9 year old Boxer Limping / Torn ACL - Is surgery really the best option?

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savgirl

Boxer Pal
Hello everyone! I am hoping to get some advice from fellow Boxer owners. My 9 year old Boxer, Sampson, has torn his ACL. He tore the first one about 3 years ago, so we knew this would probably happen to the other leg sooner or later. I am EXTREMELY nervous about having the surgery this time due to his age. He doesn't act like he is 9, not at all. Still wants to run and play. But with this tear, he is walking on his leg. Still climbing stairs, still can get on the furniture. We have also been taking him to water therapy every week. With the first tear, he wouldn't even put his leg down. We do notice that when he is standing still he toe touches alot, and I can tell he isn't putting his full weight on that leg when he is just standing. Can anyone give me some advice on what to do? I love him and will do whatever is best for him, but I am so on the fence about this, especially since he is still walking on it. They gave us Metacam and a joint supplement. We haven't started the Metacam yet, but plan to. He had a high liver enzyme (one that has been high since he was a puppy) and they want us to give him medicine to help protect his liver before we start the Metacam. Any advice would be greatly appreciated! Thank you so much! I just want him to be happy and healthy, and know that I have made the best decision for my Boxer boy!
 

savgirl

Boxer Pal
That article is very interesting, and definitely gives me more to think about! I have his surgery scheduled for September 19, because my Vet said if I wait months to do it, it will be too late. Here is an email from me to my vet:

I was hoping you could answer a few questions for me.

Answers below – let me know if you have more questions -

I am really on the fence about putting Sampson through surgery again. I am hoping you can put my mind at ease. I know when we came to see you, you mentioned laser therapy? Can you elaborate a bit on this and would this be an alternative to surgery? We have started taking him to water therapy as well. -

++++ not an alternative - just for pain control and rehab

Also, if we do try the laser therapy first, would it be possible to hold off on doing the surgery if it is still needed until December?

+++ sooner the better, if wait too long or much longer arthritis makes it so painful surgery doesnt help nearly as much.

I know you said that if we wait that long the surgery would be pointless but I am confused as to why this is. My husband and I do not have a lot of vacation time, and his company is closed the last week in December so this would work out perfect for us if we could wait. But I would want you to do they surgery, so I also want to make sure you would be there on December 19.
I do have the surgery scheduled for September 19 as of now, I guess I just want to make sure I am doing the right thing, and if you think we should go ahead with it then we surely will.

+++ i think you are doing the best having it done sooner versses better.


For me it is so frustrating trying to make the best decision for Sampson. I am afraid that no matter what I choose, it will be wrong. Has anyone here ever opted NOT to have the surgery, and if so, how did that work out?

Thanks so much!
 

Tessa

Boxer Booster
We tried conservative management with Tessa, and ended up doing TTA surgery a little over a year later. She had surgery in Novermber 2012 and is back to full speed. We thought conservative management was amazing at first...no surgery and she stopped limping. In hindsight, she never really recovered doing the conservative management approach. She was not nearly as active after that as she is post surgery. I wish we had gone the surgery route right away.

Nobody can tell you what the right decision is and it's a hard decision to make. I can tell you that if it was me and my dog was 9 and I said that you would never know he/she was that old, I would go the surgery route now and try to get them back to the best quality of life ASAP to enjoy the rest of their years. That's not the only choice or the right choice necessarily, just what I would do.

Good luck and let us know how things go!
 

MichBoxerMom

Boxer Buddy
Just my opinion.... but I would do cold laser therapy 2x a week for 2 - 3 months if possible. My boy was diagnosed with OCD at 6 months old and the specialists said the only way to repair was surgery. He gave me the option to strict rest him for 2 months and a recheck. This is what I did. I took him twice a week for those 2 months and put him on a very high quality glucosamine/ chondro - 2 months later he was like a new dog and the specialists cant believe it.
 

boduong

Boxer Pal
I'm going through the same decision making process right now for my dog Mickey whose 4 years old AND I feel you 'cause we all want whats best for our dogs. Activity level hasn't changed and he doesn't yelp in pain or anything. All he does is lift that leg up periodically but his ability to jump as high or run as fast for long is decreased. They told me that the other leg would eventually face the same predicament down the line because signs of inflammation was already present. The vets told me its easier to do one leg at a time.

