Post updated 4/18/2018
It appears as though my attempts to use conservative management to heal Sherman’s cruciate tear has been squashed by his uncooperative meniscus that tore a few weeks ago.
(Bang head on table)
Which means that Sherman will be headed to surgery next week to have his knee fixed.
(Bang head on table)
Which means over the last few weeks I have become obsessed with the anatomy of a dog knee.
That’s the way I roll.
If something is wrong with one of my dog’s I become obsessed with that. I feel the need to educate myself the best that I can and ask as many questions as I can. It’s the way my mind is wired.
So currently I’m a compulsive knee learner.
It actually got to the point at work where I was carrying around a mini knee model.
All the time.
I couldn’t put it down. I would sit that and play with the damn thing all day, just moving the knee back and forth, checking out all the working parts.
I became the knee.
I may have even stretched out one of the ligaments on the knee model to the point of where it’s only hang on by a thread and when the next person goes to use it in a demonstration……….. it may snap.
It may happen and I hope I’m not there when it does.
Anyway, back to the knee.
I really wanted to be able to understand the knee better and know what is actually happen in Sherman’s knee, so I’ve been studying.
I took the liberty of drawing my own diagram of a dog’s knee for you.
It’s amazing that I have time to sit down and draw a knee, yet I have clothes that have been sitting in the dryer for 3 days waiting to be folded.
It’s called priorities.
So my knee drawing didn’t go as well as planned because Bobby bumped into the table when I was almost finished and caused an unexpected fracture, but I wasn’t going to let this once in a lifetime drawing go to waste so I shared it anyway. You can laugh or pick apart my drawing.
It’s ok, I’m not an artist, I’m a blogger.
It gives you the basic anatomy of the knee, plus a fracture caused by a Sharpie, and a really big patella.
In Sherman’s case, and the case in a lot of dogs with a knee injury, Sherman tore his cranial or anterior cruciate ligament. The cruciate ligament connects the femur and the tibia and it helps keep the knee stable. It’s the most common knee injury seen in dogs. A torn cruciate can be treated surgically or managed conservatively. The main thing you want to do when a dog has a torn cruciate is prevent as much arthritis from happening in the joint as you can, which is why a lot of people who have large dogs with this injury opt for surgery soon after the tear occurs. A lot of dogs can have great success using conservative management. Sherman is not one of them.
Some dogs, like Sherman, that suffer from a torn cruciate can also suffer from a torn meniscus. This injury normally takes place after a cruciate tear.
The menicus is cartilage that sits on top of the tibia and acts like a cushion to the knee. An injury to the meniscus usually happens when an unstable knee drags forward and grabs a hold of the meniscus causing it to flip over, which causes even more instability, arthritis and pain in the knee. You can’t see a torn meniscus on an x-ray, but you in some cases, like Sherman’s, you can hear the meniscus clicking when the dog walks. (gag)
With Sherman he’s limping a lot and it’s not getting better. Which is why the surgeon is going to go in and trim away the part of the meniscus that is flipped over causing discomfort and while she’s in there she’s going to perform a lateral suture repair for the cruciate.
I’m not going to lie, Sherman’s knee is most likely not in very good shape so we are making an attempt to keep him comfortable and do what we can to prolong the onset of severe arthritis in that leg. There’s already degenerative changes taking place so we need to keep that in check for as long as we can.
So why didn’t we fix Sherman’s knee when the cruciate first tore? There are a few reasons.
1. Sherman was having those crazy issues with his chest and he wasn’t a good candidate for surgery when the cruciate first tore.
2. It’s suspected that Sherman has a partial cruciate tear in his left leg and the odds of that going while the right is recovering from surgery is pretty good and then I have a very large dog who can’t use either of his knees. I’m praying to the God of my choice that doesn’t happen. It’s now a risk we have to take.
3. After 6 months of rest and limited activity Sherman was doing very well with no limping. We were doing laser therapy and the knee was determined stable by two vets. Two months later he came up lame again.
Now we are at a crossroads and have to do what we think is best for Sherman in the long run. We’ll have to wait and see how it all goes down.
Tomorrow I’m going to talk about the preparations we have been doing for Sherman’s upcoming surgery. I hope you’ll stop back, because I’ll be asking for your help in making sure we’re all set!