# Real problems after cruciate surgery



## AngelandMilo (Oct 17, 2013)

Hi,

Firstly, i apologise for the long thread - i just want to get my story across, so i hope you can bear with me.

Milo, my 6 year old staffordshire bull terrier developed an intermittent limp back in jan 2013. I took him to my vets who decided to xray him and established he had some partial cruciate damage and suggested to stabilise the joint with TTA using the titanium foam wedge technique. My boy is a big staffy (29kg, long legged type) and (according to my vet after operating) has very large muscles - even for a staffy. The materials used for the op (titanium foam wedge, pin, and wire) come as a kit and come 2 sizes (i have since been informed). because Milo's bones are not very big in relation to his muscle size, the kit had to be appropriate for his bones. The op initially seemed to go well enough but after 3 weeks he became totally lame on that leg; i took him back to the vets where they xrayed him and found that he had ruptured the implants (the pin had broke in two, the wire had broken and had broken a small piece of bone that it was attached to). The wedge was still in place and the advancement of the tibia had receded very slightly. My vet contacted the specialists in this field (Crofts Vet hospital in Cramlington) who advised to do a re-op immediately. I suggested i go see the specialist at Cramlington (a 250 mile round trip). I saw the specialist surgeon there who looked at the xrays and decided not to operate because it could do more harm than good and that he still believed the outcome would be a good one. after many weeks of rest Milo was back to running around fine for about 3 weeks until one day he got up and was totally lame on that leg and developed a sizable lump on the front of his knee. I took him to my vets immediately who suggested i take him to the specialist at Crofts the next day, so i was up at 5 am with Milo and off to see the specialist. They xrayed him and removed the broken pin and believed it was that that had moved and had caused the pain, they didn't know what the lump was - possibly fluid. i rested him again as advised and then he was back to running again. He could run fine (probably adrenalin, after the ball!) but when just standing i would not put much weight on the leg. the specialist advised to give him a few weeks to see if this settled down as he believed it may be his meniscus which may be damaged; i gave him time but it did not settle down, he was walking slightly sideways to accommodate for the pain and when standing he was putting say 75% of his weight on the other leg. I spoke to my vet and hes said he would be able to have a look at the meniscus and if needed remove any damaged tissue. OK, so yesterday he had the op to look at the meniscus and to try and rectify the problem. My vet operated on Milo and told me virtually all his meniscus had gone (apart from a loose piece that was flapping about, which he removed. He also said (and showed me the photos which they took during the op) that a lot of his cartilage had worn away (above the meniscus). Now, when he first went in for the original op his meniscus and cartilage were fine, the TTA op i believe has resulted in Milo having no meniscus left and a lot of cartilage been worn away. back to my point about the implants used: my vet consulted with the specialist (before the original op) regarding the kit and asked if it was big enough for a dog the size of Milo as the implants seemed small(he told me this yesterday). Because Milos bones are small this was the only implant that would fit but my vet now believes they were not strong enough to cope with the power that could be generated by Milo. I am so upset for my boy, he suffered so much this year and my vet said yesterday that he will not get any better than he has been of late (with the obvious pain he is in) but we will have to manage his life as best we can. He is (ordinarily) such an active dog and bounds about so much, he is only 6.5 yrs old and i want him to enjoy his life. He is about to have hydrotherapy soon, he is having a course of injections (i cannot remember the drug name it begins with c:blushing but i need to get whatever i can because i have now been told he already has some arthritis in the joint which will only get worse and will require medication as he gets older, he has no meniscus and no cartilage above that so no cushioning for his knee. 

Please, i have researched glucosamine, cherry juice etc etc and would be really grateful for any help and advice and if anybody else has experienced anything like this please get in touch. I hope any other dog lovers out there dont have to see their dogs go through what Milo has been through, i feel his life will never be the same again.

Thank you

Mark


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## Cleo38 (Jan 22, 2010)

I am so sorry to read this as I understand what a worying time you must be having.

Unfortunately I am no expert in this but maybe you should get a second opinion regarding what has gone wrong & how this can be rectified.

