Is surgery necessary for a dog with a ruptured cruciate ligament?
Original Question: My Westie (just 6 years old, 8.4 kg) ruptured her cruciate ligament in the right leg. What are the implications if I do not go for surgery? She seems very happy and is not in pain or on anti-inflammatory medication. I am concerned if I do the surgery that it will not work since she is a very active dog and jumps a lot and the TPLO surgery is too expensive. - Gabriele
Thanks for your question.
You mention that the surgery is expensive. I would tell you that in a 6-year-old dog, it could become 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 in the near future 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.
You have a small breed dog and they tend to recover better than heavy dogs. With time, there will still be inflammation in the joint because it is unstable. This leads to degenerative joint disease that further breaks down the joint causing more pain and inflammation.
If you decide not to perform surgery, then you should implement conservative therapy. This involves an extreme restriction on activity while scar tissue builds up around the knee. This is the body’s way of repairing the instability in a knee that ruptured the cruciate ligament. To assist in this, it is recommended to ‘crate’ your dog every day for up to 2 months, only letting them out for bathroom breaks. I know this sounds extreme, but if you compare it to us, it would be like having someone use a wheelchair for 2 months which would be quite reasonable, the problem with our pets is we can’t tell them to not use their leg, therefore we have to crate them. The fact that you say your dog is active means that you likely won’t want to implement this treatment. Scar tissue can form with reasonable effectiveness without the use of a crate and may be enough to help a small breed dog, but the risks of improper healing become greater.
There are braces and supportive devices that people sell for this condition but it is unknown whether these work as there is no known trials on them. In general, small breed dogs will do much better than large breed dogs if you chose not to perform surgery.
Hopefully this helps. Good luck.
Dr. Clayton Greenway
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