Dealing with a Torn CCL in a K9 Search Dog- Part II: Recovery and Rehabilitation

In Part II of a series that discusses a SAR K9 team’s months-long process of dealing with my 5-year-old, high-energy Labrador Retriever, Bailey, that suffered a Cranial Cruciate Ligament (similar to the ACL in humans) rupture, I cover the surgery and the eight weeks of recovery and rehabilitation. 

In Part I, I left off with taking Bailey for surgery at Colorado Canine Orthopedics (CCO). The most common surgery for a torn CCL in dogs is the Tibial Plateau Leveling Osteotomy (TPLO). Unlike human ACL repair, which usually involves grafting a new ligament, this is not typically the case for dogs. In a TPLO surgery, the sloped top (plateau) of the tibia in dogs is cut off and rotated until it’s near level, similar to the top of a human tibia. The tibial plateau is then reattached using a plate and screws. With the tibia now level, the dog’s femur can rest on it, and its remaining leg muscles, tendons, and ligaments are able to keep the joint stable without needing a replacement ligament graft.

Post her successful surgery, we received a phone call to pick up Bailey. When we arrived at CCO, we discussed the next steps and reviewed the detailed post-surgery information. Our next appointment was scheduled for eight weeks later for X-rays and a checkup. When it was time to bring Bailey out, she was unwilling to walk due to the effects of the medication, so the staff carried her to my car. Bailey was awake but still somewhat sedated. Her leg had received a nerve block, so it was non-functional and hanging loose, similar to Eeyore’s tail.

We brought Bailey home and used the belly band to help her walk. After a quick stop in the yard, we helped her up the three steps into the house. We had bought pee pads and placed them around, but we didn’t need to use them as she slept through the night. The next morning, her leg was still not functioning, so we continued to assist her with the belly band for walking. She was very eager to eat breakfast and her appetite returned right away (no surprise for a Lab…). We started giving her the prescribed pill regime – antibiotics, pain medication, and tranquilizers. The tranquilizers were an attempt to calm Bailey’s usual high energy level. She still had a mostly non-functional leg through the first full day at home but was starting to act like Bailey again. The routine had begun: Every 1.5-2 hours, it was time for an assisted trip outside, always on a lead.

Bailey had to rediscover that she could use her leg again. During the first few days, she didn’t put any weight on it and reverted to her three-legged gait. She had been walking this way for weeks, with the bad leg not bearing any weight for many months before that. On the third day, she started to put her foot down lightly. However, she would still revert to using three legs when walking at a normal speed. I discovered that if I moved very slowly, she couldn’t go back to the three-leg walk and would put her “new” leg down softly. Every time we went outside, I had to take the time to move very slowly to encourage the use of that leg. For the first few days, she still needed help with a belly band to go up and down the three steps as she got used to using her “new” leg again.

The first couple of weeks of recovery mainly involved taking Bailey outside on a lead every few hours. I had become a full-time caregiver for her! Each trip outside included Bailey giving me a pleading stare, wanting to do more. She would often try to get me to throw a ball for her. It seemed like the tranquilizers weren’t affecting her much, as she still wanted to GO. With a lot of fresh snow on the ground, each trip also meant that I had to prevent her from her usual playfulness. A few times a day, she would reach the end of her 10-foot lead, thinking she had finally escaped, only to be stopped by me again. Once back inside, our new routine involved Bailey mostly sleeping the day away.

During the first 10 days, her lower leg was very swollen. Then, overnight, it seemed to return to normal. The incision with internal stitches was healing well. Bailey’s shaved leg looked pretty much like a chicken drumstick—it was not a pretty sight. According to the post-surgery information and other readings, her healing was progressing as expected. She was walking and not showing any obvious signs of pain.

