Nonsurgical perspectives on CCL diseaseOctober 24, 2018Part one of this series discussed managing owner expectations, strategies to protect the sound cruciate, diagnosing ligament and meniscal damage, and joint irrigation/visualization. In this continuing series on nonsurgical management of the injured cruciate, I will begin by discussing joint injectates.
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Nonsurgical treatment of CCL tearsAugust 17, 2018The message was from a colleague, a veterinary surgeon who was referring a Tosa Inu to Georgia Veterinary Rehabilitation Fitness and Pain Management, my rehabilitation-only practice outside Atlanta, for bilateral CCL tears. The owners had declined surgery for Mei Mei, a very lean 8-year-old 160-pound intact male who lumbered into my office with a significant limp in his left hind leg and short striding in the right hind. After confirming what my colleague had found—bilateral cranial drawers, medial buttressing, effusion, and a significant click on the left side—I discussed how to treat a torn CCL with the owners. As a board-certified rehabilitation specialist, I am the first person to recommend nonsurgical treatment for cases in which it is indicated, and in my opinion, this was not one of them. I have had great success treating torn CCLs conservatively in dogs less than 30 pounds or less active, older, and generally smaller dogs. Although not an active dog, Mei Mei certainly wasn’t small. However, Mei Mei’s owners were moving out of state in 11 days to an area with dozens of acres. He had not healed well from a mass removal on his hip the month prior and had chronic skin infections. Surgery was out of the question.
