Ligaments are fibrous bands that connect the adjacent parts of the joints. Their structure is elastic and therefore sprain or rupture of ligaments in dogs is the most common injury.
A sprain is a tear in the fibers of the ligament. Its severity is determined by how many fibers are damaged. If not many fibers are torn, the sprain is considered minor, because the function of the joint is not impaired, and there is practically no swelling or bleeding.
In fact, there is only pain. With a serious sprain, extensive tearing of the fibers is accompanied by swelling, bleeding, limited mobility in the joint and severe pain.
Types of ligament ruptures in dogs: symptoms, diagnosis, causes
The most important thing for a dog's life is ruptured spinal ligaments. They occur with serious trauma with fractures and dislocations of the vertebrae and can lead to urination problems, paralysis, and paresis.
This injury can be diagnosed based on x-rays, neurological examination, etc., and treatment can be mainly in the form of surgery. In some dog breeds (Chihuahuas, Toy Terriers, Yorkies), spontaneous ligament rupture is caused by abnormal development of the first and second cervical vertebrae. In this case, the dog wears a brace and is prescribed corticosteroids.
Surgery is indicated only if there is no effect from conservative treatment. The most common disease in dogs knee joint is a rupture of the anterior cruciate ligament (ACL), which leads to the development of osteoarthritis.
This ligament can rupture as a result of injury or regular trauma, degenerative changes, or inflammatory diseases of the joint. The disease manifests itself in that... More often, the dog holds its paw suspended, with the knee joint slightly bent.
Small animals (up to 15 kg) are treated without surgery, while medium and large animals are recommended to be operated on immediately. Tears and sprains of other ligaments (carpal, shoulder, elbow, hip, hock, etc.) are most often associated with joint dislocations. In case of rupture of these ligaments, the joint is simply fixed for 3-4 weeks.
First aid and treatment for sprains and ligament ruptures
If the dog suddenly becomes lame, especially after jumping or falling, apply something cold to the injured area for 20 minutes, and then apply a tight bandage or elastic bandage. For such injuries, it cannot be used, because, without feeling pain, the animal will begin to run, and this will further injure the damaged joint.
Having provided first aid, despite the dog’s good health, you need to contact a veterinarian as soon as possible to make an accurate diagnosis and decide on further treatment. At early start Treatment for these diseases, complete recovery occurs in 90 percent of cases. But the more time passes, the less predictable the result.
A. N. EFIMOV,
Ph.D. vet. Sciences, Associate Professor, Ch. Doctor of the clinic 000 "Lev"
Saint Petersburg
In dogs undergoing surgery, research over the past three years has shown that about 3% have had anterior cruciate ligament rupture. Among diseases of the musculoskeletal system, this pathology accounts for 6.1% and is inferior in number to fractures and dislocations.
Several methods of surgical treatment of rupture of the anterior cruciate ligament of the knee joint are described in the literature, where the authors often point out their lack of effectiveness. Having used cruciate ligament replacement with lavsan for several years, we were convinced of the low effectiveness and potential danger of this method, which was a prerequisite for the development of a new method of surgical treatment.
PURPOSE OF THE STUDY
The purpose of this work is to find a method for functional stabilization of the knee joint after rupture of the anterior cruciate ligament.
MATERIALS AND METHODS
An anatomical study of the knee joint, reproduction of a rupture of the anterior cruciate ligament, study of the consequences of its loss and the development of a method for restoring the functional activity of the knee joint by stabilizing it (using the anatomical elements of the limb itself) were carried out on the corpses of 6 medium-sized dogs.
The method we developed was implemented in a clinical setting on 85 dogs of different breeds with a rupture of the anterior cruciate ligament of the knee joint.
Long-term results were monitored for 3 years.
Data on the condition of patients after surgery was obtained by interviewing owners both during the re-appointment of the animals for clinical examination and by telephone at specified times.
Material about this pathology (history, breed, age, etc.) and the results of surgical treatment were obtained from medical records.
RESEARCH AND METHOD OF PERFORMING SURGICAL OPERATION
During the reproduction of movements on the prepared limbs with a transected anterior cruciate ligament, mutual displacement of the articular surfaces in the area of the knee joint with a wide amplitude was established. It has been established that when the joint is extended, the femur, mainly when pressure is applied to it from the side of the kneecap, moves plantarly (Fig. 3), while the tibia, moving out from under the femur due to the tension of the straight ligament, dorsally (Fig. Behind). In this case, quite often the medial condyle of the femur overcomes the caudal horn (edge) of the medial meniscus. When the knee joint flexes, the bones return to their original (normal) anatomical position. Thus, it has been established that the pathological displacement of the bones occurs under the influence of the powerful extensor of the knee joint - the quadriceps femoris muscle, and their return to their original position is carried out due to the posterior group of such multi-articular muscles as the semitendinosus, semimembranosus, sartorius and biceps (its tibial part), as well as the popliteal (Fig. 4).
Figure 1. Ligaments of the knee joint.
The described anatomical and physiological conditions made it possible to develop a method for dynamic stabilization of the knee joint, the main principle of which is to enhance the flexion function by repositioning (displacing) the attachment points of the legs (tendons) of the biceps and sartorius muscles. We called the proposed method of extra-articular plastic surgery biceps-sartoriotransposition.