Throughout the recovery process, I followed the vet’s advice regarding walks. During the first week, we took 2-4 short walks each day, each lasting no more than 5 minutes. In the second week, we extended the walks to 10 minutes, and in the third week, they were increased to 15 minutes, and so forth. These walks were in addition to the bathroom trips. Bailey wasn’t thrilled about being on lead, but she was at least happy to be out of the house. It was exciting to progress from just walking up and down the street to eventually taking longer walks around the neighborhood in the later weeks.

When the tranquilizers ran out after four weeks, we rediscovered our active dog. While Bailey was on the medication, we had gotten used to a new, calmer version of her. However, after a couple of days off the drugs, she was back to her old self. She’s still a 5-year-old dog that enjoys her naps, but she was now much quicker to get up during the day and drop a toy into our laps, begging for playtime or wanting to go outside to sit in the sun on the deck or go for a walk. Retrieving had always been her life, and it had been heartbreaking to have to turn her down repeatedly.

After several weeks, Bailey’s gait returned to normal. She used her repaired leg regularly. I occasionally noticed her taking a half-hop during walks, but then she would quickly return to a normal gait. I was concerned about these little hops, but since she didn’t show any signs of pain, I think it was just part of readjusting to using her leg again. Throughout the rehabilitation, she was always eager to go for a run, but we had to keep her on a leash to prevent that. By the fifth week, we blocked off our upper deck and allowed her to go outside without a leash. She enjoyed lying in the sun and was happy to be out of the house, resting on her bed on the deck.

By week seven, our walks were up to 30 minutes. When she needed to go to the bathroom, I walked her down the ten steps into the fenced backyard and then let her off the leash. Thankfully, she didn’t run around or play too hard in the snow, making these frequent trips a bit easier. She was able to walk up and down the ten steps to the backyard using both rear legs. There was still no retrieving or roughhousing, though. She was not bounding up the steps, but with months of non-use, rebuilding the strength on the one side will take time.

What could I have done better during this recovery/rehab phase?  

The dreaded Elizabethan collar: The first couple of nights at home, she cried and whined. No doubt she was in pain, but she also hated the collar. We switched to a fabric cone (it looks like a flexible pizza) and kept it on at night for about 12 days. She showed very little interest in the surgery incision, but it’s better to be safe.   

Physical Therapy & Icing:  We did some icing the first week, but I did poorly on the PT. Pushing her leg up, pulling down…it just seemed like I might be hurting her, so I neglected doing much of this. I should have watched a video and asked questions. 

Walks:  We did a lot of this! The first month, three or four daily walks were taken up to about 20 minutes each. In the second month, as the walks got longer, we were down to a couple per day, but usually, we were about one hour’s worth daily.

My wife and I were fortunate to tag team the recovery time, and we were nearly always around Bailey. We do not kennel Bailey routinely, though she does not object to it. If we had been in a position where we had to leave her unattended, a kennel would have been necessary.  

The 8-week appointment finally arrived. In a word, her knee had healed as well as could be hoped. With a new set of X-rays, the doctor showed that the bone healing was nearly complete. Her gait is good; I need to continue rehabilitation (walks) and slowly ease her into full activities. The doctor did refer us to CCO’s hip specialist—the dysplasia on the right side is quite apparent, and we need to discuss this.

Emotionally, it feels as if I have my dog back. She’s healed, but I need to minimize her running and fast start/stop activities. She can now be off-lead in the backyard and enjoys going for walks in the neighborhood. I’m considering letting her off leash for short periods in the nearby national forest during hikes. We can also start thinking about resuming search training, but I plan to keep her on a 30′ lead and do short (<15 minutes), small-area HR training. I will keep the training time based on the clock rather than trying to find all the sources.

To resume the area search training, I will place a subject in a known location and work with Bailey for just a few minutes. When I give Bailey the scent article, I know she will take off like a shot, but I can work with the wind and location to wrap up the search quickly. She knows the game, but will she remember it after 4+ months of no work?

Where does Bailey go from here? In Part III, I will cover rehabilitation during post-surgery weeks 9-16, the resumption of training, and the issue with her hips, as the x-rays do show dysplasia.