Expense of cruciate surgery

marathon

Have 6 year old beagle with cruciate ligament injury operation costs as much as 1500 euro and can't afford it I'm just wondering is there any alternative????

aonb

My terrier had his cruciate ligament replaced last year.

His second rear leg is now causing problems - the vet doesnt think the 2nd one is TORN, so he is on anti-inflammatories and weekly cartophen injections and very reduced walking.

You need to determine if the cruciate is torn. Your vet can do this by manipulating the leg on the examination table. (very ouch!)

If its torn, the knee joint can move as there is no ligament to hold it in place, thus the limping.

If the cruciate is TORN it can be replaced (new artifical ligament) - major surgery with 6 weeks of rest afterwards. Or rest rest rest rest rest, allowing scar tissue to build up to hold the knee joint somewhat. This has worked for my friends terrier bitch - about 6/8 months in her case. She still limps on/off if she does too much running around.

If the ligament is not torn, then rest with the help of anti-inflammatories and pain meds will allow the ligament to repair.

Sounds though that you are not very happy with your vet. Maybe go to another more sympathetic vet for a 2nd opinion?

Google the whole subject of Cruciate Ligament in Dogs, and get a bit savvy so that you can ask your vet some questions and know whats going on with your dog.

http://www.petmd.com/dog/conditions/musculoskeletal/c_dg_cranial_cruciate_ligament

http://www.sydneyanimalhospitals.com.au/Emergency-Care/Cruciate-ligament-injury-in-dogs/

sillysmiles

On week 2 of incarceration post surgery.
Our lab started about a year ago being intermittently lame. Initially it was on one leg. We spent most of last year on restricted expercise, anti-inflammatories, injections into the joint etc. This January the second leg start giving problems.
Two weeks ago had joint stabilisation surgery. As he is a bigger dog that the JRT, they don't replace the cruciate but realigne the joint so that other ligaments do the work.

TBH I'm not sure if we would have been better off biting the bullet last year and getting it done as then we might have only needed to get one leg done. But for us the conservative approach didn't work and we found that the reduced exercise lead to muscle atrophy in the lame leg, which probably put more pressure on the "good" leg and caused problems with that.

Ms Doubtfire1

Uhm...check with another vet.Looking at that price you're probably in dublin?

Dubs1990

My cairn had hers done I think about 3 years ago, cost around 700 definitely wasn't over a thousand, now with all the check ups after and all the meds and we went back for injections (I think this was to hopefully prevent arthritis) did probably add up to that.

Now her other leg is acting up, not a tear got it checked under xrays and under GA they manipulate the leg alot more to see if it's definitely torn. Thankfully just injections and she wasn't allowed out for a few weeks(thank God she's 8 and is a bit more chilled), seems to be working she's putting her leg to the ground alot more now and isn't limping after a short walk.

Vet practice in Baldoyle Dublin is an orthopaedic vet and very well known for it, not sure of your location but worth a shot. (this isn't the practice I use as I was comfortable with my own)

tk123

Lads you can't compare the repair for a small terrier to that of a larger dog - you don't have the same options for a bigger dog because they won't be successful. So rest or nylon etc is out - hence the cost for a bigger dog because you need implants. Bailey had TTA Rapid done yesterday and I was quoted 1800-2200(!) Insurance pays 65% but I still have to pay up front.. onto the credit card and hopefully I get a cheque from insurance before the credit card has to be paid!

rainemac

I've no advice as our beagle had the same ligament surgery at 8 years old last year and it cost €1300 for surgery alone, with 2 X-rays I think seperately charged for. As there was a huge risk of the other leg going down the road, we decided on surgery to prolong her happiness of being on 4 legs. No insurance. We engaged with a dog physio afterwards recommended through our vet, we feel this made all the difference, it strengthened both legs and hips, there was muscle wastage in bad leg and knots and tension building in good leg. Also she's on "yu move" glucosamine tablets. Took a good few months to get her back on all 4 legs but now she runs around the garden with just a little hop now and again on the bad leg. Good leg is so far had no problems.
We struggled to get our heads around the cost but when we see her now, best money we could've spent.

DBB

There are also a couple of different types of cruciate surgeries, one of which (TTA) requires very specialised surgery that is not offered at all veterinary surgeries. Specialised training and equipment costs money... assuming it's TTA the OP's dog needs, that's about what you're going to pay, and that's just for the surgery.

