Saturday, January 7, 2012

Dog Knee Injuries: Should You Say Yes To Pain Management?

It's a no-brainer, isn't it? Or is it? What would be your answer?

A friend's dog became lame and was diagnosed with a partial ACL tear. Their vet recommended to wait and see, even though the friend wanted to do a surgery (I don't see what the vet wanted to wait for but I'm not going to get into that here).

Rescued! Is My Favorite Breed
He also recommended, when asked, not to start any pain management.

In response to his surprise, my friend was told that if the leg isn't going to hurt, his dog will not be aware of a problem, overuse the leg, and might tear the ligament completely.

What do you think?

When Jasmine was first diagnosed with her knee injury, we thought the same thing.

What do I think today? Well, I do think that the concept is partially true, the injured ligament certainly is in danger of getting fully torn. It is also true that one of the functions of pain is to alert to a problem. How does that work out in a long run, though?

I know from experience that a damaged ligament can let go pretty much at any time, for any reason, and it doesn't take any wild or crazy moves.

In light of that, the above argument is kind of moot, isn't it?

I believe, that if the ligament is going to go, it's going to go whether your dog is in pain or not. Except that your dog is going to be in pain!

What is the first thing you do when you get a headache or hurt? Raid the medicine cabinet for aspirin, right? Do you think your dog wants to be in pain any more than you do?

I'm not even going to get into talking about physiological impact of pain.

Besides of making your dog comfortable, there is a practical reason behind pain management, and that is as normal use of the injured limb as possible.

Image: Dog Breed Info Center
My hot yoga instructor friend says that one should do their best not to limp for more than a couple of days. Here is why.

Firstly, the less the limb gets used, the more muscle atrophy your dog ends up with. 


Muscles help protecting and keeping the joints stable. The more muscle your dog loses, the bigger the load on the joints. So that kind of counters the whole idea of protecting the ligament, doesn't it?

Secondly, every time one part of the body doesn't get used properly, the rest of the body needs to compensate.

Since the friend's dog is no pup, the chances are that the injury was caused by gradual weakening of the ligament over time. That also means that the ligament in the other knee isn't in best shape either. Favoring the injured leg will cause additional stress on the other joint and increase the likelihood of the second ACL tearing also. This will likely happen anyway, but I think that having one bum knee at the time is quite enough.

The impact of favoring the one leg doesn't end there. It will, at the end, affect the whole rest of the body.

When you see a dog with disproportionately broad shoulders, it is a safe bet to assume that their hind legs are in bad shape. I've seen quite a few such dogs.

Due to Jasmine's knee injuries and surgeries, her shoulders got visibly broader also, and developed arthritis, from the access load they had to carry.

Today, with her hind legs working properly, her shoulders had returned to their proper proportion.

When any one part is not functioning properly, the whole rest of the body suffers.

One time, hubby had a wart on his foot. It hurt to step on and so he was not walking properly. His entire leg and back ended up hurting as a result of that. A small problem turned into a huge one.

Is there any advantage of passing on pain management then? What do you think?

It's your dog's health,
Jana

Related articles:
Compensation: An Attempt To Restore Harmony
How The Oddysey Started: Jasmine's ACL Injury 
Talk To Me About ACL Injuries
ACL Injuries in Dogs: Non-Surgical Alternatives?
ACL Injuries in Dogs and Stem Cell Regenerative Therapy
Newest Surgery For Ruptured ACL In Dogs
Preventing ACL Injuries In Dogs
ACL Injuries In Dogs: Xena's Story 
ACL Injury Conservative Management: Sandy's Story
Surviving The Post-Op: After Your Dog's ACL Surgery
Talk to Me About Arthritis
Don't Forget the Physical Therapy 
My Love Is Sleeping At My Feet: ACL Surgery Complications 
Coco's TPLO Post-Op Diary 
Small Breeds Can Hurt Their ACL Too: Star's Naughty Knee 
One Thing Leads To Another: Why The Second ACL Often Goes Too 
ACL/CCL Injuries In Dogs: Is There Such a Thing As A False Positive Drawer Sign?

8 comments

  1. I think if you're not comfortable with a vet's advice then seek a second opinion. But I also need to be open-minded. It took 4 vets to find help for DeDe, but in all fairness, none of them could have discovered the reason her problem before the last one did as it was so slow in coming on.

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  2. Hi rumpydog,

    thank you for reading.

    You're absolutely right about seeking second opinion. After all, you're the one who has to live with whatever decisions are made.

    Yes, some things are difficult to diagnose and it can get quite frustrating. Something such as an ACL injury, though, is a pretty straightforward thing.

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  3. I think that we should manage pain and control activity for our pet friends!

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  4. The concept that dogs should be left to suffer in pain to "keep them quiet" is such an antiquated notion! It saddens me to know that there are still vets out there that subscribe to this theory.

    Modern pain research shows that proper pain control not only helps the dog feel better but, from a physiological standpoint, affects the way the body recognizes and responds to painful stimuli. Not treating pain promptly can set the pet up for a situation in which a simple acute pain can become chronic.

    Years ago there were few options for pain medications in pets and even fewer research articles. These days there are numerous studies that show that treating pain is not only beneficial but critical to a pet's overall health and wellbeing. It makes me very angry to think that there are pets out there that are suffering needlessly because their vets are too lazy to bring their knowledge of pain protocols up to date....

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  5. There are many ways to safely manage the discomfort of joint issues or injuries, including natural supplements. Keeping our wonderful companions happy and healthy is what most of us truly want for our dogs.

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  6. Hi Jen,

    I know, right? That's why I felt it was important to write about it. I was quite surprised to hear that too!

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  7. Jana I agree, there is no advantage to not giving pain management. Exuberance can be controlled in other ways - confinement, strict exercise control, even sedation of needed. I have even hobbled a few dogs in a very similar fashion to horses. Sounds mean but it doesn't hurt them and it works.

    PLUS the way the spinal cord works, the more pain it sustains the more it amplifies future pain, including arthritis or future knee surgery. It can take a lot to 'wind down' this kind of pain.

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  8. Dear Dr. Chris, thank you for commenting! I found that quite surprising and scary that it was the vet who believed that ...

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