Operation technique
The skin incision is made from the upper third of the thigh to the upper third of the lower leg along the dorsal surface of the limb, focusing on the lateral edge of the kneecap and its straight ligament. Thus, we expose the fascia lata and the tendinous part of the biceps femoris muscle and the fascia of the leg. The loose connective tissue (subcutaneous tissue) is prepared in the lateral and medial (to the place of attachment of the sartorius muscle) directions in relation to the incision line. Then we cut the fascia lata along the dorsal edge of the biceps femoris muscle, simultaneously cutting off the tendon (leg) of the latter from the kneecap and the straight ligament. Next, we continue the incision in the distal direction into the fascia of the leg, 1 cm lateral from the crest of the tibia. After this, the biceps femoris muscle is separated from the fascia in the transverse direction at the level of the joint space line. Having separated the leg of the biceps femoris muscle from the capsule of the knee joint in the latero-plantar direction up to the middle caudal femoral artery, we move the latter to the side. Using an arcuate incision from the crest of the tibia, following the straight ligament, the patella and the lateral edge of the rectus head of the quadriceps femoris muscle, we expose the knee joint. We shift the kneecap together with the rectus ligament and quadriceps femoris muscle towards the medial surface, thereby widely opening the cavity of the knee joint. After a thorough examination, we remove fragments of the anterior cruciate ligament and, if necessary, the anterior horn of the medial meniscus and bone formations (exostoses) along the edges of the articular surfaces. We rinse the joint cavity with saline, reduce (restore to its original position) the kneecap and close the capsule incision with a double-row suture. Then we mobilize the pedicle of the sartorius muscle. We dissect its caudal part from loose connective tissue and separate it from the tibia. After this, we perform reimplantation of the biceps and sartorius
Figure 2. Mechanism of action of the anterior cruciate ligament.
muscles to a new place. Using loop-shaped sutures, we fix the distal end of the pedicle of the biceps femoris muscle to a flap of the tibia fascia on the crest of the tibia (Fig. 5). We also sew the leg of the sartorius muscle here. After straightening the knee joint, we suture the incision in the fascia lata of the thigh (due to the strong tension of the tissues, the suture material must be strong). The completion of the surgical operation is carried out by layer-by-layer stitching of tissues (superficial fascia, subcutaneous tissue, and skin). In all cases, except for the skin, we use non-reactive absorbable suture material.
During the postoperative period, we do not immobilize the operated limb. During the first week after the operation, we prescribe antibiotics and carry out symptomatic treatment. The stitches are removed after 7-10 days. To prevent separation of the reimplanted muscles, we restrict the animal’s movement for 3 weeks. In general, the operation was tolerated satisfactorily by the patient. Improvement in general condition and swelling of the operated limb are completed by the end of the first week (during this time the animal begins to gradually lean). With positive dynamics of recovery, lameness without the use of additional therapy disappears after 3-6 weeks.
REMOTE STUDY
A retrospective analysis of the results of treatment of anterior cruciate ligament rupture in 86 dogs using the surgical method described above was assessed as follows (Table 1):
Figure 3. The mechanism of occurrence of pathological mobility when supporting a limb.
Excellent result - complete restoration of the function of the operated limb without any restrictions;
A good result - the dog moves freely, but with heavy loads there is a slight, quick lameness without treatment;
A satisfactory result is periodically occurring mild lameness, which requires short-term administration of non-steroidal anti-inflammatory drugs;
Table 1. Evaluation of the results of surgical treatment of anterior cruciate ligament rupture in 85 dogs using extraarticular plastic surgery of the femoral and sartorius muscle pedicles.
|
Grade results operations |
Quantity |
Interest (%) |
|
Great |
66 |
77,6 |
|
Good |
15 |
17,6 |
|
Satisfactory |
3 |
3,5 |
|
Unsatisfactory |
1 |
L3 |
|
Total: |
85 |
100 |
An unsatisfactory result is permanent lameness.
When analyzing medical histories of dogs subjected to extra-articular plastic surgery, the distribution of this pathology among various breeds was established (Table 2).
It was noted that lameness due to rupture of the anterior cruciate ligament in animals was detected during a normal walk. From a survey of owners it follows that the dog “stumbled”, “twisted its leg”, etc. Sometimes the animal began to limp the next day, and its owner recalls that it squealed during a walk the day before. Quite often, after this episode, the dog's brief lameness has been reported to resolve spontaneously, or treatment has been short-lived, but after physical activity it resumed and became more pronounced.
Consequently, if a dog begins to limp “out of the blue” and the owner cannot assume that serious damage is behind this, this explains why the animal arrived so late for consultation with a veterinarian. According to our research, in most animals the time for the onset of the above symptoms ranged from two weeks to several months. Unfortunately, as it was established from the anamnesis, one of the reasons for the late admission of patients to the clinic with this pathology was the unsuccessful implementation of conservative therapy due to an incorrect diagnosis.
The diagnosis of anterior cruciate ligament rupture of the knee joint is usually not difficult, since its formulation is based on medical history, the presence of lameness, usually the second degree, and inflammation of the knee joint. The final diagnosis is made when the “anterior drawer” symptom is detected in the knee joint. It consists of a free forward displacement of the proximal part of the tibia in relation to the distal part of the thigh, which is easier to establish in an animal in a state of relaxation. During an X-ray examination, characteristic signs indicating this pathology are usually not detected, but it is necessary, as this allows us to exclude other damage at the level of the bone tissue of the knee joint.
It has also been found that the use of anti-inflammatory therapy usually leads to temporary improvement, after which the pathology worsens and the lameness becomes more pronounced. Often, upon re-application, this group of patients showed signs of meniscus damage (clicking in the joint during walking and forced movements of the limb).
