By: Amy Rosenthal, My Pet’s Brace Practitioner
The Patient: Nikko, a 92-pound 7-year-old German Shepard / Black Mouth Cur mix with bilateral cranial cruciate ligament (CCL) tears.
Case of Interest: The majority of our canine patients present with only one CCL tear. Nikko’s veterinarian diagnosed bilateral CCL injuries. At his initial evaluation/casting appointment at our clinic, he showed significant pain while walking with substantial weight transfer to his front legs and only slight weight bearing on both of his rear legs.
Diagnostic History: Nikko had been limping on and off for about two weeks on his right hind leg. The family then played ball with Nikko and he aggravated the injury-causing non-weight bearing on the right hind leg. Shortly afterward, Nikko started limping on his left hind leg. Nikko’s veterinarian diagnosed bilateral CCL tears and recommended custom stifle braces for his injuries. His owners decided to pursue conservative management treatment for his condition and contacted our facility approximately two weeks after the injury of his left hind leg.
Treatment and Plan: An evaluation at our clinic confirmed Nikko’s bilateral CCL tears. He presented with pain due to weight-bearing, severe limping, toe-touching on both rear legs, and shifting weight to his front legs during static standing. Bilateral CCL stifle braces and a restricted exercise regimen was determined to be the best treatment plan for Nikko. The CCL stifle braces restrict the tibial thrust and limit full extension at the knee.
Accurate casts of Nikko’s rear legs from his hip to his hock were obtained at our clinic. Nikko returned a week later to be fitted with his bilateral stifle braces. The CCL stifle braces were created with antimicrobial, hypoallergenic, closed-cell foam, and medical-grade co-polymer plastic in royal blue. Specialized veterinary molded urethane knee joints were utilized to ensure the full range of motion to encourage movement and natural healing.
Nikko was put on a limited exercise plan, including the restriction of stairs, running, and dog or ball playing. Walks were encouraged but limited to 2 to 3 walks a day at 10 to 15 minutes each. These walks were increased as Nikko became accustomed to the braces.
Follow-ups: Nikko was re-evaluated at three weeks and four months post fitting of the braces. At each follow-up appointment, visual pain and weight-bearing were evaluated. At the four-month check-up, mild irritation was noted and addressed on the caudal region of the Achilles tendon by adding additional padding to the Achilles tendon pad. At the same four-month check-up appointment, the My Pet’s Brace clinician noted increased weight-bearing in both rear legs, a normalized stance, increased muscle mass in the rear, decreased muscle mass in the front, an increased willingness to walk, as well as anecdotal evidence presented by the owners. Medial buttressing was present in both stifles indicating scar tissue build-up and stifle stabilization. Nikko’s family was instructed to continue wearing both braces for an additional 5 months.