CRANIAL CRUCIATE LIGAMENT RECONSTRUCTION POST OPERATIVE REHABILITATION FOR CONVENTIONAL REPAIRS
RONALD K. FALLON D.V.M. Micki Hedgepeth Fox, P.T
Week 1 (days 2-7) [ IF NO BANDAGE ]
1. Apply a cold pack or ice pack (bag of frozen peas works well) to the knee for 10-20 minutes at a time. Time between cold treatments at least 1 hour. Apply 3 or 4 times per day for the first week. Don’t place directly on skin and avoid getting incision wet. Try using a thin layer like a pillowcase between cold pack and skin. Cold/ice treatments help reduce pain by reducing inflammation and swelling.
2. Gently massage leg for 5 to 10 minutes as your pet tolerates.
3. Move the leg through its full range of motion (bend knee and ankle up, then stretch knee out straight). Do this 3 times per day.
4. Your pet should be confined to leash walks only. Initially, he/she will only be able to take a short trip outside to use the bathroom. By the end of the week, he/she may be up to 3-5 minutes. Avoid inclines or declines and icy conditions. Also be aware of slippery floors (i.e. hardwood floors). Your dog may or may not be putting weight on his/her leg at this point. If they are, it is ok and actually is good for them. Beware as time passes and your pet begins to feel better, he/she does not realize your investment in repairing his/her leg. Restrict activity - no jumping or rough play, no standing on just the back legs, no stairs, no jumping on or off furniture. Control out of doors is best managed by use of a leash.
Week 2 [ AFTER THE BANDAGE IS REMOVED ]
1. You can stop using cold and switch to warm compresses. If incision is still open, avoid getting it wet. You can make a warm compress by microwaving a wet washcloth or dishtowel in a plastic bag (don’t fully seal bag) for 30 seconds. Test on yourself before placing on animal as they can get really hot. Leave on 5-10 minutes.
2. Continue range of motion exercise 15 to 20 repetitions two to three times daily.
3. Massage leg 5 to 10 minutes as above.
4. Controlled leash walks to continue two to three times per day, gradually increasing up to 10 minutes per outing. (If dog starts to regress by not weight bearing on leg or limping a lot - use your best judgment and reduce the amount of time.)
Week 3 through Week 4
1. Continue with use of warm compresses prior to range of motion for the third to fourth week.
2. Continue range of motion exercises 15-20 repetitions three times a day.
3. Continue leash walking, increasing up to 15 minutes per outing. Avoid inclines and declines and stairs. Restrict activity level ; i.e. no jumping, no running, etc.
4. Start swimming therapy: Swim daily to weekly starting with 5-minute intervals.
Week 5 through 8
1. Continue with range of motion exercise and controlled leash walks.
2. Can start controlled walking on inclines and declines slowly. Do 3 times per day. Increase time / incline every 3 days as possible. 3. Can start stairs very slowly and cautiously but continue to minimize use of stairs.
Week 8 through 12
1. Three leg standing : Lift the good limb off the ground and extend it backwards. Hold this position for 10 seconds. ( Discourage your pet from weight bearing through your hand )
2. Para Walking : Lift both the front and rear limbs on the noninjured side off the ground. Slowly nudge your pet away to alternately step with the front and rear limbs of the injured side.
3. Circles: Walk you pet in circles. Start with a large circle and then decrease the size. Do this 2-6 times in both directions
4. Ladder Walking: Walk slowly through an obstacle course of rings of ladder
Week 12 through 24
- CONTINUE RESTRICTIONS
- SLOWLY INCREASE ACTIVITY LEVELS / EXERCISE THERAPY BY 5-10 MINUTE INTERVALS EVERY 3-5 SESSIONS
- CONTINUE SWIM THERAPY AS POSSIBLE UP TO 30 MINUTES
Week 24 through 50
- START LIMITED OFF LEAD ACTIVITY : 5 MINUTE INTERVALS TO START
- CONTINUE ALL OTHER PT AS NEEDED FOR STRENGTH AND FLEXABILITY
NOTE: USE NSAIDS AS LONG AS ANY LAMENESS IS PRESENT USE CHONDROPROTECTIVES AND NUTRITIONAL SUPPLEMENTS FOR LIFE
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