Kirby has always had “bad knees.” Luxated patellas, probably congenital, plagued him over the three years I have him.
Today we had an appointment with the orthopedic surgeon at Las Vegas Veterinary Specialty Center. We spent several hours consulting with Dr. Joshua Rexing. They had to sedate Kirby to take a complete x-ray of his hips and legs.
It was discovered not only does he have the patella problem, but both back legs have cranial cruciate ligament ruptures.
This new development changed the landscape of how we manage his discomfort and inflexibility.
Canine CCL rupture is one of the most common orthopedic conditions seen in a dog.
CCL tears can be acute or chronic, as in Kirby’s case. Acute is a traumatic injury usually occurring when the dog steps incorrectly on the limb or from jumping. Chronic disease includes age related deterioration of the ligament structure, obesity, conformation abnormalities, and immune mediated disease. With degenerative disease even repetitive normal activities can cause progressive tearing of the ligament.
We discussed treatment options at length. Would Kirby be a candidate for conservative methods such as complete rest and non-steroidal anti-inflammatory medication for six to eight weeks? This route could result in long term decrease in activity and an increasing level of disability.
Conservative measures are not really an option for the little guy as just regular walking puts too much pressure on the knees and since it is both of his knees he needs at least one working leg. Having two back legs in casts for six to eight weeks and then physical therapy would severely limit his activity and ability to lead a normal life.
His age (somewhere past ten) and size also make conservative healing more of an issue. If we tried this and he did not begin to heal, each day we prolong surgery he gets older and weaker and the thought of anesthesia and rehab is more challenging.
Thus we discussed the surgical options. Both knees are affected and on occasion they do bilateral repairs but I did not think this was appropriate for Kirby. He is older and needs one functioning leg and I did not think he could do well with the recovery necessary for both legs at once.
Thus we opted for the Lateral Fabellar Suture Technique (also called the X-Cap) surgery on the left knee, the one which is more deteriorated and the side with the hip that has had previous surgery.
He also will have his patella repaired on this knee while under.
Post-surgery he will require some physical therapy and rest but we anticipate him in his stroller, smiling and greeting people in two weeks.
He will not able to be handled much but can certainly go on simple, quiet visits and show everyone how brave he is.
Then I will re-evaluate if we do the other one right away or wait.
The poor boy cried and cried during the exam so I think it is the right decision for us.
I decided to leave him there today so he can have dinner there and become comfortable with the staff, all new people to him. This way he is fresh when he wakes up and won’t see me … He is super clingy now and not seeing me before surgery will actually be better for him.
I told Benny he had better rest up as he has to do double duty for a while!