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Dr. Bruce
Dr. Bruce, Veterinarian
Category: Dog
Satisfied Customers: 20294
Experience:  Small animal veterinarian with 15 years experience
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My spanish water dog has had a ruptured cranial cruciate ligament

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My spanish water dog has had a ruptured cranial cruciate ligament diagnosed by MUA and X ray today. He is 7 years old, an active, quite excitable dog and weighs 28kg. I have a week before his usual vet is available to discuss treatment options but have been researching said options extensively on line. I am concerned that my vet will only offer TPLO or TTA surgery as this is what has been mentioned to me so far. Having read about the potential complications of bone restructuring surgery I would like to know if less invasive solutions such as a suture are a/ appropriate and b/ available in the UK (most of what I have read about this seems to be on American websites). I am prepared for a long and slow recovery and rehabilitation and happy to do whatever is needed to maximise his chances of making a full recovery and return to an active life. There is a hydrotherapy centre near us which will help.
Welcome. I'm Dr. Bruce and I've been a small animal veterinarian for over 15 years. Thank you for your question. I'm sorry to hear about Ollie's ruptured anterior cruciate ligament (ACL). It is good that you're doing all the preliminary reading as far as what your options are for him. I'll be honest and say that a lot of times the repair recommendations made (as far as the procedure) are a lot of times influenced by your veterinarian / the veterinarian doing the surgical repair. This is one of those injuries where as time has gone by there have been lots of studies about the various repair techniques. Some that in the past seemed to be the "best" have now fallen out of favor. There honestly can be complications with any surgical procedure. The most common one with the suture repair (external capsular repair) is that the suture breaks. This is something that is more of a risk as the dog's size goes up. 28 kg is getting up there and that is where the TPLO and TTA procedures have the benefit of being better procedures, as felt by many. They change the dynamics of the knee and when healed, they don't have the situation where suture can break. I know it seems radical and scary to change the bone by cutting it and repositioning it, but those larger dogs that I've seen get it done usually do very well and they recover the quickest.
Here is a great link that I don't know if you've come across yet.
Honestly, a lot of times the decision as to what repair is done boils down to what the surgeon is comfortable with and the expense of it.
It is good that you have the hydrotherapy centre nearby as that will be a very good tool to help speed his recovery.
Customer: replied 3 years ago.

I have been reading about a suture technique called Tightrope which appears to have as good an outcome at 6 months post op to osteotomy surgery. Is this available in the uk? and what are your thoughts on this? It seems to be stronger than the extracapsular suture which as you say inevitably breaks.

The tightrope surgical repair is a very commonly used extra capsular technique for repair. It does have good outcomes / success in the smaller dogs. Again, it can have some suture breakage issues as the weight of the dog goes up. It is a procedure that honestly I would be surprised if it isn't available in the UK. A lot of times this procedure is one that can be done by the same surgeon doing the TPLO or TTA procedure. They can make the recommendation about which they feel works best with their cases. At 28 kg's, Ollie is on that boarder where I hedge more towards the TPLO or TTA (depending on which one the surgeon performs - usually they are most comfortable / trained with one or the other).
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