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ACL surgery questions



 
 
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  #1  
Old October 12th 06, 05:58 PM posted to rec.pets.dogs.breeds
[email protected]
external usenet poster
 
Posts: 2
Default ACL surgery questions

My 4 1/2 year old lab tore a ligament and now needs ACL surgery. It's
been two weeks since the injury. At first, I thought it might be a
sprain, but since it wasn't improving, I brought her to the vet
yesterday and she was diagnosed. The surgery was quoted at $2,100.

I was wondering if I should take her to a few other vets to get second
opinions and also to try and find a lower quote. Browsing online, the
fee seems to be reasonable. I belive that the technique this vet uses
is TTA, as opposed to TPLO, and it involves replacing the ruptured
tissue with muscle fiber taken from her leg. Should I be checking any
of the surgeon's credentials, other than confirming that he/she is
board certified?

Also, I am currently between jobs and can't afford to pay for the
surgery until I find a new job, which could be anywhere from a couple
of weeks to several months in the worst case. I'm worried that she'll
cause significant damage to her joint when walking around in her
current state. I'm keeping her activity to a minimum, but I was
wondering if there's any kind of brace or wrap that I can use in the
meantime to minimize movement in the joint and therefore control any
damage. Perhaps an elastic/velcro brace or something similar?

Thanks for any advice!

  #2  
Old October 13th 06, 08:56 PM posted to rec.pets.dogs.breeds
flick
external usenet poster
 
Posts: 568
Default ACL surgery questions

wrote in message
ups.com...
My 4 1/2 year old lab tore a ligament and now needs ACL surgery. It's
been two weeks since the injury. At first, I thought it might be a
sprain, but since it wasn't improving, I brought her to the vet
yesterday and she was diagnosed. The surgery was quoted at $2,100.

I was wondering if I should take her to a few other vets to get second
opinions and also to try and find a lower quote. Browsing online, the
fee seems to be reasonable. I belive that the technique this vet uses
is TTA, as opposed to TPLO, and it involves replacing the ruptured
tissue with muscle fiber taken from her leg. Should I be checking any
of the surgeon's credentials, other than confirming that he/she is
board certified?

Also, I am currently between jobs and can't afford to pay for the
surgery until I find a new job, which could be anywhere from a couple
of weeks to several months in the worst case. I'm worried that she'll
cause significant damage to her joint when walking around in her
current state. I'm keeping her activity to a minimum, but I was
wondering if there's any kind of brace or wrap that I can use in the
meantime to minimize movement in the joint and therefore control any
damage. Perhaps an elastic/velcro brace or something similar?


There would be nothing wrong with asking your vet these questions.

Nothing wrong with getting a second or third opinion, either.

flick 100785

Thanks for any advice!



  #3  
Old October 14th 06, 01:40 AM posted to rec.pets.dogs.breeds
pfoley
external usenet poster
 
Posts: 1,285
Default ACL surgery questions


wrote in message
ups.com...
My 4 1/2 year old lab tore a ligament and now needs ACL surgery. It's
been two weeks since the injury. At first, I thought it might be a
sprain, but since it wasn't improving, I brought her to the vet
yesterday and she was diagnosed. The surgery was quoted at $2,100.

I was wondering if I should take her to a few other vets to get second
opinions and also to try and find a lower quote. Browsing online, the
fee seems to be reasonable. I belive that the technique this vet uses
is TTA, as opposed to TPLO, and it involves replacing the ruptured
tissue with muscle fiber taken from her leg. Should I be checking any
of the surgeon's credentials, other than confirming that he/she is
board certified?

Also, I am currently between jobs and can't afford to pay for the
surgery until I find a new job, which could be anywhere from a couple
of weeks to several months in the worst case. I'm worried that she'll
cause significant damage to her joint when walking around in her
current state. I'm keeping her activity to a minimum, but I was
wondering if there's any kind of brace or wrap that I can use in the
meantime to minimize movement in the joint and therefore control any
damage. Perhaps an elastic/velcro brace or something similar?

