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Lab With ACL Tear

by LJH - November 26, 2009

Hi Steve,
I've been seeing a 6yr F(S) Lab x with a long history of lameness. Has arthritis of both carpi and elbows,hips and lumbar spondylosis. On cartrophen injections and Recovery. Was having episodes of RH 3 legged lameness that would work off quickly with movement but about 6 weeks ago became acutely 3 legged lame LH and diagnosed by regular vet with partial ACL tear after xrays and exam under sedation. Has been on Metacam with minimal improvement. I've acupunctured her 3 times and seen an improvement in sensitivity of back and hips but little change in severe stifle pain. Especially sensitive at GB34 which feels quite turgid. Dog is overweight(working on diet)and had a couple of episodes of hot spots during previous summers.Doesn't appear affected by weather but we're pretty generally damp here in the fall.Tongue was a little pale with a brick shade not clear pink, thin white coat. Pulse a little weak and slippery.I was looking at Ruta grav and Yi Yi Ren Tang but also wondered about Xiao Chai Hu Tang with the hip and ACL issues, sensitive GB30,33,34. However the pulse doesn't really fit and the tongue hasn't had a lavendar tinge. Your thoughts would be appreciated. Thanks again.
Llewanda

by naturevet

November 27, 2009

Hi Llewanda,

Sometimes the pulse will change to its 'true nature' once any needed chiropractic treatments have been rendered. Has anyone done any of those? They can be really helpful. Sometimes the ACL tear diagnosis is not warranted - drawer signs are not as pronounced as would be expected given the level of pain, or differ minimally from side to side. I have to say, I find ACL tears to be greatly overdiagnosed. If there's no medial buttress, I start looking for altnernate explanations, the most common of which that can produce that pain pattern is a sacro-iliac joint fixation on the affected side. This produces significant pain and is almost incapacitating to the leg, and can arise easily in dogs prone to spondylosis. Often these animals have active GB points, despite having a chiropractic component to their problems.

Assuming you've checked that out already, and the pulse is still the same, I'd try Yi Yi Ren Tang, given the polyarthritis and the pulse. Xiao Chai Hu Tang is a runner-up, but almost invariably animals that benefit from it have a deep wiry pulse.

Maybe you'll need both formulas before the dog is sound. If it genuinely is a cruciate injury, but is only a partial tear, then complete healing and soundness is possible with consistent acupuncture and herbal therapy, but will require several months, as a rule.

If the drawer sign is overt, and the tear is complete, the dog likely needs surgery.

Hope that helps,

Steve

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