What is an ACL? ACL (Anterior Cruciate Ligament) or in veterinary medicine, the CCL (Cranial Cruciate Ligament) is located in the knee. The knee, known as the stifle in animals, is an amazingly dynamic and complex joint that enables the dog or cat’s body to move in multiple directions with competence at speed as well as when walking at a more leisurely pace. The stifle is comprised of two main sets of ligaments that maintain the stifle’s integrity. Those ligaments are the medial and lateral collateral ligaments and the cranial and caudal cruciate ligaments. There are also two very important shock absorbing structures in the stifle called the menisci (meniscus).
How do I know my pet’s ACL is injured? First, it is very important to get a diagnosis by a veterinarian. Cruciate ligament injuries are typically characterized by acute onset lameness which is often non weight bearing on the affected limb typically after running or jumping. In other words, the first sign is unresolved limping. It is most common in middle aged overweight pets but can occur in pets of any age and physical condition. A surgical consultation for a stifle injury typically involves a physical exam, x-rays, and sometimes blood work to determine the extent of the injury as well as what is the best surgical technique for your pet and your budget.
Why surgery? The lameness after the acute injury will typically improve after a few weeks with anti-inflammatory, pain medications, and rest. However, the instability in the joint will persist and, if left un-repaired, will frequently lead to meniscal damage and eventual osteoarthritis in the stifle. Surgical repair of the CCL and meniscus stabilizes the stifle and moves the damaged tissue, allowing the best prognosis for return to pre-injury athletic ability and prevention of osteoarthritis in the future.
Why go to Dr. Kimmel at QCAH? Dr Kimmel has been performing stifle surgeries on cats and dogs for more than 10 years. His continuing education focus over the last few years has been on state of the art stifle surgery techniques to get our little furry athletes back on the field. Quail Crossing is equipped with cutting edge equipment by Arthrex, an industry leader in human and veterinary orthopedics. Lastly, Dr Kimmel has had surgery on both of his ACL’s and has a first hand understanding of what it’s like to be an ACL post-op patient.
What to expect: CCL surgery is performed on an outpatient basis which means you will bring your pet to the hospital on the morning of the procedure and they typically go home in the afternoon. The surgical site is anywhere from 5 to 10 inches in length depending upon the size of your pet and is usually closed with sutures that are under the skin and not visible. Swelling of the stifle is to be expected over the next couple of days and icing of the area is recommended as tolerated. Discomfort is usually mild to moderate and tapers off over about 24-48 hours. Pain medications, anti-inflammatories, and sometimes mild sedatives are used to keep our little friends as comfortable as possible.
The surgery to repair a torn CCL or damaged meniscus involves invasion into the stifle joint as well as placement of bone anchors and screws. Bones take anywhere from 6-8 weeks to heal. That being said: Your pet will be on restricted activity for a minimum of 6 weeks! By restricted activity, we mean crate rest only and short leash walks to relieve themselves, that’s it. Ensuring a good outcome from surgery is 50% the surgery itself and 50% your pet and adhering to the post-op guidelines.
Does he or she have to wear the “cone of shame”? YES! For 10-14 days after surgery without exception they will be wearing an e-collar. You may think, “I know my dog, and he wouldn’t chew open his incision”, trust us, he will. E-collars are annoying and problematic, we get it, but two weeks of inconvenience outweighs the complications that can come from your pet’s own worst enemy after surgery, themselves!
Post-op follow up appointments are important to evaluate the healing process and are usually within 1 week of surgery, 3-4 weeks, and again at 6 weeks. Immediately after surgery, the patient is usually completely non weight bearing on the injured limb. After 1-2 weeks, they will still typically hold the leg up, but will start placing it on the ground when standing. At 4-6 weeks, they are usually walking on the leg, albeit with still some lameness evident. Regaining strength in the limb and a return to full function can be expected to take as long as 6 months or sometimes longer depending on the extent and duration of the injury, but the majority of patients go on to do very well.
All of us at Quail Crossing will be with you every improving step of the way!
How much will this cost? We understand that your pet’s health is important to you, but not all of us have countless dollars to spend. With that in mind, we aim to give you the best price on CCL stifle surgery we can. Typically, the cost of surgery will be around $2,000. Please call the office for more accurate pricing and to make your consultation appointment ($50).
Dr. Kimmel and the rest of the staff at Quail Crossing Animal Hospital
look forward to speaking with you!
Note: Some patients, depending upon their activity levels or joint confirmations, may be better served to see an orthopedic surgical specialist and, when this is the case, we will always put you and your pet in the most capable hands to ensure the best possible return to function.
Meniscal Injuries: CCL (ACL)
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