This isn’t the usual type of blog post I’d generally write, but natural pet health is something I’ve been asked to write many times. So when Pickles partially tore the ligament in his left knee, I dove into research on what to do.
The following are based on my own opinions experience thus far. I’m not a licenced vet, nor am I suggesting that you don’t get surgery. Instead, I’m giving you a personal account of my choices and reviews on what has worked thus far for us, from supplements to knee braces and why we’ve chosen the Conservative Management route.
Little did I know that CCL injuries are the number one orthopedic injury in dogs. Surgery, particularly the Tibia Levelling Plateau Levelling Osteotomy (TPLO), is considered the gold standard.
Here’s an overview from VCACanada regarding the outline of the procedure:
“This surgery changes the angle and relationship of the femur and the tibia. The overall intent of the surgery is to reduce the amount that the tibia shifts forward during a stride. This is accomplished by making a semicircular cut through the top of the tibia, rotating the top of the tibia, and using a bone plate to allow the tibia to heal. This realignment of the surfaces within the stifle (knee) helps to provide stability during a stride and helps to reduce future joint inflammation and OA. By carefully adjusting the angle or slope of the top of the tibia, surgeons can replicate a more normal configuration of the knee joint and reduce mechanical stress.”
In other words, it’s incredibly invasive.
There is an over 50% chance that the other knee will require surgery as well. We were told if he didn’t receive the surgery within six weeks, he’d have severe arthritis by the time he was five years old.
Just a side note: The surgery per knee is roughly $5,000.
But this wasn’t about the money because I invested its weight in gold in my dogs from raw dog food, supplementation, a brace and now alternative therapeutic appointments for Pickles.
There was more to this for me. I knew if Pickles had surgery, he’d endure:
- Serious pain and suffering
- Months of excruciating rehab
- A pervasive list of medications which, when I had researched, would predispose him to leaky gut and potentially liver and kidney issues down the road.
- Potential surgical complications: Infections, drug reactions, bone cancer (there have been two recalls of TPLO)
- A 70%+ chance that the surgery would cause a bilateral injury
- Arthritis (surgery doesn’t obliterate them from having arthritis down the road)
You see, just like hysterectomies (which are recommended to women all over the country as the gold standard for various hormonal ailments) I always want to pause first to assess the causative factors behind why things happen the way they do versus feeling pressured into surgery as my only option.
Here was a breakdown of Pickles’ case and his predispositions for having this CCL injury:
He was neutered young
(this is a photo of him at the shelter).
We got Pickles from a shelter when he was just a baby after his mother (a black lab was being used in a puppy mill operation). They had neutered him very young. While I understand the predicament shelters are in, early neutering doesn’t allow a dog’s testosterone to build naturally.
And if you’re unaware, testosterone is the hormone that helps to make bone.
Without these healthy testosterone levels, their bones grow longer and thinner, predisposing them to knee injuries.
Genetics
Certain breeds (Labrador Retrievers, Rottweilers, Newfoundlands, and American Staffordshire Terriers) are predisposed to these injuries because they have “hockey sticks” for legs, then the chances increase even more. Pickles for reference is part American Staffordshire Terrier, Boxer, Lab, Golden and Beagle. In other words, he’s a Heinz 57 dog, and we adore him (and Bodhi too, his brother).
Crooked Butt Syndrome
In addition to genetics, neutering leaves significant scar tissue around the bladder and pelvic area (even more so in females). This predisposes them to what’s called “Crooked Butt Syndrome,” which I first heard about from Dr. Taylor, a Holistic Veterinarian out in Calgary, Alberta.
If there is a misalignment, then, in my opinion, they will be predisposed to this injury from the get-go, and I question how well they’ll do post-surgery.
We likely over-exercised him.
This is the hardest part for me to swallow, especially when we felt we were giving him a good life as an active couple ourselves. We even had learned from his physiotherapist that you shouldn’t be using the Chuck-It because of the strain its puts on their joints and knees.
The Chuck-It was Pickles’ favourite toy.
After many tears and tons of research, I knew he needed a solid plan that featured supplementation, physio and a brace (which I’ll start with).
The goal of knee braces for dogs is to immobilize and stabilize the knee and leg to help reduce pain and inflammation and provide support during healing.
Unfortunately, when I started this version, I purchased one brace from a company, and despite feeling hopeful, it didn’t work for us.
You can tell below by the video how much I hated this strappy brace.
Not only was it tough to put on, but it would slip down when he went to pee, and it gave him a rash on the interior of his knee. Plus, he hated (and likely more than I did having to put on what looked like “50 Shades of Pickles.”)
It was literally over $300 down the tube.
This was when I decided to try Posh Brace, a custom brace for dogs with CCL injuries that require no casting.
In hindsight, we should have invested in a custom brace right from the start. The company, Posh Brace has helped over 8,000 dogs recover naturally, and they invest over 11 hours to help dogs recover.
I haven’t seen a single company that does that.
Posh Brace is a biomechanically correct custom knee brace that provides immediate relief for dogs by stabilizing the knee and correctly aligning the femur, tibia and knee structure.
The Posh Brace actively suppresses what’s called “Tibial Thrust” by holding the tibial bone in correct alignment and allows the dog to exercise and walk again with more ease.
Unlike the other brace, this new brace fit snug on his knee, didn’t slip, and we had zero issues with rashes.