DISCUSSION
The knee joint is a complex, uniaxial anatomical structure. The articular surfaces of the condyles of the femur and tibia (form the femoral joint) have a convex shape and their congruence is provided by the lateral and medial articular menisci (biconcave cartilaginous plates). The medial meniscus in the region of the posterior horn (edge) is connected to the joint capsule by fairly loose connective tissue.
Figure 3 a. The mechanism of pathological mobility during extension.
The presence of two anatomically isolated condyles complicates the ligamentous apparatus of the knee joint. In addition to the collateral ligaments of the knee joint, which perform important role in its stabilization, there are also cruciate ligaments (Fig. 1). The latter, located in the middle of the joint, prevent dorsoplantar mutual displacement of the femur and tibia due to the rounded shape of their condyles, which participate in the formation of the articular surfaces. On the dorsal surface of the knee joint there is a sesamoid bone (patella) enclosed by the quadriceps tendon. When the quadriceps muscle of the reed muscle contracts, the kneecap slides along the block of the femur, while during the tension of the direct ligament of the kneecap, a force occurs that is transmitted to the crest of the tibia. Our studies on prepared limbs have established that if the knee joint is in a physiological half-bent position, forces are distributed according to the parallelogram rule, where the kneecap simultaneously exerts significant pressure on the femoral block. Under the influence of this pressure during the loading of the limb (leaning it on the substrate) in conditions of fixation of the knee and hock joints with the calf muscle, the femur could shift in the plantar direction, but this is mainly prevented by the anterior cruciate ligament. When extending the knee joint of a hanging unencumbered limb, the tension of the rectus ligament would not only rotate the tibia at its articulation with the femur, and also displace it dorsally in relation to the latter, but it is also mainly limited to the anterior cruciate ligament. We can conclude that the maximum expressed load on the anterior cruciate ligament at the most critical moments of the functioning of the knee joint predetermines its damage (Fig. 2).
Our anatomical and functional studies have shown that flexion and extension of the knee joint is associated with constant tension of the anterior cruciate ligament. In this case, the main load occurs due to the counteraction of the pressure of the kneecap, which it exerts on the femoral block. It is logical to assume that one of the reasons for the frequent occurrence of this pathology is the body weight and well-developed muscles of dogs. Data from a retrospective study of dog breeds show that the most common ruptures of the anterior cruciate ligament are Rottweilers, Staffordshire Terriers and Chowchows, which respectively amounted to 17.65; 17.65 and 11.8% (Table 2).
Figure 4. Initial location of the biceps femoris muscle.
Table 2. Incidence of rupture of the anterior cruciate ligament of the knee joint among different breeds of dogs.
|
Breed |
Quantity dogs |
Interest (%) |
|
1. Rottweiler |
15 |
17,65 |
|
2. Staffordshire terrier |
15 |
17,65 |
|
3. chow- chow |
10 |
11,8 |
|
4. mastiff |
9 |
10,6 |
|
5. dobermanpinscher |
6 |
7,0 |
|
6. Central Asian shepherd |
5 |
5,9 |
|
7. GermanGreat Dane |
4 |
4,7 |
|
8. east- Europeanshepherd |
4 |
4,7 |
|
9. boxer |
3 |
3,5 |
|
10. cocker- spaniel |
3 |
3,5 |
|
11. Airedale |
2 |
2,3 |
|
12. giant schnauzer |
2 |
2,3 |
|
13. poodle |
1 |
1,2 |
|
14. Frenchbulldog |
1 |
1,2 |
|
16. pitbullterrier |
1 |
1,2 |
|
17. BordeauxGreat Dane |
1 |
1,2 |
|
18. Moscowwatchdog |
1 |
1,2 |
|
19. Americanbulldog |
1 |
1,2 |
|
20. Newfoundland |
1 |
1,2 |
|
Total : |
85 |
100 |
A study of the functional activity of the knee joint after an artificial rupture of the anterior cruciate ligament shows that when the quadriceps femoris muscle contracts during extension of the limb in the knee joint, both when moving it forward and when supporting body weight, a mutual displacement of the femur and tibia occurs in the plantar and tibia. dorsal directions, respectively. When the knee joint flexes, it reverses the displacement and the bones return to their anatomically correct position. In this regard, the main idea of the proposed method of surgical treatment is to enhance the function of the knee flexors by replanting the knee part of the tendon (pedicle) of the biceps femoris muscle and the pedicle of the sartorius muscle on the crest of the tibia. This method of surgery helps prevent the negative effect of the quadriceps femoris muscle, which causes mutual displacement of the femur and tibia. To prevent abduction (abduction) of the limb, we distally shift the point of attachment of the pedicle of the sartorius muscle. The damaged anterior cruciate ligament is not restored, and we do not replace it with prosthetics. As is known, antagonism of muscle tissue is manifested by the condition DC voltage. Movement in the joints is ensured by a synchronous increase in the tone of one muscle group and a decrease in another. Thus, it can be assumed that when the knee joint is extended, contraction of the quadriceps femoris muscle occurs, which is simultaneously accompanied by greater resistance to relaxation of the biceps femoris muscle, which thereby prevents the movement of the tibia dorsally in relation to the femur. Active dynamic stabilization of the knee joint by applying the proposed method of surgical treatment is confirmed by the fact that in recovered animals in a normal state, it is not possible to reproduce the “anterior drawer” symptom, whereas during relaxation, as a rule, this is possible.
In addition to replantation of the legs of the above-mentioned muscles, complete removal from the joint, whenever possible, of fragments of the damaged ligament and medial meniscus is of great importance. Without this, aseptic arthritis may continue despite anti-inflammatory therapy.
