Don't care if this dog was truly helped by Myristin, aka cetyl myristoleate, aka Cetyl M, aka CMO or CM or not - the fact that a dog with 2 lame hind legs can go to the 2 front legs like this is incredible.
CNBC's Sara Eisen ends every sentence as if she's constipated. Doesn't matter if it's a statement or a question either.
Eisen asking a question (note the head cock to the right, pursed lips, and furrowed brow as if she's pushing a bowel movement out at the end).
God forbid you're a colleague saying something that contradicts something she's stated, ok? Because she pulled the transcripts jerky and that's not what he said 2 weeks ago.
Quick follow up questions? Constipated for sure.
Been going on forever.
Don't you dare, Carl Quintanilla, point out something that Sara Eisen knows or -- you'll get the eye roll, dummy.
And yet why is it that colleagues almost seem forced to tell her 'Yeah, yeah Sara, it's alright.' Is there a CNBC mandate to tell Sara Eisen, 'Yeah Sara, good question!'?
Low IQ Democratic Socialist Alexandria Ocasio-Cortez is on the United States House Committee on Financial Services.
Yes, Democrats made the decision to put this idiot, who confused the entire 2017 US military budget with an increase while mocking soldiers, on a financial committee.
Imagine this moron asking questions of bank CEOs. Obviously the questions have to be written out for her and she will have an inability to ask any follow up questions because she's that stupid on the subject. Good work Dems.
A compassionate Donald Trump offered protection for young migrants brought here illegally in exchange for wall funding during a speech to the nation last night. A common sense compromise that both parties should enthusiastically support. Yet, 14 hours later the Democrats STILL have the government on shutdown. Sickening.
8 weeks ago today on Wednesday November 14th 2018 at approximately 10:30 AM our 11 year old German Shepherd Zero was racing towards a ball running away from her on slick grass when she stopped short and tore her ACL/CCL. Over the next 8 weeks, following a lot of TigerPoz.com and Tiger's owners experience with ACL tears in dogs, we attempted a non surgical treatment of her torn knee ligament.
Check out Zero on day 11. (Almost 2 weeks in. Not the next day and not 3-4 days in. 11 days in. It was bad...)
And check out day 60 (Zero got to enjoy a little bit of snow) after careful confinement.
We had setbacks in between and we had a lot of progress. We went from the leg being held off the floor to her tapping it to her walking with it to her sitting down at the front door on her own on day 61.
We went from backyard bathrooms to front sidewalk walks to up and down the sidewalk to across the street and finally to up and down across the street. We did a 15 minute walk two days in a row (possibly a mistake that early) on day 52.
Also on day 61 we introduced sit stands for the first time (we had been discouraging any sits up until then). A 10 minute walk followed by 10 sit stands. Several 5 minute 'heel' walks (walking in circles) on a slight incline (to put the injured leg on the downside so it was forced to work) and a 2nd set of sit stands.
It was an amazing day. She was so much stronger and we were on our way.
Laying downstairs when it was time for bed we got up and Zero went out for one last bathroom break. She was beat. She had eaten roughly 1/2 of what we had for her on a regular day and we chalked that up to ... a lot of glucosamine and other crappy tasting stuff on there. (Keep them thin! She was 55 pounds on day 61 - 5 pounds lighter than on day 1. That is your 2nd must. 1st being containment - no running, no jumping, no stairs and no slippery surfaces.) But she wouldn't take her CBD oil either. And she loved it. We had to rub it on her lips. Up to bed she was panting a bit and we noticed her stomach breathing quickly as well. We're as conservative with docs as anyone (obviously) and yet we both said - let's go. And we went to the NorthStar Vets emergency room in Robbinsville NJ.
Triaged they saw that her gums were pale. Heart rate was up but pulse was weak. Doc said it indicated internal bleeding and that the color loss was more than anyone would typically see from any knee ligament tear. And this doc, Dr. Kanika Singleton, was a retired Army Vet. (An Army Vet vet for working dogs!)
In she went for ultrasound.
Zero had a mass on her heart (a pericardial effusion). Pericardiocentesis was ordered and performed. We got the call at 3AM. It was blood filled and there was a tumor.
Hemangiosarcoma cancer.
We got the 2nd call at 7AM. The mass had refilled. It was the worst of several scenarios. Blood filled. Hemangiosarcoma. And it was quick to refill. (Hemangiosarcoma is idiopathic. Very much isolated in dogs. When dogs decided to give up their prescribed evolutionary path and join us humans - things like this entered the picture. Genes interacting with the environment are what we currently believe this god damned cancer grows from. Seen in larger dogs (Golden Retrievers top the dreaded list) a textbook scenario would be an ultrasound finds the tumor on the spleen. A splenectomy is done and chemo is started. 6 months later they've died anyway. Zero didn't use tick and flea drops. Didn't have a chip. Drank filtered water. Great food. Had excellent supplements. Snacked on cabbage, green beans, carrots, lima beans and brussel sprouts. (Yes, brussel sprouts and cabbage.) Lived in a smoke free home. Didn't have chemicals on her lawn. Had rock solid blood work 3 months ago. (Had rock solid blood work right before the pericardiocentesis this night.) Exercised like a demon and rested like a pup who had exercised like a demon.
And she had cancer that was going to kill her.
