Diary of a Cruciate Injury

This is a diary of Kita's cruciate/stifle injury, and the various stages she went through during recovery.

Background

Kita, at the time of injury, was a 3.5 year old Belgian Malinois who has mainly competed in French Ring, but has also done a little Schutzhund and more recently had started agility classes. She also tends to be quite rough on herself, and routinely sees a chiropractor.

Injury background

June 19th – The dogs were outside running around in the back yard, playing fetch, etc. I noticed that Kita was moving a little "off" in the rear, not limping, just a minor movement change. Didn't think much of it, figured she smacked her foot on something or … Took the dogs inside about an hour later, she was still just "off", not limping. 1/2 hour after relaxing in the house she was limping, 1.5-2 hours later she was 3 legged and in a lot of pain. Any manipulation by me, or bumping of the leg while hopping around resulted in her crying out. Iced it and put her in a crate.  While the dogs were out playing, Kita was doing her usual behavior with the neighbors, which was spinning in a clockwise circle when she heard their car coming, then racing the length of the yard with their car, then spinning some more as they pulled into their driveway.  She happens to love my neighbors, they feed her cookies through the fence.  We had just put in a new retaining wall, with fresh dirt, which she was spinning in.  I believe she sunk her back right foot into that dirt, then tried to spin, and the foot didn't turn with her.

3 Weeks 4 Weeks 5 Weeks 9 Weeks 11 Weeks 17 Weeks 10 months 2 years 3.5 years Supplement List List of Videos Calendar

Diagnosis and Recovery

June 20th – took Kita to her regular vet. He said it looked like a textbook cruciate injury, manipulated her leg, then sedated her for x-rays and more manipulation. Could get no drawer movement at all, or any other movement that would indicate ligament injury, also found nothing on the xrays indicating any bone injury. Biggest pain reaction was when he put pressure on the bone just above the knee, but it xrayed fine. Thought it was just a sprain, recommended 2 weeks crate rest and Rimadyl. I also began giving her Traumeel and stocked up on bully sticks, rawhides, raw bones, chew hooves, kongs, and other edible and non-edible toys to keep her occupied while she is in the crate.

About 10 days into the crate rest I called the vet, Kita was still on 3 legs and I didn't see that changing by day 14, was curious if we just needed more time or … She'd take an occasional step but that was it. He recommended 1 more week of crate rest and bring her in for a follow up appointment. Added Dasuquin with MSM to the supplements. Have been letting Kita out of the crate for a few hours every day to lay next to me on the couch, just so she doesn't go stir crazy. She's also allowed to "face wrestle" with the other dogs, as long as she doesn't try to actually get up, and they don't try to get on the couch.

July 8th – We did the follow up appointment, almost 3 weeks from injury. Kita will take maybe 2 steps out of 10 with the back leg, the rest of the time she's 3 legged. Sometimes she'll use the leg for more steps, but then she's 3 legged again for longer, like she over did it just with those 5-6 steps. She is more likely to use the leg on very even surfaces like concrete, and less likely to use it on the grass. Still no drawer movement, and she was OK with the exam for the most part, but she's very tender when the vet put pressure right on the front of the knee in that little hollowed out area under the patella, that got a quick head check. Now he's worried about meniscus or patella injury. She's got an appointment with a board certified specialist for next Friday, until then more crate rest and Rimadyl.

3 weeks (July 10) – Kita is using the leg to take a step 30-40% of the time, not a full weight bearing step, but putting the foot down solidly and limping. She is also standing on it at least 50% of the time. When she wants to do a slow trot (fast trotting is not allowed) she will still tuck it up and go 3 legged, also when turning corners.

July 14 – Kita went to see a specialist in a technique called Bio Energetic Synchronization Technique (B.E.S.T.), which is a holistic approach to healing, in addition they utilize chiropractic/massage techniques. We added a variety of mineral and herbal supplements to her diet, plus more arnica. She had 3 visits, 1 week apart.