Having many years of experience in cruciate ligament replacement with Mylar cord, we can say with confidence that this material does not have sufficient strength to withstand the loads that continue to act in the knee joint after surgery. Malygina M.A. et al. indicate that “after the craze for lavsan plastic surgery for ligament restoration, disappointment came” due to the large number of complications. It cannot be said that in all dogs the Dacron ligament is subject to rupture, however, quite often the implant ruptures after a certain time and the problem recurs. At the same time, our proposed method of extra-articular plastic surgery is more reliable in contrast to intra-articular plastic surgery - an artificial material intended to replace the cruciate ligament.
It is impossible to ignore the increased risk of infection when a fairly massive implant is inserted into the cavity of the knee joint. In this regard, the foreign material has to be removed, and the problem of restoring the dynamic function of the joint remains insoluble. Movshovich I.A. insists on strict adherence to the rules of asepsis when implanting lavsan, which is difficult to achieve in the real conditions of a veterinary clinic.
Figure 5. Moving the biceps femoris pedicle onto the crest of the tibia.
We also consider replacing the damaged anterior cruciate ligament of the knee joint with fascial flaps and other ligaments to be unpromising, as evidenced by studies of humanitarian medicine, which show that the implanted material, deprived of blood supply, atrophies, and a decrease in its strength inevitably leads to rupture. Klepikova R.A. showed in an experiment that lengthening the reimplanted flaps leads to repeated destabilization of the knee joint.
Using biceps and sartorius transposition for anterior cruciate ligament rupture, we have also observed several complications.
1. In one dog, on the fourth day after surgery, the reimplanted muscles were torn from their attachment sites as a result of increased physical activity (the animal was attacked by another dog).
2. In two dogs, in the coming weeks after the operation, signs of meniscus damage were revealed, although this was not observed during joint revision during the operation (repeated surgery - meniscectomy resulted in the recovery of the patients).
3. Septic arthritis was observed in three dogs. In two cases, gonitis arose 1.5-2 months after the operation, when lameness was not observed in the animals, and they passed exhibitions. During bacteriological examination, Staphylococcus aureus was isolated from two patients and Escherichia coli from one. Rational antibiotic therapy made it possible to quickly cope with the inflammatory process and restore limb function. In the third dog, the inflammation was complicated by damage to the articular cartilage and, although the septic process was eliminated, she continued to limp despite additional treatment. The owner of the animal refused arthrodesis.
It should be noted that the operation using the proposed method is possible, and it is better to use absorbable suture material, such as Dexon, Vicryl and even catgut. This is explained by the fact that there is no foreign material left in the operated area, which could, due to random circumstances, become a source of an infectious inflammatory process.
Data from a retrospective study shown in Table 1 indicate that in 95.6% of animals the function of the knee joint was fully restored, while in 3.8% of dogs good limb function was associated with the need for periodic simple therapy. One unsatisfactory surgical outcome was associated with an accident.
Our own studies regarding the relationship between the age of animals and rupture of the anterior cruciate ligament do not give reason to agree that the injury is preceded by degenerative changes in the knee joint. As can be seen from Table 3, the highest incidence of this pathology occurs at ages from 1 to 3 years, for which degenerative changes in the knee joints are questionable.
Table 3. Incidence of anterior knee ligament rupture in dogs depending on age.
|
Age |
Quantity |
Interest |
|
dogs |
(%) |
|
|
1 year |
9 |
10,6 |
|
2 of the year |
29 |
34,1 |
|
3 of the year |
17 |
20 |
|
4 of the year |
10 |
11,8 |
|
5 years |
7 |
8,2 |
|
6 years |
9 |
10,6 |
|
7 years |
1 |
1,2 |
|
8 years |
3 |
3,5 |
|
Total : |
85 |
100 |
On the contrary, in older individuals, for whom this type of joint injury is most common, rupture of the anterior cruciate ligament is quite rare. An additional argument against secondary ligament rupture is usually the optimal condition of the other, uninjured joint. The often observed sequential rupture of the anterior cruciate ligament, first in one and then in the other knee joint, in our opinion, is associated with additional burden on the uninjured limb in the context of the continued action of the same causative factors.
Analysis of the anamnesis obtained from the medical history in our clinic regarding rupture of the anterior cruciate ligament in dogs shows that injuries in animals occurred in the same type and completely safe environment for their health. The resulting lameness, as a rule, was not accompanied by visible deformation of the limb and any pronounced pain symptoms, which, in fact, was the main reason for the late request of animal owners for consultation. It should be borne in mind that the news of a rather serious injury in their pets and the need for complex surgical intervention caused distrust among some owners. Despite the fact that a rupture of the anterior cruciate ligament of the knee joint manifests itself with pathognomonic symptoms, the examination of the animal must be complete and requires a final diagnosis.
CONCLUSION
A long-term study of the results of treatment of a rupture of the anterior cruciate ligament in 85 dogs using the above-described method of reimplantation of the legs of the biceps femoris and sartorius muscles on the knee joint over 3 years allows us to draw the following conclusions:
1. The proposed method, in comparison with prosthetics of the anterior cruciate ligament of the knee joint in dogs using artificial materials and own tissues, is the simplest and least labor-intensive.
2. The inflammatory reaction in the postoperative period is less pronounced and appears within a week.
3. Complete recovery of the operated limb generally occurs within 3-6 weeks from the date of surgery without the use of additional treatment.