My Toby had 2 TPLO ops last year (first leg went in March & the second in Novemeber). I felt so sorry for him as he had such a bad year. Luckily he recovered from both really well but after the second op he suddenly went lame & I immediately worried it was a problem with the meniscus. It wasn't, I panicked but after some rest he was (& has been) fine.

In the mean time I would advise against too much running/jumping around in case this makes the problem worse. I was overly cautious with Toby & even now he doesn't get too much chasing of his ball. 

Hopefully someone else may be able to give you more advise but I really hope that there is some improvement with Milo soon


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## AngelandMilo (Oct 17, 2013)

Thank you for your reply.

I know with his cartilage been worn away and his meniscus gone, these cannot be replaced so unfortunately it is about making the best of what we have now. I just hope i can find the best supplements to alleviate his pain and help with the arthritis he will develop. The vet did mention the possibility of a knee replacement but i really don't want to put Milo through another op, especially as i don't think knee replacements in dogs is that advanced.

I need to find the best way to manage it i think, no more operations if i can help it - poor thing.


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## Cleo38 (Jan 22, 2010)

I think that hydrotherapy sessions would be a good idea. Toby really benefited from these & we are lucky to live with a lot of water around so during the warmer months he swims a lot.

I also give him Yumove tablets & regular massages (he has hip displaysia as well) which he really enjoys.

He gets the occasional bout of mild lameness but he is 10yrs old now so probably to 've expected after all he has been through


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## 8tansox (Jan 29, 2010)

I was going to suggest hydrotherapy. Builds up strength without weight-bearing. Gives them mental stimulation too and, the water is so warm at hydro, they don't want to come out. 

Sorry for your situation though I know only too well what it's like having a dog that's not 100% fit.


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## AngelandMilo (Oct 17, 2013)

Yes, he will start hydrotherapy soon and the supplements i am researching as much as i can. he loves water so he may like the hydrotherapy. I think i will get him on the best glucosamine i can and need to look at oils like flaxseed and i think cherry juice works well for arthritis...my head is spinning!


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## Wildmoor (Oct 31, 2011)

sorry to hear of your problems, my dog had a TTA along with partial mensical removal in 2010, I am suprised it ailed my dog went to Torrington Othopeadics in Brighouse who have over 98% success with tis operation. After surgery he was caged 12 weeks and on time limited on lead exercise along with being on lead in the house and garden until he had a 6 week post op xray. After surgery I had him on Go4 pure glucosamine rom a vets in Royton who specialises in sports injuries, by the time my lad had his 6 week xray where they remodeled the bone & graft had completely grown together


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## AngelandMilo (Oct 17, 2013)

The feeling i got from my vet who did the initial op (after the implants had ruptured) was that the implants were probably not strong enough for a dog the size of Milo, and that he had questioned the specialist who supplied the implants at the time, but the specialist had said it should be OK. What i am struggling with is: why, when he went in because of a partial tear to his cruciate has he ended up with no meniscus and cartilage that has worn away?


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## AngelandMilo (Oct 17, 2013)

My dog was on garden walks only for 2 weeks then he was on lead walks for 2 x 5 mins per day in 3rd week, 4th week 2 x 10 min walks. Looking back, if i had been aware of the possibility of meniscus and cartilage damage as a result of this op i would have researched it more and maybe looked at a different technique, especially knowing now that the implants were probably not strong enough; my vet did not explain these possibilities (meniscus and cartliage damage) could arise. i just hope with the right supplements he may be able to live a happy life. I have bought some easeflex for him and Udos choice oil, and i am looking into cherry juice to see if thats appropriate for dogs as this is supposed to be a fantastic help with arthritis and joint issues.


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## Renata (Mar 18, 2013)

Our Keera had TTA operation in Jan 2013. She was 11 years old. Fortunately everything went well, healing took longer (probably because of her age). She is on no medication currently, we only give her glucosamine and fish oil. I changed her diet after reading some articles about food for dogs with arthritis. 
She is on grain and potatoes free dry dog food.

