I'm looking for objective opinions of those of you who might have been through a similar situation

Our 50 lb. Aussie/Beagle mix is 7 years old. The vet recently determined she has a torn ACL. She said the surgery is elective...
Obviously it's expensive (quoted nearly $1,600) and no surgery is 100% safe. I'm also concerned for recovery with a toddler and 2nd dog in the home. I HATE to think she's suffering but the vet said she'd be fine either way. (she has occasional limping and her activity level has remained the same)

Has anyone seen a pet through this type of surgery? I'm trying to weigh the pros/cons objectively.

You can look things up on the internet and read every horror story and every heart jerker on the subject. It really comes down to what you are financially able to do and what you feel is right for your dog. ACL surgery is one option, Amputation is another option.

People will tell you it's the best thing ever, other people will tell you that it was a long, hard, painful and very time consuming recovery. The surgery does cost a lot and the dog is going to have to be kept very still for quite a few weeks.

Just take a few moments to think about the surgery and the constant attention your dog is going to need after the surgery. Are you going to have time for this? Can you afford the surgery without anything else being neglected to be paid? Can you keep her quiet and SANE at the same time?

When it comes to my dogs, I always choose quality of life over anything. ACL is an option, so is amputation. Amputation is a quicker recovery with less nursing needs for at home care. Its cheaper and there is no risk of the ACL of rupturing again.

HOWEVER... Typically with ACL problems, if one ACL is weak, the other is weak as well...

You need to talk to your doctor about the pros/cons of this surgery. Your doctor knows you, knows what you can and cannot do, knows your concerns and knows your dog.

Complete crate rest.

My mum has had 2 dogs do an ACL and both have recovered from total crate rest. It's not just pop the dog in the crate during the day though, it is complete restriction of movement for a minimum of 6 weeks. Yo carry the dog out to toilet and put it back in the crate.

Saves a lot of money but it is risky, things don't always heal as well and it is hard work keeping a dog entertained while confined for such a long period.

It is the surgery/recovery that concerns me. Quality of life is very important to me, which is why I'm still thinking on it. The financial burden will be dealt with somehow if that's what needs to be done.

Her size and the recovery you both mentioned is difficult to imagine. I can't carry the dog and with such a busy household, we'd manage but it would obviously be difficult...

Hmmmm... more to consider. Thanks both for your responses. I will discuss again with vet.

I had a 120lb dog recover from ACL surgery. It was hard because we had other dogs in and out of the house at different times, not to mention 2 cats. I live on a very rural area where the dogs basically get free run of 2 acres. It was very hard during the recovery time, but well worth it as he made a full recovery. I believe he was 8 at the time of surgery. I am pretty sure it was closer to $2,000 grand, but of course there is a big weight difference there. One thing I suggest is pre and post surgery, put your dog on a diet. This will help with recovery. I also had to take my Max to physiotherapy. Swimming was a great low impact exercise that tired him out, but didn't cause strain on the ligament.

I am wondering if the ligament is completely broken, or just partially torn, since he is getting nearly normal use from the joint. The ligament is like a cable... made up of thousands of fibers, all or only part of them may break. If this is the case, I suspect the ligament will completely fail in time with continued normal use, time depending on the extent of the injury, and the dog's activity. Usually, a simple miss-step, such as stepping into an unexpected depression, or hole, with a simultaneous slight twist of the leg will over extend the knee and subject the ligament to an abnormal force, often tearing it to some degree if not completely.

The type of repair is also a factor in the recovery time. TPLO, the use of a metallic surface covering the lower surface of the knee joint, requires a longer healing time, but is usually the strongest repair, if done properly. Previous successful experience by the doctor is desirable, although not a complete guarantee. This is the favored technique for heavier dogs, usually at or over your dog's weight. Larger dogs need a stronger repair, simply because of the forces produced by weight. There have been several simpler techniques used in the past, but these are now generally reserved for smaller dogs, if at all.

As Lucky said, many dogs that suffer an ACL without an apparent traumatic event will usually suffer another ACL on the opposite leg. This suggests a genetic predisposition for 'weaker' ACL's in some dogs. And it is often hastened by the extra pressures of limping on the injured leg during pre- and post-operative use (healing, post-op). Amputation is an option, but fairly extreme. When the other leg 'goes', what do you do? Non surgical cage rest treatment can be effective, and if you have an incomplete tear, may be a viable option. But it requires total dedication to the animal not using the leg. Some vets suggest putting something on the foot that the dog won't want to step on, so it carries the leg rather than trying to use it. If you can find something like this, it may work, but only for walking (not tugging on a leash) to and from the yard for "duty time". Ligament tears don't heal well, nor do they regenerate as a suture would. Time allows them to possibly 'adhere strongly' to each other.