Cortina_MK_IV

I had MMP surgery on both my Retriever's legs for cruciate ligament damage at €2k each time. My insurance covered most of it but I was charged 15% excess.

omicron

marathon wrote: »

Have 6 year old beagle with cruciate ligament injury operation costs as much as 1500 euro and can't afford it I'm just wondering is there any alternative????

Generally with cranial cruciate ligament tears you have 4 options:
Rest - this has to be done right to have any chance of success and has a better chance in small dogs, they need to be confined to a very small area with minimal exercise for a prolonged period. It's not great for quality of life from that point of view. Anti inflammatories are needed, and glucosamine and chondroitin supplements help. The aim is that scar tissue will build up around the joint which will perform the function of the cruciate ligament.

Lateral support suture - cheapest of the surgical options, from 500-1000 usually depending on the vet, size of dog etc. Requires up to 6 weeks of rest, best chance of success in smaller dogs. Generally not performed in large dogs but medium sized breed so often do well. Follow up with anti inflammatories. The suture only holds for about 6 weeks, but it gives a chance for adequate scar tissue to form and then hold after the suture gives up.

TTA and TPLO: These are much more advanced surgeries generally performed in specialist referral clinics. Cost is usually 1000-2000. They both involve cutting the bone and reshaping it to eliminate the need for the cruciate ligament, then holding it in place with bone plates. Both techniques work really well and it's generally surgeon preference as to which is chosen. 6 weeks rest also required here. Generally used in large breed dogs. Has a very good success rate but if there are complications (rarely) they can be severe and require another major surgery to remove the implants.

With all of the above, weight and exercise control is key. If your dog is carrying ANY extra weight you massively increase the osteoarthritis risks. Exercise restriction is vital. Anti inflammatories (metacam/carprofen etc) are necessary. Joint supplements (glucosamine and chondroitin) help with osteoarthritis, as can courses of Cartrophen injections.

tk123

DBB wrote: »

There are also a couple of different types of cruciate surgeries, one of which (TTA) requires very specialised surgery that is not offered at all veterinary surgeries. Specialised training and equipment costs money... assuming it's TTA the OP's dog needs, that's about what you're going to pay, and that's just for the surgery.

There's two types of TTA now to spice things up! Bailey got TTA rapid which is the newer one with posh 3D printed implants etc...and also the standard one.

marathon

Cheers one and all she was operated on today and is confined to very small spaces for 7/8 weeks. Op cost 500 it wasn't the tt op it has a 66 percent success rate but worth the .

DBB

omicron wrote: »

glucosamine and chondroitin supplements help....

Joint supplements (glucosamine and chondroitin) help with osteoarthritis,

Do you, by any chance, have any links to research on this?
I had always assumed that there was empirical evidence to support the use of glucosamine and chondroitin in joint health, but have recently been advised by an orthopaedic specialist that there's not much support for their use after all. Omega 3 is where it's at, apparently!
Would be interested to see if you've seen anything... just to convince me I haven't been wasting my time giving joint supplements

tk123

DBB wrote: »

just to convince me I haven't been wasting my time giving joint supplements

If it ain't broke don't fix it - I've no intention of stopping or changing what I give anyways(!) The combo I give makes a big difference but each of them are individual combos themselves of different things so I can't say what works...it just does? Able to stand vs stuck on the floor was the difference we saw so not something we dreamed up..

omicron

DBB wrote: »

Do you, by any chance, have any links to research on this?
I had always assumed that there was empirical evidence to support the use of glucosamine and chondroitin in joint health, but have recently been advised by an orthopaedic specialist that there's not much support for their use after all. Omega 3 is where it's at, apparently!
Would be interested to see if you've seen anything... just to convince me I haven't been wasting my time giving joint supplements

http://www.sciencedirect.com.ucd.idm.oclc.org/science/article/pii/S1090023306000554

There is evidence for the efficacy of glucosamine and chondroitin sulfate as shown in this paper (and plenty of other papers, this is an Irish one though). Unfortunately as with almost all veterinary papers, numbers in the trials are small and results are often subjective but there is evidence of clinical improvement in dogs with osteoarthritis.

http://onlinelibrary.wiley.com.ucd.idm.oclc.org/doi/10.1111/j.1939-1676.2012.00901.x/full

There is fairly strong evidence for the efficacy of omega 3 oils also, the paper above is a review of this compared to other products and found omega 3 oils to be most effective, however its a summary paper which focuses mostly on omega 3 and less so on other nutraceuticals.

http://onlinelibrary.wiley.com.ucd.idm.oclc.org/doi/10.1111/jvim.12033/abstract

There is potential for adverse effects with omega 3 supplementation however this is mostly limited to diabetics.