4. Complications that arise do not affect the final result of treatment and are easily eliminated.
5. The result of the operation does not depend on the animal’s body weight and the conditions of its detention.
6. Excellent and good treatment results, which were obtained in 95.6% of operated animals, as well as positive reviews from colleagues who have mastered the method we propose, allow us to recommend it for the treatment of anterior cruciate ligament rupture.
Literature
1. Akaevsky A.I. Anatomy of domestic animals M., Kolos, 1975.
2. Klepikova R.A. Auto- and homotransplantation of fascia in an experiment: Author's abstract. dis.cand. honey. nauk.-M., 1966.-14 p.
3. Malygina M.A. etc. What is more important: the strength of the ligament prosthesis or its isometric location in the knee joint? Collection of scientific works. Transplantation and implantation in surgery of large joints. Nizhny Novgorod. 2000, pp. 68-72.
4. Meshkov R.M. Plastic surgery of the ligaments of the knee joint using various plastic materials: Abstract of thesis. dis... candidate of medical sciences. - Baku. - 1968. - 18 p.
5. Movshovich I.A. Operative orthopedics M., “Medicine”, 1983, art. 13-14, 255-259.
6. NiemandH.G, Suter P.F. and others. Diseases of dogs. Practical guide for veterinarians M., “Aquarium”, 1998, pp. 215-217.
7. Shebits X., Brass V. Operative surgery of dogs and cats. M., "Aquarium", 2001., pp. 452-458.
8. H.R. Denny, A guide to canine orthopedic surgery, Oxford, 1991.
9. Paul GJ.Maquet Biomechanics of the knee With Application to the Pathogenesis and the Surgical Treatment of Osteoarthritis 2nd Edition, Expanded and Revised. With 243 Figures Springer-Verlag. Berlin Heidelberg New York Tokyo 1984, pp. 59-62.
10. Wade O. Brinker, D.V.M., M.S. Handbook of small animal orthopedics & fracture treatment, Philadelphia, 1990.
Magazine "Veterinarian" 6/2003
Injury to the anterior cruciate ligament (ACL) of the knee is a fairly common injury in dogs and can cause the dog to limp on its hind leg. This injury occurs when the anterior cruciate ligament of the knee is stretched or torn, causing acute or chronic pain. Despite the pain of PCL damage, the dog is often quite capable of recovery if provided with medication and proper rest. After some time, the injury will certainly heal, but large breed dogs may develop arthritis as a consequence of the injury if surgery is not performed in a timely manner.
Steps
Relieving your pet's pain at home
- Move all of your dog's personal belongings to his temporary resting place to make him comfortable.
- If your house has several floors, it is best to place the dog on the ground floor.
-
Rest your dog for 6 weeks to allow the injury to heal. The dog should be able to lie down in a comfortable position to reduce inflammation around the affected joint. Temporarily avoid long walks with your dog, and do not let him jump or walk on stairs.
Provide a ramp for your dog so he can easily climb onto upholstered furniture. It is best to lift the dog yourself in such situations, but you yourself will not always be there to help your pet. You don't want your dog to jump on furniture, so create a ramp for him to climb up.
- The ramp can also be used to make it easier for your dog to get into your car if he needs to go somewhere.
- Pre-made ramps can be found at local pet stores or purchased online. There are even folding ramps.
-
Use baby gates to limit your dog's movements around the house. Baby gates are a great way to provide your dog with the rest he needs. Using gates, limit the area accessible to the dog to just one room, and also block the stairs with gates so that the dog cannot use them.
- Make sure the gate you use is high enough so your dog won't try to jump over it. You know your dog best, so choose the appropriate gates at your own discretion.
-
Avoid keeping your dog on slippery floors such as linoleum or laminate. The dog should walk on surfaces that provide good grip on its paws. Otherwise, the dog may be re-injured or injure another paw. Block her access to rooms with slippery floors or cover slippery floors with non-slip mats.
- Do not try to cover slippery floors with towels or blankets. The fabric will slide violently across the floor, which can cause injury to the dog.
- Failure to undergo prompt surgical treatment may result in the dog subsequently developing early arthritis of the injured joint.
- Dogs larger than 10 kg may not respond to conservative home treatment and often require surgery.
Changing the Routine for an Injured Dog
-
Put your dog on a diet to prevent excess weight gain while recovering from injury. The dog will be sedentary for at least 6 weeks, so it will not need as many calories as before. Additionally, putting extra weight on the injured anterior cruciate ligament can prevent the injury from healing. Choose a dog food specifically designed for weight loss or weight maintenance.
- Consult your veterinarian first to determine the best food for your dog.
- Follow the dosage recommendations on the packaging of the food you are using.
-
To provide your dog with physical activity, give him swimming sessions 2-3 times a week. Since swimming does not create a special load on the musculoskeletal system, the animal’s joints, muscles and ligaments will not suffer from such exercises. If your dog can swim regularly, his muscles will maintain their tone, and he will receive good mental stimulation.
- Consult your veterinarian before swimming with your dog.
- Provide your dog with enough support while swimming to prevent him from overexerting himself.
- Swimming may not be an option for exercise during the colder months, as dogs are not allowed in pools in most cases. If the injury occurred in the warm season, the dog can be taken swimming in natural bodies of water.
-
After 6 weeks, start taking your dog for five-minute walks twice a day. This will allow you to gradually increase physical activity on your legs without overloading the injured limb. Keep your dog on a leash at all times to prevent him from running around and risking a recent ligament injury. As your dog's condition improves, you can gradually increase the duration of your walks.
- Consult your veterinarian before exercising.
