Re: Re: Conservative Partial CCL rupture.

[Guest guest]

Amy and Tania,1) In your conservative management of CCL disease in dogs, how are you addressing the apparent biologic component, (Cook 2010) (Hayashi 2003) (Bresherars 2010) (Bleedorn 2011) (Comerford 2011)? 2) Do your patients that do not have medial buttress formation at the beginning of your therapy go on to develop it during or following therapy?3) Have any had second look arthroscopy at some period of time after initial procedure in those meniscal patients? Was debridement of the CCL performed?4) In your practices is conservative management offered as an alternative to surgical correction for any and all patients or only those that perhaps surgery is not an option? 5) Do you recognize any conformations that might predispose the conservatively managed patient to less than desirable outcomes (Griffon 2010)? I look forward to your comments!Rick Wall, DVMThe Woodlands, TXCook JL. Cranial Cruciate Ligament Disease in Dogs: Biology versus Biomechanics, Vet Surg 39 (2010) 270-277.Hayashi K, et al. Histologic Changes in Ruptured Canine Cranial Cruciate Ligament. Vet Surg 32 (2003) 269-277. Breshears L, et al. Detection and Evaluation of Matrix Metallproteinases Involve in Cruciate Ligament Disease in Dogs Using Multiplex Bead Technology. Vet Surg 39 (2010) 306-314.Bleedorn JA, et al. Synovitis in Dogs with Stable Stifle Joints and Incipient Cranial Cruciate Ligament Rupture: A Cross-Sectional Study. Vet Surg 40 (2011) 531-543.Comerford EJ, et al. Update on the aetiopathogenesis of cranial cruciate ligament disease. Vet Comp Orthop Traumatol 24 (2011) 91-98.Griffon DJ, et al. A Review of the Pathogenesis of Canine Cranial Cruciate Ligament Disease as a Basis for Future Preventative Strategies. Vet Surg 39 (2010) 399-409.

[Guest guest]

Every pet is different and there is no "cookbook" but if you go to our website www.calanimalrehab.com under the tab For Owners there is an article written called "Rehabilitating Cranial Cruciate Ligament Rupture." This will give you some ideas but each pet needs to be assessed individually and treated as such. A physical therapist would be helpful in creating a program using appropriate manual techniques and modalities and we find acupuncture also very helpful.Amy Kramer, PT, DPT, CCRTCalifornia Animal RehabilitationWould you mind sharing your protocol for these cases? I only have the LEH protocol and was interested in any others out there. Thanks for the info and I look forward to your study coming out. Scata DVM, CCRTSent from my iPadAmy Kramer, PT, DPT, CCRTCalifornia Animal Rehabilitation

Hi Amy,

which surgeon do you use?

I have not find anybody yet who would be willing to do this in Orange County.

Caroline

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Caroline Goulard DVM

CCRT Certified in Canine Rehabilitation Therapy

CVA Certified in Veterinary Acupuncture

Paws On The Go

Housecalls for Animal Physical Rehabilitation and Wellness Care

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> > Hi all,

> > Just hoping for some advice. I have a client with an 8 year old, active, large Labrador with a partial RCCL and "mild" bilateral hip dysplasia who would prefer not to operate on this dog. I have not seen the dog yet, but was wondering if others are having success treating the partial CCL conservatively in a dog this size ( I believe he is 40kg!). I am relatively new to rehab and have not attempted conservative tx on a cruciae yet. Is there harm in trying rehab in a dog this size? The RDVM is very skeptical about rehab in lieu of Sx. The owner is a nurse and has had knee Sx and lots of rehab herself. Thanks for your advice!

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> > Scata DVM, CCRT

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