Dog Breed Info Center(R) DBIC

Bruno's First ACL Ordeal: 13th to 21st Week after the Suture Lateral Surgery Left Knee—The Recovery

Anterior Cruciate Ligament (ACL) rupture/tear in dogs

Bruno the Boxer sitting outside

We have had so much ice and snow that it seemed from week 10 to week 13 Bruno started slowly going backwards. He was still leashed while taken outside to do his business but I too was slipping and falling as I was trying to walk him as carefully as I could.

On week 13 Bruno did something to his knee somehow that had him holding his leg in the air for about four days. I don't know if it happened during one of the times he slipped on the ice, walking in the snow to do his business, when he was playing with Spencer, or the time I went to lift him into the truck and the sucker jumped on his own. A vet appointment was made for x-rays to see if he had done any damage to his knee cap or if he had a torn meniscus.

The appointment had been scheduled for the following week. In the meantime the temperatures warmed up. One day it even had reached 60 degrees! All of the ice and snow melted. He was still leash-restricted but this time neither of us was having a hard time walking.

Day 102

Bruno the Boxer laying on the floor in a veterinary office

About 14 1/2 weeks since his surgery.

During that week he seemed to heal up very well and by the time we got to the vet appointment that following week I was sure he was most likely fine. We had even gone for an hour-and-a-half slow walk with no issues whatsoever a couple of days before. I proceeded with the test and x-ray just to be sure. The test results came back good. No tear in his knee.

His report read:

"A lateral of the left stifle was taken revealing no significant abnormalities of a postoperative ACL tear. The joint is stable and there is no meniscal tear noted."

While he was under for the x-ray it was decided to inject his joint with a hyaluronate sodium injection. That is a solution similar to the substance that naturally occurs in joints. It acts as a lubricant and a shock absorber.

At the vet Bruno weighed in at 91 pounds. I was told he was not fat; he had a lot of muscle and was tall. I had been working on getting him to lose a few pounds. He had lost two more pounds since his last vet visit on his grain-free diet.

Bruno's injection was on a Thursday. After I brought him home he slept most of the night away. However at one point he got up and ran with Spencer. He then pulled his leg up. I am not sure what exactly he did to his leg, but whatever it was really hurt him.

Day 103

Friday—he would not use the leg at all. Hopped around on three legs. I looked up the type of knee injection that Bruno had and read that it can cause joint swelling and pain for a while. I also read that after an injection one should be limited on what they do 48 hours after treatment. I had not been made aware of these instructions or after-effects.

Bruno the Boxer outside in the driveway holding up his back leg

Day 104

Saturday—he would not use the leg at all. Hopped around on three legs.

Bruno the Boxer eating out of a dog bowl with its left leg in the air

Day 105

Sunday—he toe-touched the ground and would use it a little bit, limping heavily if he was walking very slowly. Most of the time he held the leg up.

Day 106

Monday—he toe-touched and walked on the leg a tiny bit more than the day before. When he did use it he limped heavily. If he was walking really slow he would use it, if he walked at a normal pace he would pull the leg up and hop on three legs.

Day 107 - Acupuncture

Tuesday—he would use the leg a little more than the day before. He still hops on three legs if he tries to walk at a normal pace but is slightly better. Still not good enough to go for a walk, however. He limps heavily when he does use the leg.

Bruno the Boxer at the Acupuncturist laying under a table

I have decided to go a different route in trying to get Bruno's leg stable enough that he can go out to pee without a leash and go for our long walks. I would also like to get him off of the pain medicine. He is too young to be on pain meds for the rest of his life. The longer he is on them the higher his risk of side effects.

I decided to try acupuncture on Bruno. I took Bruno to a holistic vet. He had his first session of acupuncture.

Close Up - Acupuncture needles in the back of Bruno the Boxer

I used his "dead dog" trick with a belly rub as his reward to get him to lie down and relax. He was a very good boy and lay down during his session. I had to remind him to stay there the first time he heard another dog bark in the other room. He tried to pick his head up and was about to stand when I made a "Shhhhh" sound and guided his head back to the down position. "Down, Stay," I told him in my calm, relaxing, yet authoritative voice. He understood he was not allowed up and he lay there the rest of the time until the needles were taken out.

Close Up - Acupuncture needle in the leg of Bruno the Boxer

I am switching Bruno's joint supplement. It is still Glucosamine, Chondroitin and MSM with one other ingredient in it, which I do not recall. Apparently not all Glucosamine, Chondroitin and MSM joint supplements are the same. Some work better than others with a higher concentrates of important factors in them.

He is also being put on another tendon/ligament supplement which is also in a prescription bottle.

Bruno is also on a new fish oil that has been proven to work as an anti-inflammatory. Apparently not all fish oils are anti-inflammatories. This one contains fish oil, barley grass extract, gelatin, beeswax, lecithin, glycerin, purified water, caramel powder and Vitamin E.

Bruno will go back for acupuncture once a week for a while and then the sessions will lessen.

Day 108

Wednesday—Bruno showed slight improvement on his leg and used it a little more. If he walked fast, however he would still pull the leg up. I called the vet and they said to give him a slow 15-minute walk twice a day to loosen up this joint. We did one 15-minute walk because that was all I think he could handle. He used his leg but only if we walked very, very slowly.

Day 109

Thursday—one week since the injection. Bruno showed slight improvement from the day before. He was walking fast for spurts while inside the house without pulling up his leg. For the first time all week he started to initiate a play session with Spencer his Pit Bull brother. I stopped them from playing and put Spencer outside. Bruno then started tossing a ball around the house and pouncing on it. I took Bruno for a short walk to try and get him to calm down. He was definitely feeling better. I walked slowly and he used his leg for the walk. However, after Bruno gets up from lying down his leg is still in the air about 50% of the time and toe-touching the rest but with the occasional weight on the leg. He is still limping heavily, but not like he was a few days ago.

