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Buster ‘busts’ his knee: A case story

Buster ‘busts’ his knee: A case story

Buster’s owners have enjoyed his easy-going, lovable character from puppyhood. Epitomising the best elements typical of Flat-Coated Retrievers, his owners describe him as having “…always been a good boy.” A fit and active lad, there is only one breed trait that he falls short of; his owners say that:

“He didn’t read up on what retrievers do! He’s no good at retrieving and will not return with the ball when thrown!”

It is easy to forgive Buster for this failure to conform because his love for life is only matched by his love for people, his love for his brother Samson, and a penchant for pine cones. An active dog, Buster’s idea of heaven is chasing pine cones followed by a spot of rough, ‘bear-like’ play with Samson. Regrettably, back in March of this year, one such rough-housing session resulted in unfortunate damage to the cruciate ligament of his left hind leg. This injury would see him undergo surgery and a lengthy healing process; fortunately our team at City Road Vets were on-hand with all the necessary knowledge, experience and skills in this area, and we were able to help Buster back to a full recovery.

Buster began limping after this play session with Samson, a limp that didn’t seem to resolve with rest. Upon examination, vet Lizzy could see that Buster’s left hind stifle joint (knee) was swollen. With gentle manipulation Lizzy could feel that the tibia (shin bone) was moving forward too far in relation to the femur (thigh bone). Lizzy’s experience told her that this was a classic presentation of cruciate ligament damage and she was quickly able to make a diagnosis with a reasonable degree of certainty. Buster’s owners were:

“Very impressed with the physical exam and the speed of a likely working diagnosis.”

Cruciate disease usually occurs due to either wear and tear of, or injury to, the knee joint, and is the most common cause of hind limb lameness in dogs. A common complaint in people too, a damaged cruciate isn’t able to fulfil its role of stabilising the stifle. This is no mean feat for even a healthy ligament when you consider the forward-sloping angle of the tibia and how it meets the ‘balled’ end of the femur. Left untreated, Buster’s cruciate ligament might have healed in time however its function would never be as effective; he would likely be left with a painful limp which would limit his activity. So the decision was taken to go to surgery in order to fix his knee.

Buster takes everything in his stride and seemingly had no fear when he came to us for surgery. As Lizzy says:

“Buster loves life and everybody in it! He is a big bouncy Flat-Coat Retriever and did quite a lot of excited leaping about!”

The sedative and pre-emptive pain relief within his premedication injection really helped to settle him so that the nurses could place a drip line to give him medication. Once under general anaesthetic, X-rays were taken to rule out any other cause for his lameness and also to aid the planning of surgery. Every dog has an individually constructed knee joint, so X-rays allowed Lizzy to measure how much she would need to move the bones and where to make the surgical incisions.

And then it was on to surgery to replace the cruciate ligament with an implant, a process requiring a great deal of teamwork between Lizzy and her two assisting vet nurses. One vet nurse’s sole responsibility was to monitor Buster’s anaesthetic, a skilled undertaking requiring their full concentration. An epidural was given to reduce the anaesthetic required and to manage pain post operatively also.

A second nurse clipped and prepped Buster’s leg for surgery before setting up and maintaining the sterility of all the necessary surgical equipment for Lizzy. Once this process was complete, the nurse disinfected her hands also, and ‘gowned-up’ in order to ‘scrub-in’ to assist with the procedure.

The surgery went well and Lizzy opted to place an additional implant to strengthen the knee joint which would be responsible for supporting Buster’s full 40kgs of weight and his somewhat bouncy personality. This was a joint that would be under some hefty pressure so belt and braces felt like the sensible thing to do. You can see the success of the procedure by viewing Buster’s before and after X-rays.

Buster’s immediate post-operative recovery was good, although he was a little wobbly on his feet owing to the epidural. He was transferred to our 24 hour clinic for monitoring over night. Lizzy says that:

By next morning he was full of beans and delighted to see his owners.

The importance of rest and adequate post-operative care at home was explained to his owners. As Buster’s devoted home-carers, they fully immersed themselves into the challenge even buying him some child’s pyjama bottoms to prevent Buster from licking at his wound. They were aware that licking might introduce infection so they were happy to use this novel method of prevention. And besides, Buster looked rather fetching in his ‘turn-ups’ anyway!

Two days later he was back at the vets to see Lizzy for a post-op check. As expected, there was a small amount of bruising and swelling at the surgical site but otherwise Buster was his bright and happy self. Lizzy was pleased and amazed that he was already weight-bearing on his left hind leg. 10 days later, Buster was raring to go and his owners had a job to continue to keep him quiet.

They came up with a fantastic way of entertaining him with puzzle toys and brain-training, although they do admit that Buster was able to work out some of these games even quicker than they were! 6 weeks on, the lead-only and short periods of exercise paid off and by this time Buster had no limp. His pine-cone chasing antics have returned to normal and he is back to tearing around, albeit worrying his owners slightly!

His owners are delighted with the outcome saying:

“We can’t thank City Road Vets enough. The whole team are wonderful. How lovely it is to know that the vets and nurses love your dog as much as you do”

We are also delighted with Buster’s progress and his recovery is testament to the team effort of our vets, nurses, his own compliance, and in no small part to the care and efforts from his loving owners.