After seeing two different vets, this is the message I got-
1. Vet #1 (my normal vet) -- He has a torn ACL. TPLO surgery was best . It should be done ASAP. In the mean time I was given an anti-inflammatory (Rimadyl). **TPLO surgery involves shaving down the tibia,releasing the meniscus, rotating the bone putting plates in. TPLO is the traditional surgery performed by most surgeons.

2. Vet #2 (orthopedic specialist) not affiliated with my vet. TTA was another option. This was an "elective" procedure. This vet had good success with boxers and this surgery - possibly due to anatomy of boxers. TTA surgery involves cutting the front part of the tibia which is not weight bearing at an angle and recreating a hinge with plates and using the patellar tendon to recreate angulations for movement... not all dogs are candidates though and factors are involved to allow for this surgery too but not all orthopedic surgeons are well versed in this surgery to perform it since its only been around since 2005 i believe. I can't find a lot who do both TTA and TPLO right now to get a non-biased opinion on different surgeries which made my decision more difficult on TPLO or TTA.

During both procedures, I think they clean out the meniscus-- thats the part that cushions the bone to bone interaction between joints. IF you wait to long and theres too much damage to the meniscus AND thats when surgery repair is not possible.

From my perspective, I think TPLO vs. TTA vs. conservative treatment are all good options and you can never predict what might happen 100% because they can still have arthritis in the future and we are all concerned about the quality of their life. Im leaning towards TTA surgery at this point because i don't want to wait too long and not have the option for surgery but also because TTA seems to be less invasive and allow for faster recovery. But I will admit there are days when I make sure he only goes for leash walks that I see some improvement in his legs... and this makes me consider prolonging surgical treatment.

Good luck with everything!
 

savgirl

Boxer Pal
Thank you everyone, I appreciate all your feedback! I am waiting on an email back from our vet right now. We have decided that if possible, we are going to try conservative management and water therapy until December, and if he is the same as he is now (just toe touching once in a while) we will go ahead with the surgery (that is if my vet is in the office in December FINGERS CROSSED!). My Husband is off of work the last 2 weeks of the year, so someone would be home with him 24/7 for at least 14 days after the surgery. I know my boy, and he chews, even with the collar on! He actually tore one of those collars to pieces once and still chewed the staples out!! Not to mention he ingested some of the plastic from the E -Collar ( I really hate those things!) So I really hope to be able to wait until December just for the simple fact that someone can be home with him. If not, I guess we will do the surgery on September 19, which I have scheduled at the moment. Our vet does just a Lateral Suture Stabalization surgery, not the TPLO or TTA. Sampson had his first surgery three years ago on the other ACL, and did very well. His age just scares me at this point, and now the vet wants to do an EKG before the surgery (he said they don't normally do this for all patients.) Either way this plays out, I am going to take him and have his heart checked just for my own piece of mind before the surgery is done. Thank you all again for your comments!!
 
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savgirl

Boxer Pal
we have decided to wait....

So my husband and I have decided to wait until December to do the surgery. Our vet is not happy with us. I felt like he was really pressuring us into surgery. Now, he is stating that he may or may not be able to do the surgery in December because arthritis might be too bad. I find that EXTREMELY hard to believe that it will be that bad in just 3.5 months. We are restricting his activity, doing water therapy and some home therapy as well. The email I received back from my vet now states that all of his blood work will need to be re done and also his heart needs to be checked. I am so upset with our vet at this point, because if a heart problem is suspected, then Sampson needed to be checked BEFORE the surgery anyway that was originally scheduled for September 19. I think in the next few months I will have a COMPLETE exam done on him, because apparently one of his liver enzymes is high (this one has ALWAYS been high since he was a puppy). I just feel absolutely defeated and frustrated at this point, and I hope we are making the right decision and that he can still have the surgery in December if needed. I just love Sampson so very much, and want what is best for him, just like we all do. I really feel like waiting until December is best for Sampson as well as for us because like I said in my last post either my husband or I will be able to be with him the entire 14 days following surgery.
 

boduong

Boxer Pal
I agree. get a second opinion. they won't know the damage in the meniscus fully until they get in there. but do make sure you restrict activity. I've already gotten three opinions.
 
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