Day 112

Acupuncture needles in the back and hip of Bruno the Boxer

Bruno had his second round of acupuncture. He also had x-rays of his back and hips.

Results of the back x-ray are "The cervical, lumbar and sacral spine appears normal. There is bridging spondylosis of T-10 - T-11 and T-11- T-12 vertebral spaces. These areas are not usually associated with hind lameness." In other words, Bruno has a bad upper back. The vertebrae just below his shoulder blades narrows. This would cause back pain, but usually does not cause pain in the back legs.

Bruno the Boxer outside sitting in grass

Bruno's hip x-rays show a slight abnormality in his left hip, but I was told it was not enough to be making him this lame. Notice how Bruno's left back leg (right side of the picture) is not as fully bent as the right leg. That is how Allie the Boxer who also had hip and knee problems, used to sit.

X-Ray of Brunos hips

This is Bruno's hip x-ray. The right hip is much smoother looking than the left, but it is not horribly bad.

Now with this new information the vet can better treat him with acupuncture.

Day 119

Bruno has Acupuncture needles in his back and hip

Bruno had his third acupuncture appointment. However it was his first acupuncture treatment that included his hip area. Bruno seems to be improving. I am limiting his exercise. If he walks fast, however he will still skip a step and pull up his left leg.

Bruno the Boxer sitting outside with a long haired orange cat in front of him

Here is a better picture showing how Bruno does not bend his left leg as much as he does his right one while sitting.

Day 128

Bruno the Boxer, standing in between a persons legs, with acupuncture needles in his back and hips

Bruno's second acupuncture treatment that includes is hip area. This treatment included his back, hips and knees. During the treatment Bruno had to stand for 15 minutes. I held my hand under his belly to keep him from sitting or laying down and sat on the floor with him. This week it was much easier to keep him standing than it was last week.

Bruno the Boxers back left leg

I am noticing Bruno is using his leg more than last week, but he still is not back to the way he was before the hyaluronate sodium injection was given and before he had gotten up and ran with Spencer for that short bit. Between the two events something had set him back. I honestly do not know if it was the short run or the injection. For me to say one or the other would only be speculation.

Bruno the Boxer with his mouth open and tongue out

Bruno standing like a good boy during his acupuncture. The vet’s office is very good at remaining calm, which in return helps Bruno stay calm. I had a friend who is a massage therapist give Bruno a short massage. Before the massage Bruno's gait was very off. You could see his hips were not even. After the massage Bruno's gait appeared much more normal. Thinking back I had this same friend give Bruno a massage before his ACL surgery with the same results: he went from an uneven back with an off gait to a straight smoother gait and straighter back. It appears Bruno's joints are out of alignment. This past appointment, in addition to the acupuncture, Bruno also had a back adjustment. There were a few spots in his back that were out.

Bruno the Boxer laying on his side with acupunture needles in his hips and back

Bruno had his third acupuncture treatment that included his hip and back area. He also had a chiropractic adjustment of his back.

In addition, Bruno's laser therapy treatment (low-level laser therapy (LLLT)) has just started. Laser therapy is the medical and veterinary treatment that uses low-level lasers or light-emitting diodes to alter cellular function. He is receiving treatment on his back, left hip and left knee where he had the ACL operation. It is the level-4 therapy that is said to treat both pain and inflammation at the same time.

Bruno the 3-year-old Boxer is starting laser therapy for the hip dysplasia in his left leg, the repaired ACL tear in his left knee, arthritis in this left hip and knee, arthritis in his back near his tail and some bridging of the spine near his upper shoulders. This is a “before” clip. Watch his left leg. Notice how he tends to put all of his weight on his right leg, keeping the weight off of his left. Watch how he holds his left leg up from time to time, preferring to use the right whenever he can. Watch how he has a limp in his left leg. Bruno goes back and forth between using the left leg and not using it. This was actually one of his better days. Time will tell if the level-4 laser therapy makes him feel better.

The first week of treatment he receives two treatments a day, an hour and a half apart from one another for three days in a row.

The second week he receives two treatments an hour and a half apart from one another for two days in a row.

The third week he receives two treatments an hour and a half apart from one another for one day.

The fourth week he receives two treatments an hour and a half apart from one another for one day.

Bruno will still receive an acupuncture treatment and a chiropractic adjustment of his back once a week in addition to his joint supplements.

Bruno the Boxer laying on the floor, having his hips treated with a laser

Bruno receiving his very first treatment. I asked him to lie down on the floor and the vet tech placed one end of the laser near the top of his head while the vet scanned the areas being treated. I was told the laser near his head is like a connecter; an analogy would be the area code of a phone number where the laser is the rest of the number. It links the treatment together in the body.

Bruno had totally relaxed and fell asleep during the treatment, which lasted no more than ten minutes total. When he was finished and woke back up he lifted his head and stared at his hip and then twisted to stare at his back. I am not sure if he did that because he had felt something or because he suddenly felt better? The vet had not physically touched those areas, just shined the laser at them. Only he knows why he felt the urge to look at the areas treated.

We all kind of laughed at him and he, being the silly boy that he is...

Bruno the Boxer rolled over licking the vet tech belly up

…rolled over and licked the vet tech.

Bruno the Boxer having his knee treated with a laser

Bruno receiving his second treatment for the day.

They say that 90% of patients show improvement after the seventh laser treatment.