Today we want to talk and educate you on Meniscus tears, and what they mean for your dog. Say you just got back from a visit to your vet, to find out your dog has a CCL tear with a meniscal tear as well. Now what? Your vet I am sure has gone over all of the surgical implications for this problem I am sure, but have they explained what the meniscus is?
How important it is to have in our knee, or what the function is? No, most likely they have quoted you for removing the meniscus, and the CCL repair only. Now I do know many Veterinarians that will try conservative management first, and a very huge thank you to those vets!
Well, you are in the right place. Our goal at Posh is to give you, as the dog mom and dad, options. Yes, you heard me, there are options with a Meniscus tear, not just surgery. Think of yourself for a minute. If you go into any orthopedic Doctors office, would they simply take an xray and schedule you for immediate removal of your meniscus? Absolutely not. There would be follow up appointments, probably an MRI to confirm, and then they would go over the options. Yes, there is that word again. Options.
Well, There are actually 2 menisci in each knee. The Menisci is a C shaped component made up of cartilage, and composed of collagen and joint fluid. 70% of the menisci is made of fluid that will compress with normal movement and release synovial fluid into the joint so that the knee can easily move. They act as our shock-absorbers and buffers, like in a car or truck.
With a CCL tear, it is very common to have a meniscal tear. There are several grades of tears, from a small tear, toa complete folding over of the meniscus. In most cases, the patient will have a minor tear. With this you may hear a pop or clicking sound. These tears are minor, and do well with bracing and Physical Therapy and Adequan Injections.
You can see now how it is very important not to completely remove the meniscus, as some vets may suggest prematurely. Now if the meniscus is folded over, usually you will see the knee sticking and unable to bend correctly. This is a surgical issue, and will need corrected.
Removing the meniscus almost always leads to arthritis and chronic lameness, as you just took out the joint’s buffer. Only if the meniscus has folded over, and I have seen this only twice in over 4,000 patients, will you need to consider removal.
It will take several months to heal, but healing is possible! Usually bracing for 12 months during activities, along with supplements and a good diet are enough to let the meniscus recover. Let us know if you have any questions, and we are happy to help your dog!
Nikki, Posh Lead Veterinary Technician
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Today I would like to discuss bilateral injuries with you. First off, once a patient has a CCL injury, there is a 50% chance or greater of the second knee having a tear.
This goes up with surgery, due to the overcompensating and atrophy that develops with post-op patients, and can decrease with bracing.
Lots of things can factor in as to why a patient is now bilateral. Genetics may predispose our pups, such as bully breeds, as well as early spay/neuter, diet, etc.
So, weather your dog had surgery, and now the second knee has gone out, or both were close together, a knee brace would still be the best and most conservative option. Please let me know if you have any questions, and give your dog a Big Hug for us!
Nikki, Posh Lead Veterinary Technician
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Today I want to talk about surgery vs. bracing, and why we suggest bracing first.
First off, not every patient is a good surgical candidate. Be it weight, age, anesthetic risk, liver enzymes, poor health, or maybe the owners don’t have the $10k saved that it will take to fix not only the first knee, but the second knee that will go eventually once surgery is done.
Screws coming out, plate failure, angle was done incorrectly, bone fractures are very common, especially with large breeds doing TTA surgery, and infection is also very common. I have had several patients come to me that have been fighting infections for almost a year, such as mrsa, due to the surgical site not being sterile!
Unfortunately, some have the leg amputated due to complications. Also, if the angle is done improperly, they will start to weaken the ankle and hip joints, as things are not in alignment any longer, and start breaking down. Complications are common, and unfortunately some cause irreversible damage. I have even seen some patients have surgery done on the wrong leg, and yes that actually happened!
Also, 1 in 4 dogs that have surgery have lifelong lameness! With bracing, we don’t have any complications, or risk. Our patients are able to place full weight on their affected leg within just a few hours of receiving the brace. They can go for walks right away, which we will encourage. We also do physical therapy from your home, to help build the leg up and muscles, as well as Passive Range of Motion to help build strong tissue. We also go over diet and supplements, to give you the best outcome.