I was impressed by how detailed the process was, and I took extra time reading the instructions carefully since the most challenging part was measuring him. We had to send photos, measurements and so far, we’ve had two video calls (one to go over his measurements and one for the actual fitting when we received the brace). Honestly, the support has been impressive.
They even provided us with a week-to-week physio plan with exercises and supplementation (however, I’ve created my own, which I’ll share in a bit).
It’s been about a week, and Pickles has been walking with his Posh Knee Brace and even putting pressure on his food when he walks versus hopping! Plus, he doesn’t hide in the bathroom when we’re about to put it on.
It’s been a win-win ever since.
Physiotherapy
In addition to Posh Knee Brace’s week-to-week plan, which is helpful, we’re driving seven hours to Alberta from the West Kootenays in BC to see Dr. Taylor for osteopathy.
Male dogs require roughly two treatments to fix their crooked butt syndrome, and females need approximately three (because the scar tissue tends to be deeper).*
*These timelines will vary based on the dog and its history, so please see an osteopathic veterinarian for more.
This means likely two weeks later, we’ll be headed back to Calgary for another considerable trek.
(Do you now see the lengths I’ll go for my dogs?)
In addition to those two adjustments, dogs will likely need to get adjustments three times per year, which we can deal with.
In between that, we’re seeing a physio in town and doing a range of motion and stability exercises, short walks. I use my Orion red and near-infrared light photomodulation device (use code: MELISSA10 for 10% off) on Pickles for 10mins twice daily while massaging him. Side note: It’s also excellent post-op if you do opt for surgery.
If you’re unaware, photomodulation effectively increases circulation, reduces pain and inflammation, and even powers their mitochondria (the battery of our cells!).
As someone who is a trained Acupuncturist, I’m at this point doing acupressure until I have the nerve to needle my dog.
Supplements
This is my forté, so building this protocol was easy.
Here is what Pickles has been taking (and yes, I realize it’s a lot, but the Ancestral Supplements can be considered as food)
Wobenzym – ½ tab twice daily away from food
This is one of my favourite supplements to have in my home. It’s a proteolytic enzyme whose sole purpose is to eat away at inflammation, which is why you don’t take it with food (or it’ll simply digest your food!). This supplement has over 60 years of clinical trials and is used extensively in Europe for dogs.
One tab is designed for a person of 100lbs. Pickles is 65lbs, so I give him half of that. I use Wobezym Plus, which is double the potency, so half would be the equivalent of one regular Wobenzym Plus. It’s more than his bodyweight but completely safe.
Jump for Joynts by Adorned Beast – 4 pumps away from meals twice daily
Designed by a Holistic Vet, I love most of the products in their line (their Gut Soothing Formula is excellent, for example). This is a homeopathic blend that is a blend of arnica and many others for pain and inflammation. For those wondering, I have used Traumeel tabs in his water too.
doTERRA Turmeric Dual Chamber Capsules – 1 capsule twice daily
Curcumin is very difficult to absorb, it’s why people make pastes out of it with coconut oil and black pepper (amongst many other ingredients). I chose to use their Turmeric Dual Chamber capsules which is a blend of curcumin and turmerones which is derived from the essential oil. Together they make a complete whole food form and the bioavailability of it shoots through the roof.
Recovery Extra Strength – Dosed based on weight. Pickles has three tabs twice daily with food.
This is a blend of glucosamine, chondroitin, MSM, vitamin C and E and magnesium. You have to work up slowly since dogs don’t assimilate vitamin C quickly. Giving the full dose right away will result in loose stools.
CBD Oil – 1 full dropper’s worth with meals twice daily.
We have a close source here in town, which we trust. We use this also for pain and inflammation.
Ancestral Supplements (6 caps each day broken up into 3 caps per meal):
Trachea:
- It contains glycosaminoglycans, proteoglycans, chondroitin sulphates, and type 2 collagen (which is the type of collagen that forms in your cartilage)
Wild Fish Eggs:
- I love that these are freeze-dried from Hoki fish like all their other products because you’re getting the whole food form there is. I use this for anti-inflammatory support.
Bone & Marrow:
- It contains bone matrix, bone marrow and cartilage – all of which are super-regenerative. In CCL injuries, there is also emerging evidence suggesting an immune component to it.
Living Bone:
- It contains trace minerals, calcium, phosphorus, bone-stimulating peptides, glycosaminoglycans and type 1 collagen, which provides amino acids and protein and is easy for the body to absorb.
In summary…
We understand this won’t be a short road. His activity level needs to be significantly reduced for at least 8 weeks minimum with leashed walks only, and it’ll be a year until he can even attempt not to use the brace for longer walks.
But the reality is, we’re willing to put in the work given that he’ll receive a better quality of life. I know this may be triggering to some who opt for surgery. Trust me, there is zero judgment on my end with what you decide is best for your dog.
Whether you go for surgery or not is entirely your choice – and it’s probably one of the most emotionally challenging decisions to make. I know that surgery isn’t even an option for some dogs because of their age and other factors.
I hope that if I can provide some advice, even if it’s simply using my protocol post-op, then I’ll be happy that a dog could receive some relief. Plus, I wanted to share all my research and put it all in one place because surgery isn’t always your only option – not for you or your dogs.
And if it is, then hopefully, you can feel empowered with tools that may support you and your pup along the way.
Either way, know this: I know this is extremely difficult and if you’ve read this far, I hope that I can reflect that you are a great dog mom.
Sending all the pups and their families all the love in the world.
Melissa