Thanks for any advice!

=========
This is one of the reasons I carry pet insurance. Maybe you could work out
a payment plan with the vet, if you tell her your situation. You also call
some veterinary schools in your area to see if they offer low cost surgery
to people with low incomes. Yes, you should get another opinion before you
decide which direction to go in.



  #4  
Old October 14th 06, 05:27 AM posted to rec.pets.dogs.breeds
Christy
external usenet poster
 
Posts: 41
Default ACL surgery questions


wrote in message
ups.com...
My 4 1/2 year old lab tore a ligament and now needs ACL surgery. It's
been two weeks since the injury. At first, I thought it might be a
sprain, but since it wasn't improving, I brought her to the vet
yesterday and she was diagnosed. The surgery was quoted at $2,100.

I was wondering if I should take her to a few other vets to get second
opinions and also to try and find a lower quote. Browsing online, the
fee seems to be reasonable. I belive that the technique this vet uses
is TTA, as opposed to TPLO, and it involves replacing the ruptured
tissue with muscle fiber taken from her leg. Should I be checking any
of the surgeon's credentials, other than confirming that he/she is
board certified?

Also, I am currently between jobs and can't afford to pay for the
surgery until I find a new job, which could be anywhere from a couple
of weeks to several months in the worst case. I'm worried that she'll
cause significant damage to her joint when walking around in her
current state. I'm keeping her activity to a minimum, but I was
wondering if there's any kind of brace or wrap that I can use in the
meantime to minimize movement in the joint and therefore control any
damage. Perhaps an elastic/velcro brace or something similar?

Thanks for any advice!


I did a lot of research on this over the summer. In June, my sheltie began a
funny hitch in his gait when we were at an agility trial, and after a month
of rest wasn't much improved so I took him to a very well respected and
considerably pricey specialist. After physical exams and x-rays he couldn't
be too conclusive but assumed that it was a partial ACL tear and prescribed
rest and rimadyl while suggesting I start saving up for surgery. After doing
more research I found that their prices were nearly double the norm (what
you were quoted sounds about right, at least in my area) so I began looking
for a second opinion and further investigating the surgeries available, as
well as conservative management (non-surgical methods of healing/rehabbing.)
Fortunately, Wylie's second opinion was that he did not need surgery - this
vet did not find anything wrong with his knee and concluded if it had been
injured, it was likely not his ACL.
However, in my research I learned quite a lot. There are two yahoo groups,
Orthodogs (VERY high volume, almost entirely related to ACL surgeries) and
Conservative Management, which were very informative. You may want to join
the latter to find out about ways to minimize further deterioration and
arthritis development while you're waiting to be able to do surgery. Some
folks have used braces, but they are not a cheap alternative (I can't
remember specifically but they are at least several hundred dollars.) Other
folks use a rehab period similar to, but seemingly longer than, the
healing/rehab period after surgery - crate rest for several weeks moving to
limited activity and physical therapy over a period of months. Some have had
success with this, others ended up going ahead with surgery.
The surgery that is called "traditional" uses either nylon or much less
commonly the dog's own muscle fibers to recreate an ACL. There are varied
reviews on this type - the vets I spoke to don't do this very much except on
sedate, older dogs that will not be returning to a very active lifestyle,
and primarily on smaller dogs. It is usually significantly less expensive
than the other surgeries. Larger dogs, and more active ones, seem to do
better with the TPLO, even though there is a longer healing period as there
is bone healing involved. The TTA is different from either technique and is
newer, having been done on only a few thousand dogs. It is said to have a
shorter healing period. One vet told me they often do a combination of TPLO
and TTA, depending on the angles of the dog's bones; another uses only TPLO
and has very good results. Both have seen problems with the traditional and
have had to redo knees done that way so they don't suggest it.
I would suggest that you get recommendations from people who have had the
surgery done and talk to at least a few vets. There are folks who can do
this really, really well and generally they don't charge more than the folks
who are not as skilled. It is worthwhile to do the research, especially
since it will be a waiting game until you can afford it, and since there may
be arthritic changes to deal with due to that wait.
Good luck! I definitely feel for anyone dealing with this situation, as it
is heart wrenching.

