Our dog needs surgery

[texanatheart]

and we really can't afford it. We're in not-so-great financial shape at the moment, and our black lab really did a number on his hind leg 2.5 weeks ago. We're 98% sure that it's his CCL/ACL. He's still not putting any weight on it at all. We tried anti-inflammatories to no avail. He actually gets along quite well, making it down to the basement of our very small home on his own accord.

We've gotten a quote from a vet of the following options:
-a $1,750 surgery that has a 12 week recovery
-a $2,800 surgery that has a 6 week recovery

Anyone out there been in our shoes? Anyone have any advice for us? What's worst case scenario if we don't have the surgery? I really don't want to not have it done, but we can't fund that right now.

TIA

[Sailor]

Well, the worst case would be permanent damage and chronic pain for which you'd need to buy pain medications. Eventually, the price of pain medications would add up to the surgery price. Best case is that it heals, and there's a limp. But, I really wouldn't make decisions based on the worst/best case scenario. You just never know what may happen.

Is there a payment plan you could do, spread over a 12 month period?

What about a humane society? Do they have cheaper rates? I know they must have payment plan options.

Have you contacted a lab rescue to ask if they'd help? I'm heavily involved in GSD rescue, and we sometimes have owners call us and ask if we can help out in terms of surgery. We've been able to help out a few people. We do fundraisers too - so, I would call a local lab rescue to see if they can help out.

[Nicole915]

First, a ton of questions-

You say you're 98% sure. Did the vet evaluate the knee?
Was there a drawer sign?
Did she grade the injury?
The quotes you got, are they from board cert surgeons?
Is the $2800 for a TPLO?
Did the vet talk to you about a rest regiment with pain meds instead of surgery?
What pain meds have you tried?
How old is the dog?
Is the dog overweight?
Exactly how much does the dog weigh? (This has a huge impact on prognosis if you decline surgery.
How willing are you to do the post op physical therapy?
Do you have a canine pt place with a pool nearby?
Do you have a vet school nearby?
Is there swelling on the inside of the knee? (This indicates a medial buttress and is a sign that arthritis is already in place.)


In short, the worst case scenario depends greatly on the dog and the degree of injury. Bone spurs and arthritis will degrade the joint, causing pain and lack of mobility.

There are cases where the dog does as well with 2 months strict rest/aggressive pain mgt and then pt as the dog would have with surgery. Those are obviously the statistical outliers, but they're something to consider.

Here is a link to some good info about the CCR injury.

You'll also want to discuss the probability that the other knee will rupture as well, as a result of mechanics and the animal naturally favoring the non injured leg.

[texanatheart]

Thanks for your replies, mamas. Nicole, any further insight given my answers below?

Originally Posted by Sailor

Is there a payment plan you could do, spread over a 12 month period?
The vet we spoke with would be willing to take a pymt up front and a couple post-dated checks.

What about a humane society? Do they have cheaper rates? I know they must have payment plan options.
I'll be looking into this.

Have you contacted a lab rescue to ask if they'd help? I'm heavily involved in GSD rescue, and we sometimes have owners call us and ask if we can help out in terms of surgery. We've been able to help out a few people. We do fundraisers too - so, I would call a local lab rescue to see if they can help out.
We haven't looked at this option. I'll check it out as well.

Originally Posted by Nicole915

First, a ton of questions-

You say you're 98% sure. Did the vet evaluate the knee?
We've only taken him to Banfield, where we have their basic wellness ('insurance') plan. We were just so daunted by the costs to have more done at the time. I guess we're just assuming, since he's a lab, this injury seems to be very common among labs.

Was there a drawer sign?
Don't know. DH took him the day after it happened. I don't think so, and I wouldn't be surprised if she (the vet) didn't even try it. They offered xrays for $500 or an increase in our monthly premium.

Did she grade the injury?
No.

The quotes you got, are they from board cert surgeons?
We got the quote over the phone from an acquaintance who is a vet. Not sure if he's board certified. His website doesn't say specifically, but it does say he's a member of American and Maryland Veterinary Medical Associations.

Is the $2800 for a TPLO?
DH spoke with him. The $2,800 involves breaking a bone to make the repair.

Did the vet talk to you about a rest regiment with pain meds instead of surgery?
Not sure.