10AM Tuesday January 15, 2019 we went in and had our last moments with her. Laying on the floor we sang (her song...) to her and she closed her eyes. The doctor administered Propofol 28 and she slowed further.
The last injection was given and she was dead.
And yet you can watch this video. Watch this video of Zero two days before, day 60 post CCL tear, and see her walking and looking to sprint towards us. You can read above how she did 20 sit stands 12 hours before she died. She was rough housing with us one hour before she suffered distress due to cancer.
We had such an outpouring of support after she left us we can't even come close to describing it so we will not. That's not the focus here anyway. The focus was on healing a dog with a torn ACL without surgery. And we were doing it. Actually, at 11 years and 3 months the activity we had on day 60 & for much of day 61 would have been quite enough for her to have had a wonderful quality of life knee wise. She had 14 or so hours of discomfort (the pain from the CCL tear days 1-10 was worse than that by a long shot) and the need to be in a hospital later that night because of hemangiosarcoma.
And yet she had healed and was strengthening that knee ligament while she had deadly cancer. Imagine if we had opted to do TPLO surgery that first week. Imagine we had opted to do surgery last week after we experienced a setback! She would have gone through bone cutting while unbeknownst to everyone she was dying of cancer!
She was dying of cancer. Your dog is more than likely not dying of cancer as you read this. Go back and read the posts from 1 on. Watch those videos. Look at what Zero accomplished. You can heal your dog of a torn ACL or CCL on your own.
And, as Dr. James Cook told us when we asked if one had to rush and do surgery immediately as is so often told to worried owners in brightly lit vets' offices, you do not. Specifically addressing TightRope surgery Dr. Cook wrote, "TR can really be done anytime that you feel surgery is necessary."
So don't wait a week. Don't wait two weeks. Wait, as Tigger Poz tells us, at the very least 8 weeks. Christ wait the 8 weeks even if you're going to just be great parents and protect your pup from stairs, running, jumping and slippery floors.
Get them immediately on the ligament and joint supplements and let them at the very least get that rest. Not only do you have a good chance of seeing improvement - you may just heal them.
AND? You get to bond even tighter with that little goomba johnny of yours.
Watch this video again of day 11 v day 60. That's day 11 with that crappy need for that leg to be up in the air. Not the day of the tear. Not a week in as maybe your vet will recommend you wait. Day 11. And day 60 is before any rehab exercise has really begun to strengthen the muscles of the injured leg. It's after the 8 weeks of careful confinement that we've been detailing.
You can wait. You should probably wait. You can heal your dog's torn ACL / CCL without surgery. You can get them back to a pain free existence with rest alone. You can have walks again with them without the use of a bone saw.
Pain free walks. Check out that last video again. Zero wanted to run on our heel command - only stopped by us stopping her. Before any strength rebuilding in that right leg.
Take the time to confine your pup near you. You'll be with them more. You'll interact more. You'll love each other more. You'll most likely save them from the surgeon's saw and...you'll help your dog heal his or her torn ACL / CCL.
We hit day 61 today post CCL tear in our 11 year old dog Zero. Not mentioned in day 60's synopsis in How we tried to heal our 11 year old dog's torn CCL without surgerypart 5 was one observation - Zero sat on her own while looking out the front door. She'd sat on her own when she was getting a treat but that was a first - sitting on her own as opposed to standing or simply laying down.
Today we did a 10 minute walk and several 5 minute walks. The walks were on inclines when possible with the right leg on the down slope so it'd be forced into working. ROM is going to continue so we'll stop writing that. Icing, if possible, is done after exercises for 15 minutes up to 2x per day. Heat is added first thing in the a.m. when possible and 30+ minutes after icing when possible. (I.E. not doing true hot cold contrast therapy. Instead cooling a warmed up leg and...warming a cooled down leg for looseness, etc.) We'll stop writing this aspect up too. Today we did 10 sit stands ending with a 'down' to treat her. We did this twice. Notice her weight in past posts. We've kept her thin. It is a must. We won't write this up anymore either.
We've gone through many supplements in the 61 days and we've decided on a few to stick with. It's more a gut feel than anything else except for the HA liquid which she hated. We could put the glucosamine sulfate in a teaspoon and she'd eat it. The HA? Put her nose down. Was the proof that was what she was fully ignoring in her food so we cut it though it had initially been planned to be in the 'gut' list.
Myristin - Myristin supplies 500 mg Cetyl Myristoleate Complex, the evening dose of Glucosamine Sulfate to total above, 250mg MSM, 150mg Vitamin C, Manganese Citrate 10mg, Curcumin 6mg
Why? None of this would be possible without the CBD oil from Endoca. 15mg would be the max on a dog of 60 pounds and here, a highly conditioned GSD used to running to exhaustion is now being asked to sleep at night during 8 weeks of doing nothing. And she's done it. With a scant 2mg. This would be the number one supplement we'd never not use.
The Glucosamine Sulfate. It's the gold standard. There's conflicting reports, yes, but...it's just going to be there. And there are enough reports to make it worth it when a fine company like Source Naturals makes one that provides 750mg in 1/8th of a teaspoon. (The chondroitin would have stayed if we hadn't found some other items to add. First off, the eggshell membrane...)
