri extracted from stool samples of newly diagnosed patients appears genetically distinct from P. copri found in healthy individuals, the researchers found.

To determine if particular bacterial species correlate with rheumatoid arthritis, the researchers sequenced the so-called 16S gene on 44 fecal DNA samples from newly diagnosed patients with rheumatoid arthritis prior to immune-suppressive treatment; 26 samples from patients with chronic, treated rheumatoid arthritis; 16 samples from patients with psoriatic arthritis (characterized by red, flaky skin in conjunction with joint inflammation); and 28 samples from healthy individuals.

Seventy-five percent of stool samples from patients newly diagnosed with rheumatoid arthritis carried P. copri compared to 21.4% of samples from healthy individuals; 11.5% from chronic, treated patients; and 37.5% from patients with psoriatic arthritis.

Rheumatoid arthritis is treated with an assortment of medications, including antibiotics, anti-inflammatory drugs like steroids, and immunosuppressive therapies that tame immune reactions. Little is understood about how these medications affect gut bacteria. This latest research offers an important clue, showing that treated patients with chronic rheumatoid arthritis carry smaller populations of P. copri. “It could be that certain treatments help stabilize the balance of bacteria in the gut,” says Jose U. Scher, MD, director of the Microbiome Center for Rheumatology and Autoimmunity at NYU Langone Medical Center’s Hospital for Joint Diseases, and an author on the new study. “Or it could be that certain gut bacteria favor inflammation.”

The researchers plan to validate their results in regions beyond New York, since gut flora can vary across geographical regions, and investigate whether the gut flora can be used as a biological marker to guide treatment. “We want to know if people with certain populations of gut bacteria respond better to certain treatment than others,” says Dr. Scher. Finally, they hope to study people before they develop rheumatoid arthritis to see whether overgrowth of P. copri is a cause or result of autoimmune attacks.

Goldendoodle Lame after Surgery for Osteochondritis Dissecans (OCD)

Goldendoodle Lame After OCD Surgery

My 8 month old goldendoodle had ocd shoulder surgery 10 weeks ago.  It was not arthroscopic, but open surgery.  He was still limping 4 weeks later, so he was opened up again for a second surgery on the same shoulder.  It has been five weeks.  He has been given the series of 8 adequan shots, which he just finished, and he limps as bad or worse that he did at the beginning. What can we do?  I am heartbroken.  My vet says he has ocd in the other shoulder as well, but I’m not about to do anything about it, until we can get our dog out of pain from his first shoulder.

hi! I just finished my last appointment and I’m on my phone right now voice texting you via email.
are you near me in Austin, Texas?
my first thought is this takes quite a while to heal and your dog needs more pain medication.
what meds is your dog on right now?
also, since this takes a while to heal, she should be doing specific short controlled walks and no extra activity around the house.
let me know what’s going on with these things-
Deborah

Deborah-

Sadly, I am not near you.  I live in Missouri.  We actually have 2 doodles.  They are brothers.  I think that might be part of the problem, however, the vet said that after 4 weeks of quiet time, that there are no restrictions on Cxxx (my poor puppy).  He can run like the wind with his brother, but walking slowly is a real challenge.  I could go on forever.  Are you in the medical field, or are you familiar with this problem?  I feel so bad for him.  Yesterday was a beautiful day, so he ran around alot.  Today, he walks almost like his leg is broken.  I give him 1/2 of a Rimadyl tablet, every few days.  I’ve heard so many bad stories about how that drug hurts his liver, so I hate to keep him on it. I also have some tramadol left over from the second surgery, but I didn’t know if it was okay to use it.  I really thought the adequan shots were going to be the miracle drug, but I don’t see any change at all.  I so appreciate taking the time to discuss this with me, as I am at wits end, and the thought of putting him through another surgery just sounds awful to me.  Thanks again for your response.   P

