给大家分享一下我们vet的一封信 (关于狗狗-韧带受伤）

hohoho

Charlie 快九岁了， 上周四突然在dog park 玩的时候腿不好用了， 第一时间去见了Vet, 医生怀疑是韧带有问题了， 开了消炎药。今天一早， 给我们发了长长d的email, 很高心有这样负责的医生。 把email 贴这里， 分享给有furry baby的家庭.


Thank you for bringing Charlie in to the clinic last week to investigate her sore right back leg. Based on the palpation of Charlie's leg, I believe that Charlie has torn her cruciate ligament (like the ACL ligament in a human knee) and that this is causing the knee to be inflamed, painful and will predispose it to developing arthritis. To further confirm this diagnosis, we can take an xray to assess the knee for other underlying changes that would indicate likely ACL tear.

Please see below the options available for management or treatment of Cranial Cruciate/ACL rupture in dogs:

Cranial cruciate ligament tears and knee disease is very common in dogs and is largely due to microtears that gradually happen in the knee over a long period of time. As the ligament gets thinner and thinner it has less ability to cope with the strain of weight bearing and exercise. Eventually, the ligament tears as it is unable to heal itself. This is quite different to human ACL tears, which are more commonly associated with sudden trauma or excessive force being applied to the knee.

There are a number of management and treatment options available for  helping the knee become more comfortable and to also slow down arthritic change in the knee.

MANAGEMENT OPTIONS:
The below management options will not heal the torn ligament at all but may help to manage the pain and inflammation associated with the knee being unstable and lax.
1) anti-inflammatory tablets. This provides pain relief as well as anti-inflammatory support to help slow down further arthritic change in the knee. Whenever joints move abnormally or have inflammatory disease in them, there will inevitably be arthritic change and this is always progressive. We know that in dogs that rupture their cruciate ligament, that there is a 60-70% chance that they will rupture the other leg's ligament in the next 12-24 months. This is probably due to the same underlying micro-tears and degenerative process in the ligament but also because of the increased weight that the animals put on their 'normal' leg following a cruciate tear.
If we continue these tablets indefinitely, there is a significant risk for patients to develop gut ulcers, vomiting, diarrhoea and kidney disease.

2) This is why the second option for management is strongly suggested; CARTROPHEN injections. Cartrophen is an injectable anti-inflammatory that is very specific for joint disease and helps cartilage to remain as healthy as possible to slow down the arthritic process. It will not help the ligament heal itself however will keep the joints as comfortable and healthy as possible.  The starting course of these injections is 1 injection once a week for 4 weeks, followed by once a month injections.  If ever a patient plays or runs vigorously though, there is a very high likelihood that they will become non weight bearing again. If this occurs, it is strongly recommended to consider surgery.

TREATMENT OPTIONS:
These treatment options allow the knee to be as stable as possible and to prevent  any lameness or soreness in the knee in the future. It will prevent arthritic change and will mean that the patient has the best chance of being able to exercise and play fairly normally. You will always need to be monitor your dog during play though to make sure she doesn't suddenly change direction, jump or run too unpredictably.

1) EXTRA-CAPSULAR repair. This surgery aims to replicate the weight bearing and biomechanical function of the cruciate ligament by inserting an implant ligament/wire around the knee. This helps to stabilise the knee, prevent it from sliding forward excessively and therefore minimises the pain and arthritis associated with cruciate rupture.
Immediate healing time for the stitches is 2 weeks with complete rest; no walks, running, playing, jumping.
After the 2 weeks, we recommend a very gradual re-introduction to exercise over 6-8 weeks, ideally accompanied by physiotherapy or hydrotherapy to ensure that the muscles around the knee are as strong as possible
There is a chance with this procedure that if your dog is too active, that she can 're-tear' the implant and therefore go back to being lame.
Cost of this procedure is $2000-2500

2) TIBIAL PLATEAU LEVELLING OSTEOTOMY (TPLO); this surgery changes the angle of the knee so that the knee no longer needs a cruciate ligament to stabilise the joint. This is done by cutting some of the shin bone and rotating forward a little. By doing this, your dog will have less chance of re-injuring the knee in the future and can be a little more active than if she had the extra-capsular repair.
The healing time is very similar to the extra-capsular repair however there has to be slightly greater care for the first 8 weeks as this procedure requires bone to heal back together (like a fracture wound). This process generally takes 8 weeks before we are confident that the leg wouldn't fracture or destabilise the moved piece of bone.
Cost of this procedure is $4000-5000 and is performed by a specialist surgeon at our clinic.

I know that this is a lot of information to take in via email and am certainly happy to discuss these in greater detail over the phone or in consult. I would recommend considering either the Extracapsular repair or TPLO surgeries.

hohoho

Google
感谢您上周带查理到诊所检查她右后腿酸痛的情况。 根据对查理腿部的触诊，我认为查理撕裂了她的十字韧带（就像人类膝盖的 ACL 韧带），这导致膝盖发炎、疼痛，并容易患上关节炎。 为了进一步确认这一诊断，我们可以进行 X 光检查以评估膝盖是否存在其他可能表明 ACL 撕裂的潜在变化。

请参阅以下可用于管理或治疗狗的颅骨交叉/前交叉韧带断裂的选项：

颅十字韧带撕裂和膝盖疾病在狗身上很常见，主要是由于长时间在膝盖上逐渐发生的微撕裂。 随着韧带变得越来越薄，它应对负重和运动压力的能力越来越弱。 最终，韧带撕裂，因为它无法自愈。 这与人类 ACL 撕裂完全不同，人类前交叉韧带撕裂通常与突然外伤或对膝盖施加过大的力有关。

