ACL surgery for dogs

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My Brothers Lab developed an ACL problem last summer and is going to need surgery to repair it.

He's spoken to his veternarian but regardless we (my brother and I) are curious to find other opinions and information about surgery available to repair this problem.

Our understanding is there are primarily two methods to repair this problem:

the first is a relatively standard (at least is has been done for a while) ACL repair where the surgen repairs the torn ligament.

The other procedure is called Tibeal Plateau Leveling Osteotomy (TPLO) where they where they actually cut the tip of knee bone off, rotate it, and reattach it.

From what we can gather the second method (TPLO) is generally more effective in correcting the problem in Large breed dogs (which Casey is...) although it is a "Newer" surgery as it has been in practice about 10 years. TPLO is much more expensive (almost twice as much as standard ACL surgery)

I guess I'm wondering if and of y'all know anything about either of these two procedures and can give us an idea about them?

I've attached a Photo of Casey cause... well just cause...

Livin' on the Edge... sleeping with my rigger's wife...

[cocheese 0]

Awe wook at da baby.

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Awe wook at da baby.

yeah both Karma and Casey are great dogs...

Here's one with my brother and the girls... and annother with Casey after a short bought with the hose... (she loves herself some running water... )

Livin' on the Edge... sleeping with my rigger's wife...

[vtamb81 0]

I don't post much, but felt the need to post here because I've gone through the same thing with my dog Bailey. She's a 100lb lab/rottie mix. This May she partially tore her right ACL while playing in a field. We did the TPLO surgery a few weeks later. Its a very invasive surgery (as you described in the OP) but it is incredibly effective. We were lucky enough to live in the same town as one of the top 5 vet schools in the country and she was on a 2 month rehab plan comprised of progressively increasing walks, range of motion, etc.

By the end of 2 months you couldn't even tell there was anything different between her 2 legs. The benefit of TPLO (when compared with other common ACL repairs) is that as long as the dog doesn't bend any of the screws or does something crazy during rehab, it will never be a problem again.

Then in October our worst fears were released and Bailey tore her left ACL after jumping out of our xterra. For dogs that undergo ACL surgery, its very common for the second ACL to go. This time her ACL completely tore as did her meniscus. We did the TPLO surgery again and she is finally starting to walk with no apparent limp or discomfort (rehab typically takes longer the second time around).

so 6 months from the original incident and $4000 poorer, Bailey is finally back to her old self with little chance of ever having these issues again. Bailey is only 5 years old, and i would do it all over again if it meant she could run and play without pain for the rest of her life.

I can't recommend the TPLO surgery enough!! Its hard to see your dog in a good deal of pain after the surgery but the result is SO worth it. If you have any questions feel free to PM me, i'd be more than willing help.

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that's good to hear... I'll be sure to let my brother know...

Scott

Livin' on the Edge... sleeping with my rigger's wife...

[wmw999 2,447]

We did the standard surgery many moons ago with our dog (TPLO wasn't an option then). She didn't have any further instability, but when she had a hip dislocation a couple of years later, keeping the leg immobilized for the hip was incredibly painful for her. The vet really tried to make it as easy as possible, but it still ended up painful.

Fortunately for her, her hips went back into joint as easily as they came out after that, so I'd just manipulate it back in and she was OK with a day of quiet after that.

But I'd say that an alternative to the standard is good if the dog is at all prone to hip dysplasia.

Wendy W.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

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But I'd say that an alternative to the standard is good if the dog is at all prone to hip dysplasia.

She's a large breed so that is a possibility...

Livin' on the Edge... sleeping with my rigger's wife...

[cocheese 0]

Awe wook at da big baby. It's been a while.

[tdog 0]

My dog

<---------

Has had two TPLO - one for each leg.

Damn, I went to look for the Xrays because they are cool, but all I found was my own MRI, I must have given them back to the vet...

He recovered very, very quickly, showing no signs of discomfort, and despite having 4 plates and 20 screws in two legs (making any swooper proud) he is a completely normal dog now. I can't even feel the plates when I rub his legs, I have forgotten he was ever injured (and when he runs miles with me at 20MPH next to my mountain bike) so has he...