The eggshell membrane info we found last week made it a no brainer. The small studies showing that eggshell membrane significantly reduced pain both rapidly (seven days) and continuously (30 days) in joint and connective tissue disorders (exactly what you've got if you've got a canine with CCL disease!) is the most spot on supplement to date, perhaps. And it's an eggshell membrane. That's it. And that membrane is comprised of more than 80% collagen and includes naturally occurring glucosamine, HA, chondroitin and calcium. Combined with the vitamin c - it would be right up there with the CBD oil just based on the ingredients in it sans any of these other studies.
Myristin is kept here for several reasons. A) She loves it. B) The Glucosamine means no 2nd dose of powder with her evening meal yet she's getting a 2nd booster dose of the Glucosamine. C) Cetyl Myristoleate (CMO etc) is starting to show up in the joint supplements of other quality companies and D) Vitamin C, manganese, and a bit of MSM to boot in one pill is a winner.
1 other supplement that we might go back and forth with is Vet's Best Seasonal Allergy Relief. The latter for its well priced MSM, Quercitin, and additional vitamin C and the former for the collagen, eggshell membrane (See??) and CMO. Plus, she loved both supplements.
Our following 'Zero' -- our 11 year old highly athletic 60 pound German Shepherd following a CCL tear where the vet recommended TPLO surgery but we attempted a non surgical treatment approach (dog acl recovery without surgery). (See the beginnings: How we tried to heal our 11 year old German Shepherd Dog's torn ACL without surgery part 1: Week's 1-4.)
Day 58 - Been trying to throw the heated buddy on her leg if it's available in the a.m. before we do any walking. Today 10 minute walk. No audible popping while walking. Click is there doing ROM exercises if we push the flex or extension. We did 7-8 sit stands. Iced down for 15 minutes after the walk and sit stands. About an hour or so we do some circle walks in the back yard for 3-4 minutes. Then we did acupressure and massage on the leg (we do it on both legs when possible to not ignore the healthy leg).
Our backyard has a bit of an incline so we can do heels over it, going to a larger incline as we hopefully progress.
Going to, at this point, not go as detailed as you get the point in videos 1,2,3 and 4...of what we're trying to do.
Also found a couple great videos that we'll share. Dr. Lane, veterinarian and owner of the Broadway Veterinary Clinic in Anderson, Indiana, with the help of his brindled boy Douglas, demonstrates the first two weeks of basic rehabilitation techniques, for the post-surgical care of a canine cranial cruciate ligament rupture. You can use these on your non-surgical dog as well.
And then we found Dr. Andrew Jones' Natural Pet Health Channel 'Veterinary Secrets' -- Here's several.
Cruciate Ligament Rupture in Dogs: Diagnosis
Cruciate Ligament Rupture in Dogs: Healing Without Surgery
Dog Cruciate Ligament: Treating Without Surgery [Part 2]
And Massage for Hip Dysplasia and Acupressure for Cruciate Injury
Day 60 -- We limited yesterday to four 5 minute walks in the backyard as rest for the sit stands we did on Friday. Today, a bit of snow on the ground, she is much better off than last Sunday when we felt that the back to back 15 minute walk days set us back.
Strong, more balanced on the pee. Step up off the injured leg. No audible popping while walking. Ability to walk with the right leg on the down slope of an incline. Going to repeat yesterday today. Short 5 minute walks. ROM. Rest.
This week the plan is to do the sit stands tomorrow. Do a 10 minute walk out front. Perhaps do two 10 minute walks and go from there. We also have an idea now what supplements we'll stick with for the long term. Will write that up as well.
Our following 'Zero' -- our 11 year old highly athletic 60 pound German Shepherd following a CCL ACL tear where the vet recommended TPLO surgery but we attempted a non surgical treatment approach (dog acl recovery without surgery) entered its 8th week. (See the beginnings: How we tried to heal our 11 year old German Shepherd Dog's torn ACL / CCL without surgery part 1: Week's 1-4.) At this point we're going to start some physical therapy. Last week on day 44 we did a 15 minute walk to end the week knowing the weekend was going to be rainy and she'd be resting.
That's when we came up with another trick. She doesn't really like the chondroitin and glucosamine powders on her food (as you wouldn't). And she'd avoid them as best she could with her morning meals. And then we though about the fact that she (like Lexy before her) likes the Udo's Choice Pet Essentials we put on her lunch. So we put the chon and gluco on her food and covered them with the Udo's choice. Result, at least day 1, was -- all got gobbled up. Cool.
Day 51 - 15 minute 3/4 walk around the block.
Day 52 - Here's a good lesson. Don't push it. Just telling ourselves two days ago that we weren't going to push it as exercises were looming in a few days and...we pushed it. On the 2nd consecutive day of 15 minute walks she really dragged the last 3 minutes. So, we're going to have to do something like -- if you do a 15 minute walk don't do many exercises. And if you do many exercises don't do the longer walk that day. And you might want to take a day or two off the day after exercise or longer walks. Day 53 - Already pegged as an almost complete rest day - we see the negative results of too much too soon. Audible popping from the knee crossing the street for the bathroom. ROM exercise brought about crepitus / meniscus play -- clear popping noise on extension and flexion. And a sick feeling in our guts. Icing her down. Rule of thumb is if a meniscus is at play but there is no pain or limp because of it - keep up with the joint supplements. Now we need to watch this really closely. Thank god for TiggerPoz. Upsetting because just 8 days ago we had noted that the click / pop in the knee during ROM had disappeared.
