The ACL Injury Diagnosis is Confirmed. Now What?

Let’s talk about dog ACL recovery without surgery. One day, you find your dog limping. Your vet performs the drawer test and diagnoses your dog with an ACL or CCL injury. You’ll probably immediately hear that TPLO surgery is the only treatment. We believe that you have the right to know that there could be other, less intrusive options. Read on!

Since you’re here, you’re likely exhausted, afraid, and confused. Above all, you’re probably desperately trying to figure out what the best route is for treating your dog’s ACL injury.

We’ve been there. Not once, but twice. Believe me, I understand how helpless you feel! I’m not a vet, and I’m not here to ultimately tell you how to help your dog heal from an ACL injury. Instead, I’m here to give you a dog parent’s perspective and share our experiences, so YOU can decide how you’d like to proceed. Just like you, we believe that dog parents have the right to know all of their options.

Grab a coffee or tea and some snacks, because this is going to be a very long and eye-opening read.

MY FINDINGS: THE PROBLEMS WITH TPLO SURGERY

1. After TPLO surgery, dogs commonly rupture the second knee within a year. In fact, vets now push double surgeries “to get it out of the way” even though the other knee is just fine.
2. TPLO surgery is highly invasive. The tibial bone is cut and altered.
3. Permanent metal plates and wires are placed during this surgery.
4. Veterinarians may not disclose the complications, including how many dogs end up with double surgeries, bone cancer, and other problems resulting in a terrible long-term quality of life. This includes full-limb amputations!
5. TPLO surgeries are touted as having a high success rate because the many problems down the road, such as bone cancer, aren’t taken into account.
6. TPLO surgery does not prevent arthritis in the affected region.
7. There are general risks of surgery, including occasional anesthetic death. We personally would only do surgery if absolutely necessary.
8. Some of the post-op issues reported by dog parents are as follows: poor healing of the bones; breakage of plates or screws; fracture of the tibial crest; blow-out fracture of the tibial plateau (requiring surgery again); screws coming loose; shifting of bones; arthritis; tearing of the meniscus; allergic reactions; implant failures; deep infections of bones, joints, and implants; angular limb deformity; seroma formation; and bone cancer.
9. The biggest issue I had at the time was that I felt that we were being pushed into doing surgery and told it was the ONLY option, even though I was starting to find online alternatives and non-invasive, lower risk treatment methods.

INITIAL CONCLUSION

The biggest reason we opted to WAIT before jumping to surgery was because I learned that our alternative treatment methods do not carry any risk. If these methods didn’t lead to improvement, we could then take the surgery route.

We had no veterinary support for this method, so we tried the best we could. And we succeeded!

TIDUS’ FIRST ACL INJURY RECOVERY METHODS

1. Strict conservative management was critical, and I followed it to a T.
2. I put Tidus on a diet to achieve a more slender build. This alleviates pressure on the injured joint.
3. I had a custom knee brace built for Tidus. Critically, this brace helps stabilize the joint to prevent re-injury. A custom brace also allows the gentle introduction of mild exercise, which reduces the onset of muscle atrophy, while keeping risk very low.

THE PROCESS AND STEPS TO RECOVERY

• With the custom brace, Tidus started using his injured leg immediately and walking (with a limp).
• Within two months, we were already hiking up to five miles at a time, always with the custom brace.
• Within three months, the limp was completely gone. Nevertheless, I kept his brace on every time we walked or hiked for more than 10 minutes.
• TIME UNTIL FULL RECOVERY: 11 months. Tidus “asked me” to take off his brace during a typical 7-9 mile hike. He stood there staring at me on the trail, and I knew he wanted me to trust him and take off the brace. I did.
• We continued conservative management throughout the 11 months.

THE GOOD TIMES

For the following four years, Tidus hiked the alpine mountains and the craziest terrains like nothing had ever happened. He fully kept up with our girls Yuna and Kimahri, without any signs of pain or fatigue.
Tidus showed no signs of his injury throughout these four years, when most dogs experience the second rupture within the first year of surgery.

WHAT I WISH I HAD KNOWN AND DONE

I still carry the burden of the things that I didn’t know or do after his injury with me every day. Unfortunately, traditional vets don’t tell you about these things. It takes years to figure it out on your own, often after the damage is done. That’s why I feel SO strongly about sharing all of this information with you, so you don’t need to carry the same burden.

• The overall health and well-being of a dog is tied to its diet. Tidus has been on “premium kibble” since the beginning. We later learned the hard way that kibble, no matter how premium, is not the right nutrition for dogs and can cause a lot of health problems.
  High-quality omega-3 fatty acids are essential to good joint health.
• There are so many amazing physical and other therapies that can both speed up healing and drastically reduce the chances of re-injury.
• “Holistic veterinarians” exist and can help you create a minimally (or non-) invasive treatment plan.
• Tidus would probably have benefitted from having two braces instead of just one. The first to support his injury, and the second to help alleviate the pressure on the healthy leg while the injured leg recovered.
• I should have continued with permanent conservative management, especially not allowing the dogs to jump into and out of cars.