Christy


  #5  
Old October 14th 06, 04:08 PM posted to rec.pets.dogs.breeds
[email protected]
external usenet poster
 
Posts: 2
Default ACL surgery questions

Thanks for the very helpful replies!

Yes, it definitely is heart wrenching to see my dog in pain and not
being able to do anything about it right away. Hopefully, I'll get her
fixed up soon...within a month at most.

I'll take her to a couple more vets for 2nd opinions and quotes. One
thing that concerned me about the first vet is that he showed me a
model of a dog's knee joint, with rubbed ligaments on the sides of the
joint as well as a ligament inside the joint (this is the one that he
says is most likely torn). He then "demonstrated" this on my dog's
injured knee by holding her upper and lower leg near the joint and
moving both sections to show that there was significant movement
(indicating a torn ligament), whereas the non-injured leg does not have
this movement. I wonder if his demonstration might have worsened the
tear or caused additional stress to the uninjured ligaments. He also
didn't prescribe any pain medications, which raises some doubts (though
I should have thought of asking).

I guess my first post was inaccurate in mentioning that the vet uses
TTA. Rather, he uses the muscle fiber/nylon repair method and he seemed
biased towards this method, perhaps because that's all he does. Based
on your comments, it sounds like this may not be the best solution for
my dog, as she is active and still quite young.

I'll definitely check out the Yahoo groups. Thanks again.


Christy wrote:
wrote in message
ups.com...
My 4 1/2 year old lab tore a ligament and now needs ACL surgery. It's
been two weeks since the injury. At first, I thought it might be a
sprain, but since it wasn't improving, I brought her to the vet
yesterday and she was diagnosed. The surgery was quoted at $2,100.

I was wondering if I should take her to a few other vets to get second
opinions and also to try and find a lower quote. Browsing online, the
fee seems to be reasonable. I belive that the technique this vet uses
is TTA, as opposed to TPLO, and it involves replacing the ruptured
tissue with muscle fiber taken from her leg. Should I be checking any
of the surgeon's credentials, other than confirming that he/she is
board certified?

Also, I am currently between jobs and can't afford to pay for the
surgery until I find a new job, which could be anywhere from a couple
of weeks to several months in the worst case. I'm worried that she'll
cause significant damage to her joint when walking around in her
current state. I'm keeping her activity to a minimum, but I was
wondering if there's any kind of brace or wrap that I can use in the
meantime to minimize movement in the joint and therefore control any
damage. Perhaps an elastic/velcro brace or something similar?

Thanks for any advice!