Day 54 - Videos below.
Part 1:
Part 2 contains a clear audible crepitus / knee pop click from the knee at the 5 second mark:
Video 3 is range of motion exercises from early on the morning of day 54:
Of course we're now going to add a few more supplements. Ordered Dr. Mercola Joint Support. It'll add a bit more CMO and MSM along with egg shell membrane and low density Hyaluronic Acid and collagen. Also ordered Hyalogic Hyaluronic Acid for dog joints. That includes a bit more MSM and N-Acetyl Glucosamine. NAG is thought to increase the availability of oral HA to the joint. In the same order we picked up some Sweet Sunnah Black Seed oil as a pure anti-inflammatory. Not going to use it right away but this way we can have it on hand.
Oy. It's at this point where it is again, research time. We turn to horses with torn ACLs and, guess what? This is how they do it with horses. No surgery due to the weight bearing aspect of a horse's knees. They do what we're calling the conservative approach with dogs. And when they get to the point where they're doing some walking they hit a number, say 10 minutes, and do it for TWO WEEKS before adding, say, another 5 minutes the next week. Torn Horse Tendon: The Long Road Back from This Equine Injury is a very good read right about now.
Day 55 we did 3 sit stands. Day 56, yep week 8 anniversary, we did an across the street 8 minute walk. 3 hours later we did 5 or so 'sit stands.' Video below.
We're going to stick with the 8 minute walk for a few days slowly looking to extend that. We'll do the sit stands every other day. Increasing slowly number and number of times. We're now icing once a day after either the sit stands or the longer walk. Heating to loosen before exercise or the longer walk whenever possible. Goal now is to lengthen the walk again and ... see if we can clear that popping sound out again. Also, more supplement research.
Our following 'Zero' -- our 11 year old highly athletic 60 pound German Shepherd following a CCL ACL tear where the vet recommended TPLO surgery but we attempted a non surgical treatment approach (dog acl recovery without surgery) entered its seventh week. (See the beginnings: How we tried to heal our 11 year old German Shepherd Dog's torn ACL / CCL without surgery part 1: Week's 1-4.)
Day 44 - can tell by the second 13 minutes into a S&P walk. First walk of the day 13 minutes in is the perfect ending point as she slows at minute 14. Another bright spot today - doing her passive ROM and we note ... no more click in the knee. (Friday November 16th when we went to the vet there was an audible pop upon manipulation but we didn't know if that was a secondary issue. We'd heard a click in there during ROMs ever since the day we began doing them roughly week 5.)
An interesting twist today. Doing further research into supplements and we started seeing pieces on manganese. Specifically 'Manganese deficiency and CCL disease' by Karen Shaw Becker, DVM. The doctor says that she started investigating causes of tears because she was seeing young, active, not fat dogs ripping ligaments in the knee sans trauma. She wrote, "I continued my research and came up with one recurring factor related to connective tissue resiliency: the dietary intake of manganese (Mn). Manganese is required for healthy, strong ligament development and maintenance. A dog’s manganese requirements are high, and food sources vary as to the amount of manganese they contain." She added, "If your dog is eating a ligament-supportive diet, he shouldn’t develop degenerative cruciate damage unless he gets into a serious accident. If your dog has sustained a CCL injury, partner with a high quality canine rehabilitation facility as well as a proactive veterinarian who can offer him the best chance of recovery."
So we went looking for a supplement for dogs that contained roughly 3mg of manganese. And we couldn't find any. We found several multivitamins for canines with less than 1mg. We even found one joint supplement with what would be 30mg for a 60 pound dog. We contacted the company about the high level they use (as no one else included anything even near that level) and they told us to 'not believe everything you read on the internet.' They pointed us to the article 'Manganese Requirements in Dogs' because the last line on the page is 'Manganese toxicity is basically unknown in dogs and cats.' Funny, they didn't note that a few paragraphs up is the line, 'Dogs should receive 2.3 mg of manganese daily for every pound of dog food they eat (on a dry matter basis).'
Yeah, we're going to move on from them.
And then we stumbled upon something called EHP Products' Myristin canine hip and joint formula because it has 10mg of Manganese Citrate (elemental manganese 2.9mg). OK, great. Here was the 3mg or so we were looking for. And then we spent the next several hours researching Myristin, aka cetyl myristoleate, aka Cetyl M, aka CMO or CM -- discovered by Harry W. Diehl. Diehl took a fatty acid, myristoleic acid, and combined it with a fatty alcohol molecule, cetyl alcohol, creating an ester of that fatty acid called cetyl myristoleate. A common set of bullet points one might find on a site selling it included:
Myristin works to:
Promote recovery from joint injury (joint repair)
Creates synovial fluid that lubricates the joints
Reduces joint pain and inflammation
Regulates immune response for optimum joint recovery
We had heard that cetylated fatty acids improve knee function in patients and that CFA provides an improvement in knee range of motion and overall function in patients with OA of the knee so CFA could be an alternative to the use of nonsteroidal anti-inflammatory drugs for the treatment of OA. And then we looked further into its ingredients:
A couple of notes. So we add the Myristin (same day delivery on a Sunday is just incredible). Plus we'll be getting 250 mg of the correct version of Glucosamine (the Sulfate). We'll continue to give the powdered GS in the A.M. (750 mg) for a total of 1000 mg. We'll continue to give the chondroitin sulfate in the morning until it runs out. We've put the quercetin away for the time being. She didn't like it and now we're getting curcumin and bromelain here anyway. Thrilled to get the vitamin C here as well. So we'll put the Vet’s Best Seasonal Allergy Relief supplement to rest for the time being. And we have the 2.9 mg of manganese we were seeking. Thrilled to find this.
