My Dogs ACL Knee Surgery

Note: February 5, 2016 Cassie crossed the Rainbow Bridge. She was nearly 17 years old and provided joy and companionship to us for all those years.  She is deeply missed.  Below is a description of her progress with two ACL surgeries several years ago.

I didn't know a dog could blow out it's knee ligaments. But after my dog tore both of hers over a two year period, I've come to learn it's not an uncommon experience.

In the summer of 2009, our mixed breed dog, Cassie, tore her rear knee acl chasing squirrels in the backyard and required surgery to repair the torn ligament. At the time I knew nothing about this process, however, it was successful and she has made a full recovery. The following narrative reports her recovery and the process involved. This account includes the surgeries from two acls, having torn one knee ligament one summer, then tearing the other rear knee ligament the following summer. Cost for this surgery varies across the country. My vet charged $1200 for the surgery and follow-ups.  I had called around prior to going with the surgery and had estimates as high as $3500.

On 6/13/09, around 11 am our 10 year old Cassie was enjoying her daily romp chasing the squirrels in the backyard.  I was weeding the garden and heard her bark at the squirrel and take off chasing it.  She suddenly stopped, and was holding up her rear leg.  I picked her up, carried her into the house and tried to determine what she had done.  It was obvious she had hurt her leg, but I couldn’t determine exactly what was injured. As it was a Saturday, my regular vet did not have office hours.  I scoured the phone book, before finding a vet’s office that was open.  The vet, Dr. Singh in Niles, Ohio agreed to exam Cassie.  In short order, he determined she had torn the ligaments in her right knee!  

Surgery was scheduled for Monday, June 15th. Dr. Singh in Niles, Ohio, performed a Lateral Fabellar Technique (Extracapsular Technique) . From what I’ve researched, this is more successful for smaller, light weight dogs. Cassie is a small framed, Sheppard/Terrier mix and weighs about 28 pounds. We were assured she would recover, but just didn’t know how successful the recovery would be.

Fortunately she has done really well. Our thanks go out to Dr. Singh and his staff for their willingness to see Cassie on an emergency basis, the compassion of Dr. Singh and the staff, and the success of the surgery. The following time frame may help you understand the process a dog may go through.

Week 1:

We left Cassie at the vet’s office Monday morning.  She stayed overnight and we picked her up the next afternoon.  Surprisingly she hobbled to us on three legs, wagging her tail, but obviously groggy.  Our instructions were to keep her as inactive as possible, allow her to eat normally and to keep the incision dry.  She had about 6 inch incision on her leg.  The entire leg had been shaved.  We commented it appeared to look like a chicken breast.

The first night she wet herself, probably from the pain medication that kept her sedated. On the third day, there was some swelling in the heel area. The vet re-examined her and instructed us to massage this area several times a day to dissipate the fluid. After three or four days, the fluid build up had disappeared.

I would carry her outside often during the first week to limit her use of steps, and she was able to move about the yard on three legs fairly well.

Week 2

A week later the vet removed the sutures. He demonstrated the therapy exercises he wanted me to perform on Cassie. Basically they were stretching of the leg in various directions. During this week Cassie began toe-touching with the leg when outdoors. She did this more for balance rather than actual weight bearing.

Week 3

The third visit to the vet resulted in more therapy techniques. Cassie is showing more weight bearing on her leg and is adjusting very well.

Week 4 -8

By now Cassie is showing more and more use of the leg. She was released from the vet’s care during the sixth week after surgery. She shows weight bearing on the leg and runs. I’m still cautious about letting her run too much but she seems to tolerate it well. I began short walks with around the 6th week and have extended the length of the walks each day. By week 8, she is walking fairly normal, although there is a slight limp. Her thigh muscle still has not fully regained its regular strength as it had atrophied significantly during the initial few weeks.

12 Weeks after surgery

Three months after surgery she is fully active. Her muscle mass in her thigh appears nearly equal to the non-surgical leg. Our walks are up to 30 minutes. She still limps a bit, but it is hardly noticeable. She runs, jumps and seems like her old self. When standing, she tends to put more weight on her non-surgical leg and often will limp real noticeably when she first gets up from laying down. Overall, I am quite pleased with her progress. It appears she will make nearly a full recovery, if not a complete recovery. She runs and walks with ease and can jump on and off the bed although we still try to deter the jumping.

Our walks have returned to pre-surgery length of 20 to 40 minutes. She can run, jump and do all that she did before. She does limp and favor the leg when she first starts to move, and this is as the vet told us would occur. He also said she’ll likely develop arthritis as she ages. She’s currently 10. She takes Synovi daily. Dr. Singh prescribed this to minimize the arthritis. Overall, we are very pleased with her recovery.

Surgery Number Two

Fifteen months after her first surgery, Cassie takes off after a squirrel, runs about 20 feet and comes up lame on her right rear leg. I knew immediately what she had done. The vet had us bring her to his office to check the leg. He confirmed the other knee ligament is torn. Surgery was scheduled for early Friday morning, the 23rd of September, 2010

I took Cassie to the vet's office at 7am. By 9:30 I received a call from the vet that her surgery was successful. I picked her up Saturday morning. From last year's surgery I knew what to expect so our anxiety was less regarding her condition. Cassie is permitted on our couch and bed, therefore we had to make sure she didn't try to jump up and down.