P-

Thank you 🙂 (for the kudos on the FB page)
So, from what you have said, everything I have posted on my WordPress website should answer your dilemma  even though this info is different from what you might have heard to do.
Cxxx needs pain relief and at least 12 weeks of no crashing around and very slow exercise protocol. No wild running. Read all my posts on pain after surgery.
Yes, I am very familiar, as you may have figured out by now, and I was blessed to have Grace Great Dane in my life for 10.5 yrs, and she had very bad OCD in one knee and mild in the other. That’s a longer story I haven’t written.
Anyway, in all my years of athletic involvement and now animal recovery, the biggest issue I have seen is lack of appropriate recovery time.
Get a harness and MAKE him go slowly, following any of my post-surgical homework assignments beginning at WEEK 1.
Use the Tramadol as if just after surgery, and see if that is enough to enable solid leg use during the very, very slow walks, and if so, you won’t need to use the nsaid for now. If you need to use the anti-inflammatory (nsaid), it is likely not going to do a bunch of damage. Usually vets don’t prescribe the meds without checking blood work anyway, and that was likely checked prior to surgery, at the least.
The bone was modified, and at the least the recovery time is 12 weeks. That is a general statement, but you will almost never, ever go wrong with strict control and specific recovery and rest.
I am currently working with two Goldendoodle sisters, and yes, they collaborate to damage each other.
This is a good opportunity to work on your being the alpha and doing some training. 🙂
Blessings-
Deborah

You also said this in the other mail stream:
The Rimadyl doesn’t seem to take the edge off either. I give him a baby aspirin sometimes too. He was first diagnosed with pano. I knew something was wrong since he was 5 months old, but I was always told it was “growing pains”. We went to a different vet, who took xrays and found the divit in his bone. The Dr. said it was about the size of his thumbnail. When he went in the second time, he went in the backside and found more, some of the cartilage had taken hold, but some had not. I could explain more, but don’t want to bore you with details. Wish I could bring him in to see you. P

So, more replies for you…
Adequan is ok. In theory it is better than ok, however in my experience, very many animals do not respond notably to it. It is expensive for something that often doesn’t bring the expected relief. If you have a pet that doesn’t seem to notably benefit, then it is likely that he is not getting enough benefit to warrant the cost and potential drama of application. My Dane didn’t seem to benefit. Once in a while I see a pet that the owners REALLY think is benefiting from Adequan, so it’s likely a good choice for them.

Do not give baby aspirin along with another anti-inflammatory. It is very important to not double up on any nsaids (anti-inflammatories: Prednisone, Rimadyl, Deramaxx, Previcox, Metacam, Meloxicam, Vetprofen, etc…). They will be quick to give a bleeding stomach ulcer. Like I suggested previously, stick to the dog nsaid and let it do the work is is supposed to, use it as a good tool, and then he will be able to get off it for longer periods in his life. ALWAYS give an nsaid on a full meal, not just with a snack and definitely not an empty stomach. Tramadol may be given on an empty stomach, as may Gabapentin.

If you don’t give more restricted care and medication to the shoulder(s) now, the chance for arthritis increases, and since arthritis is likely at this point, take care and be gentle to let the body heal better.

I highly recommend Omega 3’s in fish oil, either by using sardines as part of daily food (reduce kibble accordingly and don’t make him fat :)), or using a good quality supplement. Find a supplement that contains about 400 mg of EPA in each capsule and start with one of those daily, moving up to 2 daily after about a week and after seeing that he adjusts in his gut (no squishy poop).

I also really like Xymogen DJD as a joint health formula.

I also highly recommend going grain-free in food and treats. Short story is that grains are difficult to digest and they are pro-inflammatory. End of short story. Substantial clinical research validates this.

Gotta go-
Blessings

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-

Possible Torn ACL (Cranial Cruciate Ligament)-How Should We Proceed?

Possible Torn ACL (Cranial Cruciate Ligament)-How Should We Proceed?

Hi Deborah!

I’ve enjoyed following the stories you post on FB about the dogs you heal, and who’d’ve thunk I might one day need your services?