Now 46 days into this long journey, tired but really hopeful, we come across another good read. Questioning Canine Cruciate Ligament SurgerySee why these 8 claims that surgery is the best option for your canine patients are false. By Narda Robinson, DO, DVM (She holds a Bachelor of Arts (AB) degree from Harvard/Radcliffe, a doctorate in osteopathic medicine (DO) from the Texas College of Osteopathic Medicine, and a doctorate in veterinary medicine (DVM) as well as a master’s degree in biomedical sciences (MS) from the Colorado State University College of Veterinary Medicine and Biomedical Sciences!) Go ahead - it's a great read.
Day 47 video - New Year's Eve. Wow. Forty seven days...
Our following 'Zero' -- our 11 year old highly athletic 60 pound German Shepherd following a CCL ACL tear where the vet recommended TPLO surgery but we attempted a non surgical treatment approach (dog acl recovery without surgery) entered its fifth week. (See: How we tried to heal our 11 year old German Shepherd Dog's torn ACL / CCL without surgery part 1: Week's 1-4.)
5 week anniversary of the tear. 35 days in. After she warms up in the morning she can walk for 5 minutes with no discernible problem. If we go to the 10 minute mark we'll see the subtle limp. Same thing with subsequent 5 minute walks. So she's building up stamina. Have to be careful not to push it. Video below is a compilation. Beginning followed by 2 clips that would be at the 6-7-8 minute mark. She's got some giddy up (which we also have to not let her exercise...) and she's a bit more stable while peeing.
We had an MD view the above videos. After that last one he wrote us back, "Cool. Yes when she pee'd I didn't see any wavering and I agree I see more vitality in particular you can see it in her face. Great job!"
Day 37 -- We have a marker that walked to and back takes approximately 5 minutes. Today we wondered back and forth to it twice. So that was a good 10 minute S&P (it was also warmer today, nearing 60) without much of a limp. We continue to do hot/colds as possible (always ending with hot). We also do some range of motion (ROM) stifle stretches (never longer than for 1 minute at a time) and if you are interested in adding them 5,6,7,8 weeks in - ask your vet about them. The following video contains most of what we do.
A) We would never put Zero on her side. We ONLY did the ROM exercises when she was already laying around. To put her down into that position might invite her to fight that movement...with her injured knee a strong pusher! And B) We do them nice and slow and we hold them at the full flex or extension point for 5-10 seconds. Keeping one hand over the knee (acts like a brace) and the other moving hand very, very loose. The looseness allows us to release the paw if she pulls back.
While searching for the above video we came across something called 'TTA Rapid Surgery.' Hmmm, never heard it referred to before. Rapid sounds good, right? And they even go as far as to talk about how invasive TLPO surgery is. We read up on what Tibial Tuberosity Advancement Rapid surgery is and, after reading this, were even more enthused to keep doing what we've been doing. Jeeze!
Day 40 -- 13 minute walk. For us it is to the park and back with a tail end extension. It is followed by a mostly inside day as it is Christmas Eve. We're able to, through the course of the day, do 7 hot colds on her. The 13 minute walk is on what I'd call the safe side of the street (i.e., we were always 3-4 minutes from home). What it really does is set up a complete walk around the block sometime next week if we don't have any setback. (We have 2-3 sections of the walk were we can cut through if we needed to cut it shorter.) We also did two 2-3 minute walks out back during bathroom breaks.
Merry Christmas! 11 minute walk. These walks knock her out like her runs used to. But today is Christmas.
Unlike Thanksgiving day, when visitors arrive she'll be free range. She's excited to have them in the house and she moves around a lot for several hours. They saw her on Thanksgiving so they know the difference five weeks later and 6 weeks total in. They also note she's thin - remember that. No chance this works if she had gained weight. They leave and she is conked out. Hate to awaken her but we have to bring her upstairs with us at bedtime. Ahhh. The one day since day one / two that we wouldn't have needed CBD oil to ensure a long winter's nap...
Day 42. Week 6 anniversary of the ripped ACL. We walk for 11 minutes and wind up standing around another 8 for a total of 19 minutes. We continue to do the hot colds and ROM. First weekend we hoped to be able to get to the front of the house. Week 2 we hoped to get up and down the block. Then we hoped to get across the street. Then up and down the block across the street. Now, 6 weeks in, we have to slow down a bit. Want to make sure the next couple of weeks we don't push past the 11 minute walks. Let that scarring really take shape. 2 weeks and we can start to add minutes to those walks. Now we're just going to do the walks and then do multiple small 5 minute walks in order to keep the knee moving.
Dog torn ACL / CCL - Is recovery without surgery possible?
Wednesday November 14th 2018 at approximately 10:30 AM our 11 year old German Shepherd Zero was racing towards a ball running away from her on slick grass. Muscular and well trained she flew at it. Past it. Stopped short and came up lame.
She limped back with her hind right leg in the air. Picked up and put in the car she was taken home.