July 15th – saw the surgeon (DVM/DACVS), who did basically the same things as Kita's vet. Checked for drawer movement while she was not sedated, then sedated her, xrayed the knee from different angles, and checked again for drawer movement. He felt it was a cruciate injury, and said although there is no instability it's not possible to tell how badly ruptured the ligament is without going in surgically, it could be a minor tear but could also be a total tear, either way he felt she needed a TPLO. We discussed the pros and cons of surgery, and also putting it off for a month or two. After talking with the specialist, and doing more research on my own, I have decided to continue with conservative management (crate rest, controlled potty breaks, etc) for another month or so and see how things are progressing.  Partly because I wasn't comfortable with the specialist, I felt he was giving me unrealistic information, 8 weeks from surgery to a 100% recovery and back to Ring work, he was doing a TPLO regardless of what he found when he got in there, etc

Have started taking Kita outside with me for a couple of hours each day, just to lay next to the lawnchair, chew on a bone, and watch the world go by. She's handling the crating extremely well, better than I expected, but she's started to get a little tired of it

4 weeks (July 17) – Kita is using the leg to take a step about 80% of the time at a walk, not a full weight bearing step, but putting the foot down solidly and limping. She is also using it to step with when at a slow trot, although not as often as when she's walking.
I purchased an above ground pool, which is 3.5 feet deep, and have begun swimming Kita to help regain some of the muscle she has lost in her leg, and also to simply take the edge off from being crated so much. I need to get a life preserver for her, it will put less stress on the leg during swimming since it will help her float, but it will also allow her to swim for longer periods of time.
5 weeks swim session, one of her first

This video was taken at 5 weeks and 2 days. The injury is to her back right leg. Next video will be taken in the back yard, I actually water the grass there 🙂 Normally I discourage the trotting at the end, but I wanted to video her movement so I let her do it, as long as it didn't turn into running or zoomies.
5 week post injury video
This was the first time I saw her stand with full weight on the injured leg, while picking up the non-injured leg to scratch.

7 weeks – Kita continues to improve. She is swimming 10-15 minutes at a stretch now, I let her swim until she starts indicating she wants to get out, then encourage her to swim for a few more minutes. I bought her a life preserver and that seems to help with the duration of the sessions, she's more willing to swim for longer periods without needing a break.
Video taken at 7 weeks post injury

8 week – Kita is now walking and slow trotting with only a minor limp, at times it's not visible at all. We are still doing controlled movement, the walking and slow trotting I'm allowing, but no fast trot, running or other Malinois nuttiness. Kita will also bear full weight on the injured leg now, when she stops to scratch or even at times when she's squatting to pee and lifts one leg, so in those cases she's bearing full weight, with the knee bent completely.
She's been swimming on a regular basis, and has gotten to the point I don't have to get in with her to encourage it, she just paddles around with a toy in her mouth for 15-20 minutes while I supervise and occasionally encourage her to change directions in the pool (she tends to paddle in circles, so I make her circle both ways). Unfortunately I threw my back out last week, probably lifting Kita in/out of the pool so she hasn't gotten to swim in a week, since I've basically be "recliner ridden". But the swimming has really helped take the edge off her energy level, and is also helping her regain the muscle she lost in the injured leg.

8.5 week – Kita had a minor setback, I noticed that when I got her out of the crate for a potty break and little walk, she was skipping steps with the injured leg again. Not holding it up against her body, but just skipping a step every few steps. After talking to my teenager I found out that because he couldn't see any limp anymore, he thought she was fine again, and had put her outside to potty and let her run around freely. Luckily it appears to have just set her back briefly, it only took a few days for her to be back on track but we didn't really make any progress this week overall.

9 weeks – Kita is back to swimming again, although she does have to get in and out of the pool with only minor help from me, I am still not lifting her. However since we have an above ground pool with soft sides, she can get in and out without much effort, we just loose a few gallons of water each time making the side bend over a little.
Video taken at 9 weeks post injury after a swimming session

I have been cutting back on the frequency and amount of Rimadyl, and have noticed some minor differences in her gait with and without it. There is almost no visible limp or favoring of the leg with the Rimadyl, without a minor limp and occasional hop step when turning a tight corner is evident. I'm going to try the Traumeel for now, in place of the Rimadyl, I would rather she still be a little careful of the leg while the healing process continues.
Once again we are taking a break from swimming, I threw my back out a second time, this time putting Kita's life preserver on for a swimming session. Currently her exercise consists of just monitored walking in the yard.

Video of Kita walking around the yard taken on Sept 5th
11 weeks (Sept 7) – back to swimming again, Kita couldn't wait to get in the pool and paddle around. Looks like it was short lived though. After her swim sessions we always take about a half hour for her to dry off in the yard, stretch the leg and let the muscles "cool down" from the exertion. I put Kita back in her crate, and when I let her out a few hours later, she had "dead tail". Until the "dead tail" has resolved, Kita will just be walking/trotting around the back yard.

