Following Pt 1:
Common Cruciate Repair Options
1) Surgery (one of the so-called “leveling osteotomies” is recommended for medium and large breed dogs, the one at Eltham Veterinary Practice is a “TTO”).
2) Surgery (a procedure called an “Lateral Suture repair”— considered a good option only for smaller breeds) …and when funds are scarce:
3) Rest, anti-inflammatory (pain) medication, weight loss and nutraceuticals. It works great in conjunction with 1)and 2),but is usually unsatisfactory without surgery.
The most commonly reported rule of thumb is that cruciate injury patients weighing over 12-15kg are best served by the surgical procedure called TTO (Triple Tibial osteotomy) or TPLO (tibial plateau levelling Osteotomy), which employs cutting the bone, leveling it, and holding it with a metal plate to help stabilize the joint.
This type surgical procedure is typically done by a specialist surgeon. However a regular vet like myself who has a special interest in surgery and orthopaedics, has taken a certified course and gained the experience can be a very good option. It allows you to get your dog treated locally (we like to see your pet a few times after the surgery to ensure recovery is going to plan) at a practice where they are (hopefully) more comfortable, and generally for less expense.
The price of this repair typically ranges from $3,500 to $5,500, (higher with a specialist surgeon).
Lateral Suture Repair
The next most common surgical approach is called a Lateral Suture repair. Dogs may appear to gain some immediate relief with it but in the long run it doesn’t statistically compare to the success of the TTO/TPLO approach in the larger breeds most commonly afflicted.
The price of this procedure runs from $1,500 to $2,500.
Who should I choose to do the surgery?
As with many medical procedures, the frequency with which the surgeon performs either of these surgeries is an excellent indicator of proficiency. In fact, cruciate repairs are one area in surgical vet medicine where skill is considered especially critical to success.
I would say that while these surgeries are commonly done, they difficult to do well and the prices for this procedure usually reflect this —ultimately, it’s up to the individual buyer to beware of the competency of their chosen surgeon—and it’s not an easy task.
Then there’s the issue of hospital policies and procedures and the cost of these oft-unseen variables. Eltham Veterinary Practice spares no expense when it comes to materials and staff and other safety nets designed to provide the best surgical outcome possible.
What happened to JASPER??
Jasper had a TTO surgery at my hands a couple of days later and after 2 nights in hospital, he walked out the door, happy to be heading home.
This is Jasper today visiting our hospital 6 days post-surgery, and as you can see, he is back to his happy self! His owner knows he has to be kept confined for the next 3-4 weeks while the bone is healing. After that, he can progressively increase his walks to rebuild his thigh muscles, and should be fully functioning in about 4-6 months.
It’s also important to keep his weight down and keep him fit for a good long term outcome, and we recommend regular Zydax (cartrophen) injections to help prevent arthritis.
Dr Steve Pryor BVSc MACVSc (Surgery)