This is video from one year before the tear. It's a pretty good representative shot of what she was doing when she tore the knee.
[Reminder - we are not veterinarians -- You should not do what we did without experts with you. This is simply a biography of Zero's torn ligament odyssey.]
She had done this before over the years. As we mentioned - she was a supremely conditioned exercised to exhaustion daily GSD. Weighted vest on days she didn't run. And every time it was the same. 650mg of aspirin with her next meal. Another 12 hours later with the next. And by the third meal 12 hours apart already showing signs of recovery. One last 325mg aspirin with a meal and a few days later she was back running.
Not this time.
Friday November 16th we went to the vet at 4pm. Exam showed it was her right knee. There was an audible pop upon manipulation but we didn't know if that was a secondary issue. X-Ray showed the smallest bit of fluid. The vet said torn anterior cruciate ligament (ACL) i.e., cranial cruciate ligament (CCL) or (CrCL) because dogs have 4 legs. She advised waiting a week to watch before setting up a surgical consultation with the orthopaedic surgeon. She added that he liked to do tibial plateau leveling osteotomy (TPLO) or Tibial Plateau Angle (TPA) and not Tightrope or vertical suture surgery on large, strong dogs 'so that they had complete recovery' and could go rough and tumble post surgery.
Asked what the recovery was like she said: '15 days and the leg will be down.' '30 days and we're close to recovered.' '45 days for full recovery.' We were given Rimadyl 50MG BID for 10 days and told to restrict her movement. If she looked any better in a week we could extend the script for the carprofen longer. Zero was not putting ANY weight on the leg 48 hours post injury and we feared hearing 'you need surgery today' so the wait one week and the anti-inflammatory sounded nice and conservative. $200 bucks and we were back in the car and headed home.
Saturday November 17th we posted video of her on Facebook now 36 hours post injury and leg still high in the air. It was when we really started research. ACL in dogs. CCL injury management in dogs. Supplements for ACL tear in canines. Treatment for CCL sprain in canines. ACL, CCL, TPLO, TPA, Tightrope, vertical suture surgery in dogs. ACL, CCL, TPLO, TPA, Tightrope, vertical suture surgery in large dogs. Dog ACL tear non surgical treatment. Dog ACL tear no surgery. What had friends done in similar circumstances?
And that's when we knew - this sucked. All the surgical options were sketchy. There were no good studies with any of them. And TPLO or TPA was extremely invasive. It involved CUTTING THE DOG'S BONES to create a different geometry in the leg. An unnatural geometry with metal and screws to boot. An unnatural geometry in one side that obviously would create an imbalanced dog. (And that's when we found TigerPoz.com and Tiger's owners experience with ACL tears in dogs. It is a must read for all dog owners facing a ligament surgery in their own dogs. Go there now and come back after you've read everything there. Then go read what surgeons at the School of Veterinary Medicine at the University of Pennsylvania think about TPLO surgery. Finally, read what Dr. Ron Hines thinks of ligament repair in dogs. It combines all of the above and is a must read too.)
This look like a good ligament repair idea?
Zero had already been on cannabidiol (CBD) oil from Endoca for sleep (she'd workout in the morning, rest most of the rest of the day...and be up at 3AM, done!). 60 pound dog we would have maxed out at 15mg but just two milligrams at bedtime worked. We immediately began giving her 2mg in the morning and 5mg at night. The additional amount helped a now not exercising doggie sleep through the night. The anti-inflammatory effect was the reason for adding the morning dose. We also kept the bottle in the bedroom (where she'd now be locked in with us for sleep at night) along with some water. (Typically cut off from water at night now not drinking much during the days as she rested we wanted her to have it - especially under the drying heat of a winter furnace.) A few times when she awakened either from boredom or from what might have been pain - we gave her 2mg more during the night.
Conversations with an MD and friends and family who had avoided surgery lead us to collagen, vitamin C, and quercetin. Purely Inspired Collagen Protein Powder was delivered by Amazon Saturday night (same day!). Didn't notice the stevia until it got here but...she loved it. Based again on her 60 pounds we aimed to get 10 grams of collagen protein in her. Started with a tablespoon that night. One tablespoon 2X on Sunday. During the upcoming week we actually went to 20 grams (approximately 2 tablespoons twice per day). Collagen needs vitamin C to work to heal ligaments and to cushion joints and there's a quercetin benefit we'll get to later so we had Vet’s Best Seasonal Allergy Relief delivered as well since it had both in it. (We're also fans of Vet's Best neem oil toothpaste.) One pill that night. 2 the next day. Up to 2 in the a.m., 1 at lunch, and 1 at dinner by mid week watching both new supplements for stomach issues - there were none.
We kept her on the Rimadyl for 3.5 days until Monday 11/19. Now 5 days post injury she'd tap her foot down from time to time and we didn't want her to do more just because a drug was artificially making it feel better. We were out of the acute phase and felt it had done all that it was going to do. We kept the remainder in case of a slip up.
All along after day 3 if Zero laid on her left side (right side up...) -- we'd run to get an ice pack on her knee. Often she'd get a good 20 minutes with it. Then we'd switch up with a heat pack (a buddy) for contrast therapy. i.e., hot / cold - that we'd learned from herbalists Dr. Christopher and Dr. Richard Schulze.
