Zeke’s Case Report – R TPLO Surgery for Cruciate Tear

Completed by Jessica Chronowski

Michigan State University

College of Veterinary Medicine Class of 2015

1. Patient name: Zeke
2. Signalment: 6 year old intact male German Shepherd

 

1. Clinical problems:
   • 18 month history of intermittent right hind limb lameness
   • January 7, 2014: Ruptured anterior cruciate ligament
   • January 10, 2014: TPLO (tibial-plateau-leveling osteotomy) and menisectomy
     • Stance analyzer and clinical presentation reveal that Zeke is non-weight bearing at his initial appointment

 

1. Rehabilitation goals:
   • Zeke is a canine officer; thus, the primary goal is to get him back to work via:
     • Strengthening core muscles
     • Strengthening the muscles (quadriceps) of the affected limb
     • Overcoming Zeke’s (18 month) habit of favoring and “turning out” his right hind limb

 

1. Modalities used in rehabilitation program
   • Therapeutic floor exercises including:
     • Staggered cavalettis
     • Walking over uneven surfaces
     • Figure eights
     • “Rocky Road”
     • Trampoline exercises  
   • Underwater treadmill
     • Take weight off the joints while simultaneously increasing resistance
   • Cold laser therapy
     • Class IV laser applied to affected limb as well as compensatory areas (lower back and contralateral limb) to increase blood flow and promote healing
   • Homework exercises:
     • Restrictions include: stairs, fast-paced or long-duration walks, working
     • Cookie stretches, cookie side bends, cavalettis, sit-to-stands, “sit pretty,” uneven surfaces, slow leash walks, backward walking along a wall, correcting improper “sits”
     • Homework assignments were given in a controlled manner, starting with few reps of basic exercises and increasing to more frequent repetitions of more complex exercises.
   • Assessment:
     • After Zeke’s initial exam, he was still non-weight bearing most of the time with occasional toe-touching and a “turned out” right rear foot
     • Between the initial therapies and Zeke’s second visit, he began using his right rear limb more frequently. Although it was still “turned out,” he went from exclusively “holding up” the limb to toe-touching most of the time.
     • At Zeke’s third visit, he was reported to have started lifting his left rear limb to urinate and balancing on his affected leg while urinating--- a big step in his recovery!
     • Zeke’s third, fourth and fifth visits revealed a dog what was consistently using his affected leg, although not bearing much of his weight. The owner reports that he seems to be putting more and more weight on the limb daily. He is becoming more consistent with his homework exercises.
     • Although still favoring the limb, he was bearing more weight and turning his foot to a more normal position.
     • His progress is notable! Both owner and doctor are pleased to see how he is coming along

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