An easy question that is difficult to answer. Every dog is different and each situation is different so I don’t have any definitive answers in this post but I will tell you what I have learned and what Loki has taught me since October.
When Loki was three, she partially tore her CCL (cranial cruciate ligament). Using conservation management techniques she was able to return to full activity. She ran with us when we were biking and skiing with no ill effects. July 2016 she had a full tear. It took 8 months before she was able to weight bear on that leg enough to go on longer walks and to run off-leash. I wanted to do more to help her but didn’t know what I could do until I came across the Bum Knees class offered through Fenzi Academy .
I went through the Bum Knees class at the Gold level (I submitted homework videos and received feedback from the instructor) which taught me how to identify when Loki was in pain and my big learning was when I discovered that the times she was in pain came after doing exercise that I thought her knee could handle.
My go-to assumption for Loki’s knee has been observation. If I didn’t see any signs of limping and she seemed to be bearing weight on the leg no worse than before, I assumed she was okay. Definitely it wasn’t comfortable for her to put weight on the leg all the time but she didn’t ‘seem’ to be in pain. I have learned that observation is good but not good enough.
My first ‘oh my’ moment came shortly after starting the course. It was a nice day and we took Loki for a short off-leash walk. We walked the lake on our local rail trail and Loki was having a great time playing with my husband. He would toss some sticks for her and she would run up and down a short but steep bank to retrieve them. After we arrived home; her leg seemed fine. Later that evening my husband and I commented that we seemed to have tired Loki out; and then it twigged.
The class instructor, Dr. Debbie Gross Torraca had just released the handout which included the signs that your dog might be in pain. The signs were:
- Vocalization such as crying or whimpering
- Refusal to move
- Lameness – and this should be differentiated from recovery lameness. Often, when a dog is recovering from surgery, he will exhibit a slight lameness with activity. If it worsens, discontinue activity.
- Avoidance of an activity
- Withdrawal from activity – if the dog does not want to participate in normal activities
- Excessive sleeping after exercises
I was stunned; “Excessive sleeping after exercises” a sign of pain…wow. Loki confirmed this for me the next day when we tried to do our rehab exercises. The difference between what she could do the day before and what she couldn’t do the day after was glaringly obvious. That was an eye opener. We took it easy for 5 days; short walks and no rehab and then I tried the rehab again. This time she was back to what I considered her baseline. You can see the difference in the video that I submitted for homework.
The event that really got my attention, in that it brought about a change in my behaviour(!), came with one of the last assignments in the class. We were asked to film our dog walking down a short hill. Since Loki’s leg again seemed fine and it was possibly the last chance for an easy hike before the snow came, we took Loki for a short hike and I filmed the last small downhill portion of that hike. I opted for prudence and kept Loki on leash so she wouldn’t overdue the exercise. Once again, I thought her leg handled the hike with no problems, but the next day she wasn’t weight bearing when I tried to do the rehab exercises. When I watched the video she looked okay but when the instructor watched the video she commented “As she is walking down the hill, she is pacing. This is telling us she is not extending her limbs all of the way. This could be because she is hurting or conserving her energy. I still see her favoring that left leg – downhill actually puts more stress on the knee than uphill (my emphasis). So my advice is to focus more on the uphill and zigzag down.”
What is pacing?
Pacing is a gait in which the both right limbs and then both left limbs move and are placed on the ground simultaneously. It is an inefficient gait that can be the result of compensation due to laziness, pain or poor conformation. It is not a structurally supportive gait and the lasting negative effects on the back are considerable.
An efficient gait tends to be movement in a diagonal fashion. When a dog walks or trots, their opposite forelimbs and hindlimbs advance at the same time. For example, when the right forelimb moves forward, so does the left hindlimb.
Here is the video of Loki walking down the hill. Watch it from YouTube in slow motion (0.25 speed); in the first 20 seconds you can see her gait and she is definitely pacing.
On Sunday November 19th Loki re-injured her knee. At 3:30pm Loki was fine, she went outside and when she came back in at 4:30 she was not putting weight on her left leg and was noticeably limping.
I have stopped all rehab exercises until Loki can once again start bearing weight on her leg and we are back to walks that are no more than ½ a block. I have found a holistic vet and will be taking Loki to see her before Christmas. I am looking for a second option from a vet with both conventional and holistic experience with CCL tears. I don’t know if surgery is in our future; it might be but I want to explore as many other options as possible before I go down that path.
If you find yourself in this same situation with your dog, here are some links that I found helpful and interesting in my journey to research non-surgical solutions to CCL tears:
Is Surgery Really Necessary For Your Dog’s ACL / CCL Ligament Injury?
Treating A Torn Cruciate (ACL) Holistically
Alternatives to Surgery for Ligament Injuries in Dogs
The Benefits of Canine Rehabilitation & Conditioning
Protect Your Dog From Cranial Cruciate ligament injuries
Cruciate Ligament Rupture: Missing The Big Picture