Orthopedic issues in pets can range from mild discomfort to severe conditions that limit mobility and cause chronic pain. These issues often require surgical intervention to restore function, alleviate pain, and improve quality of life. Common orthopedic conditions in pets include injuries to the cranial cruciate ligament (the equivalent of the ACL in humans), hip dysplasia, and bone fractures. Addressing these orthopedic issues requires a nuanced understanding of the animal’s anatomy, as well as the specific needs for postoperative care. Veterinary experts, such as Cynthia Maro, underscore the importance of seeking early presurgical as well as post-surgical intervention to ensure the best possible outcomes for pets. Below, we explore when to begin rehabilitative care after three key types of orthopedic surgeries frequently performed in veterinary medicine.
Understanding ACL Repairs in Pets
Injuries to the cranial cruciate ligament (CCL), often compared to the anterior cruciate ligament (ACL) in humans, are among the most common orthopedic issues in dogs, particularly in large breeds and active pets. This ligament is essential for stabilizing the knee joint, and when it becomes damaged or ruptures, pets experience pain, instability, and difficulty bearing weight on the affected leg. Surgical intervention is often recommended in cases of significant CCL injury, as this type of ligament does not heal effectively on its own. The goal of surgery is to stabilize the knee, reduce pain, and restore mobility. A non-surgical intervention can also be effective, with Prolotherapy and PRP injections being effective options.
There are several surgical techniques for repairing CCL injuries, and the choice of procedure depends on factors such as the pet’s age, size, weight, and level of activity. Common surgical options include the Tibial Plateau Leveling Osteotomy (TPLO) and the Tibial Tuberosity Advancement (TTA), both of which alter the dynamics of the knee joint to provide stability without directly repairing the ligament. Another technique, known as the extracapsular repair, involves the use of sutures to mimic the function of the CCL, creating stability for pets with less intense activity levels. Recovery from CCL surgery can be extensive, often involving weeks of restricted movement and physical therapy, but with proper care, pets can return to a high level of activity and comfort.
Post-surgically, pets benefit from therapeutic massage, chiropractic adjustments and nutritional therapies which aid in protection of other joints, including the other stifle joint and chondroprotection, as well as muscle repair. Inflammation control is key in aiding pets in full recovery, while working to rebuild the muscle atrophy which occurs during the exercise limited phase of healing.
Many of Dr. Cynthia Maro’s patients benefit from swim therapy in the underwater treadmill and laser therapy. This helps prevent the frequent tears of the opposite knee or stifle joint.
Treating Hip Dysplasia in Dogs and Cats
Hip dysplasia is a genetic condition that primarily affects larger dog breeds, although it can also be seen in cats and smaller dogs. This condition arises from an abnormal formation of the hip joint, where the ball and socket do not fit together properly, causing them to rub and grind instead of moving smoothly. Over time, this friction results in pain, inflammation, and eventually degenerative joint disease or arthritis.
Dr. Cynthia Maro has found that most dysplastic pets can be managed through early diagnosis, dietary management and use of nutraceuticals, as well as regular chiropractic adjustments.
In more serious cases, she recommends an acupuncture technique, called gold bead implants.
For the most severe cases, Dr. Maro refers pets for surgery for hip dysplasia. She recommends this course of management AFTER the growth plates have closed, but BEFORE serious arthritis changes have begun. This helps prevent both stifle and spinal arthritis.
Femoral Head Ostectomy (FHO), is typically recommended for smaller dogs or cats. In this procedure, the head and neck of the femur are removed, allowing a “false joint” to form, which can provide pain relief and a functional range of motion. For larger pets with hip dysplasia, a Total Hip Replacement (THR) may be the most effective option. This procedure replaces the mal-formed ed hip joint with an artificial implant, offering pain relief and improved function. Postoperative care for hip surgeries often includes a period of restricted activity, physical therapy, and pain management to ensure optimal recovery.
Addressing Fractures with Fixation Techniques
Fractures are common orthopedic injuries in pets, often resulting from accidents, falls, or trauma. When a pet sustains a fracture, veterinary surgeons use various fixation techniques to stabilize the bone and facilitate proper healing. The specific approach depends on factors such as the location and type of fracture, as well as the pet’s age, size, and overall health. Internal fixation, which involves the use of metal plates, screws, or rods, is frequently used for complex fractures or those in weight-bearing bones. This method provides strong, stable support that allows the bone to heal properly and is typically left in place for the life of the pet.
External fixation, on the other hand, involves the use of pins and an external frame to stabilize the bone from outside the body. This technique is often used in fractures that are not amenable to internal fixation, or in cases where an external approach may be less invasive or more effective. External fixators can be adjusted over time as the bone heals, allowing for a customized healing process. Another technique, known as intramedullary pinning, involves inserting a metal rod into the center of the bone, providing stability for simple fractures, especially in long bones like the femur or tibia. Each of these methods requires careful consideration of the pet’s specific needs, as well as dedicated postoperative care, including restricted activity and follow-up imaging to monitor healing.
Fracture fixation is a significant undertaking, and it is crucial for pet owners to follow all postoperative instructions provided by their veterinarian. Pain management, wound care, and physical therapy are essential components of recovery, and adherence to these protocols can make a marked difference in the outcome of the surgery. Although recovery from fracture fixation can be lengthy, most pets eventually regain full function of the affected limb with proper treatment.
The Importance of Postoperative Care and Rehabilitation
No matter the type of orthopedic surgery, postoperative care is a crucial element of successful recovery. For pets, this often means a combination of restricted movement, physical therapy, and close monitoring for any signs of complications. Physical rehabilitation plays a transformative role in recovery, helping pets regain strength, mobility, and function in the affected joint or limb, while preventing excessive weight bearing in other limbs, which can lead to later injury.
PT may involve spinal and joint manipulation, exercises, underwater treadmill therapy, and or laser therapy to reduce inflammation and promote healing. Owners are an integral part of this process, as their commitment to postoperative instructions, regular follow-up visits, and supportive home care can dramatically influence the outcome of the surgery.
It is also essential for pet owners to work closely with their veterinarians to manage any pain and discomfort that their pet may experience during recovery. This may include a combination of medications, supplements, and environmental modifications to create a comfortable healing environment. Ensuring that pets are not allowed to overexert themselves too soon after surgery is critical to avoiding complications and ensuring that healing proceeds as expected. With patience, dedication, and appropriate care, most pets can return to a pain-free, active lifestyle following orthopedic surgery.
Orthopedic surgeries in pets, such as CCL repairs, hip dysplasia treatments, and fracture fixation, offer a lifeline for pets dealing with pain and limited mobility. Advances in veterinary surgical techniques and postoperative care have made it possible for more pets to recover successfully. By understanding the options for repair and recovery available, as well as the importance of preventive care and early intervention, pet owners can make informed decisions that prioritize their pets’ well-being and quality of life.
Author: Dr. Cynthia Maro – Integrative Veterinarian, Cynthia Maro, DVM, CVA, CAC, VMRT, VNAET