The following story comes from Jan in the United Kingdom. Though most of our readers are from the United States, I thought that it’d be great to offer information for those readers who are overseas and Jan agreed to share her story about her Doberman named Fiel. I hope that all of you all find Jan’s story helpful (this will be released in 3 parts).

Jan’s Doberman Pinscher CCL Story (Part 1)

My 6 and half year old Doberman called Fiel (means Loyal/faithful in Spanish) was just recovering from a hematoma of his ear and lying on his sofa when Millie my cat decided to walk past and wave her tail his way for the daily ritual of chase. Except this time Fiel jumped off the side of the sofa and landed awkwardly and yelped straight away. I had heard a sort of dull crack noise so I knew this wasn’t good. He cried and couldn’t put his back leg down.  I rang my vet immediately and his first thoughts were the cruciate ligament. As Fiel was already on Myloxidyl for pain relief and inflammation for his ear, he suggested to carry on with that until I could get him to his office for an evaluation. This took two days as Fiel was in some pain and the joint was not stable so he had to learn a different way of walking and getting in and out of my car.

My vet confirmed that he had the drawer movement of his knee joint which confirmed to him that he had ruptured his cruciate. He booked us in with a Orthopedic Surgeon not far from us who has a fantastic success rate with this particular operation and went to meet him two days later. Sure enough, he had completely ruptured the cranial cruciate ligament (dog ACL) and he explained the tightrope procedure to me and how it is less invasive than other types of surgery but it is likely that arthritis will be a problem in the future because of the nature of the injury. He also mentioned that his knee might have been weakened before and this time its completely snapped. Looking back I suspect he was correct as I do remember Fiel sliding badly on my laminate flooring when he was younger and limping a bit but he healed and I thought nothing more about it.

So he’d had the accident on the Monday, saw his Vet on the Wednesday, the Surgeon on the Friday and the operation was scheduled for the following Tuesday. Eight days from injury to operation. It perhaps would have been quicker but between my Vet and the Surgeon, they were running tests for Von Willibrands disorder and other clotting tests as well as checking Thyroxine levels as he has an under active thyroid. That incidentally was picked up because of a research study on Dobermans as they have a high rate of death due to heart failure, so he has quite extensively tested. Thankfully all of those tests came back negative!

Be sure to come back to read the remainder of Jan & Fiel’s story – Read Part II.

Related Posts

• Diagnosing a Torn/Ruptured Cranial Cruciate Ligament in Dogs
• Surgical Procedure for a Ruptured CCL in Doberman Pinschers
• Diagnosing a Cranial Cruciate Ligament (CCL) Injury

The stifle (knee) joint in dogs, is very similar to the knee joint in humans, in that there are ligaments that run through the joint providing stability, and just like in humans, there can be many varying degrees of injuries in the stifle joint which makes it very important to have it properly diagnosed prior to rushing into surgery or treatment.

The injury could be something that happened suddenly as the result of a stressful event, or the injury could develop over time through normal “wear and tear”. Injuries that develop over time can be the result of many different factors, overuse, incorrect stifle joint angle, high impact activities, and many other things can contribute to cranial cruciate ligament injuries that develop over time. Ligament injuries that happen suddenly can be caused by jumping and landing awkwardly, twisting wierd on the leg, or being run into by another dog.

For the injury that happens suddenly, the dog will immediately stop bearing weight on the leg. Every dogs reaction will be different, as all dogs have different pain threshholds, but you as the owner will definitely be able to recognize that your dog has a problem. In stifle injuries that develop over time, the symptoms may not be so obvious, but they will still be noticeable. In slowly developing injuiries, the dog may limp occasionally, sit awkwardly (sloppy sit – sitting on the side, rather than on its legs), etc.