My dog, K, has been gimpy for about a month or so (back right leg)… took her to our vet a couple of weeks ago. By poking and prodding, they figured it’s her knee. Gave us some anti-inflammatories and said to keep her from running, going up stairs, etc. It showed improvement during the first week, but then we let her back on the stairs and it’s back to the same.

My former vet friend, P, looked at it a couple of days ago… She strongly suspected an ACL tear.

I poked around a bit on your site, and it looks like there may be a nonsurgical route for ACL injuries…. I thought I’d ping you and ask you a few questions:

– What would our next step be? (we haven’t had x-rays or the “drawer-test” that Pam described to me)

– If we wanted to do any rehab through you, how would that work and what would the fees be?

K seems very happy and it doesn’t really slow her down too much (unfortunately! She wants to continue being the family dog that she is, around us all the time). Yesterday, we decided to confine her (like crate rest), but the problem is, the gimpiness seems worse after she’s been lying down for a while, then it seems to warm up and work itself out once she walks around a bit. So by keeping her confined, she’s lying on it a lot more and not moving as much, so it actually seems worse. (making me wonder if the confinement is the right thing to do…)

Thanks!!
T

My Answer Today:
Hey Gurl…
Goody…I happen to be home and able to give you a better answer via the pc keyboard!
The best option, imho, is to have me come out and do a consult regarding how you should proceed. It usually takes an hour for something like this. I prefer to see animals for the first visit in the home environment so I may discuss potential pitfalls and see home items we may use for drills, among other reasons. I am also able to do phone consults at $1/minute, but I prefer to see the pet in person…

The second best option is for you to go onto my rehab site and look under notes for the homework for post cruciate ligament rupture rehab.
I also have a video posted on YouTube and my WordPress site regarding a massage technique that is beneficial. The Pittie featured in the video is 3 years out from a cruciate ligament tear and never had surgery. He is doing great because the owner did the homework as I recommended. The YouTube link is on my WordPress and is under RehabDeb if you search it.

I do not think I would ever have surgery on one of my own dogs for this issue again. My little Grace had two TPLO’s, the major surgery where the bone is cut and replaced at a different angle, and both didn’t work out. One wouldn’t have worked out because she had a congenital joint disorder on that knee and the surgery wasn’t ever going to be solid, and on the other knee she ended up getting a raging infection at the time of surgery that eventually ate up the whole joint. The Grace had a poor immune system, and she was open too long on the table, due to unforeseen circumstances, among other things.

She was bone on bone in both knees for the last 3 years of her life, yet she was definitely full of life! She ended up tearing all three ligaments in the second knee, so far as I/we can tell, and it was muscle support of the joint that enabled her to function as well as she did. None of the available braces were of a good enough design for her, and I’m not a fan of what is currently available for most dogs, especially not without working on my walking and exercise drill protocol first.
I deal with many dogs whose owners don’t want surgery for a variety of reasons, and the feedback I receive is that they have done great without surgery.
Of course, I also do rehab with many pets that have had surgery also, from both boarded surgeons and regular vets, using all types of modifications.
I’d be glad to discuss the differences.

We don’t do surgery on every human athlete, much less every human, yet most of the dogs are immediately referred to surgery as if there isn’t another answer the vet knows to suggest. This is because the vets are trained to react in that manner, and they usually don’t have any foundation in muscle-building and joint support protocol. Most of the reasons I’ve heard given in favor of surgery aren’t necessarily scientifically correct, according to available research and anecdotal evidence. I’m trying to make my functional rehab protocol using principles of exercise physiology more readily available.

My background in sport science definitely gives me a huge edge in developing protocol for recovery, and it is just taking slow time, getting the word out and getting people to think more wholly about the situation, and to see/know therapies that exist in other areas of physical science and apply them here. The angle of a dog’s knee, or any quad-ped knee, is definitely different than that of a human/bi-ped, however many principles of physiology and of the relationship between soft and hard body tissue apply and are useful to improve function and quality of life.

Blessings!!

(10-17-13 and now you may purchase the guide book for rehab of this condition at http://wp.me/p1wSDA-cU )