Shortly over 2 weeks ago Anya came up lame after a training run of approximately 30 miles. During the run she showed no signs of injury. She pulled hard and ran perfectly all the way back to the yard. It wasn't until about 1/2 hour later that I noticed she wasn't putting any weight on one rear leg.
Took her inside the house, put her on rimadyl. Could not find anything wrong but I assumed it was a bruised or sprained foot, as the trail had been rock hard with nuggets of ice.
4 days later there was no change, no improvement - she was still completely non weight-bearing on that leg. I had taken her along to a race and decided to ask the race vet to take a look at her. The vet didn't feel it was an ACL rupture, but did think it was either a knee or hip issue and advised me to see my own vet when I returned home, since the injury wasn't getting better.
So about a week post-injury I got Anya in to see my regular vet, who happens to be very good at diagnosing sporting dog injuries. He did some feeling, a drawer test (look it up if you are unfamiliar with the term) and came back with the diagnosis I feared: a ruptured ACL.
Now this is HIGHLY uncommon in a well-bred sled dog from generations and generations of well-bred, experienced, trail-tested sled dogs. None of whom have ever had an ACL tear or rupture. The siberian huskies I've known or heard of in the past with ACL tears are generally rescues, show lines, or puppy mill dogs. Not a dog with thousands upon thousands of training and racing miles on them, with what I consider a truly ideal structure!
Nevertheless, a part of me wasn't all that surprised at the diagnosis because her gait was the same one I'd seen in friends' dogs who'd ruptured their ACLs.
The vet recommended a procedure that he does called a Lateral Suture. Since I trust that vet implicitly and feel he's one of the top surgeons around, I booked the surgery. I thought I was dealing quite well with the news, but once on my way home I lost it and cried for the loss of a major contributor to my race team, and for poor Anya who would likely have to retire at the age of 7.5.
After some consultation and advice from various other mushers and my friend Becki, who is a canine physical therapist, I decided I should seek a 2nd opinion. I also determined that the Lateral Suture technique was not the way to go if she were to have surgery. Having the TPLO surgery done by a qualified orthopedic veterinarian would give Anya a chance to actually run again in harness - perhaps not on my race team, but at least for exercise and fun with the puppy or yearling teams.
So off we went to a 2nd veterinarian this past Monday. By this time Anya had had almost 2 full weeks of house rest and limited exercise and was beginning to put weight on that leg again. Not full weight, but not just toe-touching either. I was hopeful that perhaps she only had a tear and not a full rupture, but X-rays and a thorough exam under sedation came back with the same diagnosis: a ruptured ACL. Cost of TPLO with the orthopedic vet: $2400-2600.
By this time I had started to question whether it was worth it. Many mushers had offered up tales of other dogs diagnosed with this, whom they had rested for 4-6 months and who had then returned to running without surgery. Plus Anya would be 8 by the time fall training started. If she had to retire a few years early, she would probably be just fine. And since she was putting more and more weight on her leg each day it gave me hope that perhaps there was another way.
So I did some research online. And found there is a whole slew of folks out there who've chosen NOT to do surgery for ACL/CCL ruptures. These folks are using what's called Canine Conservative Management (CCM) as treatment for ACL injuries, and they're getting their dogs back running, playing - even competing in agility and fly-ball. Now if a dog can do THAT without surgery, why not run in harness with the puppy team too?
The CCM treatment plan is practically the same as one would do just following traditional ACL surgery:
- controlled activity for 8 weeks. No stairs, no jumping, no running, no getting up on furniture.
- short leash walks 2x daily
- range-of-motion physical therapy
- joint supplement, fish oil, and an anti-inflammatory medicine every day
3 days after starting this program and she's already putting even more weight on her leg each day. I still need to make some modifications here at the house (build a ramp down the deck stairs, for example) as well as read up on what ROM exercises I need to do with her, but I'm hopeful that this will work. I'm also going to bring her in for laser therapy on the knee, as I had amazing success with that on a dog with a severe achilles tendon injury that I thought would never run again (and he not only ran again, he was racing 100 milers with me the following season).
I realize CCM doesn't fix a ruptured ACL. But surgery doesn't fix it either. All surgery does is add man-made support to the joint to keep it stable while scar tissue builds up to support it. And CCM doesn't work for every dog - but if it doesn't work, then I can always opt to have the surgery done later.
