Meet Bogey!

January 4th, 2015 by Tulip

Bogeymeet-01Bogey is a young, energetic, active dog who partially tore his ACL in his knee.  He originally came to us with a mild lameness that had improved with rest, but recurred every time his owners tried to allow more activity.  We started his rehab sessions with therapeutic laser and cryotherapy to decrease pain and inflammation in his knee.  After a 2 week period of strict rest and exercise restriction, his lameness resolved and we guided his owners through a more gradual return to his normal activity.  He started walking in our underwater treadmill which provides more strengthening for his muscles since he has to walk through the resistance of the water, but less work for his joints because the buoyancy of the water helps to support his body weight.  We started strengthening exercises for his hind legs, back, and abdominal muscles to help prevent a recurrence of his injury.  Months later, Bogey is still doing great, has not had anymore episodes of lameness, and is stronger than ever.  He even starts wagging his tail when the car approaches CRCG now!

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4 Responses to “Meet Bogey!”

January 4th, 2015
  1. John Ortega Says:

    Hi,
    I read your story about Bogey and the partially ruptured CCL (it’s CCL in a dog, not ACL as is written in the article). While I agree that PT is a vital component to recovery and for rehabilitating many injuries in both humans and dogs, I am skeptical that it would really work at all for a CCL tear. In my own dog experience and talking with many vets and dog owners, partial CCL tears will always result in full tears. I wish it weren’t that way, but it is. I think it’s mis-leading to give dog guardians a false sense of hope. If Bogey truly has a partial CCL tear, I would be astounded if it didn’t eventually fail and his lameness didn’t return. If he continues to recover and remain injury-free, then I think the problem was something other than a CCL tear. I don’t normally advocate for surgery, but for CCL tears in dogs, I think it is really the only viable option for full recovery, minimal down time, and to slow arthritic progression within the stifle joint. Respectfully, John Ortega.

  2. Lori Beuerle Says:

    Hi Mr. Ortega,

    Thank you for taking time to share your thoughts on this topic. You are absolutely correct that the ligament is called the CCL (cranial cruciate ligament) in dogs, but sometimes we veterinarians refer to it as the ACL (anterior cruciate ligament) for simplicity-sake, as most people are familiar with that structure in their own anatomy.

    Your concern that surgery is the only option for partially- or completely-ruptured CCL’s is a common one. For some dogs, surgery truly is the best option; this is generally the case for larger, very active dogs that put a lot of force on their joints. Many of our patients have undergone surgical correction for ruptured CCL’s (TPLO’s, extra-capsular repair, tightrope sutures, lateral sutures, etc.), and for those dogs, it is often the best choice.

    Some owners do not pursue surgery due to personal finances, religious beliefs, health concerns, or previous experiences. Likewise, surgery is not the only option for some dogs (not ALL dogs, but some). We, and other veterinarians across the country, have had great success in conservative management of CCL tears, focusing on strengthening the muscles of the affected limb to help support the stifle (knee joint). With partial tears, the ligament can scar and continue to offer support, though this is a very slow process that can take more than a year due to limited nutrient delivery to ligaments, but it is possible with activity restriction, compliant owners, and enough time. Like you mentioned, it is not rare for partial tears to become complete tears, but it is not guaranteed in all dogs.

    Even dogs with complete ruptures can do well with conservative management if they have a calm temperament; for example, older dogs that are no longer as active as they once were or small patients that do not put excessive force on their hindlimbs generally excel at conservative management.

    We work with our clients through the rehab process to educate them on the risks of surgical recovery versus conservative management, and if at any point they decide to pursue surgery or it looks like their dog is not improving with only rehab, we completely support that decision. As with any aspect of veterinary care, canine rehab is truly a team effort, and decisions are made jointly between you and your vet to pursue treatment that will best benefit your canine companion.

    We at CRCG are not alone in offering conservative management as a viable alternative to surgery. Here are a few articles online we would like to share with you:
    From a veterinarian at Colorado State University: http://www.boulderdogfoodcompany.com/blog/treatment-options-cranial-cruciate-ligament-tears/

    From a magazine (notice that conservative management was an option even a few years ago, as the article was written in 2010):
    http://www.whole-dog-journal.com/issues/13_2/features/Canine-Ligament-Injury-Options_16198-1.html
    From a veterinary news magazine for veterinarians and their clients:
    http://www.veterinarypracticenews.com/November-2012/Questioning-Canine-Cruciate-Ligament-Surgery/

    From a website focused on dog stifle injuries:
    http://dogkneeinjury.com/conservative-management/

    If you have any other questions or concerns, please let us know.

  3. Nancy Stone Says:

    This profile of Bogey couldn’t have been more timely! I was just about to call CRCG when your email arrived. I have a 3-1/2-year-old Newf (Daisy) with pretty much the same story–TLPO (5-2013) with Dr. Van Vechten; met with Shannon Stringer at CRCG after her surgery for rehab exercises; did well until this past summer when she started limping again; had menisectomy (7-14), again at VRCC. I have tried to increase her leg strength with short walks but her lameness recurs and then I’m giving her Rimadyl. I’m thinking water therapy might be the solution. Suggestions? Next step?

  4. Dr. Abby Says:

    Based on your description of her situation, strengthening Daisy’s legs is exactly what she needs, and water therapy sounds like it would be an excellent option for her! We can also help alleviate some of the pain with cold laser therapy. Give us a call to schedule an evaluation with one of our vets, and we’ll get her started with a rehab program! (303)762-SWIM (7946)

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