11.5 weeks – Another setback, this time I have no idea what happened. After about an hour outside walking around, chewing on a bully stick, etc Kita and I went inside and she wandered around the living room for awhile then laid down on the floor next to me. 15-20 minutes later she got up and was completely 3 legged, barely doing any toe touching at all. There is no obvious swelling in the joint, but she obviously injured, or re-injured, something. When or how I don't know as she was supervised 100% of the time, unless she stepped wrong outside in the yard, and it just took awhile for the stiffness to set in.

12 weeks – There has been improvement in the last few days, we are basically back at week 4 in terms of movement, how much Kita will use the leg, etc. I started swimming her again, only 10 minutes. She handled it well, the limp was less pronounced after the swim session. It's the worst when she first gets up from resting or out of her crate, then improves with some movement and warming up, but she is still skip stepping quite often, and not standing with full weight on it. This is more pronounced in the house where there is less room to move around, she will tuck the leg up and basically go 3 legged quite a bit, outside where there is more room to move in a straight line and not turn corners, she will use the leg a lot more.
12 weeks post injury
12 weeks post injury swim session

13.5 weeks – I continue to see improvement, less 3 legging it inside the house, and about 90% usage outside the house. Also a lot less favoring of the leg when Kita first gets up or is let out of the crate. I haven't seen her actually stand and bear full weight on the leg yet while scratching with the other leg. Kita has another chiropractic appointment today to make sure nothing is out of whack and causing more favoring of the leg than neccessary.

14 weeks – I saw Kita stand on her injured leg while scratching with the good leg, ie bearing full weight on the right leg, for the first time since the setback.
Video taken immediately after letting her out of her crate, then 5 minutes later, then of her scratching

17 weeks – Kita is still slowly but steadily improving. She still does a hop step at times to protect the leg but her walk and trot in a straight line is showing less and less limp, and she doesn't need as much warm up time when first out of the crate before she's moving smoothly. At times when she sits the knee still sticks out, but other times she sits and lays down with both knees in an equal position.
17 weeks post injury

5 months – Kita has continued to improve, at the walk and trot there is barely any noticable limp, although the healing is still fragile and she has mis-stepped a few times resulting in a day or two of limping. But she recovers quickly and gets back to moving almost normally. I have been giving her more freedom, she is still not allowed to go "all out" but is allowed to trot and run in the yard at will, as long as she doesn't start really racing around, doing quick turns, etc. Kita will still sometimes go 3 legged to protect the knee on unstable terrain. She had her first experience with snow recently while traveling, she realized quite quickly it was unpredictable in terms of when a step was going to be on something solid and when she'd sink 6 inches, and went 3 legged until she was on firmer terrain (the cement).

6 months – At 6 months Kita is doing well, and I'm allowing her a lot more freedom. There is still a minor hitch in her step that I can see, some people see it, some people don't, IMO based in part on their knowledge of movement/structure. Once in awhile I'll see her skip a step or two, on uneven terrain, but I've been able to up what she's allowed to do, without loosing the progress we've made, and she's a MUCH happier dog. She's still not allowed to play with the other dogs. But I am allowing her to walk/trot/run in the yard, she plays with toys throwing them up in the air then pouncing on them, etc. The only thing I still don't allow is "doughnuts" in the yard, no spinning and shoving off on that back leg. We've had a few setbacks over the last 6 months but she's recovered from each of them and continued to improve. I'm hoping in a few more months she'll be restriction free, at least for individual play in the yard and time in the house with the other dogs where any play can be supervised. I don't envision allowing her to play with the other dogs in the backyard for quite a bit longer, considering the level of stress that will put on her leg.
6 months post injury

10 months – At 10 months post injury it is pretty much back to life as normal, at least in a supervised fashion. Kita is still not allowed to be outside unsupervised for extended periods of time, in case she does something stupid and then doesn't stop, but she is allowed to play as much as she wants with the other dogs and race around in the yard as long as I'm there. And race she does, she is enjoying the freedom she is given. There is still a minor hitch in her step once in awhile, or she'll skip a step, but it's not very often. The stiffness when she first gets up from an extended period of laying down has greatly improved also, the times she has to "walk it out" and warm up after getting up are in the minority now, instead of the majority.
10 months post injury playing in the yard with the other dogs this video was taken as soon as the dogs were let out, no warm up time first.

