Are there other treatment options besides TPLO surgery for my dog?
Original Question: My dog had TPLO surgery in March; post-op infection and hardware removal in April. Abdominal obstruction (spot on X-ray, nothing found upon surgery for my dog). I am nearing $15000 (yes, three zeros) in expense this year – now the other back leg is lame. I have no money for surgery. Are there conservative options for treatment/pain management. I'm devastated. - Lisa
Thanks for sending in this question.
Gosh I really feel for you. I know this situation well believe it or not and you’re not the first person to ever go through it. The issues your dog has encountered are complicated, serious and very expensive to treat when selecting the best options for success and long-term function. You’ve done an impressive job so far and your dog is very lucky to have you. Here are some thoughts I can share with you.
First and foremost, you have to confirm the diagnosis. I can tell that in your question, you are assuming the other leg has a cruciate rupture as well. It’s true that the risk of a cruciate rupture in a leg increases if the other leg had previously had one as well. I suggest you start by having your veterinarian confirm the diagnosis with radiographs and sedation so they can palpate the knee and see if it is indeed consistent with another cruciate rupture.
In the event that this is another cruciate rupture as you fear, let’s make a point about the expense. You mention that the surgery is expensive and it is. However, I suspect it will be more expensive if you don’t do the surgery. If the cruciate is torn and you don’t do the surgery, there is a good chance you’ll have to buy anti-inflammatory medication very soon and use it until the end of your dog’s life. The cost could be $50-$80 a month and then glucosamines and painkillers may need to be added later. Think of that cost on an annual basis going forward for years. In addition to that, the leg will still be painful on a daily basis and their quality of life and function will never reach the level it would with surgery compared to just using monthly medication. So despite the cost, you have already put in, I would recommend you consider these financial features as you move forward in making the decision.
As far as alternatives to surgically correcting a cruciate rupture in a dog, there are limited options and they are not considered very valuable or effective. There are braces and supportive devices that people sell for this condition but it is unknown whether these work as there are no known trials on them. In general, small breed dogs will do much better than large breed dogs if you chose not to perform the surgery. You would have to consider restricting their movement by caging them for at least 1 month and only taking them out for bathroom breaks to achieve the best success with conservative therapy. The extreme restriction of activity is necessary for them to build up supportive scar tissue around the joint to help stabilize it. This typically does not result in a full return to function or the complete elimination of future joint inflammation, pain and degeneration.
You can certainly discuss these concepts with your veterinarian and have them weigh in on these options in regards to your particular dog.
I wish there was a really good option I could point you to but this is the current state of treatment options we have for this common and significant disease of our dogs.
Good luck and I wish you the best.
Dr. Clayton Greenway
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