Ligament damage
My 11-year-old spaniel, after a lifetime of beating, was injured chasing a ball with my daughter. He has apparently ruptured his cruciate and requires an expensive operation. Will he be able to work again?
Neil says: The cruciate ligaments are arranged in a criss-cross manner in the knee joint and damage to the anterior part results in instability, leading to arthritic change and the potential for cartilage problems. Cruciate injuries are common in sporting dogs and tend to be debilitating unless surgical repair is carried out. While there have been more than 50 procedures described, the most successful are the tibial plateau levelling osteotomy (TPLO) and the tibial tuberosity advancement (TTA), both of which are specialist surgeries done at orthopaedic referral centres. There are cheaper, ‘in-house’ options, which employ fascia from the thigh or super-strong suture to enhance stability of the joint. The TPLO aims, by way of cutting the shin bone and rotating it, to change the angle of the top of the bone relative to the knee, so that instability is prevented. The TTA involves cutting the top of the shin bone and moving it forward to achieve the same result. The latter procedure offers initial advantages, as it is less invasive and patients tend to walk sooner, but studies have shown that TPLO is better after six months. Results a year post-op are broadly similar. Implant problems – mainly infections – occur in about 7% of cases and TPLO implants are much easier to remove than TTAs. My advice would be to have your vet do the procedure that they favour and with which they are most familiar. The season is some time away, which should allow for your spaniel to recover sufficiently to get back in the beating line. Patience, care and a bit of luck are required in the recovery period. I hope you are insured, as costs vary from around £2,000 to £4,500.