14 months – I decided to breed Kita, doing a surgical AI.  While she was under I had the vet check her knee, and see if she felt there was anything different we could or should have done.  Once again no drawer movement.  She felt the CM had healed the knee as well as any surgery could have, and there was nothing more we could have done, or should do at that point.  As a more "old school" vet she might have recommended a tight rope surgery initially, but she was not a fan of the TPLO.  The purpose of the tight rope is just to help stabilize the knee while the body builds scar tissue, which we had accomplished with CM.

2 Years – At 2 years post injury, I began training Kita again. She was sound, back to jumping a 4 ft hurdle with ease, and looking good. However, after a few we had started training she was "esquived" during one session. This means as she came in for a bite in protection, the decoy quickly moved out of the way so she would miss, a standard move in French Ring. While trying to change directions quickly on dry grass, she slipped. She got right back up, and went for the grip, but she was obviously limping on her back leg. She was able to "walk it off" and a few minutes later looked like nothing had happened, but I decided it wasn't in her best interests to try to bring her back and retired her again. She still continues to run and play with the other dogs, and live a normal high energy pet dog life.
3.5 Years – Unfortunately Kita's other knee is starting to show signs of arthritis from her compensating for the injured knee. This was mainly showing up when she would get up from laying down, with her pulling herself up using her front more than pushing up from the rear. I have also been lax the last year or so on the supplements, which in retrospect was not my smartest moment. As soon as I put her back on the supplements, and took a few pounds off of her (she'd gotten a little thick), she began moving better. She still continues to run and play with the other dogs, and live a normal high energy pet dog life without any issues other than the occasional day she's a little sore.

Supplement Information

Rimadyl – 50mg 2x day, then down to 50mg 1x day, taken off at 10 weeks
Arnica – 2x day
Trace Minerals
Alka Dog – Barley Grass microground, desiccated beef liver, carrot powder, trace mineral powder, multi-strain acidophilus, garlic powder.
Fish Oil – 4000mg per day
Traumeel – 1 tablet 2-3x day, increased to 2 tablets 2-3x day when taken off Rimadyl

  • Each 300 mg tablet contains: Aconitum napellus 3X (Reduces pain after injury) 30 mg; Arnica montana, radix 3X (Reduces swelling and bruising) 40 mg; Belladonna 4X (Reduces swelling and pain) 75 mg; Bellis perennis 2X (Treats bruises) 6 mg; Calendula officinalis 2X (Stimulates healing process) 15 mg; Chamomilla 3X (Soothing pain relief) 24 mg; Echinacea 2X (Immune support) 6 mg; Echinacea purpurea 2X (Stimulates healing process) 6 mg; Hamamelis virginiana 2X (Relieves bruised soreness) 15 mg; Hepar sulphuris calcareum 8X (Stimulates injury healing) 15 mg; Hypericum perforatum 3X (Relieves pain) 8 mg; Mercurius solubilis 8X (Reduces swelling) 15 mg; Millefolium 3X (Treats minor bleeding) 15 mg; Symphytum officinale 8X (Relieves joint pain) 24 mg. Inactive ingredients: Lactose, Magnesium stearate.

Dasuquin with MSM – 2x day

  • Dasuquin from Nutramax Laboratories, Inc. is a joint health supplement for dogs that goes beyond standard glucosamine supplements. It contains NMX1000®* avocado/soybean unsaponifiables (ASU), decaffeinated tea, FCHG49®* glucosamine hydrochloride, and TRH122®* low molecular weight chondroitin sulfate.

2 Months
Fish Oil – 4000mg per day
Trace Minerals
Dasuquin with MSM – 2x day

Video List

The following videos are on YouTube. More information on the videos is found in the diary section of this page.
Except where noted the videos were taken after a 5-10 minute warm up (potty break), or a swim session.
5 weeks post injury
5 weeks swim session, one of her first
7 weeks post injury
9 weeks post injury after a swimming session
11 weeks post injury
12 weeks post injury
12 weeks post injury swim session
14 weeks post injury and setback
17 weeks post injury
6 months post injury
10 months post injury
1 year 11 months

Calendar

Other Links

British Veterinary Orthopaedic Assoc paper on TPLO
AVMA Journal Abstract on TPLO

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