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cruciatesurgery2

cruciatesurgery2

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Published by Jana Rade

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Published by: Jana Rade on Oct 15, 2011
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05/20/2012

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CRUCIATE LIGAMENT SURGERYPOST- OPERATIVE CAREThe convalescence period for a cranial cruciate ligament repair is lengthy and difficult for the patient as well as the owners. However, judicious post operative care will increase the success rate of this procedure to approximately 90%.1.Absolutely NO OFF LEASH exercise for 20weeks. Your dog should be ON A LEASH at alltimes when outside, even if only in the backyard. The in house activity should be kept to aminimum.2.See your veterinarian in 14 days for suture removal3.Follow the physical therapy instructions, given to you by your veterinarian.4.See you veterinarian in 4 weeks so he/she can check the healing progress. You can expect your dog to still be lame but weight bearing at this point. If your veterinarian feels that the healing process is advancing as expected, then be sure to continue with the physical therapyinstructions.5.See your veterinarian 8 weeks after surgery for a final re-evaluation of the knee. If your veterinarian feels that the healing process has not been completely achieved, then he/she willcall. If all is well then be sure to continue to follow the physical therapy instructions. It maytake up to 6 months before your dog is as good as he/she will be on that limb.6.Cruciate ligaments can tear in any type of animal, because of a misstep. However, in the large breed dogs(Labradors, Golden Retrievers, Rottweilers, Akita's, Mastiffs) the cruciate ligamentsmay simply degenerate(deteriorate). 30% of these dogs will have the same problem with theother knee. Therefore monitor him/her especially during the healing process because of theextra weight carrier by the other leg (ask your veterinarian about “towel walking” ). These dogsare also more likely to develop arthritis. The arthritis may or may not cause problems later inlife but it is a good idea to keep your dog as lean as possible because obesity will greatlyaccentuate the arthritic pain.
PHYSICAL THERAPY
For the Post-Operative cruciate patient1.The first 10 days after surgery:a. Apply cold compress to the knee, 3-4 times per day for 15 minutes for the first 3 days.Apply 2-3 times per day for 15 minutes for the next 7 days. This will help decreaseinflammation. b. Passive Range Of Motion(PROM): This activity involves moving all the joints of the limbsthrough a comfortable range of motion. This will promote cartilage and joint health, preventcontraction of the muscles and stimulate blood and lymphatic flow. Do be careful as this maycause discomfort in the early stages. You may wish to place a muzzle on your pet to protect
 
yourself and to get the work done efficiently and safely. Your pet should lie on his/her side withthe affected limb up. Gently and slowly extend and flex each joint (ankle,knee and hip) 10 times2-3 times per day. If you are unsure, ask your veterinarian to demonstrate.c. Massage the quadriceps and hamstring muscles (large muscle groups at the front and back of the thigh respectively). Best to massage for 2-3 minutes before and after PROM. Massagingwill help stimulate blood and lymphatic flow and break down scar tissue within the muscles.Start by applying light pressure and gradually increase it over the coarse of the massage. Try tokeep a steady rhythm. Start close to the knee and move up the muscle toward the hip.d. Assist your dog over slippery surfaces by placing a towel under the belly and supportinghim/her (commonly referred to as towel walking).
2. Days 10-28
a. Multiple short,slow, controlled, short leashed (NO FLEXI-LEADS PLEASE!) walks. Startwith 5 – 10 minute walks 2-3 times per day. After 7 days, increase the frequency and length of walks gradually so that you are eventually walking for 15-20 minutes 3 times per day by day28. Monitor your pet's performance; do not exceed his/her limit. b. Continue with the massages and PROM (Before and after the walks).c. Use warm compress for 5 minutes before walking and use cool compress after the walk. Tosave time, apply the compress to the joint while you are massaging the muscles.d)See your veterinarian around Day 28. You can assess your dog's progress by measuring thecircumference of the thigh muscles ( it should increase with exercise) or simply compare it tothe muscling on the non operated leg. Your veterinarian will assess the knee for swelling, pan,stability and the position of the knee cap.e) Use a foam mat or pad 4,5, 6, 8 ft long , thin (¼ to ½ inch) then thicker as legs get stronger to encourage a higher foot fall and increased joint use. Just have them walk back and forth on it.3.Weeks 5 to 8a. Continue with the slow, controlled ,short leash walks. Gradually increase to 20-30 minutes 3times per day. b. Add functional strengthening exercises. Walk your dog in a figure 8 pattern to the left and theright ( this will help with neuromuscular re-education as well). Start with a large figure 8 , andwalk the pattern 4-5 times in one direction before switching to the other direction. As your petimproves and becomes stronger gradually (over 3-4 weeks) tighten the figure 8 (no sharp turns)and switch directions more frequently. Do “sit-to-stand” exercises: Ask your dog to sit andthem ask him to stand several seconds later (this is not an exercise in speed). Start with 3 to 4repetitions, 2-3 times per day. Gradually increase (over 3-4 weeks) the frequency (to 10 times

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