TIDUS’ SECOND INJURY

During a relaxing evening hike in December 2018, Tidus stopped walking and cried out again. This was all too familiar to me. My heart sank, and I immediately knew that he had hurt his other knee. We were temporarily living two states away from home (and our incredible holistic veterinarian), so we had no choice but to get the diagnosis done locally by a traditional veterinarian. The classic drawer test confirmed that Tidus had a second ACL injury, either a full tear or deep partial tear, coupled with a meniscus injury. This time, Tidus didn’t even touch his toes to the ground for weeks, and his injury seemed more painful than the first.

I quickly contacted our holistic veterinarian to discuss the next steps. We made it clear that our absolute priority is to give our dogs an incredible long-term quality of life, and we would take the best route possible no matter the cost.

During our consultation, our holistic vet confirmed that he was comfortable with us attempting recovery without surgery, while keeping surgery as an option if we needed it later on. Together with our vet, we came up with a plan: monitor Tidus, make sure the treatments were proving to be effective, and have a fantastic surgeon on standby just in case.

NUTRITION AND CURRENT SUPPLEMENTS

The entire Husky Squad is on a raw food diet. We made this switch approximately 11 months before Tidus’ second ACL injury, after Kimahri was diagnosed with cancer, and we’ve seen some incredible benefits from this change!

Additionally, the entire pack has been on the following supplements for almost a year so far:

1. Curcumin bites (to fight/prevent cancer and inflammation)
2. High-quality omega-3 oils (for healthy skin, coat, heart, and joints, as well as cognitive function)

THE PROCESS AND STEPS TO RECOVERY

When Tidus sustained his second injury, we had a lot more experience under our belts. With an amazing holistic veterinarian by our side and confidence in our abilities as dog parents, we started a much more aggressive (but non-destructive) approach to Tidus’ recovery.

I’ll distinguish what my intuition and experience tells me were absolute essentials from the steps that were important in speeding up the process, preventing re-injury, and providing a fantastic quality of life. Tidus recovered from his second ACL injury in LESS than HALF the time it took to recover from the first.

ESSENTIAL STEPS:

1. Double custom knee braces. One to support the new injury, and the other to support the previous injury. Double braces helped Tidus use both legs equally, which avoided putting pressure on his previous injury and re-injuring it.
2. Conservative management. We also quickly implemented permanent conservative management for the entire pack. Critically, we carry them into and out of the car, or use a ramp. This helps to PREVENT this injury.
3. Daily gentle leashed exercise with custom braces. We started with 5 minutes for the first few days, and increased slowly with time (follow your intuition).
4. Cold and Hot Pack treatment, three to four times a day for the first three months to alleviate pain and reduce inflammation. (instructed by Tidus’ Physical Therapist)
5. Maintaining Tidus’ slender weight to keep pressure off his joints and ensure better overall health.
6. Providing non-slip surfaces in common living areas. Carpets and rugs are fantastic and help tremendously with removing fear of slipping. Fearful dogs on slippery surfaces can easily re-injure themselves.
7. A healthful, homemade, properly balanced raw food diet (not kibble!).
8. Essential omega-3 oils.
9. Anti-inflammatory curcumin supplements.
10. An amazing, WARM, LOVING, CONFIDENT, SUPPORTIVE, HAPPY home to give your dog a positive environment to heal. Dogs feel EVERYTHING, and this impacts your dog tremendously.

We feel these ten items were absolutely essential and the bare minimum to Tidus’ recovery, and that he would not have healed without them.

IMPORTANT STEPS

With a Professional or Facility

1. A holistic veterinarian for natural medicine and monitoring progress/improvement. Tidus was prescribed Chinese medicine for his joints, CBD for pain and inflammation, and custom herbal blends to speed up recovery. In other words, we gave his body the tools to support his healing.
2. Hydrotherapy in a water treadmill for three months. We started immediately with two times a week for the first six weeks, then tapered to once a week for the remaining six weeks. Hydrotherapy builds muscle without putting pressure on the joints. (Instructed by our holistic veterinarian)
3. Cold laser therapy for three months. We started immediately with two times a week for the first six weeks, then tapered to once a week for the remaining six weeks. Cold laser is a noninvasive procedure that uses light to stimulate cell regeneration and increase blood circulation. (Instructed by our holistic veterinarian.)
4. Land therapy for six weeks, twice a week. Within two weeks of the injury, we began working with physical rehab specialist who’s experienced with treating dogs with ACL injuries. We continued land therapy on our own after six weeks, since we no longer had access to the facility after returning home.
5. We introduced swimming, with a life vest and professional instructor, six weeks after the injury happened. I would have done this sooner, but didn’t have access to a pool earlier. Tidus swam weekly for 6 weeks. Swimming is a fantastic low-impact exercise which helps muscle conditioning, in turn supporting the joints. (Instructed by our holistic veterinarian.