What pain meds have you tried?
No pain meds. The vet gave us the anti-inflammatories to try out for 4 days (starting about 8 days after the injury).

How old is the dog?
He turned seven this past April.

Is the dog overweight?
No.

Exactly how much does the dog weigh? (This has a huge impact on prognosis if you decline surgery.
A very lean 85-90 pounds.

How willing are you to do the post op physical therapy?
Hmmm...we could do it.

Do you have a canine pt place with a pool nearby?
Yes.

Do you have a vet school nearby?
No. Quick online search looks like closest is in Philly, about 90 miles from us.

Is there swelling on the inside of the knee? (This indicates a medial buttress and is a sign that arthritis is already in place.)
Not sure. I could check this evening.


In short, the worst case scenario depends greatly on the dog and the degree of injury. Bone spurs and arthritis will degrade the joint, causing pain and lack of mobility.

There are cases where the dog does as well with 2 months strict rest/aggressive pain mgt and then pt as the dog would have with surgery. Those are obviously the statistical outliers, but they're something to consider.

Here is a link to some good info about the CCR injury.
Thank you for this link!

You'll also want to discuss the probability that the other knee will rupture as well, as a result of mechanics and the animal naturally favoring the non injured leg.

[Nicole915]

Sounds like its time for you to go in and get a consult with either the vet school or your friend. The doctor offering you Xrays to diagnose a soft tissue injury is wacko, unless she's looking to see if there is secondary damage. It is indeed a very common injury in labs, in all dogs. Knees are the new hips, as they say.

In the mean time, your dog should be on pain meds and very restricted excercise. I've seen football players on TV who tear their ACL/CCL and can't stop crying from the pain. There are some pretty inexpensive pain management options out there, something like Tramadol that can be filled in a human pharmacy for around $10 will go a long way towards keeping your pup comfortable.

With a dog that size, I suspect that surgery is the only way you're going to be able to give the dog much use of the leg. The option where they break and plate the leg is slightly more well suited to your type of situation, given that labs are wacky, fun and big. That surgery is more expensive, because its harder to accomplish, uses patented tools and isn't as widely available.

I suspect that the humane society doens't do ortho work, but the vet school will. The vet school will probably also be a lot cheaper.

[texanatheart]

Originally Posted by Nicole915

Sounds like its time for you to go in and get a consult with either the vet school or your friend. The doctor offering you Xrays to diagnose a soft tissue injury is wacko, unless she's looking to see if there is secondary damage. It is indeed a very common injury in labs, in all dogs. Knees are the new hips, as they say.

In the mean time, your dog should be on pain meds and very restricted excercise. I've seen football players on TV who tear their ACL/CCL and can't stop crying from the pain. There are some pretty inexpensive pain management options out there, something like Tramadol that can be filled in a human pharmacy for around $10 will go a long way towards keeping your pup comfortable.

With a dog that size, I suspect that surgery is the only way you're going to be able to give the dog much use of the leg. The option where they break and plate the leg is slightly more well suited to your type of situation, given that labs are wacky, fun and big. That surgery is more expensive, because its harder to accomplish, uses patented tools and isn't as widely available.

I suspect that the humane society doens't do ortho work, but the vet school will. The vet school will probably also be a lot cheaper.

Well, it is Banfield, after all. Over the 7 yrs we've been taking him there, we have seen probably at least as many vets. We do it b/c it's cheap; $18/mo pays for all vaxes, free office visits and discounts on services/meds. Not ideal, it's but what we've chosen.

I'm going to call the vet school tomorrow. And look into getting some pain meds; it amazes me how well animals can mask their pain. Not a whimper from him, even when it happened.

I really appreciate your input!! I'm feeling so guilty about not having the funds for this.

[ColoradoHELLP]

FYI - not all vet schools are cheaper.

To the original poster - I would suggest calling around to compare vets and prices. When you find a couple you think will fit your needs (financially and in the way that they respond to your questions), see if they will pass along your information to other clients that have had the same surgery performed on their pet.

Not everyone that is expensive is good, and likewise, not everyone that is cheap is a poor surgeon. Anyway, that's just my experience and of course my personal opinion.

[texanatheart]

Originally Posted by ColoradoHELLP

FYI - not all vet schools are cheaper.

Yup. I called University of Pennsylvania Vet School, and sure enough, it is actually MORE expensive through them. Apparently their doctors perform surgery, not the students. Oh well, it was worth the call.