-
Use a special brace to support your dog's knee joint. Attach a special bandage to your dog's knee joint to provide additional support. Slide your fingertips under the bandage to check that it provides light pressure on the paw without cutting into your dog's skin. You may need to adjust the bandage periodically throughout the day. Be sure to make sure your dog is comfortable wearing it.
- Using a knee brace will help your dog recover from an ACL injury without surgery, however, this measure is not always effective. Ask your veterinarian if a bandage will help in your case.
- It is best to use a bandage specially selected for your dog from a veterinary clinic, but you can also order a bandage online.
Seeking veterinary help
-
Take your dog to the vet to have the injury diagnosed. The veterinarian will examine and possibly x-ray your dog to check for a fracture. The veterinarian will also be able to rule out other possible causes of the dog’s pain and make a correct diagnosis. After diagnosis, the specialist will recommend treatment for your dog.
- The veterinarian may need to put the dog to sleep briefly to examine the injured area without causing pain or discomfort to the animal.
-
Ask your veterinarian to give your dog non-steroidal anti-inflammatory drugs to help relieve pain. To eliminate the pain symptom, the veterinarian may prescribe non-steroidal anti-inflammatory drugs to the dog. Dogs are often prescribed drugs such as meloxicam (Meloxicam-Teva), Norocarp, Carprofen and Onsior. Give the prescribed medication to your dog at feeding times as recommended by your veterinarian.
Discuss with your veterinarian whether or not surgical treatment is necessary. The dog can recover from the injury on its own, but in some cases surgery may be the best option. The surgery will stabilize the dog's joint, which will facilitate recovery. Surgery can also reduce the risk of recurrent injuries and the development of arthritis as you age.
Identifying symptoms of an anterior cruciate ligament tear
-
Notice that your dog is not as active as usual. A dog with an injured ACL is in pain, so he will not run, jump, or climb as much as he normally does. You may notice that your dog is reluctant to climb on furniture or has difficulty getting into your car.
- Constantly active dogs tend to remain active after injury. However, even in this case, you will notice a decrease in activity.
-
Notice the appearance of a limp on the hind leg. The dog may walk unsteadily, limp, or try to put all its weight on its three healthy legs. This is a sign that something is wrong with the animal, so be sure to take your pet to the vet.
- The symptomatic presentation of lameness may vary depending on the severity of the injury. The dog may limp only slightly or be unable to step on the affected paw at all. Both symptoms indicate injury.
Provide your dog with comfortable bedding and place bowls of water and food nearby. Choose a place to place the bedding where your dog can safely recover from injury. Make sure that your dog can still spend time with your family members and go outside to the toilet without any problems.
Young dogs are often exposed to various injuries due to the fact that they are quite mobile, but their bodies are not yet adapted to significant stress. One of the most common pathologies of this kind is a sprain in a dog’s hind legs. This can happen to any animal, so it is very important to understand what the causes of this problem are, what symptoms you should pay attention to, and how to treat if the animal is affected. Knowing this information, you can easily restore your pet’s previous life within a few days, even if it was accidentally injured.
Causes of sprains
This is one of the most common injuries that this animal can receive in childhood by overloading its paw. The joint of the limb is designed to protect the bone from various types of damage, covering it with elastic fibrous tissue, and is also responsible for the process of shock absorption when walking or jumping. Stretching causes several of these fibers to break due to sudden overstrain. For an animal, this condition is very painful and unpleasant. It is expressed, among other things, by severe swelling of the paw.
Among the main reasons why a dog develops sprains, veterinarians identify the following:
- Limb injury. The most severe cases may even be accompanied by fractures or dislocations. In such cases, spraining is not the most significant problem.
- Incorrect nutrition. First of all, this concerns a lack of calcium, as well as some other microelements. As a result, elastic tissue loses its functions, which is accompanied by weakness of the ligaments.
- Genetic predisposition. Often, heredity in decorative dogs leads to the fact that they suffer from certain diseases, including abnormalities in the development of the ligamentous apparatus.
- Sudden weight gain. As a result, the animal’s body simply does not have time to fully adapt to the changes that have occurred to its body.
- Excess weight. In this case, the dog, despite its low mobility, can still get a sprain.
- Some types of loads during the active growth phase. First of all, this all concerns climbing to heights or overcoming high obstacles.
Sprained ligaments are a rather unpleasant consequence that can be influenced by all of the above factors. It requires a certain level of care for the pet and changes in its lifestyle. In any case, it is worth giving up regular workouts for a while.
Symptoms of injury
The symptoms of sprains are quite characteristic and easily recognizable. This is due to the fact that after an injury and rupture, an inflammatory process begins in the limb. Depending on its severity, veterinarians distinguish three stages:
- Easy. The dog feels only slight pain because several of its fibers have broken, but the rest remain intact.
- Average. In this case, the gap is more significant and serious. It still preserves the overall integrity of the paw joint.
- Heavy. This case is considered the most unfavorable. It characterizes a complete rupture of the ligaments. Often this pathology occurs against the background of fractures and dislocations. That is why veterinarians classify it as a separate type of limb injury.
If we talk about signs and symptoms, then it is definitely worth highlighting the following complex:
- Lameness. The animal tries very carefully to stand on the damaged paw.
- Swelling of the paw tissue. Swelling can be seen at the site where the damage occurred.
- Painful sensations. The dog pulls out its paw when examined.
- A certain position of the limb. Most often, the animal will hold it in a half-bent, suspended position. This is due to the fact that the dog will be afraid of the pain that he can get from leaning on his paw. In some cases, if the gap is significant, you can even determine by touch where it occurred.