I did a lot of research on this over the summer. In June, my sheltie began a
funny hitch in his gait when we were at an agility trial, and after a month
of rest wasn't much improved so I took him to a very well respected and
considerably pricey specialist. After physical exams and x-rays he couldn't
be too conclusive but assumed that it was a partial ACL tear and prescribed
rest and rimadyl while suggesting I start saving up for surgery. After doing
more research I found that their prices were nearly double the norm (what
you were quoted sounds about right, at least in my area) so I began looking
for a second opinion and further investigating the surgeries available, as
well as conservative management (non-surgical methods of healing/rehabbing.)
Fortunately, Wylie's second opinion was that he did not need surgery - this
vet did not find anything wrong with his knee and concluded if it had been
injured, it was likely not his ACL.
However, in my research I learned quite a lot. There are two yahoo groups,
Orthodogs (VERY high volume, almost entirely related to ACL surgeries) and
Conservative Management, which were very informative. You may want to join
the latter to find out about ways to minimize further deterioration and
arthritis development while you're waiting to be able to do surgery. Some
folks have used braces, but they are not a cheap alternative (I can't
remember specifically but they are at least several hundred dollars.) Other
folks use a rehab period similar to, but seemingly longer than, the
healing/rehab period after surgery - crate rest for several weeks moving to
limited activity and physical therapy over a period of months. Some have had
success with this, others ended up going ahead with surgery.
The surgery that is called "traditional" uses either nylon or much less
commonly the dog's own muscle fibers to recreate an ACL. There are varied
reviews on this type - the vets I spoke to don't do this very much except on
sedate, older dogs that will not be returning to a very active lifestyle,
and primarily on smaller dogs. It is usually significantly less expensive
than the other surgeries. Larger dogs, and more active ones, seem to do
better with the TPLO, even though there is a longer healing period as there
is bone healing involved. The TTA is different from either technique and is
newer, having been done on only a few thousand dogs. It is said to have a
shorter healing period. One vet told me they often do a combination of TPLO
and TTA, depending on the angles of the dog's bones; another uses only TPLO
and has very good results. Both have seen problems with the traditional and
have had to redo knees done that way so they don't suggest it.
I would suggest that you get recommendations from people who have had the
surgery done and talk to at least a few vets. There are folks who can do
this really, really well and generally they don't charge more than the folks
who are not as skilled. It is worthwhile to do the research, especially
since it will be a waiting game until you can afford it, and since there may
be arthritic changes to deal with due to that wait.
Good luck! I definitely feel for anyone dealing with this situation, as it
is heart wrenching.

Christy


  #6  
Old October 14th 06, 06:37 PM posted to rec.pets.dogs.breeds
Christy
external usenet poster
 
Posts: 41
Default ACL surgery questions


wrote in message
ups.com...
Thanks for the very helpful replies!

Yes, it definitely is heart wrenching to see my dog in pain and not
being able to do anything about it right away. Hopefully, I'll get her
fixed up soon...within a month at most.

I'll take her to a couple more vets for 2nd opinions and quotes. One
thing that concerned me about the first vet is that he showed me a
model of a dog's knee joint, with rubbed ligaments on the sides of the
joint as well as a ligament inside the joint (this is the one that he
says is most likely torn). He then "demonstrated" this on my dog's
injured knee by holding her upper and lower leg near the joint and
moving both sections to show that there was significant movement
(indicating a torn ligament), whereas the non-injured leg does not have
this movement. I wonder if his demonstration might have worsened the
tear or caused additional stress to the uninjured ligaments. He also
didn't prescribe any pain medications, which raises some doubts (though
I should have thought of asking).

I guess my first post was inaccurate in mentioning that the vet uses
TTA. Rather, he uses the muscle fiber/nylon repair method and he seemed
biased towards this method, perhaps because that's all he does. Based
on your comments, it sounds like this may not be the best solution for
my dog, as she is active and still quite young.

I'll definitely check out the Yahoo groups. Thanks again.


From my research, the traditional method, that the vet you saw uses, runs an
average of $800-1200. I'd definitely seek a second opinion and investigate
TPLO and TTA. You can Google "slocum tplo" to find the website that lists
all ortho vets that have trained and are certified to perform TPLOs and
hopefully there is someone nearby.
It is unlikely that the vet did any damage with the demonstration on your
dog's leg. That is called the "drawer sign" as in, the lower part of the leg
slides back and forth like a drawer being pulled out and pushed in. It
doesn't even always happen with a tear, so it's pretty certain that the
ligament was majorly or fully torn for him to be able to do this movement in
the first place. That movement is occurring when the dog walks, which is
what causes the pain and arthritis development, so having it manually
manipulated a few times doesn't make a difference.
Is your dog weight bearing at all since the injury? It is common for the
dogs to show the most limping or not using the leg at all right after the
injury, then slowly adapting and becoming more mobile but never fully weight
bearing. The problems are twofold - arthritis develops in the injured leg,
and the other leg has a high rate of ACL injuries as well, either from some
genetic shortcoming in the dog's structure, or due to compensating for the
injured leg. So the faster the surgery is done, the better.
Good luck!

Christy


 




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