In both of these situations, it becomes necessary to have the injury diagnosed, and this is where things can get a little bit tricky. When consulting most vets and clinics, there will typically be multiple diagnosis methods available, each of which will be the preference of the practicing veterinarian. These are the typical diagnosis options for the stifle joint:

• X-Ray
  One recommended course of action will typically be an x-ray. The problem with an x-ray is that ligaments cannot be seen on x-rays (which I’ve learned through injuries of my own). X-rays basically serve one purpose, and that is to see if there are any broken, dislocated or misplaced bones.
• Manual Joint Manipulation
  Another course of diagnosis is manual manipulation of the joint in which the veterinarian checks for “drawer movement”. Drawer movement is the lamens term for instability in the joint, and comes from the fact that the knee joint will slide back and forth, like a drawer, if there is ligament damage because the ligaments won’t be there to hold the bones in place. Dogs will almost have to be sedated in order to test for “drawer movement” as it would be very painful for the dog to be awake during the procedure.
• MRI
  A common option in human injuries, having an MRI done is not as feasible for our pets, though it would quickly and easily be able to tell us whether there was a torn or ruptured ligament in the knee. The reason that MRI’s aren’t necessarily available for dogs is that the equipment is very expensive, and the cost of the procedure is highly expensive as well.

Of the above diagnosis options, an x-ray is usually recommended to check that there are no broken bones, and once that is verified, the veterinarian will check for drawer movement to determine if there is ligament damage. I’ve heard stories, and read stories of misdiagnosis online, and I’ll try to address that in another post, as this post will strictly focus on diagnosising cranial cruciate ligament injuries.

In a perfect world, we’d all be able to get MRI’s for our dogs if there was any question that they had a CCL injury, however, it’s not a perfect world, so we use the methods that are available to us. Thus, manual joint manipulation is one of the more common diagnosis techniqes, and with it, we have its drawbacks. The biggest drawback of manual manipulation to check for “drawer movement” is the possibility of furthering the injury. The injury can be worsened by any/all of the following:

• Sedation – as mentioned above, the vet will often sedate the dog in order to be able to manipulate the leg without the dog “fighting” it. This can result in over-torquing the joint.
• Rough exam – twisting of the joint

These factors can actually lead to injuries to other parts of the joint as there are multiple muscles, ligaments and tendons running through the knee. You may wish to be present durin the manipulation of the knee joint so that you can read your dogs reaction to the twisting.

Conclusion

I understand that all of the above isn’t necessarily great news if your looking for answers about your dogs recent injury, but I’m just trying to provide as much information as possible to allow you to make an informed decision on the treatment of your dog. If I had known a fraction of what I know now, I may have gone an entirely different route at the time of our dogs injury, but on the same note, I’m very glad that we went the surgical route as our dog has been doing great since her recovery. If you haven’t already, make sure you read our story.

Related Posts

• Diagnosing a Torn/Ruptured Cranial Cruciate Ligament in Dogs
• Diagnosing a Ruptured Cruciate Ligament in a Doberman Pinscher
• Surgical Options for Torn/Ruptured Cranial Cruciate Ligament (Cranial Crucial Ligament)

One of the most difficult things we faced with our dogs knee injury was that cost. Obviously, the cost of surgery was a huge burden, especially due to the fact that it came at a time that was unexpected, as most torn CCL’s and other knee injuries do. After the initial cost of surgery, we thorugh we were in the clear, but we hadn’t even taken into account the cost of medications after the surgery. Buying all of the pills and medicines for our dog directly from our veterinarian became very pricy. After doing a little research online, we found that there were plenty of online stores that offered the same medications at a fraction of the cost of what we were paying our veterinarian for the same medicine. This realy was a no-brainer for us – we needed to save money, so we decided that we’d start ordering the medications online.

Come to find out, pet medications are treated as controlled substances (just as drugs and medications are treated for you and I) – you need a prescription in order to place an order for pet medicines online. Now this is a slippery slope, and I’ll address this issue in a later blog post (How do you tell your vet that you want to buy your medications from another source). If you want to order your pet medications online, you’ll need to ask your veterinarian for a prescription, and as I mentioned before, that could put you in a tough place because the veterinarian obviously just performed a huge surgery on your pet then you (in a way) tell them that you want to go elsewhere.  There is a way to keep both parties happy, you’ll just need to use some creative thinking. I’ll explore that a little bit more in a later post.

Image by Darren Hester.