There wasn't much change the next few days. A week had gone by and she was still just toe tapping. Thursday, Thanksgiving, we created a penned off area in the living room and told family the Dog Whisperer Cesar Millan refrain, “No touch, no talk, no eye contact.” I stayed with her as folks entered -- careful not to push her down but also keeping her from looking to stand up near the fence. After they stayed for a while she calmed down and we could have family pet her while she stood actually lifting her from sitting cross legged because she was trained to sit! (She also had to be stopped from sitting when treats were given. What a good dog.) This was the first day that her stretches (done by her, not us...) included the right leg a bit. She also would walk extremely gingerly for steps at a time. Finally - it was something. Thanks given on day 8.
Days 9-11 the stretching she does now included the right foot at all times. Also the stretch would occur most of the time without a jut like shake in the leg. Here's video of her limping around day eleven.
Week 2 -- Today, 2 weeks after the injury, we see some improvement. If she was at zero percent (pun intended) day 1, 5-6% after day 9 -- this morning she's at 10%. 10% is still very bad. Especially when you recall what this dog was doing 2 weeks ago but it is a strong signal of hope. Little more walking from bed to get ready to go downstairs. Little more walking around after eating. And a little bit better 'look' to the pee and poop squats. The leg went up after walking a minute or so after all that. But she's putting it down more today.
That said - if she were to run after something right now...have to keep vigilant. Do not want to lose what we currently have.
Day 13 and we were able to grab good video of her hot cold contrast therapy.
Day 16 and we got to thinking -- if we're trying to get her to form enough scar tissue to hold the knee why wouldn't the less invasive Tightrope (TR) surgery be of a benefit? Kevlar in there would be like a stronger scar at the very least, right? So we emailed James L. Cook, DVM, PhD, OTSC -- William & Kathryn Allen Distinguished Chair in Orthopaedic Surgery Director, Thompson Laboratory for Regenerative Orthopaedics & Mizzou -- BioJoint® Center -- Chief, Orthopaedic Research Division University of Missouri -- Missouri Orthopaedic Institute (4028A) summing up what we were doing and asking him for a list of local TR surgeons. Dr. Cook replied with a list and a note, "Happy to try to help however I can. Did you have an Xrays taken? I would like to see if so. TR can really be done anytime that you feel surgery is necessary. The keys are good joint exploration, clean up, meniscal treatment, good TR, good imbrication and great postop care."
See, there are good guys out there. We are in the process of getting the Xray for Dr. Cook to look at. We replied thanks and, "I thank you very much for the quick reply. So you're ok with an athletic dog of 60 pounds and TR? Also, when we finally are complete with this journey I'm going to publish our diary." His answer? "Yes if you address all components listed then TR good."
Got that? All those local yocals who tell you no TR if over 40 pounds...pfffst. Also, you know how the local vets tell you give the dog with the torn CCL one week confinement to see if it gets better? Recall how tiggerpoz said you gotta go at least 6 weeks and more likely 8 weeks? How about the vet who tells you TPLO is a fast recovery? 2 weeks and they're walking. 30 days and they're close to fully healed. 6 weeks and they are all healed up and going strong. Dr. Cook's protocol for post Tightrope surgery? Ready?
EIGHT WEEKS RESTRICTIVE CONTAINMENT of your dog! Remember that if you are trying to cure your dog's torn CCL without surgery and, PLEASE, remember this if you have chosen to do the extremely invasive TPLO or TPA surgery no matter how quickly your vet has told you it's ok to run or go for those long runs. (Published with Dr.'s approval)
POST SURGICAL CARE FOR TIGHTROPE PATIENTS
We want XXXX to have the best possible outcome after his/her TightRope surgery and your role in the postoperative care is CRITICAL to success! Please follow these instructions exactly and call us if right away if you are having problems in doing so.
1. Please do not let XXXX lick or chew at his/her incision sites at all. An Elizabethan Collar MUST be worn at all times until the incisions have healed well and we are able to take the sutures out. Please check the incisions each morning and evening for any swelling or drainage. If at any time any incision looks like it could be infected or you have other concerns about it, please call us. Please schedule an appointment for XXXX with us for 10-14 days after surgery so we can examine the incisions and remove skin sutures or staples.
2. XXXX should be strictly confined for the first 8 weeks following surgery. Three activities are allowed: A) he/she can be in the house under your direct supervision on a carpeted or other non-slip surface without the possibility for jumping on or off furniture, playing with toys or other dogs, or accessing stairs. B) When you are not home or are unable to DIRECTLY SUPERVISE XXXX, he/she should be in a kennel or crate. C) You may take your pet outside on a short leash to go to the bathroom and a very short (2-3 minute) controlled walk. No other activities such as running, jumping, flexi-lead activity, stairs or playing of any type are allowed. Prolonged walks are not allowed. These restrictions are necessary to allow the knee to heal well and provide the long term, pain free function we are working to achieve. No unrestricted/off leash or unobserved activities are allowed until proper healing is confirmed at your 8-week recheck. Please schedule an appointment for XXXX with us for 8 weeks after surgery so we can examine his/her knee and assess healing. Based on this 8-week assessment, we will then set up the rehabilitation phase of recovery with you in order to progressively bring XXXX back to full function.
3. During the 8-week confinement period, it is recommended that XXXX be given a reduced portion of his/her normal food amount to prevent weight gain. We will discuss the details of this with you at the time of discharge.