有许多管理和治疗方案可用于帮助膝盖变得更舒适并减缓膝盖的关节炎变化。

管理选项：
以下管理选项根本无法治愈撕裂的韧带，但可能有助于控制与膝盖不稳定和松弛相关的疼痛和炎症。
1）消炎片。 这提供了止痛和抗炎支持，有助于减缓膝盖的进一步关节炎变化。 每当关节活动不正常或有炎症性疾病时，就不可避免地会出现关节炎变化，而且这种变化总是进行性的。 我们知道，在十字韧带断裂的狗中，它们有 60-70% 的几率在接下来的 12-24 个月内使另一条腿的韧带断裂。 这可能是由于韧带中相同的潜在微撕裂和退化过程，但也因为动物在十字形撕裂后增加了“正常”腿的重量。
如果我们无限期地继续服用这些药片，患者患上肠溃疡、呕吐、腹泻和肾脏疾病的风险很大。

2）这就是为什么强烈建议管理的第二种选择； 卡托芬注射剂。 Cartrophen 是一种可注射的抗炎药，对关节疾病非常有特异性，有助于软骨尽可能保持健康，从而减缓关节炎进程。 它不会帮助韧带自行愈合，但会尽可能保持关节舒适和健康。 这些注射的起始疗程是每周注射 1 次，持续 4 周，然后每月注射一次。 但是，如果患者剧烈运动或跑步，他们很可能会再次变得无法承重。 如果出现这种情况，强烈建议考虑手术。

治疗方案：
这些治疗方案使膝盖尽可能稳定，并防止将来膝盖出现任何跛行或酸痛。 它将防止关节炎的改变，意味着患者有最好的机会能够相当正常地锻炼和玩耍。 在玩耍期间，您将始终需要监视您的狗，以确保她不会突然改变方向、跳跃或奔跑过于不可预测。

1) 囊外修复。 该手术旨在通过在膝盖周围插入植入韧带/钢丝来复制十字韧带的承重和生物力学功能。 这有助于稳定膝盖，防止其过度向前滑动，从而最大限度地减少与十字韧带断裂相关的疼痛和关节炎。
缝线的立即愈合时间为 2 周，完全休息； 禁止散步、跑步、玩耍、跳跃。
2 周后，我们建议在 6-8 周内逐渐重新开始锻炼，最好同时进行物理治疗或水疗，以确保膝盖周围的肌肉尽可能强壮
如果您的狗过于活跃，此程序有可能会“重新撕裂”植入物，从而恢复跛脚状态。
该程序的费用为 2000-2500 美元

2) 胫骨平台整平截骨术 (TPLO)； 这种手术改变了膝盖的角度，使膝盖不再需要十字韧带来稳定关节。 这是通过切割一些胫骨并向前旋转一点来完成的。 通过这样做，您的狗将来膝盖再次受伤的机会就会减少，并且比接受囊外修复的情况下更活跃。
愈合时间与囊外修复非常相似，但在前 8 周内必须稍微多加注意，因为此过程需要骨骼一起愈合（如骨折伤口）。 这个过程通常需要 8 周的时间，我们才能确信这条腿不会骨折或使移动的骨头不稳定。
该手术的费用为 4000-5000 美元，由我们诊所的专科医生进行。

我知道要通过电子邮件接收大量信息，我当然很乐意通过电话或咨询更详细地讨论这些信息。 我建议考虑进行囊外修复或 TPLO 手术。

清墨水

VET真好，腿不好用是因为走路瘸了吗？

hohoho

当时瘸了， 三条腿。吃了vet的消炎药， 现在基本恢复， 但还是能看出来一点。
现在有吃网上大家推荐的4cyte

胡须康

我们家从12岁半开始注射Cartrophen，一周一次之后是三个月一次，对付逐渐老化的膝关节关节炎

胡须康

4cyte也在吃
但是他常常有本事从一堆食物里剩下那几粒小药丸不碰

hohoho

我们家sophie 吃药的时候，要两个人把着， 才能灌进去。
Charlie 吃药很省心， 以为vet的药她不会吃， 我们做好准备， 结果她像吃糖丸.4cyte吃的也很顺利。
Charlie是一个很温和, 很安静的狗狗， Sophie就很demanding, 总是叫的很多， ask more attention.

lindaxnyang

你家的VET很负责啊。 我家狗狗前一段时间也是在dog park 和别的狗追着玩的时候伤着右后腿了，走路瘸，看了VET, VET刚开始的诊断也是韧带拉伤，给吃了消炎药，建议2周后拍X光。后来拍X光发现是髋关节问题 (CHD)，手术建议是骨盆两刀切（DPO)或者换髋关节。考虑到我家是大型犬，DPO对她不合适，决定给她换髋关节手术，约了这周五看专家做CT 确认。

hohoho

是啊，我们也计划两周后拍片，会诊，明确一下。真希望她平安无事。家有毛孩，也多了一份操心。

水天蓝

我家的毛孩子也是叫Charlie , 两岁半的哈士奇。不知道有什么办法从小就帮助防止这些病痛的发生， 或着推迟。

hohoho

4cyte现在每天随食物吃两勺，发现后第一时刻买了买了保险。现在三个月过去，腿好了:) 看起来，不能着急，那个4cyte还是有用的。

水天蓝

不知道经常按摩狗狗的关节部位， 帮他放松肌肉， 会不会又帮助。我真不愿意我家狗狗疼。

hohoho

应该会吧。我们dog Park 的一个狗友 ：） 把他家的电子磁疗机借给我们家。结果我老公和狗狗每天轮着做磁疗。管他有没有用，起码心理作用是有的：）不得不说老外太热心了。

OO2023

感谢分享留给毛孩子备用

oppstuu

这应该和人差不多，老了，漆盖都会不好的。估计也没什么特别的保护办法的。