I have pictures of him wearing a red bandage somewhere around here... Within 2 days of the surgery he was, except for the haircut and stitches, almost completely back to normal. How do you tell a dog not to jump off a sofa when it doesn't hurt and he does not understand the concept of screws...

There is only one thing you probably should know... The reason why dog's ACLs tear is not trauma or injury, but how their knees are formed from birth. (not genetic, not breed, but a toss of the coin) My surgeon told me to expect a 80% chance the other leg would need to be done within a year based upon the xray. He was 100% right... He could tell by looking at the Xray (the other leg was in the background of the leg that he was limping on and the angles were the same as the torn leg and greater than "safe", so it was just a matter of time.)

So, expect to double your costs - the second surgery is slightly cheaper if they have bloodwork on file... The surgeon should be able to tell by just looking at the angles. I have somewhere the exact pre and post op angles, but I remember about a 15 degree change.


I kind of have to admit, like all medical things, the cost is due to the R&D, and while I am glad they did the R&D, I hate paying for it... Part of what you are paying is royalty fees to the inventor of the procedure. Perhaps things have changed, but I remember a few hundred dollars in the form of proprietary tools and royalty fees going back up the food chain...

[vtamb81 0]

I agree that its almost impossible to tell that the surgery occurred by rubbing my dogs legs, its amazing!! (aside from the shaved leg and ass ) Like tdog said, many times you can expect to have to do the other leg sometime down the road after the first surgery.

I would recommend shopping around. Now I'm by no means saying to take the cheapest price, as that could have obvious consequences, but the prices can vary considerably.

The first leg we had down was at the Veterinary Research and Teaching Hospital at Virginia Tech and was around $1800. Around September we moved to the DC suburbs and had the other leg done up here. It cost almost $3000 for the same exact procedure.

Both places were absolutely wonderful and i have no regrets, but i was amazed at the difference in price just due to location.

[tdog 0]

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The first leg we had down was at the Veterinary Research and Teaching Hospital at Virginia Tech and was around $1800. Around September we moved to the DC suburbs and had the other leg done up here. It cost almost $3000 for the same exact procedure.

My second procedure was supposed to be a hundred dollars cheaper because of blood tests, but in the same hospital and same doctor, it was slightly more expensive. Turns out the anaesthesia is billed by the minute, and the procedure took just 15 minutes longer to get stuff lined up, so that made up for it...

When I called around I was able to get firm pricing on the doctor's fees, the daily fees of the hospital, etc. But all the supplies and medicine is always a rough quote. So a smart consumer will ask, "how much do you charge per minute for anaesthesia"...

BTW, in my neck of the woods, the teaching hospital was more expensive than my normal clinic where they "shipped in" the surgeon from his home office...

[livendive 8]

So Minka ran out to the landing area Sunday morning and came back on three legs. A visit to the vet confirmed she sustained this injury, and she’s tripodding it while I research the different surgical options. The TPLO and TTA are the most invasive and most expensive (and the most prescribed), as opposed to the various intracapsular methods such as the LSS (fishwire?) or tightrope CCL. Additionally, the more expensive options would require taking Minka to some other city 100-200 miles away, whereas a simpler method can be performed locally by her regular vet. She’s less than two years old, and it’s looking to me like all the options have a similar long-term prognosis that includes some degree of arthritis. If it’s true that the TPLO is simply the fashionable method of running up charges to between $2k-$3k per leg (I know to expect the other to go within the next 6-18 months) with no tangible benefit over other treatments, I think she’d be better off with a less invasive “surrogate ligament” that can be done locally, with less pain, and an extra grand plus in Dad’s wallet. Still, I feel like this is an important decision and I want to do what makes the most sense, so other opinions are desired. Anyone got an informed perspective one way or another?

Blues,
Dave

"I AM A PROFESSIONAL EXTREME ATHLETE!"
(drink Mountain Dew)

[wmw999 2,447]

My dog's other ACL never went, so it's not a guarantee. The one piece of advice I got when shopping for someone to do the surgery was to go with the guy who does them every day, rather than the potentially less-expensive guy who does one or two a month.

Wendy W.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)