Original Question: Sunshine hurt her right knee and we were given some painkillers and an anti-inflammatory. About a month after she hurt her knee and via compensating on her other leg, she went to jump after our other dog and hurt her “good” knee and that one is now worse. So, after X-rays we were sent to the orthopaedic vet surgeon who cannot see her until Nov 21st and all we are being told is to do TPLO (tibial-plateau-leveling osteotomy) surgery but we see there are a few options and not all are $3000 per leg. From an unbiased source, (you), can you tell us what the recommended course of action might be and if she can wait that long for surgery? Thanks a lot. - Michelle
Thanks for your question.
I’m sorry to hear about your situation.
When a dog has a torn cruciate ligament, it will cause instability on the joint that leads to inflammation, pain and eventual degeneration. It can be quite debilitating and the effect on mobility in the future can reduce their quality of life much earlier than if it hadn’t occurred.
There are not many treatment options. Surgical intervention is strongly recommended. I have discussed non-surgical options many times with pet parents but it is certainly not the ideal course of action. They often consider this to avoid the expensive cost of the surgery, however, I would tell you that in a middle-aged or young dog, it could become more expensive if you don’t do the surgery. If the torn cruciate ligament exists 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 in order to control the inflammation and discomfort in the joint. 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. For this reason, I would make the argument that performing surgery can actually be the cheaper option.
The size of your dog can have an impact on your treatment options. A small breed dog may have some level of recovery and return to function where a large breed dog rarely does. With time, there will still be inflammation in the joint because it is unstable. It will form scar tissue around it in the attempt to stabilize itself but this has a high variability of success. The treatment option other than surgery is to keep your dog restricted, ideally to a kennel for at least 4 weeks to allow for the scar tissue to form. This is often impractical for owners to do. You could consider brace and orthopaedic supports that have come on the market but the research about their effectiveness is slim and debatable.
For the surgical option, you could always look for quotes and options. There are general practice veterinarians that perform a cruciate repair with different techniques. If you’re wondering whether the TPLO surgery is necessary, I will say it is often preferred but research shows that the long-term success of other procedures are comparable and the cost can be greatly reduced.
I hope this helps. Good luck.
Dr Clayton Greenway