Last week Lucy came in for her check-up. She was brought in by an elderly couple I have known for many years through what seems like a lifetime of pets. Because they were elderly and lived alone, Lucy had become the centre of their world.
Whenever elderly clients bring in their pets, the biggest concern for me is knowing how extremely important and beneficial pets can be to the health of elderly people.
In Canada, dogs were, at one time, banned from residential homes. This ruling had to be overturned due to the negative effect this was found to have on the well-being of the residents.
A similar case happened in Australia, where it was found that allowing cats in residential homes had a huge beneficial effect on elderly people. In the UK, I have actually met dog owners who voluntarily visit residential care homes, accompanied by their dogs that have been vetted and approved for voluntary work. And here I was once again facing a situation where elderly clients had come to the clinic worried sick about their beloved pet.
Lucy is an 11-year-old slightly overweight white female poodle. She had been limping on her left hind leg ever since she had fallen the week before. My initial suspicion as to the probable cause was confirmed upon examination: Lucy had a rupture of the anterior cruciate ligament in the left knee joint.
The knee joint is one of the largest joints in the body and greatly depends on its ligaments for stability. There is no ball-and-socket configuration, as you get in the pelvis or the shoulder. Instead, all you have are two flattish bone surfaces of the femour and tibia which are largely held together by two ligaments in the centre of this interface.
These ligaments cross over each other just like the letter X. Hence, the description ‘cruciate’, which means ‘cross-shaped’ and comes from the Latin term cruciatus.
Overweight dogs have a tendency to rupture the anterior of the cruciate ligaments. This destabilises the joint due to the fact that the dogs’ weight is too much for their knees to cope with, especially when making certain movements, as happened with Lucy.
The same injury can, however, happen in fitter dogs during exuberant activities, such as chasing rabbits. This actually happened to another patient of mine.
There are many other ailments that may cause a dog to limp on its hind legs, and X-rays may be necessary to exclude other possible ailments and to ascertain the development of arthritis in the knee joint.
Diagnosis of anterior cruciate ligament rupture is based on the evidence of what is known as the ‘drawer movement’ of the joint, while the dog is heavily sedated. When the stability of the joint has been compromised due to the rupture of the cruciate, the two bones – namely the femur above and the tibia below – can be manually made to slip across each other in a drawer movement.
This movement and lack of stability is the reason why the dog limps and also why, if left untreated, it can give rise to secondary permanent arthritis in the joint. Lucy was lucky because her owners chose to bring her in very soon after the injury, thus preventing secondary arthritis.
Because of the elevated degree of ‘drawer movement’ and the lack of secondary arthritis, surgery was the treatment of choice. My clients were willing to have Lucy operated upon, and within a few days, the operation was carried out.
There are many different techniques for cruciate ligament repair, which may vary according to surgeons’ discretion as well as the size of the dog, but all are aimed at restructuring and reinforcing the ligaments to re-establish the stability of the knee joint. Any orthopaedic surgery carries its own risk of complications, so I was glad to see Lucy’s owners walk in one month after her operation with a big smile on their faces.
Lucy was certailnly walking much better and I hope this improvement continues over the coming months.
thisweekwiththevet@gmail.com
Dr Debattista is a veterinary surgeon.