At Home

1. Homemade bone broth slow-cooked for 48 hours with a tablespoon of apple cider vinegar. Dose: ½ cup of gelatinous bone broth made with organic beef bones. Our veterinarian stressed the importance of using organic bones. Feed-lot, non-organic cattle (and other animals) store chemicals, antibiotics, and other harmful compounds in their bones, and this would be counterproductive to healing. Bone broth is liquid gold for joint rejuvenation and a healthy gut. A healthy gut processes nutrients better, and is essential for absorbing all the goodness we were throwing Tidus’ way. (This was instructed by our holistic veterinarian.)
2. Fascia-strengthening exercises at home. Tidus’ physical therapists showed us how to work with Tidus on strengthening his fascia. The health and strength of the fascia is so important to overall proper health. This is a newer subject to me, but we see incredible improvement in general with Tidus’ gait, posture, and balance, which is critical in supporting the healing of this injury.

THOUGHTS FROM MY HEART

Words can’t describe what it feels like to see Tidus happy, healthy, and THRIVING again at a beautiful age ten. There’s no better feeling than seeing him enjoy the outdoors, climbing mountains with all of us as a family. The results we’ve achieved are way beyond what we hoped for. We’re incredibly grateful to the entire healing team around Tidus, along with all the loving wishes and support from the Husky Squad community around the world.

Although it may seem that we “got lucky,” I have to say that I believe our experiences support the value of physical therapies, ancient proven healing practices, new non-invasive healing techniques, determined positive energy, and absolute commitment to following through with all the steps, no matter how difficult or challenging. This healing regimen is NOT for the lazy.

We all wish for our fur-kids never to get sick or injured, but circumstances, genetics, and other factors play a big role. It’s not likely that any dog will go its entire life without any issues. We’re absolutely committed (and hope you are too!) to providing the best possible healing and care based on what’s right for our pups, rather than the fast, seemingly convenient options with long-term risks and harm.

ACL INJURIES ARE NEVER EASY

ACL injuries are never easy or cheap, no matter what route you take. Sure, the $8,000-$13,000 cost of surgery is outrageous, and for many people it is impossible to even borrow that much. However, the alternative route will cost money too.

Personally, I’d eat one meal a day if I had to, and cut out all “nice things,” because I made a commitment to our fur kids to give them the absolute best. However, we understand that not everyone is in a position to be able to afford expensive treatments, even after cutting out all the luxuries.

With that said, no dog should be left dealing with this without any help. We feel that the minimum that any dog with an ACL injury deserves is a custom brace to support this very painful injury, and to provide at least a good shot at management and recovery. Custom braces can run anywhere from $600-$2,000 depending on where you live. #DogsAreFamily.

TODAY AND THE FUTURE

Although Tidus is in the clear and recovered, we don’t take this subject lightly. We’ve learned so much about ACL injuries, and even more about the topic of prevention. These things don’t “just happen.” More on this in the future.

CLOSING THOUGHTS

I was initially reluctant to write this and film the entire process for our YouTube channel, because as a society we collectively suffer from “degree syndrome,” or the belief that we need to absolutely trust every doctor or vet. I didn’t feel that I had the energy to deal with a barrage of “gold standard” comments, and I’d rather focus 1000000% of my energy into Tidus’ recovery. But I stepped away from these thoughts, because I KNOW that if I had found something detailed and helpful from a fellow dog parent when I needed it the most, it would have been incredibly helpful. That’s all that matters.

There are some people who suffer from “degree syndrome,” implicitly trust every vet, feel that there’s only ONE WAY to heal, and believe that dog parents don’t have the right to know and try the alternative with common sense and an open mind. I will not waste my precious energy debating with this perspective except to point out that science is a collection of data. The moment we stop learning, or dismiss data due to our own biases (whether in degrees or beliefs), that’s when progress dies. A doctor’s jacket and a degree simply come from your fellow human beings, not from some divine source. This information should evolve and not be closed to new learning and evidence.

TO EVERY DOG PARENT READING THIS

I repeat: I’m not a vet, and I’m not here to ultimately tell you how to help your dog heal from this injury. Instead, I’m here to give you a dog parent’s perspective and experiences to help YOU do further research and ultimately decide how you’d like to proceed. We feel that dog parents have the right to know their options, and the choice belongs in your hands.

OUR DEEPEST GRATITUDE

We’re forever grateful to Tidus’ amazing healing team (in no particular order):

1. Tidus’s incredibly knowledgeable primary physical therapist Minet at the Woof Center, Santa Clara Utah. This would not have been possible without her compassionate almost magic like care. She’s also Tidus’ favorite person.
2. Dr. Derrick Campana for the bionic-like custom braces. I highly doubt any of this would have been possible without his expertise.
3. Dr. Keith Weingardt, Holistic Veterinarian for supporting us, monitoring Tidus, and for the best holistic care a dog parent can dream of.
4. Denisse, physical therapist at Cascade Animal Park Hospital, Tidus’ amazing therapist who took over when we went back to Portland Oregon.