The current trend in treatment of osteoarthritis is moving towards intra-articular injections of platelet rich plasma to promote joint healing. It's taking off more in horses as far as I know but there are certain clinics that have the equipment to do it in dogs also.

DBB

omicron wrote: »

The current trend in treatment of osteoarthritis is moving towards intra-articular injections of platelet rich plasma to promote joint healing. It's taking off more in horses as far as I know but there are certain clinics that have the equipment to do it in dogs also.

Thank you for going to the trouble of finding those links, I appreciate it
I've heard of fantastic results from the platelet therapy in dogs... Must read up on it when I get a chance

liquoriceall

Very interesting but yes the sample sizes are small.....in humans there is no evidence to show benefits from glucosamine
As an aside my dog was diagnosed with a complete cruciate rupture 3 months ago, took him home to rest and consider our options with anti inflammatories, at 10 was slow about surgery
He made a dramatic recovery and is perfect!

aonb

liquoriceall wrote: »

Very interesting but yes the sample sizes are small.....in humans there is no evidence to show benefits from glucosamine
As an aside my dog was diagnosed with a complete cruciate rupture 3 months ago, took him home to rest and consider our options with anti inflammatories, at 10 was slow about surgery
He made a dramatic recovery and is perfect!

good to hear. what breed? totally restricted or somewhat restricted? assume the scar tissue has built up to hold the joint? how long approx did that take do you think, and is he fully active now?

tivvo

Cortina_MK_IV wrote: »

I had MMP surgery on both my Retriever's legs for cruciate ligament damage at €2k each time. My insurance covered most of it but I was charged 15% excess.

I'm very interested to hear how the MMP surgery went? Did you get it done in Drogheda by chance? I am currently ringing around trying to find good ortho surgeons for my 7yr old retrievers torn cruciate surgery and came across this. My own vet had not heard of MMP surgery before so i did a bit of research on the internet. It looks pretty good. An orthopedic surgeon here in Dublin (who is considered one of the best around) said my Goldie would probably benefit from the TPLO (as opposed to the TTA) however, i don't think he actually does the MMP surgery?! It hasn't seemed to infiltrate Ireland yet, hence my curiosity. Did your dog get both legs done at the same time??!! Recovery time is supposed to be shorter, did you find that? How is your Goldie doin now?

omicron

tivvo wrote: »

I'm very interested to hear how the MMP surgery went? Did you get it done in Drogheda by chance? I am currently ringing around trying to find good ortho surgeons for my 7yr old retrievers torn cruciate surgery and came across this. My own vet had not heard of MMP surgery before so i did a bit of research on the internet. It looks pretty good. An orthopedic surgeon here in Dublin (who is considered one of the best around) said my Goldie would probably benefit from the TPLO (as opposed to the TTA) however, i don't think he actually does the MMP surgery?! It hasn't seemed to infiltrate Ireland yet, hence my curiosity. Did your dog get both legs done at the same time??!! Recovery time is supposed to be shorter, did you find that? How is your Goldie doin now?

The MMP is not really a different surgery, it is a TTA using a different implant than is usually used, which is claimed to cause less soft tissue inflammation.

tk123

Isn't that wedge/sponge thing just fascinating in that the bone just knits through it!? I thought it was mad lol! (the TTA Rapid implant has it too)... Anyways we're due in for a checkup this evening so hopefully we find out when Bailey can be released from jail lol!

3dogs

DBB wrote: »

omicron wrote: »

The current trend in treatment of osteoarthritis is moving towards intra-articular injections of platelet rich plasma to promote joint healing. It's taking off more in horses as far as I know but there are certain clinics that have the equipment to do it in dogs also.

Thank you for going to the trouble of finding those links, I appreciate it
I've heard of fantastic results from the platelet therapy in dogs... Must read up on it when I get a chance

My Vet ( In Slane,  think you know her  ) is looking into platelet therapy at the moment. She thinks it may be beneficial for my 4 year old