West Highland Terrier, 13, Torn ACL and Luxating Kneecaps in Both Knees

West Highland Terrier, 13, Torn ACL and Luxating Kneecaps in Both Knees

March, 2013


I have a thirteen year old West Highland Terrier who has torn his ACL in both legs. (The vet used the term, “blown-out both knees.” Also, his kneecaps are “floating around.”) What I am wondering is: surgery or no surgery? He is less active than a young terrier, for sure; but not inactive– he injured his first leg during play and the second as a result of over-use. I am taking him to consult with a surgeon this week. In the meantime I have been trying to keep him confined. Despite his age, this has been a challenge. He’s letting me know on a daily basis that he wants to go for a walk and he has no aversion to jumping down from the sofa (accomplished one time only– to my horror). He is not overweight. If you have any advice, I would be very grateful. Thanks!


I got your message on my website, and I will continue to write more to you this evening.
Where do you live? Are you in Austin where I am, and do you see a veterinarian here in town?

Hi Deborah–

Thank you for responding! No, I don’t live in Austin, I live in California.

My little guy is 13 years old. My vet’s diagnosis (by manipulating the knee joints) is that he has “blown-out” both of his knees. After going over and over it in my mind and scouring the internet for information, I’ve decided to wait and watch. I’m concerned that putting him through a very difficult surgery like knee replacement(s) may, ultimately, be worse than his current status. I have, thus far, been restricting his activity– but he has been choosing to walk around the house. I have not allowed him to jump down from the sofa or bed. He is not panting or trembling. And, today, he has for the first time since his injury, showed interest in a toy. I ordered a doggie wheelchair for him and it is scheduled to arrive Friday (tomorrow). I think this will enable him to get out a little more and alleviate his boredom. He has led me out the front door and down the street several times while in his sling (which I use to take him out for potty), so I know he wants a (short) walk.

I would love to hear your input. I’m worried about him and I want him to be happy and healthy.

Yours,  C


I have just a short moment right now, so I’ll give you some definitive info that I assure you will help:

Don’t cry, but I really really really really don’t want you to put him in a cart. The cart won’t really help him improve, because he will use his hind legs less. He needs to use the legs in a specific program. Go to my site again, and read the homework for luxating patellas, no surgery, and the homework for torn CCL/ACL, no surgery. I have dealt successfully with 100’s of these cases. I cannot emphasize enough that you not put him in the cart. It will take him downhill, in my experience, and not toward recovery…short story. 

I know this will help, and feel free to write back once you are successful following the first few weeks of the homework.

Hi Deborah–

No wheelchair. Got it.

I went to your website and read the protocol for rehab.

One more thing: when I took my guy to the vet, I was told the only solution was surgery on both knees (or implied euthanasia). I now know that advice was not correct for us. I was also told that my dog must be in horrible pain. While I’m positive he is experiencing pain, I’m not sure it’s as horrible as my vet told me it was. I’ve been observing my dog and, as I mentioned, he’s not panting or trembling or refusing food. He IS walking with difficulty and eating less. My vet prescribed a pain reliever: Torbugesic Syrup; and an anti-inflammitory: Novox caplets. One of the two of them gave him horrible diarrhea within about 12 hours. So bad, in fact, that he was eventually passing blood. His discomfort from these drugs was worse (to my observation) than any pain he was having in his knees. We were out during a terrible rainstorm every two hours. I felt so bad for him. I stopped giving him both meds because I didn’t know which one was the culprit– though I suspect it was the Torbugesic Syrup because he had about 4 or 5 doses of that compared to only one of the Novox. I called my vet and he said it was probably the Novox and to discontinue that, but continue with the Torbugesic. I’m not willing to risk it. He has always had a tender tummy and I’m not going to put him through that again.

So, now, he is not on any pain meds. He always gets fish oil anyway and I have started giving him some of my glucosamine and condroitin supplements. I’m trying to be safe rather than sorry.

Thank you again–C


I could write better from my PC but I’m going to dictate to my phone while I wait to talk to a veterinarian who’s in a room with a client…
where in California are you?
based on what you’ve told me I think it’s a good call that you discontinued those medications.
1 of the first patellar luxation cases I had when I was independent of the surgery specialty hospital was for a Westie that belonged to a human radiologist. she also used to be a runner so she understood my program very well. also, what happened to you also happens here, that sometimes people are given the impression they have to euthanize their dog if they don’t have either 1 of the most common knee surgeries.
I have to go now, but look at my paper that says “should my dog still be in pain after ACL surgery?” you will probably find it under 1 of the pain headings in my index-


Ok, so, I keep giving you stuff to read about luxating patellas, which is the floating around part, but you should read the stuff about torn CCL/ACL no surgery I have on the site, too. The first four weeks of the homework is the same. I have had several small dogs with both issues at once, in fact, it seems that usually one is due to the other at that size and age.

My pain posts have info about standard drugs that would be good in this situation. It is possible that, depending on where you are, you could work on getting a vet on board with your conservative treatment of this issue and would prescribe some of the medications I mention.

The torn ligaments will be painful for a number of weeks. The luxating patellas sooner than later stop being painful, once the tendon and muscle either tighten with my exercise or the tendon stretches completely out.

Until you get adequate meds, you may use ice before exercises, using a cube going around the knee for 10 min. on top of the fur, before the walks so he uses the knee better and the exercises are more beneficial. The exercises are most beneficial if he is using the leg in gravity-based, land-based exercises, and he will use it best with additional help from pharmaceuticals until he is no longer lame.



Hello Again, Deborah–

Thank you so much for your helpful advice. I am using your protocol and I must say that my little guy is already showing a little improvement. Every day seems a little better. He ate his full dinner last night, he’s going both kinds of potty on his own (no sling) and he walks freely around the house (or shall I say toddles?), he even showed interest in a toy for the first time since the pain in his second leg. I think rehab is going to be the best route for him.

I will use some ice on his knees and then take him for a five minute walk today.

And to answer your question: I live in Bakersfield, California. We don’t have any holistic vets here. Not even close. Heck, we are lucky to have one natural foods grocery store! I really appreciate your help since I am navigating unfamiliar waters. I am an advocate of natural medicine and only turning to pharmaceuticals when there’s no other choice. My fear almost made me forget those things. Almost.

I’ll keep you posted on my little buddy, D. I really appreciate your help.

Sincerely, C

I’m glad the ideas are working out for you!
Also, you might measure out his regular food from before injury, reduce it by 1/4 c daily (just guessing for now), because he doesn’t need all his usual food if he is restricted, and then divide the meals into 3 daily if that works for you.
Do you mind if I use our communication on my website as a learning tool for others? I will take out your name and some of the things that are more personal and/or detract from the point…


Hi Deborah–

My dog knows more than I do because HE’S the one who’s been reducing his meal portions. I’ve been saving the leftovers for his breakfast (which he doesn’t usually have). So, yes, I think your plan will work for us!

Please use our correspondences if you think they will be helpful to others. We dog lovers should help one another as best we can to ensure our pups live long, happy lives– and all the better if we can use natural remedies as much as possible!

Sincerely, C



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