***Certain foods may increase inflammation and aggravate arthritis. Some people have found that eliminating grains from the diet improves their dogs symptoms, sometimes to the point that no other treatment is needed. In addition, plants from the nightshade family, including potatoes (not sweet potatoes), tomatoes, peppers (all kinds), and eggplant may aggravate arthritis.***
Canine Arthritis Treatment - Whole Dog Journal Article

I hope your dog will recover and enjoy his life even though there may be some limitations.


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## rona (Aug 18, 2011)

AngelandMilo said:


> The feeling i got from my vet who did the initial op (after the implants had ruptured) was that the implants were probably not strong enough for a dog the size of Milo, and that he had questioned the specialist who supplied the implants at the time, but the specialist had said it should be OK. What i am struggling with is: why, when he went in because of a partial tear to his cruciate has he ended up with no meniscus and cartilage that has worn away?


I think the answer to the arthritis/meniscus and cartilage problem is probably due to the fact it was a partial tear.
The damage may have been going on for some time before it got to the stage that you noticed it, all the while damaging the structure of the joint.
If that is so however, I cannot understand why they didn't perform a TPLO 

I don't know if it would be possible to re-operate with a TPLO!!


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## Burrowzig (Feb 18, 2009)

AngelandMilo said:


> Thank you for your reply.
> 
> I know with his cartilage been worn away and his meniscus gone, these cannot be replaced so unfortunately it is about making the best of what we have now. I just hope i can find the best supplements to alleviate his pain and help with the arthritis he will develop. The vet did mention the possibility of a knee replacement but i really don't want to put Milo through another op, especially as i don't think knee replacements in dogs is that advanced.
> 
> I need to find the best way to manage it i think, no more operations if i can help it - poor thing.


A friend's dog has had both knees replaced, and he's doing fine. No post-op problems though his gait is a bit strange as the knees appear more bent than in a normal dog. He still competes at agility in the 'allsorts' or 'anysize' classes where the jumps are lower (and gets loads of rosettes).


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## lozzibear (Feb 5, 2010)

So sorry for poor Milo  

I can't advise too much, but hydrotherapy should do him some good. I would really be caution with his exercise... My dog had TPLO surgery on one leg at the beginning of July. He is now going through the process to refer him to get his second one done, unfortunately  However, I wouldn't be throwing a ball for him for a LONG time... even before the problems started again with the second leg, I was very careful with when and where he was off lead and it was only for up to 10 minutes at the most and doing a gentle run... chasing a ball would be far too much for him and not something I would want to risk. As it now, he isn't getting off lead at all or else he is terribly lame on the second leg...


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## Malmum (Aug 1, 2010)

Different op entirely but my 62kgs boy had double hip replacements in 2010 & 2011 and although he's perfectly fit I still don't play ball games, not that he'd fetch anyway, lol. Fetch games put a lot of pressure on joint areas because of the sudden stop, so just regular exercise is best for a very long time after recovery. I've often read that cruciate ops take longer to stabilise than total hip replacements and the crate rest and exercise limitations are even longer than for a THR.

I'm wondering if he'd be better off with a total knee replacement, as his knee is in such bad shape. Also I would always go for a specialists opinion and wouldn't let a general primary care vet operate on one of my dogs. I would ask for another specialists opinion as your dog is in the prime of his life and needs to enjoy many more years.

I don't know where you are but if you're near Surrey you can't go wrong with going where I went with Flynn. 
Veterinary Practice & Hospital | Specialist Orthopaedics + Neurosurgery | Fitzpatrick Referrals

Hydrotherapy will help but I'd still ask for a referral elsewhere and see if a total knee replacement is an option.


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## AngelandMilo (Oct 17, 2013)

Thank you!


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## Kunakizz (Nov 25, 2012)

I have no experience of the TTA op but have had dogs undergo the extra capsular type of op and TPLO. They all benefited from hydrotherapy. One of them had Cartrofen injections (the meniscus was involved) and a specialist recommended Syonquin. I was VERY cautious with off lead exercise and no ball games unfortunately.

In your situation I would get a second opinion on the knee replacement. It's horrible to see your dog so uncomfortable isn't it.


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