During the first week, this is relatively easy since she just seems to know she is unable to do this. We keep her on the couch and spend a lot of time making sure she stays there. Since we're retired, one of us can usually be in the room with her. Last year she had some swelling around her ankle and foot of the repaired leg, but this time that did not occur. The inside of her leg where her fur was shaved was pretty irritated, just like last year. We put Dissident on this figuring if it is okay for a babies bottom it should be fine with her. We just had to make sure she didn't lick this.

By the end of the first week, her incision seems to be healing pretty well. The redness is basically gone. Within a week, she is beginning to use the repaired leg to support herself when going to the bathroom although it is more a "tapping" motion to maintain balance. She still walks using three legs.

Two weeks after surgery Cassie visited the vet to have the sutures removed. The vet is pleased with her recovery. Over the next three weeks I will begin therapy on the leg to strengthen the thigh muscle and improve the motion of the knee joint. She'll have another follow-up in 4 weeks. 

Three weeks after surgery Cassie is beginning to put some weight on her leg. Outside she'll put the leg to the ground when standing still sniffing the grass. She's started to tap it lightly to the ground when walking, however, most of the time she moves on three legs. Her progress appears good. Four weeks after surgery and Cassie still is not showing much weight bearing on her leg. It appears the muscle atrophy is the bigger issue as she doesn't have the strength in the thigh muscle to support her.

I've begun the second phase of therapy whereby I lift her good rear leg and force her to stand on her repaired leg. She can do this for only 10 seconds or so. Other than that she appears to be her normal self, is alert, eats well, and enjoys the yard. It's been five weeks since surgery. There is still not much weight-bearing on the repaired knee. She tries to use it about 30-40% of the time although if she runs she appears to use it. There is some noticeable improvement in the muscle tone of the thigh and she moves about the house in her normal fashion, but most of the times uses three legs. 

Cassie had a follow-up checkup with the vet six weeks after surgery. He is pleased with her progress. No swelling and the knee joint is tight. I have begun walking her around the block this week. She limps, but uses the leg nearly 90% while walking the block. The vet also wants me to continue stretching the thigh muscle to help build it up. Around the house, Cassie uses her leg about 70% of the time. The home is all hardwood floor or laminate floor and she doesn't seem to feel real comfortable on them.

Seven weeks since Cassie had her surgery. Her recovery is pretty much the same as reported last week. The short walks around the block continue, but by the end of the walk she is limping noticeably and occasionally will go back to three legs. It appears the thigh muscle tires. Overall she seems to progressing fairly well, but it seems the recovery is slower this year as compared to last year. After all she is 11 years old. Eight weeks after surgery. Cassie still limps, especially when initially getting up on her feet from a resting position and occasionally will hop on three legs for a short time. Her recovery is definitely slower this time. Perhaps she'll always have a limp and be somewhat lame with this surgery. Walks are limited to around the block, but she is active in terms of her exploring the yard. I don't know if her knee joint bothers her or it's the lack of muscle in the thigh, but she does not seem to be bothered much with her leg.

At about nine weeks after surgery,   Cassie is moving around pretty good. Only rarely does she walk with three legs. However, when she first stands up, she walks with a noticeable limp. Once she gets moving, she still limps, but it is less pronounced. I continue some stretching of the thigh muscle and short walks. She remains active in the yard.

By 10 week she uses her legs practically all the time. The thigh muscle is still smaller than the other leg, and she noticeable favors the most recent surgically repaired leg when initially moving, but once she stretches and begins moving on it, her limp is minor. It appears her recovery has been good, but has been slower than the knee surgery on her other leg last here.

By 12 weeks after surgery  Cassie is doing fairly well. She seems to experience stiffness when first standing, but once she stretches her most recently repaired leg, she moves fairly well. There is a slight limp, but she is able to run and jump well. Part of the stiffness may just be age; she is 11 years old.

Cassie celebrates her 12th birthday  in 2011 and is doing well. She runs and jumps well, although her age limits extended periods of outright running. More than anything else, she has developed stiffness in her left front leg, which she favors when she gets up. Just like us, her joints are stiff and probably a bit sore.

Cassie is 14 1/2 and still relatively healthy. Her rear knee joints are stiff and she struggles to sit down and get up, but otherwise moves fairly well. She doesn't run much anymore, but still wanders around the yard. She no longer chases the squirrels, although she will give them a bark or two at times.

In two months Cassie will be 16. Overall her health is fairly good. The vet believes she is experiencing hip displasia as she appears to have some difficulty walking well and when she does run, it is more of the bunny hop associated with hip displasia. Her knee surgeries have held up well however. She sleeps a lot and when not sleeping, paces about the house. I figure this is good exercise for her. Her appetitie remains good.

On 9/1/15 Cassie turned 16.  In general her health is good although her activity is very limited, she sleeps a lot and moves rather slowly.  She can no longer leap onto the bed or couch and has difficulty going down steps.  Her vision and hearing are poor, otherwise she is healthy for a 16 year old dog.