- Increased body temperature. This only applies to the site of the inflammatory process.
- Damage to the skin or skin. This happens when you get injured.
- Hematoma formation. This rarely happens when blood vessels are affected.
If your dog has one or more of the above symptoms, you should contact your veterinarian.
Treatment of pathology
Treatment for sprains in dogs can be of two types: first aid and comprehensive primary therapy. If the pathology is mild or moderate, then the dog can remain at home. The most serious injury requires appropriate surgical intervention by doctors. In most cases they suffer hind legs. This is due to the fact that they bear the largest share of loads, both when running and when jumping.
As first aid, it is worth determining the following sequence of actions:
- It is necessary to apply an ice pack to the place where the ligament was torn. This can help reduce swelling and the inflammatory process itself. This way you can prevent the development of complications such as high fever or hematoma formation.
- After 15-20 minutes, you can remove the ice from the paw. A fairly tight bandage should be applied to it, thereby fixing the limb. This is necessary so that the dog cannot accidentally aggravate the existing damage.
- If your dog continues to experience severe pain and cannot find a place to rest, you should definitely see a veterinarian. This may indicate that the injury is serious and requires specialist intervention.
- Under no circumstances should you give your pet painkillers. This can significantly worsen the situation. When the dog stops feeling pain, it begins to lean on the sore leg, thereby continuing to tear the weak elastic fibers.
Treatment requires quite a long time, so every owner of his pet should understand how to carry out therapy in the following days after the animal’s condition has been relatively stabilized.
On the second day after a sprain, you should apply alcohol compresses to your leg. They help improve blood circulation and warming.
On the third day after the sprain, you can begin to lightly massage the paw. Thermal wraps and paraffin applications will also be useful.
On the fourth day after the injury, you can start using ointments and gels based on troxevasin. This greatly promotes healing. First of all, it is worth highlighting such drugs as Phytoelita and Hydrocortisone.
Attention! In the first few days after a sprain has occurred, it is worth very carefully monitoring the animal’s health. It is necessary to pay attention to the temperature of his body, as well as directly to the site of injury. If an abscess appears, this may indicate that the wound has become infected. Subsequently, the dog will have to be treated for this infection.
In most cases, a pathology such as sprained ligaments in dogs goes away within 3-5 days, if there are no additional problems or complications. When they are present, therapy can take a longer period.
Conclusion
Sprains in dogs are not a rare pathology, which most often occurs in young animals whose bodies are not accustomed to significant stress. That is why it is very important to choose the right training courses, monitor the animal’s nutrition, and also monitor its condition. In this case, injury can be prevented. If sprains cannot be avoided, it is necessary to promptly seek the help of a specialist.
About the author: Ekaterina Alekseevna Soforova
Veterinarian at the intensive care unit of the Northern Lights veterinary center. Read more about me in the "About Us" section.Active, inquisitive, and sometimes hyperactive four-legged pets are often subject to a variety of injuries, accompanied by damage to the ligamentous apparatus. Ligament rupture occurs for various reasons: an unsuccessful jump, a collision with a vehicle, degenerative processes of the musculoskeletal system. Competent first aid actions by the owner will help reduce the negative manifestations of the injury.
In veterinary practice, it is customary to take into account the following factors that lead to severe damage to the ligamentous apparatus in dogs:
- Injuries of various kinds. A pet falling from a height (especially important for miniature and toy breeds), broken limbs, being hit by a car, unsuccessful jumps are common causes of sprained and ruptured tendons.
- Developmental anomalies. Improper formation of the bone structure during the prenatal period leads to excessive load on the fascia as the pet grows.
- Obesity. Excess weight of a four-legged friend is fraught not only with problems with the normal functioning of internal organs, but also negatively affects the condition of the musculoskeletal system. Obese animals are more likely to suffer a variety of limb injuries, including sprains and torn ligaments.
- Breed predisposition. IN last years veterinary specialists and experienced breeders note a negative trend of increasing pathology of the ligamentous apparatus in representatives of a number of breeds.
German Shepherds, Great Danes, Dachshunds, Basset Hounds, and Bulldogs experience problems associated not only with hip dysplasia, but also with weakness of the fascia of the limbs. Toy breeds of dogs, such as toy terriers, lapdogs, and shih tzus, are also susceptible to orthopedic disease.
- Violation of mineral metabolism during the puppy's growth period. An intensive gain of muscle mass, especially in representatives of large breeds, should be accompanied by the inclusion in the diet of vitamins and minerals that are responsible for the strength and elasticity of muscle and connective fibers. Their absence leads to an imbalance between the development of muscle mass and fascia.
Tendon weakness is caused by a lack of calcium, vitamin D and some microelements.
- Degenerative changes in the musculoskeletal system. Diseases such as rickets at a young age and osteodystrophy in older pets are accompanied by destructive changes in the joints. Changes in the anatomical configuration of the vertebrae and large articular formations of the upper and lower extremities due to arthrosis lead to deformation of the structure of the ligaments, loss of their elasticity and rupture.
Rickets - A common cause of hock tendon rupture in young animals is intensive training without prior preparation of the pet. Muscles and tendons that are not warmed up before intense physical activity are subject to constant microtrauma, which is accompanied by stretching and rupture of the fascia.
Older animals are predisposed to the disease, in which, due to age-related changes, changes in the structure of the connective tissue occur. Veterinary experts include metabolic disorders in animals and decreased immunity as provoking factors.