In the final analysis, consultation with a trusted vet is usually the best option. Pose different alternatives to surgery and express your desire and commitment to do whatever is felt to be necessary (after you find out what it may be, of course!) The advice of others who have undergone this before must be considered in light of differences in techniques, dogs, and surgeons. Best of luck.

I must live in an expensive surgery area because both my friend and I paid closer to $3500 for ACL surgery. You are between and rock and a hard place. If elective then the dogs life style has to change and not for the better. No more running, jumping or chasing. I could not do that to my dogs and putting them down was not a consideration. The recovery was a bit tough but with a sling a dog can do fine on three legs, I'd go for it but get at least one more opinion, preferable from a specialized vet who does this surgery most every day.

Ballenger, you must have had your TPLO 'several' years ago. That was about the going rate then, and yes, location does matter.

A second opinion by a vet surgeon ( with DVM, ACVS after his name) would answer all the questions that you will come probably up with 'later', I suspect. Also, it would be helpful in whatever decision you have to make.

Thank you all very much for your well-informed answers. They are helping me tremendously. I am currently leaning toward surgery (amputation is not on my radar) but I will make a second consult appointment with our vet before deciding for sure. My hope (of course) is that Millie still has many years ahead of her so quality of life is paramount. It's the "details" that have to be worked out I suppose.

*VENT* Our vet is new to us, but I believe her to be good. (All four in the practice are DVM's) Our previous vet didn't do thorough physical exams and never properly diagnosed Millie's ACL tear, nor apparently a broken tooth she'd been suffering with. I have such guilt as a pet owner!

Aww that's too bad! It not your fault, we can only go what the professionals who we pay to help us care for our animals tell us.

I had a vet before I worked at my current job who used to fight tooth and nail with me about dog food. He used to tell me I was a negelctful pet owner if I didn't buy the Scient Diet that they sold in their clinic. He also told me one of my dogs was really under weight. I had only had her for a month and she was a rescue, so yea she was a little under nourished. He told me he was going to make a permanent record of that in her charts. I was furious, he sounded like he was implying I didn't feed my dogs. Anyone who knows me knows my dogs eat better than I do! Lol

I hope Millie makes a speedy recovery. She'll be in my thoughts! :)

My Rott tore her ACL. While recovering she slipped and tore the second ACL. We kept her quiet but not crated (we had 3 dogs at the time). She made a full recovery.

This was about 7 years ago and I think the surgeries were $2,500 each. As it happens she died about 10 months later from something totally unrelated and was "only" 6 years old.

She spent most of her time trying to remove the bandages but had a very smooth recovery. She DID have a slight limp following the surgeries, though. Swimming was recommended for her but she didn't like the water so that idea went nowhere.

Would I do it all over again? Yes, without hesitation.

All 'vets' in a practice are supposed to be DVM. The ACVS after that means a board certified (bona fide specialist), American College of Veterinary Surgeons. This isn't required in order to do surgery on animals, but indicat3s several years more of clinical experience and learning, plus a rigorous exam by experts.

Too often the diagnosis of ACL is left to a manipulation of the knee... with a broken ACL, the knee has abnormal front-back movement. Sometimes this is misinterpreted... how much is 'too much', and did the person do the manipulation correctly? Anaother place where experience 'helps'. Whoever you feel comfortable with doing the surgery (if you should so elect) will be the one to really be able to tell you what to expect.

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Originally Posted by paleophlatus

All 'vets' in a practice are supposed to be DVM. The ACVS after that means a board certified (bona fide specialist), American College of Veterinary Surgeons. This isn't required in order to do surgery on animals, but indicat3s several years more of clinical experience and learning, plus a rigorous exam by experts.

Too often the diagnosis of ACL is left to a manipulation of the knee... with a broken ACL, the knee has abnormal front-back movement. Sometimes this is misinterpreted...how much is 'too much', and did the person do the manipulation correctly? Anaother place where experience 'helps'. Whoever you feel comfortable with doing the surgery (if you should so elect) will be the one to really be able to tell you what to expect.

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Great info! My "Vet" referred us to a specialist who did the surgery. I should have asked about his credentials but I did not.

Again, great info.

I don't know if ACL is graded on the same level as the Patellar luxation, but sometimes dogs can live with these bones and tendons out of wack due to no pain being present.. even if the level of the issue is high.

