One of the most common problems that come to me are the dogs with a ruptured or damaged cranial cruciate ligament. In football terms, it is the footballer’s knee and they are usually out of the season after undergoing a knee reconstruction. Dogs of all shapes and sizes can suffer this injury. Big dogs, little dogs, fluffy ones, lap dogs, frisbee dogs, agility dogs and so on. The only exemption seems to be the greyhound.I haven’t seen that but I have probably jinxed myself now by saying this.
At any one time I have a handful that I am working with. Why do they need to see me? Don’t they all need surgery? Isn’t rest all they need to get them better after surgery? 20 odd years ago when I worked in general practice, that is also what I used to do. After the operation, they all went home with a bandage, strict instructions to rest, walk 5-10 steps a day on a lead and that was it.
About seven years ago, Mack, an energetic, young border collie who came to me four weeks after cruciate repair surgery. The owner reported that she had been walking him to the letterbox and back each day since the ‘op’. That was it. There was no other rehabilitation. If a person had the same surgery, they would be sent off for rehabilitation as standard practice. Why was this not offered for our dogs? I had treated dogs in the past who could not bend their knees at all a few years after surgery. Maybe rehabilitation could have helped. Since that day, I have tried to explain the importance of rehabilitation to other vets and clients. One vet told me that in some textbooks, it still says to cage rest them for six weeks.
The principle behind rehabilitation is to give the dog a series of exercises that will gradually improve the flexibility, strength and use of the bad leg. Rehabilitation can start within the first week of surgery and with each visit, the exercises are tailored to suit the recovery stage of the leg. It has been shown that if the dog is encouraged to use the bad leg in a controlled manner, the amount of arthritis and pain is reduced. Flexibility is maintained and the muscles recover better. A damaged ligament does not exist by itself. The muscles around that whole leg are often knotted, weak and tight. They need to be rehabilitated at the same time as the joint.
Over the years, I have also rehabilitated stifles that haven’t been operated on. Some dogs are too old, some owners cannot afford the surgery. It is an option that can give good results in some dogs. The young, energetic larger breed is probably not a good candidate. Neither are dogs with busy owners or dogs that have done both legs at the same time. Rehabilitation in my hands is usually a twelve week period of specific exercises, stretches and restricted activity. So we need obedient dogs and owners with the ability to put in the work required. The results are worth it.