An Anterior Cruciate Ligament (ACL) surgery is a LARGE operation and you need to prepare your home environment, possibly your work roster and mentally prepare for it! It is also a large financial investment in your pet's quality of life including its mobility and activity levles, and minimization of arthritis and pain.
When your pet has injured one of its back legs, and then is in need of cruciate surgery:
1) Immediately restrict your pet's activity to prevent injury to the other hind leg (or its back, its front legs ... or further hurting the already injured hind leg)!
2) Get to a Vet as soon as possible so that treatment can be started to minimise pain and inflammation.
3) Prepare your home for when your dog returns after surgery.
4) Wash your dog the day before its operation, and 5) Ensure your dog has been to the toilet on the morning of the surgery.
1) Restrict its Activity - IMMEDIATELY. AS SOON AS your dog has hurt one of its legs, you must restrict its activity (even confine it) because dogs very soon 'bounce back' and will want to run, jump and play as much as before the injury, ONLY now on THREE LEGS. This means that the opposite leg to the one initially injured is at EXTREME RISK of being injured itself and many dogs will injure their OTHER leg's ACL with in a few days. By 3 months, statistics show that between 40 and 60% of dogs have RUPTURED THEIR OTHER ACL!!!!
Restrict it to a Leash so it doesn't run around or play.
If you have a Cold-Pack or a frozen bag of peas, wrap in a tea towel and apply gently to the front and the outer (lateral) side of your dog's knee stifle. This reduces blood flow, thus slows swelling and slows inflammation. Apply for 1 to 3 minutes, less for small dogs and longer for large. Not only will this help at the time of the injury, BUT immediately AFTER your dog's surgery, we will provide a Cold-Pack for you to use in this manner, and using beforehand hopefully will help your dog's acceptance of it after surgery. A Cold-Pack is best kept in the FRIDGE and not the freezer, because it remains soft and can be moulded around the knee giving much more contact and comfort than a rock-hard frozen block!
2) Get to a Vet as soon as you can. You will be given pain relieving antiinflammatories AND advised to have X-Rays of your pet's stifle, hips and possibly its lower back (in older patients). An anaesthetic and X-rays will be advised to determine what injury is present and its severity, plus assess the other joints, including the hips and often the lower back. This is important as it helps us determine what surgery is best AND how well your pet will cope with the recovery period.
The ligaments are accurately felt and assessed under an anaesthetic and is how a cruciate injury is diagnosed. The x-rays provide supportive evidence in cases that are less obviously a full rupture of the ACL, but are able to tell us the severity of secondary changes in the stifle (knee) eg arthritis and degenerative changes that sart as soon as the injury occurs. An x-ray is important because sometimes it is NOT an ACL injury at all and bone fractures, bone cysts, bone cancers, dislocated patellae (knee caps), hip dysplasia and back issues are often found.
Commence the Pain relieving, Antiinflammatory tablets IMMEDIATELY. Injuring an ACL is VERY painful because the stifle is now unstable and swollen, and any attempts to place weight on it cause the lower leg (tibia) to wobble forward STRETCHING the sensitive joint capsule (that is full of nerves). The torn ACL weeps inflammatory fluid into the stifle joint, causing it to swell and tighten - which is painful - but also less weight can be placed before the unstable tibia causes pain. You WILL be prescribed pain relieving antiinflammatories by the vet.
The inflammatory fluid ALSO contains destructive inflammatory enzymes and chemicals that attract more inflammatory cells to the area.The enzymes damage the cartilage and the whole process is the beginnings of ARTHRITIS.Confining your dog helps the pain relief work better as well as minimizing more damage.
3) PREPARING YOUR HOME FOR YOUR PET'S RECOVERY FROM SURGERY. This is SO IMPORTANT !!! Remember how many dogs rupture their OTHER ACL within a very short time and, after surgery, your dog will initially still not want to place much weight on its leg that had surgery! The Isometric Ligafiba surgery gives the earliest return to weight-bearing, some placing 10-20% weight on their leg as they walk out after surgery. This helps minimize injury to the other leg's cruciate by allowing earlier sharing of the body weight BUT you must prepare some sort of CONFINEMENT for your dog.
*** We advise STRICT CAGE (or similar) CONFINEMENT after cruciate surgery for TWO WEEKS initially. We provide a confinement cage FREE for FOUR WEEKS for small to medium pets (you must pay a cage deposit fee, but you get this back on its return).
It is a great idea to pick up the confinement cage a few days before your pet's surgery and introduce it to the cage. Give it treats in the cage, feed it in there, have it lay in the cage while you watch TV next to it so that the cage becomes a wonderful thing!
4) Give your dog a bath the day before its operation. This may not be feasible but all humans are asked to have a shower beforehand ... it helps reduce skin bacreia, remove loose hairs and remove skin dander (fine flakes of dead surface skin). It may not be feasible to do this if your dog HATES water or is too excited or scared of a bath! If your dog has a skin rash (which often involves spots caused by Staph skin bacteria) then a medicated shampoo would also be advised.
The skin is clipped of its hair prior to surgery and the skin scrubbed clean and prepared aseptically to obvioulsy provide a clean and sterile an operatibg site as possible! To ensure the least liklihood of infection (bacteria can still beharboured IN the dog's hair follicles even after a sterile preparation fro an operation!), your much-loved pet will be on an intravenous infusion of antibiotics, plus have another antibiotic injection. Then the IV antibiotic is also used to flush out the surgery site once the Ligafiba cruciate repair is in place, and you will be provided with antibiotic tablets to home with!
5) On the morning of your dog's cruciate surgery, please take it out to the toilet. Keep it on a lead and spend as much time as it takes for your dog to pass a stool or two!!! If it doesn't pass number two's then it will either do so DURING the operation, or while it is recovering from the anaesthetic. This does make a mess, as you can imagine, and it is difficult to clean up as we have to lift and move the patient! SO ensure you spend some time in the morning wandering outside around its favourite toilet place to encourage it to go!!!