Related Posts

• Save Money On Pet Medications by Asking Your Veterinarian to Match an Online Price
• Cost of Repairing a Torn ACL/CCL Injury in a Dogs Knee
• Diagnosing a Cranial Cruciate Ligament (CCL) Injury

As a pet owner, one of the worst things that you could ever imagine happening is having your dog become injured to the point where it is painful for him/her to walk. When our dog tore her CCL (comparable to an ACL in humans) she couldn’t put any pressure at all on her leg. It was terrible to see, especially considering the fact that she was always such an active dog prior to her injury. The good news is that with dog knee injuries, there are many surgical repair options, just as knee injuries in humans, there are many repair and rehabilitation options.

When it comes to the cost of surgery, that is really going to depend on 5 major factors:

1. First and foremost, the type of surgery that you choose will be the biggest factor in determining cost. Here are some common types: TPLO, TTA, and Lateral Fabellar Technique
2. The veterinarian performing the surgery can substantially increase/decrease the cost. Believe it or not, just like human doctors, veterinarians also “specialize”, so if you go to a vet who only does dog knee surgery and knee repairs for dogs, chances are the price will be higher than if you go to your typical veterinarian.
3. Unfortunate, but true, I’ve come to learn that your location will greatly affect cost. I live in southern California, and we paid almost twice as someone in Texas who contacted us about having the same surgery performed on their dog.
4. The type of dog that you have. This effects the cost primarily due to the type of surgeries that are available, as larger breeds typically have less options available, through some veterinarians will perform any of the 3 techniques mentioned above regardless of the breed of the dog.
5. The final cost, that can be partially controlled by the owner is the follow-up visits, medication expenses, food expenses, care, rehab, etc.

So I’ve given you the factors, What is the Cost??? The thing is, there really isn’t a set cost for the dog knee surgery, or knee repair. To give you a range, I’d say that you could expect anywhere from $1,000 all the way up to $5,000. $1,000 would probably be the very low end of the spectrum and $5,000 would be the very high end. I’d like to say that the average dog knee (CCL) surgery would cost you around $1,500, but depending on the factors above, it really can fall anywhere in that range. Ours was about $2,500, then after all the follow-up office visits and medications were factored in, our final cost was probably closer to $3,500.

If you and your dog are unlucky and this happens to you, I’d recommend shopping around before heading in for surgery. Obviously, the first choice would be your primary care veterinarian, but don’t be afraid to ask them if they have any recommendations (even if they are capable of performing the surgery).

As always, I hope this information is helpful, and I always love to hear comments, so don’t be afraid to drop a line below.

Image by jstar.

Related Posts

• Cost of Repairing a Torn ACL/CCL Injury in a Dogs Knee
• Cost of TPLO Surgery – Cost to Repair Torn Cruciate Ligament in Dogs
• Cost of TTA Surgery for Cranial Cruciate Ligament – Cost of Knee Surgery for Dogs

When our dog tore her CCL, she imediately came up lame and was unable to put any weight or pressure on her right hind leg. She had minor hip problems previously, so at first we thought that she just overdid it while playing at the beach, so we took her home, gave her some MetaCam and let her rest overnight. When nothing had changed the next day (Sunday), we decided to take her to the pet Emergency Room.

At the ER, they told us that to diagnose the problem with her knee they were going to have to do 2 things:

1. Take x-rays of the stifle (knee) joint to make sure that there is no bone damage and/or arthritis.
2. Manipulate the joint while the dog is sedated to check for instability (drawer movement)

So we left our dog at the emergency clinic so that they could sedate and diagnose her injury, and when we next heard back from them, they told us that she most likely has a torn cranial cruciate ligament (CCL; misspelling: cranial crucial ligament) and that we should take her to her primary care veterinarian to discuss repair options.

Image by anearthling.

Related Posts

• Diagnosis – How We Determined Our Dog Had A Torn/Ruptured Cranial Cruciate Ligament (CCL)
• Surgical Options for Torn/Ruptured Cranial Cruciate Ligament (Cranial Crucial Ligament)
• Diagnosing a Ruptured Cruciate Ligament in a Doberman Pinscher