Ellie’s cruciate ligament injury: Part II
It’s been about two months since Ellie’s injury — the ligament tear in her right hind leg. The hardest part of all this is trying to contain her natural excitement for life. She’s a very over-reactive dog by nature. She’s either at zero or 100 and there’s often no middle ground. Anyone who’s ever met her can corroborate this statement. :)
Trying to stabilize Ellie and discourage her excitement is difficult on us, both mentally and physically. She just wants to run and jump and play like she used to, but it’s just too dangerous to allow these behaviors right now as they will erase any healing and progress she’s made.
The dangers of anti-inflammatory drugs
At the end of my first post about Ellie’s injury, I mentioned that her vet told us to keep her on the twice-daily carprofen chewable pill (prescribed to manage pain and inflammation for canine arthritis or joint issues). We did as we were told. Ellie usually had a lower dose than was prescribed, but she took it almost everyday for nearly two months because it seemed to offer her some relief.
For anyone familiar with the long-term side effects of taking a non-steroidal anti-inflammatory drug (NSAID), they aren’t good! These drugs aren’t designed to be taken as a maintenance drug and they can often have fatal side effects. When I asked the vet if this was safe for her to take long-term, she paused almost as if she was saying to herself, “Oh crap, busted!” She reluctantly said no, the carprofen could have side effects, so they recommended we get Ellie’s blood tested periodically to check her levels.
In my endless hours of research after receiving Ellie’s diagnosis, I learned that carprofen can be toxic to dogs and even lead to kidney failure, seizures, liver issues, and/or bleeding stomach ulcers. I knew I needed to get her off all medications ASAP, but any time I tried to wean her off the pain pills, she only made it about two days or so before becoming noticeably uncomfortable and more immobile. That injured leg became very stiff and she would put less and less pressure on it when walking. I begrudgingly continued giving her more of the pain meds (still a lesser dose) because I knew that within a couple of hours she would get some life back in her and act more like herself. I wasn’t finding any other acceptable alternatives to replace the medication, so it felt like we were slaves to the prescription for the time being. I felt guilty every time I fed her that little chewable pill because I knew it could be causing long-term damage, but that it would make her feel better in the short-term. Talk about a mental struggle!
Considering surgery
Besides being instructed to keep her on the medication and limit her activity as much as possible, we were referred to a couple of local surgeons to discuss treatment options — both for the active injury, but also to prevent future issues. This is how it was sold to us anyway. As I mentioned earlier, I didn’t hear much of what the vet was saying over the phone when she was delivering Ellie’s diagnosis, but I vaguely remember her giving the details of the surgery options. Something about cutting the knee bone, removing the ligaments and putting a metal implant in, which changes the angle of her bones or something like that! Wait — cut a bone to repair a ligament? Did I miss something or doesn’t this make good sense? Well, apparently this is THE recommended surgery for this type of injury and it’s done all too frequently, in my opinion. It’s called Tibial Plateau Leveling Osteotomy (TPLO). We obviously didn’t want to put Ellie through surgery, but it seemed like this was the only real solution to fix the problem and get her back to her pre-injured condition the quickest.
Again, because this was happening during the pandemic, it was difficult to get an appointment. We got on a waiting list and were moved up a couple of weeks thanks to a cancellation. This felt like good news because we just wanted some answers and a fix for Ellie, but I was still unsettled about taking her to the consult with the surgeon. What I learned through my own research was that none of the surgery options were that reliable or effective long-term and they could do much more harm than good — not to mention the long rehab, recovery times and physical stress on the dog and owners. Did we really want to put Ellie and ourselves through this?
How about physical therapy?
In the meantime, my research also led me to considering physical therapy for Ellie. This, to me, made more sense than surgery. Rehab the injured leg doing a combination of treatments like underwater treadmill therapy, laser therapy and possibly even acupuncture. I read that some dog owners saw success with treating their pups with physical therapy, so I pursued it. We went for the consult, Ellie put up with their poking and prodding throughout the 90-minute exam and won over the hearts of all the staff members. The techs and the doctor were all great, we loved how they handled her, but she’s not cooperative in any sense of the word. And she’s a puller! When she’s excited, she pulls on the leash very hard, which as you might expect isn’t kind to an injured leg. Bringing her to and from appointments is stressful both for us and for her body, so we weren’t thrilled with the idea of transporting her to physical therapy appointments weekly for the next several months, so we’ve put that on hold for now.
With no great options being presented to us and Ellie not really improving on her own, even with medication, a ton of nutritional supplements, and restricted activity, I kept searching for answers. Again, because of Delilah, I have this extra stress that I’m not doing the right thing or not doing enough to make our poor Ellie feel better. We just want to see her run and play off-leash with Max again (her 7-year-old Boxer friend down the street) and just get back to normal.
Ellie and her best bud, Max
My ‘a-ha’ moment
One night, a couple of weeks ago, I finally came across something in my endless online searching that brought both comfort and enlightenment (and kept me up until 3am reading!) A Facebook group, believe it or not, run by the most helpful and encouraging people I have ever virtually interacted with. This online group is strictly for dog owners dealing with the same injury as Ellie and not considering surgical treatment options. Reading the countless posts and comments from both the group administrators and members was the first time since this all started that the light bulb went off in my head. Something finally made sense!
The biggest takeaway? Ellie’s injury can be treated without surgery — and surgery is never required for this injury. What!? Most of what I read online and was hearing from our vet was that surgery was the only way to go. Finally, some relief from the anxiety about what to do next! For any of you overprotective pet parents like myself, the amount of worry you have for your dog can be too much at times. You don’t want to see them suffer and since they can’t speak for themselves or really help themselves, it’s up to us to do whatever we can to help them feel better.
This past week or so (thanks to the Facebook group) has been more productive and calmer because I now have a clear treatment path and support, more importantly, from those that have seen dogs heal from this nasty injury. We’re still focused on keeping Ellie’s activity limited, but now we’re streamlining the supplements she takes daily and also pursuing a custom leg brace by the highly-recommended folks at Posh Dog Knee Brace. The brace is designed to support the injured leg and take some of the pressure off their good leg, which is compensating for some of the work that the bad leg can’t currently handle. You need to safeguard that injured leg as much as possible to promote healing because this type of injury can have many setbacks, as the ligament is easily re-injured. This type of injury heals very slowly and can take up to a year to rehab appropriately. The goal is to get the scar tissue to form and strengthen around the injured knee to provide the dog with the stability it had prior to the injury. Ligaments never regenerate, so it’s up to that important scar tissue to give Ellie her mobility back.
I’ll document Ellie’s experience with the brace in the coming weeks. I’m not entirely sure she’ll be a good candidate for this type of brace, but we’re marching forward to at least give it a try!
Where there’s a will, there’s a way!
Another great resource I came across via the Facebook group is a site called tiggerpoz.com, which is loaded with information and advice based on the site owner’s experience with his dog, Tigger. There’s a lot to read and consume and it’s incredibly helpful, so I highly recommend it for anyone dealing with this type of injury.
I will continue to document Ellie’s recovery and progress in the coming weeks, including providing a full list of her current nutritional supplements, with links to purchase them. They are helping already and without the dangerous side effects of the prescription drug she was on!
Until next time, thanks for your time and attention.
