What does it mean?

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In the vast majority of dogs, the Cranial Cruciate Ligament ruptures as a result of long-term degeneration. The fibres within the ligament weaken over time. We do not know the precise cause of this. Cranial Cruciate Ligament may be treated either conservatively or surgically. The decision to treat your dog’s CCL disease with conservative or surgical management will very much depend on the stability of the stifle joint (knee) and severity of clinical signs. Fraying of the ligament triggers a cascade of events resulting in knee pain and lameness. At the earliest stage, osteoarthritis is already present. Joint care is important to maintain function along with short/long term non steroidal anti inflammatory pain relief. 

• When treating conservatively it is vital that the quadriceps and hamstring muscle groups are maintained as they control flexion and extension of the stifle joint. If these muscles become weak the stifle can become vulnerable and at risk of further injury. There is flare ups at times in the joint and it is important to only exercise as advised to control this.

There are ways to surgically secure the stifle joint. These are:

• Synthetic fibres that are placed through the femur and tibia bone tunnels in a tightrope technique. 
• TPLO - Tibial Plateau Leveling Osteotomy  This surgery involves creation of a radial cut in the top of the tibia and rotation of the plateau segment until the previous slope in the bone is no longer present. The bone is subsequently fixed in this new position using a bone plate and screws. 
• Tibial Tuberosity Advancement -  This surgery follows the same principle as TPLO, with a cut being created in the tibia to allow a change in shape of joint to reduce the force. 

Generally 90% of dogs return to normal activity after TPLO or TTA at 12 weeks +. Performance dogs including military dogs are expected to return to work after these surgeries. 

Our rehabilitation plan is specific to your pets needs and will need strict rest at home for 6 weeks post surgery; working towards a plan from day 1 to 12 weeks to normal function.

The normal hip is a ball-and-socket joint.  The head of the femur (ball)  allows the hip to move freely in all directions in that socket (acetabulum). When the hip becomes damaged or diseased mobility can be affected and can lead to chronic pain and inflammation. 

FHO restores mobility to the hip by removing the head of the femur. This removes the ball of the ball-and-socket joint leaving just an empty socket as shown in the picture above opposite the L marker. The muscles of the leg will initially hold the femur in place and over time scar tissue will form to provide cushioning that is referred to as a false joint. Although this joint is anatomically very different from a normal hip joint, it provides pain-free mobility in most patients. 

 The muscle mass that has been built up through activity such as hydrotherapy using an underwater treadmill helps to stabilize the joint allowing the dog to regain pain-free mobility more quickly than inactive pets. Inactive dogs have less muscle mass around the joint, making the joint less stable post-operatively and leading to longer recovery times. 

A FHO is usually perfomed from the following factors: 

• Legg-Perthes disease - This is an uncommon condition mostly seen in miniature and toy breed dogs. It  causes the bone within the femoral head to begin to die at early age causing collapse of the bone giving pain. Once this part of bone is removed the pain is alleviated. 
• Fractures involving the hip and the hip joint cannot be repaired. 
• Hip luxation/dislocation where it is not an option to repair the dislocation.
• Severe arthritis in the hip joint.

Rehabilitation is a great way to engage specific muscles to build strength around the false joint and support other structures of the body. Post-surgical it is advised for a specific rehabilitation plan and will need strict rest for 1-2 weeks with recovery at 6 to 12 + weeks.

Check out Harveys' story.  Scroll to 'road to recovery..'

The Patella glides up and down in a groove that forms the front of the knee joint. In some dogs, the patellar luxates (dislocates) out of this normal groove. The luxation creates an intermittent inability to properly extend the knee joint. As well as the lameness caused by the mechanical and bio-mechanical deficiency of the affected knee; there are varying degrees of pain and osteoarthritis. When severe; there is often cartilage loss from the underside of the patella and/or the surface of the grove as the cartilage is physically abraded from the patella slipping out of the groove. The Patellar commonly tends to move inwards towards the body (medially) and over time affects walking and muscle creating an abnormal walk (gait) with characteristic skipping or limping a few steps and then quickly return to normal.  Most animals start to show signs as puppies or young adults, although onset of signs in mature dogs is also common. Animals with a “bow-legged” stance are more likely to be affected and some dogs affected by Patellar Luxation in both knees will have a stiff, awkward gait with knees that do not extend properly. 

We use a grading system from 1 to 4 to address the severity of the luxation. After grade 2 we refer for surgery. 

• The cornerstones of conservative treatment are weight management, hydrotherapy, exercise modification to specific muscle groups and medication (anti-inflammatory pain relief). 

There are ways to surgically support and prevent the Patellar moving from its designated purpose. These are:

• TTT - Tibial Tuberosity Transposition. The repair is to realign the tendon along the patella (kneecap) and tibia (shin bone). Because bones heal much more efficiently than tendons, the bone that this tendon is attached to is cut and moved to a more appropriate position. It is pinned back into place with the bone healing over the following 4-8 weeks. Wire is placed in addition to the pins so that the pull of the quadriceps muscle is effectively balanced by wire anchored to the tibia in the opposite direction. 
• Femoral Varus Osteotomy - Dogs with a severe bow in the femur requires straightening.. This is achieved by taking out a wedge of bone (sometimes in three dimensions) and repairing the femur using a plate and screws. 
• Recession Sulcoplasty - When the groove that the patellar normally glides in is very shallow; a surgery is performed to deepen the groove. This involves removal of a wedge or block of cartilage and bone, which is replaced in a recessed position.

 Our rehabilitation plan is specific to your pets needs and will need strict rest at home for 6 weeks post surgery; working towards a plan from day 1 to 12 weeks to normal function. 

If there is a developmental abnormality in the elbow joint that involves a complex structure of three bones and those three bones do not fit together (articulate) absolutely perfectly; this will result in abnormal concentration of forces on a specific region of the elbow joint; causing lameness. This in time can cause osteoarthritis. Pain medication such as anti-inflammatory pain killers can help reduce inflammation in acute or chronic stages. 

There are a few options for management in conservative and surgical for ED. Rehabilitation such as hydrotherapy in a one directional force using an underwater treadmill are always beneficial to facilitate mobility and alleviate pain, exercising and strengthening the joint and improving mobility under warm buoyant water. 

We can design a plan specific to your pets needs to make them more comfortable. Water provides a fun, enriching time whilst also treating specific target areas for further quality of life.