Last Updated on 2021-08-26 by Admin
Based on a study in 2005, USA Dog owners spent over 1.3 Billion US dollars on knee surgery. Another surprising thing is that all the focus is on the surgery, and very little about the recovery. Recovery time after surgery is 8 to 16 weeks and will require physiotherapy. How many dog owners are informed upfront what the risks are of surgery and complications one might expect. If my experience is any indication, then it is not many.
That got me to take a more in-depth look into alternatives to knee surgeries for dogs in the first place.
Platelet-Rich Plasma Therapy
The Platelet-Rich Plasma treatment was my hope when I made the appointment for a second opinion regarding Annie’s limping. Unfortunately, this treatment will not work for Annie as she has a fully torn ligament. And they give this treatment only to dogs that have a partially torn ligament. Here is an article that provides a good overview of how Platelet-Rich Plasma Therapy works.
Platelet-Rich Plasma works on humans and animals. The treatment is also relatively new, so its understandable that there are not many studies available yet. What I noticed is that Holistic veterinarians are up to date with this treatment. Many of them have used this type of treatment for years.
If I had known about this treatment earlier, there would have been no reason to let things go till surgery is needed. This treatment would have helped Annie after her first episode of limping. Unfortunately, not many Veterinarians perform this treatment in my area. Maybe that is why my veterinarian did not bring up this treatment. Another reason could be that they don’t know about it.
It is up to Dog owners to be on the ball and get second opinions and ask for referrals. Platelet-Rich Plasma could be a treatment for some dogs to avoid surgery if applied early enough.
Stem Cell Treatment
The following is a great link to get a good understand stem cell treatment.
This treatment sounds promising, being able to regrow broken tissue without significant surgery. How can You not like that? I did not find a lot of studies on this topic. One concern I have is how suitable this treatment is for dog breeds prone to cancer? This treatment would most likely also promote cancer cells. I would be very interested in reading a study on how the various dog breeds perform on this treatment. As at this point, I don’t know if Annie would be a candidate for this treatment, I sent an email to an animal hospital in the area that performs this treatment.
Conservative Treatment
This treatment relies on scar tissue build-up so that over time the knee can bear weight again. Even some types of knee surgeries rely on scar tissue to make the surgery successful. Some research on larger and heavier dogs have shown that conservative treatment can work for them. Mostly smaller dogs, older dogs or dogs with health issues get treated this way. For larger dogs, Veterinarians recommend surgery, based on the studies I read.
Unlike the other treatments, conservative treatment is not as specific as a surgery. One approach rests the leg by restricting the dog’s activity. Non-steroidal anti-inflammatory medication is given and may include a brace and some physiotherapy. Method two is where dog owner and\or Veterinarian use Natural remedies, supplements, Acupuncture, Physiotherapy, blue laser, braces etc. That makes it hard to evaluate how well the conservative treatment works. When dealing with joint pain, type II Collagen can be very effective in reducing pain. One mentions that Collagen can reduce pain by 62 %. Please also read my article on Collagen, You Dog will love You for it.
In preparation for this post, I came across a recent study: “Disease-related and overall survival in dogs with cranial cruciate ligament disease, a historical cohort study.“
It compares outcomes for dogs that had surgery and ones treated with Conservative treatment. Dogs that had the conservative treatment died earlier, and many due to issues related to joint problems.
Update 2021-08-14
Read about my experience with Conservative Treatment and why, after one Year of conservative Treatment for my dog’s knee injury, I decided on surgery.
Cui bono – to whom is it a benefit?
But that somehow does not surprise me since a Pet insurance foundation financed the study. They have a vast interest that people buy pet insurance. And I will be surprised if the people that decided on the Conservative treatment had insurance. One reason would be that not every dog owner has $4000 to $ 5000 or more available for surgery. That does not include any aftercare costs such as physiotherapy etc.
Conservative treatment has various ways to be applied. I would have expected to see some very rigid details regarding conservative treatment in the study. I sent an email to one of the study authors regarding insurance coverage and details of conventional therapy. One of the older studies referred to did include the details on conservative treatment. Another study did mention that about 2/3 of the conservatively treated dogs had successful outcomes.
Conclusion
In last week’s post, I wrote about the different surgeries for treating a torn ligament. Not sure what an MRI costs for a Dog. I did contact a clinic that does Pet MRI’s but got no reply. An MRI would clearly show other vets and dog owners the condition of the knee. And I struggle with the thought of doing a drawer test on dogs that already have a torn ligament.
The Painful Drawer Test
The drawer test is a test done by manipulating the knee and check for play on the joint. Every time Annie gets the drawer test performed, she limps and is in pain for weeks. For that reason, I will cancel the third opinion appointment for Annie.
Are we on our way for a conservative treatment?
My wife and I have decided to get a Brace for Annie and see how that works out. I would like to see if her muscle mass on the thigh returns to something like the other leg. Unlike many dogs with this condition, Annie does put some weight on the affected leg. It makes me wonder if maybe she only has a partial tear or the knee is already building scar tissue. In any case, using a brace gives us more time to look into stem cell treatment and other options.
It also prepares Annie better for surgery if we later decide to go that route. By then, her muscle mass should be close to normal. Her general fitness level should be better if she can go for long walks or do short runs with a brace. And there is less risk of Annie gaining weight this way. Weight gain is a big concern. Since Annie got spayed a few weeks ago, she is way more food-focused.
Dog Massage for Comfort
Annie also gets leg and back massages that touch Acupressure points related to Knee issues. For these efforts, I get hugely rewarded with licking. Imagine You limp for an extended period. It causes back pain. Now that she knows what feels good, Annie will place herself right in front of me and look back at me when she wants a back massage. In the morning, Annie also puts herself sideways in front of me, the injured leg facing me when she wants a leg massage. She never stops to amaze me.
Adjustment Time for Man and Dog
In our now very short morning walks, Annie does not limp at the beginning of her walk. Generally, she is limping a little after she gets home. Each day Annie gets better. I try to keep here walks as short as possible, but make sure she has time to sniff and lay in the grass. When other dog owners come close, I ask them to stay away. That helps to prevent Annie from getting into situations where she jumps. Annie is very social and loves people and dogs, making it challenging to keep her away. It also makes her depressed, not having many social interactions and minimal walks. We both miss our multiple 1 hours a day walks.
Resources
Estimate of the annual economic impact of treatment of cranial cruciate ligament injury in dogs in the United States https://pubmed.ncbi.nlm.nih.gov/16313037/
Disease-related and overall survival in dogs with cranial cruciate ligament disease, a historical cohort study https://www.sciencedirect.com/science/article/pii/S0167587720301914
Partial cranial cruciate ligament Tears Treated with stem cell and Platelet-rich Plasma combination Therapy in 36 Dogs: a retrospective study http://www.nupsala.com/wp-content/uploads/2017/10/CCL-tears-with-BMAC-.pdf
Short-term and long-term outcomes for overweight dogs with cranial cruciate ligament rupture treated surgically or nonsurgically https://avmajournals.avma.org/doi/abs/10.2460/javma.242.10.1364
Conservative treatment options for partial and complete CCL tears in dogs https://www.veterinarypracticenews.com/conservative-treatment-options-for-partial-and-complete-ccl-tears-in-dogs/
Stem Cell Therapy https://vcahospitals.com/know-your-pet/stem-cell-therapy