So it depends on your dog as well.. If your dog is really feeling it, then surgery is a yes, if the dog is perfectly fine, then surgery is at the discression of the owner. Of course a DVM is the one to determine pain level and will push surgery if need-be.

$3500 and $2500 is a lot! Fort Collins Veterinary Teaching Hospital charges $1600 for ACL... And if you want to talk about expensive vets.. they're the ones! But they only take the major or weird cases...

And unfortunately, if one ACL is weak, the other is too.. So I hope the OP is prepared for ACL #2 to go soon.. :(

There's considerable difference between patellar and knee problems. With a luxated patella, the patella has jumped out of the bony groove and lays to the side of the knee, away from any bone to rub on.

However, with the knee, it is almost the opposite case. The knee joint is one in which bone meets bone, and move against each other. Even though it looks like a hinge joint, the bones also slides a bit on each other as the knee flexes. It is this sliding, or 'gliding' motion that is regulated by the cruciate ligaments (ACL and PCL (for posterior). They both cross each other, hence the name 'cruciate'.

There is another 'soft' structure in the knee, the 'Meniscus' cartilage, a long, thin cartilage, curved to fit the contour of the top edge of the lower bone (tibia), and helps keep the upper bone (femur) centered on the tibia by filling the space between the two bones, around the edges, which also resists the lateral tipping of the joint. The moving portions of the bones in a joint are also covered with an 'articular' cartilage, which protects each bones if they touch. The whole joint is contained in a 'joint sac' which contains lubricating 'synovial' fluid. It also helps stabilize the joint. Outside this is a tough, fibrous sheathing, strongly attached to the edges of the tibia and femur that provide even more stability to the joint.

As the leg is extending, the femur and tibia rotate (roll) on each other. As the knee nears full extension, the curved shape of both bones changes (where they are touching) so that the joint shifts from a rolling to a gliding type and the ftibia slides, a short way, backwards under the femur. It stops it's glide rearwards when the ACL reaches the limit of it's length. If the tibia twists slightly, this further tenses the ACL. It is in this condition that it is usually torn, whether it is a dog stepping into an unexpected depression, or a fullback hits you when your leg is extended as in a running step. I had a client one time, whose Springer went swimming and got out of the pond with a ruptured ACL. How? The owner said he heard her 'yipe' as she neared the edge of the pond. Can't be sure, but I presume her rear foot hit the rising bottom of the pond at some point as she had 'reached' and was pulling her foot back in a swimming motion. So, "Nowhere is absolutely safe", it would seem.

The popular (and expensive) TPLO procedure "replaces" the flat 'plateau' of the tibia, thus the name Tibia Plateau Leveling Operation. Basically this stabilizes the joint by making the curved tibial plateau flatter (actually sculpting the tibia bone), and less angled downward. There is no longer a need for either cruciate ligament.

As one may suppose, bone rubbing on bone is uncomfortable, especially when the articular cartilage wears off and you have actual bare bone on bare bone This stimulates arthritic conditions to form in the affected joint and is the expected, eventual result to an untreated knee injury, other conditions permitting.

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Originally Posted by Aurora_Bell

Aww that's too bad! It not your fault, we can only go what the professionals who we pay to help us care for our animals tell us.

I had a vet before I worked at my current job who used to fight tooth and nail with me about dog food. He used to tell me I was a negelctful pet owner if I didn't buy the Scient Diet that they sold in their clinic. He also told me one of my dogs was really under weight. I had only had her for a month and she was a rescue, so yea she was a little under nourished. He told me he was going to make a permanent record of that in her charts. I was furious, he sounded like he was implying I didn't feed my dogs. Anyone who knows me knows my dogs eat better than I do!! lol

I hope Millie makes a speedy recovery. She'll be in my thoughts! :)

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How sweet. Thank you :)

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Originally Posted by paleophlatus

All 'vets' in a practice are supposed to be DVM. The ACVS after that means a board certified (bona fide specialist), American College of Veterinary Surgeons. This isn't required in order to do surgery on animals, but indicat3s several years more of clinical experience and learning, plus a rigorous exam by experts.

Too often the diagnosis of ACL is left to a manipulation of the knee... with a broken ACL, the knee has abnormal front-back movement. Sometimes this is misinterpreted...how much is 'too much', and did the person do the manipulation correctly? Anaother place where experience 'helps'. Whoever you feel comfortable with doing the surgery (if you should so elect) will be the one to really be able to tell you what to expect.

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Thank you again for your sound advise. I misspoke with the "DVM" comment when I replied earlier. (of course they are all DVM's -silly me!:rolleyes:)