Hi Julie,

Thanks for your question.

The first thing I’d like to be clear on when I get a question like this is that we don’t have a diagnosis. It’s possible it could be a cruciate ligament injury, arthritis, repetitive injury or a small fragment fracture to name a few. A physical examination is where to start but keep in mind without X-rays or other diagnostics, we truly don’t know what the diagnosis is. So my first recommendation is to perform X-rays to determine a diagnosis. Please make sure your veterinarian performs something called a drawer test to assess the integrity of that ligament. Often this test needs to be performed under sedation to assess it properly. Without diagnostics, we are left making assumptive conclusions as to the diagnosis.

Keep in mind it may not be something really serious and it could just be sore or painful from injury. By giving anti-inflammatories and letting them rest, if the injury was simple and uncomplicated, this should be sufficient. However, we know that the symptoms are persisting so we have to consider other possibilities.

If it is a cruciate rupture, which permanently changes the physical structure of the knee, the joint becomes unstable. As they use it, it will become inflamed recurrently. With this condition, we often see the patient improve temporarily on treatment, but the instability persists and it becomes reinflamed and lame. This seems to be the case here so I would recommend your next step to be a visit to your veterinarian where they plan to sedate your dog, examine the knee physically and take radiographs to assess it. The best treatment for this condition is surgery which is expensive, but if it is not performed you often end up spending much more money on lifetime anti-inflammatories and they can’t achieve the improvement and quality of life that the surgical option can offer.

So now let’s assume the diagnosis is arthritis. There are very critical things you can do to control or improve arthritis in your dog. We have a really terrific article “7 Strategies for Treating Arthritis in Pets” that goes over these different issues to address. You can use medication which one of them is traditional anti-inflammatories but I do review other ones in the article that are healthier and may have greater benefits, such as polysulfated glycosaminoglycans. You can also use painkillers to help alleviate some of the symptoms and discomfort that your dog is experiencing.

In the article mentioned above, I also discuss weight management. This is one of the most important features for preventing arthritis and reducing its progression. Over 50% of dogs are overweight and this really contributes to arthritis. I’ve actually seen cases where dogs with arthritis have been removed from anti-inflammatory therapy once their weight reduces down to a healthy amount.

Exercise is key to control as well. You want to achieve a level of exercise that does not stimulate lameness, pain or a flare-up of arthritis. So you’ll have to experiment by doing a level of exercise consistently for a week or two and judging the response. For example, you could leash walk your dog 10 minutes twice a day for two weeks and monitor how much lameness that creates. If there are no symptoms, then you could increase the duration, frequency and intensity of the exercise to a small degree and reassess after another two weeks.

Glucosamines are a great supplement to use as well. The research is largely anecdotal but many clients have noticed an improvement in their dogs’ arthritis when it’s used. There are all sorts of different glucosamines you could try and the dose can range quite a bit. In the article on this website, it discusses those products and how to dose them properly.

Lastly, I want to mention a very important concept. Arthritis is progressive. Waves of inflammation that occur in a joint will slowly break that joint down. It’s called degenerative joint disease. So what I always tell clients is that if you see your dog limping, then that means there is pain in the joints, then that means there’s inflammation in the joint, then that means that the joint is being destroyed. So the goal is to never see lameness. Any lameness means that you’re contributing to degenerative joint disease. So use the four concepts mentioned above and implement proper treatment and management to control the condition. This will improve your dog’s function and quality of life in the future.

To summarize, I recommend that you follow up with your veterinarian and discuss sedation and radiographs as the next diagnostic step to attempt to achieve a diagnosis. Also, you mention that the surgery is expensive. I would tell you that in a young to middle-aged dog, I suspect it will be more expensive if you don’t do the surgery. If the cruciate is torn and you don’t do the surgery, there is a good chance you’ll have to buy anti-inflammatory medication very soon and use it until the end of your dog’s life. The cost could be $50-$80 a month and then glucosamines and painkillers may need to be added later. Think of that cost on an annual basis going forward for years. In addition to that, the leg will still be painful on a daily basis and their quality of life and function will never reach the level it would with surgery compared to just using monthly medication.

Best of luck.

Dr. Greenway