Wednesday, December 2, 2009

Canine Cruciate Injury

I was talking to my friend Kelly yesterday, and we were discussing all her options for her dog Champ's cruciate injury. She thought surgery was her only option, and I was telling her about a cruciate brace I had heard about... so I thought to share this with everyone else who may not have heard of it either.

Check out the pawsability brace below... I love how they can match it the color of your dogs coat!

What is Canine Cruciate Injury?

The Anterior or Cranial Cruciate ligament helps to hold the knee or stifle joint together. An abnormal forward shifting motion at the knee or stifle joint is the end result of tearing the anterior or cranial cruciate ligament. Lameness, or inability to bare weight on the affected leg initially results from the pain and swelling of the initial injury but subsequently results from the pain caused by the unstable knee or stifle joint.

How does this injury occur and how does it affect my dog?

Anterior Cruciate ligament injury in humans always occurs as a result of trauma or injury. In dogs this injury can occur as the result of trauma or injury, but it can also occur as the result of wear and tear. Because the dog's back leg is always bent at the knee, there are constant stresses applied to the Anterior / Cranial Cruciate ligament on a day to day basis. Certain breeds such as the Mastif, Labradore Retreiver, and Rottweiller to name a few have a higher incidence of this type of injury, but it can occur in any size dog. Size may be a factor, but it is more likely related to some genetic or inherited biomechanical deficiency.
The visible result of an Anterior / Cranial Cruciate injury is always lameness. Either the dog does not bear weight on one of its back legs or only partial weight is born. This may be almost constant or it may be intermittent. There may even be days in between episodes of lameness. Lameness should always diagnosed by a veterinarian because there are many other medical problems that can cause lameness such as:
back problems
hip dysplasia (especially in younger dogs),
avascular necrosis ( loss of blood supply to a bone),
bone cancers,
penetrating objects of the pad or between the
pads of the dog's feet.
Back to Sections

What are the treatment considerations?
Treatment of an Anterior / Cranial Cruciate injury is not very clear cut even within the veterinary community. Surgical treatment while it is almost always recommended is not necessarily always the best choice. As with any diagnosis treatment needs to be tailored to the individual. Just as in humans, one treatment rarely is beneficial to all. Many considerations such as:
Is there a partial tear or a complete tear
Is this a working dog, sporting dog,
or house pet
Are there any complicating factors, such as damage to
the meniscus or other orthopedic issues.
Age and health status
Size and weight
Owners ability to care for the animal after
surgery or during rehabilitation
Owners financial status
Other factors
These considerations should all be taken into consideration by your veterinarian and your veterinarian should be prepared to discuss the benefits and risks of the various options.
In humans generally a brace would be used for treatment unless the patient was a high level athlete. This would be followed be physical therapy and a brace for when the patient was to be more active.

All ligaments attach bone to bone. The Anterior / Cranial Cruciate ligament attaches the Femar to the Tibia at the knee or stifle joint of the dog's rear leg. Tear in this ligament causes instability of the bones these ligaments attach to.
Reestablishment of the stability of the joint depends on a number of factors:
1 Scar tissue can unite a torn ligament however the torn ends must remain close to one another in order to heal to the appropriate length

2 Maintenance of joint stability during the healing phase prevents continued re-injury and poor healing and maintains the proximity of the torn ligament ends.

3 Reestablishment of muscle strength around the affected joint. The large muscles which are at the back of the thigh and which attach around the knee or stifle joint of the dog contribute about 51% of the stability to this joint.

4 Restoration of proprioception. Injuries at a joint often disrupt the small proprioceptors (nerve cells) around the joint which provide a feedback mechanism critical in maintaining its stability. This feed back mechanism provides the dog information regarding the position of the joint based on the pressures applied to it. Restoration of proprioception in dogs and humans is known to be critical in preventing re-injury. Providing for normal range of motion and compression has been demonstrated to reestablish proprioception at the effected joint.

Orthosis as an option for treatment:

What is the Canine Cruciate Brace?
The patent pending A-TraC Dynamic Brace® is the first brace of its kind introduced for dogs. Our brace is designed to treat canine cruciate injuries. A- TraC" stands for "anti-translational cruciate" brace which it prevents anterior or cranial (abnormal forward shifting) movement of the tibia on the femur. "Dynamic" infers that the brace is not static in its design and functions in a manner which allows for a select range of motion of the stifle joint (knee joint) against resistance. The brace therefore promotes rehabilitation of the limb and joint.. The A-TraC Dynamci Brace while preventing abnormal motion, allows for normal motion against resistance to provide rehabilitation of the knee while it heals.

What is the Pawsability brace?
One challenge of bracing the canine stifle is how to suspend the device on the conically-shaped hind limb.

A recent design development in the braces from PawsAbility has eliminated the need for harnessing and has made the stifle orthosis self-suspending. Like in the photo above.

Dog Responsibly.

1 comment:

Kerri said...

Very inventive, thank you for sharing.