We called another local vet that came highly recommended from a friend whose dogs have all together had 4 ACL/CCL surgeries (no repeats!) with him, and we're going to do a consultation for only $45 with him Saturday morning. At least then we'll have a more definitive diagnosis and know for sure what we're dealing with.

I then went to Banfield and got a few days' worth of pain medication, so at least he's got that for now.

The next closest vet school to us is 350 miles away. Once we get a quote from this new vet, we'll call the other school and see if they happen to offer cheaper surgery.

I'll keep y'all posted. Thanks for everyone's input!

[Nicole915]

Sorry that Penn was a bust, some schools are cheaper, some are more expensive.

When pricing the surgery, just make sure that you're comparing apples to apples. One estimate might be higher because the vet does more monitoring, more analgesia, a different technique, or any other number of factors. I'd get a stock estimate mailed from Penn (or I can print one of ours and mail it to you) and make sure that everything that a high standard surgeon does is going to be done for your dog. The knee is a difficult joint to work on, and the last thing you want is to have to do this over again or to have your pet in pain.

Is there another Banfield in the area that has a vet who does cruciate repairs and will honor your discount?

[texanatheart]

We had the consultation Saturday, and it went really well. Sure enough, it is an ACL tear, and a complete tear at that. This vet does a surgery for $1000 which is still WAY out of our range, but some family is going to help us out. We scheduled the surgery for Wednesday, we pick him up Thursday evening and there is about an 8 week recovery.

Thanks again to everyone for their ideas and input. I'm still curious...what the heck do people do when they just cannot come up with money for a procedure like this for their pet??

[lilith1]

I couldn't read and not reply.
Last year Christmas our active 9 year old Weimaraner tore her ACL. We did extensive research, went with a non-board Certified Surgeon. He did a great job, had ton of experience.

Based on her weight (80 lbs) we should have gone with a TPLO (2800$), but based on her age and the fact that resources are simply tight, we choose the simpler procedure. We paid 1800$.

As for the recovery, I took a few days off work, for 6 months she had to walk on leash, no running, no jumping. That meant to take the dogs out twice since our Ridgeback needs his run to be sane.
She will be permanently on Anti-inflammatory Drugs which we order from Pet care RX.

The only complication she had was a laming 1 month post surgery due to a flipped meniscus. This meant another surgery, more recovery for the girl. It happens in about 8% of all cases I have been told by 2 sources.To be fair I decided to leave the meniscus in during the surgery as a cushion. I had a choice. So, naturally, our dog happens to be the posterchild of the 8%. The surgeon injured all of his surgeries, that meant I didn't have to pay again the second time.

She is running again, happy. Pain free as far as we can tell. But do your research, shop around. ACL is one of those injuries that need to be taken care off. There is no gray area, at least from what I experienced.
Good luck.

[gingerstar]

Originally Posted by texanatheart

I'm still curious...what the heck do people do when they just cannot come up with money for a procedure like this for their pet??

I know our vet has mentioned Care Credit for expensive care. Some plans are interest free, just extending your payments out so they are more affordable. That way the vet gets paid, but the owner can make payments.

Hope your pooch heals well!

[texanatheart]

Originally Posted by gingerstar

I know our vet has mentioned Care Credit for expensive care. Some plans are interest free, just extending your payments out so they are more affordable. That way the vet gets paid, but the owner can make payments.

Hope your pooch heals well!

The receptionist at the vet we went with told me about Care Credit, but said that they don't accept it. We would have had to find another vet to do the surgery. The vet we're going with came so highly recommended to us and it was more affordable than I expected. Thankfully, family is helping out, so it won't be too crazy a hurt on us.

[texanatheart]

Just wanted to update...The surgery went well. But we took him for the 3 week post-op check up today, and the wire that sort of "recreates" (for lack of a much better word, I'm sure) the ligament has come loose, so the vet is going back in there today to get it back in place. Pup was being a bit spazzy while there - probably all the other dog smells - and vet suggested an Rx for a tranquilizer to keep him calm those first few days after this fix. Hopefully this time it'll work!!!

[Nicole915]

Glad to hear he's doing well! Sounds like a tranq would be a good idea, its part of the routine for a lot of the bouncy breeds.

Thanks for the update!!