Just remember, you can’t undo surgery complications, but with conservative management there is always more we can do. Surgery should be a last resort. If you have any questions you can contact us on or contact form or visit our Facebook Page.
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Today I want to do a quick brace comparisons with our brace vs. a hard casted brace. We get asked a lot of questions about what separates us from a casted brace, and today I will answer those for you!
First off, a casted brace is made of a very hard plastic, with basically no flexibility. This makes it difficult for patients that have muscle atrophy, as the brace will no longer fit properly once you have re-built the muscle back, as with our Posh Brace. The Posh Brace gives much more flexibility, while still having adequate support. We feel this is similar to wearing a good quality shoe. You want something with good arch support, but not something hard and unforgiving.
Another thing that separates our brace from a casted brace is Velcro straps. One thing Velcro does very well is collect dog hair. Having Velcro straps on a brace made for a dog means you will be constantly replacing those straps, as they get filled with hair. With our posh brace, we only use high quality ladder straps and buckles, similar to a ski boot or inline skate.
Also on the casted brace you will notice there is a Velcro strap with a thin pad that is supposed to support and stop the tibial thrust or forward movement of the knee. Our posh brace actually uses a shell and ladder strap to stop tibial thrust, which is much more reliable than a thin pad and Velcro.
With our Posh Brace, we use Micro-buckles, which makes the Posh Brace more weather resistant. We have patients in Arizona in the heat, as well as in the arctic in Alaska. They can get wet or muddy, and with a simple rinse look back to brand new. Our straps are also very easy to adjust, so we can again accommodate for atrophy or changes in muscle. All 3 shells of our brace are adjustable with our technician’s assistance, so we don’t usually need to have a brace shipped back for modifications, unlike with a casted brace. This will save you time and money, as we want your dog using their brace as soon as possible.
Lastly, with a hard plastic brace, it is pushing up into the groin more, without any forgiveness. This can lead to pressure sores and discomfort. With the posh brace, we use a very soft plush foam, that is much more comfortable in the sensitive areas like the groin and ankle.
Let us know if you have any questions, about other Brace Comparisons feel free to reach out! Also check out ouf Facebook page.
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Hey everyone, today we want to discus all the different bracing myths out there, and try to clarify some of the brace myth. There is a lot of information out there, and sometimes it is difficult to sort through what is accurate, and what is false.
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Truth: It is actually the opposite. Unlike with surgery, with bracing your dog can immediately start placing full weight on their injured leg. This stops the overcompensating on the opposite side, and lets them begin using that thigh muscle again. Because they are able to place weight again on the injured leg, they are able to start strengthening that thigh muscle.
Truth: Bracing does not cause arthritis, the movement going on in the knee is what will cause arthritis. So, doing nothing will probably end up causing arthritis to form down the road. With bracing, we are stopping that movement, holding the knee where it needs to be in order for scar tissue to form adequately. This process takes about 9-12 months. There is no evidence that shows bracing causes more arthritis than surgery.
Truth: Although some companies experience this with their braces, here at Posh we do not. Our brace has several components that help to keep the brace up, without straps or slings. We have a hock wrap around the ankle, then the brace attaches to the front of the hock wrap, and we have 3 straps holding up the brace. When things are properly adjusted, there is no sliding.
Truth: There is not a brace company that can guarantee that a dog will fully recover, just like with surgery there is no guarantee that your dog will not have lameness. We do the best we can with bracing, physical therapy, and supplements.
Truth: Most patients use the brace for 9-12 months. Once we hit the 12 month mark, we can usually start weaning out of the brace, depending on the initial injury. Meniscus tears may need a little longer than just a CCL tear. If your dog has arthritis present when you start bracing, you may want to use the brace a bit longer.
If you are interested in anymore information you can contact us through our contact form.
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