Types of ruptures in dogs
In veterinary practice, it is customary to distinguish tendon ruptures by their anatomical location. The hip and knee joints are most often affected due to the complexity of their anatomical structure. Depending on the degree of damage, a complete or partial rupture of the fascia is distinguished. The injury can be immediate or gradual. Veterinary specialists also note the presence of damage to the menisci of the joint and an inflammatory reaction.
Anterior cruciate fascia injury
The largest and most complex joint in a dog's body is the knee. It is formed by the femur, tibia and patella. Being a uniaxial structure, the main type of movement of the joint is flexion-extension. It is stabilized by several external and internal fascia. These include the anterior and posterior cruciate, tibial and fibular collateral.
One of the most common surgical ailments in dogs is a rupture of the anterior cruciate ligament of the knee joint. This tendon is the main stabilizing structure. Anterior cruciate ligament rupture accounts for up to 70% of all knee injuries.
Anterior cruciate ligament rupture The most common cause of the disease is degenerative processes of the ligamentous apparatus, leading to thinning of the fascia and loss of elasticity. , congenital deformations lead to microtraumas, tendon tears, and over time, to its complete rupture. In this case, damage to the ligamentous apparatus on both limbs is diagnosed.
A collision with a vehicle can also lead to this pathology. In this case, only one hind limb may be injured.
Hip injury
Veterinarians most often deal with concomitant injuries of the hip joint. In addition to a dislocation, the animal is diagnosed with a sprain or rupture of the ligamentous apparatus. A complex joint is formed by external, internal and annular ligaments.
The cause of structural destruction of the fascia of the hip joint is most often the development of dysplasia, ill-chosen intensity of physical activity, and congenital anomalies. Veterinary specialists have traced the breed's predisposition to the disease.
Signs and symptoms
One of the telltale signs of fascial injury is weight-bearing lameness in your pet. In this case, the dog tries to transfer the weight of the body to a healthy limb. 
In severe cases, the animal completely excludes the limb from motor function and holds it suspended. The pet moves in small steps, the gait becomes mincing.
In a sitting position, the owner can observe that the animal puts the affected limb aside. If the dog is forced to stand, then the sore paw rests on the toes, and not on the entire foot.
A rupture of the anterior cruciate fascia due to a knee joint injury is often accompanied by swelling, edema of the damaged area, and an increase in local temperature.
Instability in the joint can manifest itself in the form of a characteristic click when flexing and extending the injured mobile joint. The owner may experience severe pain. The pet does not allow you to touch the sore area, whines, and worries.
First aid
It is almost impossible for the owner to distinguish a sprain from a complete rupture of the ligament. If you suspect that the animal has suffered an injury or a tendon has been affected, it is necessary to competently provide first aid to it. The further prognosis and recovery time of the four-legged friend will depend on the actions of the owner in the first hours of the injury.
- Using available materials (a narrow board, thick cardboard), secure the dog’s sore limb in the position in which she holds it.
- It is strictly forbidden to straighten, bend or unbend a limb on your own.
- If the front paw is injured, foam rubber, a rolled towel or an elastic bandage are used for immobilization.
- In the first hours after injury, ice can be applied to the sore spot. The cold can remain on the affected joint for no more than 20 minutes, then a half-hour break should be taken.
- Under no circumstances should you give the injured pet any medications, much less painkillers. Feeling better, the animal can cause even more harm to itself.
During transportation, ensure the immobility of the affected limb and complete rest for the pet.
Diagnosis of the condition
A qualified doctor may suspect a fascial tear in a dog during a clinical examination. The manipulation is carried out under local anesthesia; in large breeds, general anesthesia is often used. After anesthesia, the doctor performs a series of tests (calf compression test, cranial tension test) to determine the severity of the injury.
The most informative method for diagnosing fascial damage in an animal is joint arthroscopy. A high-tech study comes down to the introduction of a microvideo camera and visual recording of the pathology.
To learn how anterior cruciate ligament rupture is diagnosed, watch this video:
Treatment for a dog
Conservative methods of treatment for complete rupture of the ligamentous apparatus are used, as a rule, in small animals. The dog's movement is limited, kept in an enclosure or large cage, and the animal is walked only on a leash.
Non-steroidal drugs (Loxicom, Previcox, Rimadyl) help eliminate pain and prevent the development of inflammation. The products are used under the supervision of a veterinarian, as they have a number of contraindications. The use of chondroprotectors and glycosaminoglycans is effective.
In case of injury in large breed dogs, veterinary specialists strongly recommend that owners undergo surgical treatment to avoid the development of osteoarthritis. In surgical practice, intracapsular, extracapsular and periarticular methods of surgery are used. The choice of one or another technique depends on the breed, weight, type of rupture, and the qualifications of the surgeon.
The rehabilitation period includes the use of antibiotics, non-steroidal drugs, chondroprotectors, and painkillers. To ensure a speedy recovery, the dog undergoes physical procedures: cryotherapy, electrotherapy, massage, swimming pool, treadmill.
To learn how surgery is performed for a torn anterior cruciate ligament in a dog, watch this video:
Forecast
The outcome of the operation largely depends on the time of its implementation. The sooner surgical treatment is performed after the injury, the lower the risk of developing osteoarthritis. Without surgery, your pet's chances of a full recovery are minimal. Surgical treatment of injury allows in 70-80% of cases to restore joint mobility and physical activity to the animal.
A sprained or ruptured tendon in dogs is a common injury that requires competent action by the owner in the first hours. Diagnosis is carried out on the basis of specific tests and arthroscopy. Treatment is most often surgical, especially in large breeds. The prognosis for timely surgery is usually good.