4. It is very important that you complete the prescribed medication regimen when you go home. The medications help with inflammation and pain relief after surgery and decrease the risk for infection. If you feel that XXX suddenly becomes painful, has an abrupt change in limb use, or is experiencing side effects from the medications, please contact us as soon as possible.
5. Please schedule your recheck appointments as soon as possible, ideally as you are checking out today.
Make a note of that again. EIGHT WEEKS. Our vet told us 30 days and we were on the road to a complete 6 week recover with TPLO!
More on our vet. We got Zero's Xray and sent it to Dr. Cook. This really bucks a guy up when the reply from THE guy in the field is, "Thanks, unfortunately these are very poor quality films - poor positioning, only one view, don’t include the ankle - so they are not diagnostic." A ninety dollar waste. I replied as much adding, "- is the x-ray any good as to any level of OA might be in there?" Doc answered, "Not really. Can say there is not severe OA based on it but not much else." Ok, so at least we had that. But the x-ray, pretty much, was a complete moneymaking waste.
Day 17 and she's showing more inclination to walk further distances and we have to stop that. We took her out front for the first time since day 2's vet visit and did a two minute walk up and down our block and then back in. Heartguard day we lessen up on the vitamin C for the day. Tonight the glucosamine sulfate, chondroitin, and quercetin arrived. Gave her 800mg of Glucosomine. Will give her 800mg of glucosomine twice tomorrow and watch for any stomach upset. Plan to stay at 1600mg per day for 30 days. Will add the chondroitin later and the pure quercetin when she finishes the Vet’s Best Seasonal Allergy Relief which has Q in it already. She's still on that and the collagen (plus the CBD oil now nightly only).
Day 18, new video below. Apparent when compared to day ll - less to no holding of leg up. No roll over of toes while walking. Took a sniff and pee (S&P) 5 minute walk out front. She let us know when to turn back up the driveway and head in and it was exactly at the time we were going to do the same anyway.
Part 2
Biggest ray of hope today was when we didn't stop her quickly enough and she sat down. Leg was pulled in. Looked more like a GSD is supposed to (ie, the right leg was not jetted all the way out akimbo while sitting.)
Day 19 and she's ancy for the first time. Probably as she now has a bit of support in the knee. We did two 5 minute S&P walks out front. She wants to play and we have to be the ones to say absolutely not and head in. Hot colds continue and we've added the chondroitin sulfate to the mix.
Day 20 and she's a bit slower today. Temps dropped to the low 20s. Still, every day sans snow is a blessing. No front walk.
3 weeks. The slowness is gone. Did a 5 minute S&P. She's not a big fan of the chondroitin on her food. Going to get a video of her taking her CBD oil one night though.
Day 25 -- We walked across the street at a place where the curb is flat. Walked for 10 minutes and later for 5 minutes. Gimpy's energy is back and we have to be careful as she grabs a bone and comes and pushes against us.
Day 26 walking video.
Also began noting day 26-27 a return to using the right hind leg to scratch things. i.e., scratching her head, behind her ear, or around her mouth.
Let's sum up one month in. Almost going to finish up the collagen. On the Vitamin C, Glucosomine & Chondroitin (SULFATE for both), and on the quercetin. Gimpy can walk. No longer hopping, she's got the walk with the limp. We can walk 10 minutes. We aim for the grass. On the past few days that we've pushed through and done say 15 min at once (still S&P pace) she will come home tired like the old sprinting to exhaustion days. So that's one thing owners have to watch - don't push it. She's also wanting to play. Pushing at us with her toy, etc. Watching that and doing it is difficult. We have to push down on her front shoulders, not back like you would typically. The same when she turns it into tug of war. Can't let her do that because a pull slip and that leg is in real jeopardy again.
If you didn't know her and you saw her walking you would probably just chalk it up to a slowed down older dog. Not one rehabbing a devastating injury. And that is hope right there folks. Especially considering we were told, 'Give it a week.' and that, on day 10, she still wasn't putting the paw down...
Another thing you'll notice a month in? Those missing walks and trips to the park? Those sidewalks and parks collected, at least some, of her shedding hair. Now it is all in the house with us.
I wanted to take a moment to check in and thank the thousands of you who have sent me your well wishes and prayers. I don’t deserve your kind thoughts at this stage of my life and while I appreciate them more than words could ever describe, I would kindly ask that you do the same for those who I have hurt as a result of my actions: Family members, friends, co-workers, investors and loyal listeners.
I let all of you down, I betrayed your trust and I’m sorry.
A list of the investors et al. was not provided. Carton faces sentencing early next year.
ESPN just keeps trotting resident moron Stephen A. Smith out there as an 'expert' on whatever it is they trot him out there for. Yesterday? Smith broke down the 'San Diego' Chargers match up with the KC Chiefs. It included references to out with a foot injury Spencer Ware and then moved on to the match-up between Hunter Henry and Derrick Johnson. HH hasn't played all year and DJ is a FA.
A man attempted to steal a gold chain from a jewelry store in Choburi, Thailand, but made one major mistake. Suphachai Panthong tried to run off, but was blocked by a locked door. He was then forced to return the item, and authorities took the man into custody.
We wrote back in May, "Barack and Michelle Obama, Hillary Clinton, and Chuck Schumer: Build the Trump Wall." And we advised the GOP to use those words in ads. And now they have. Enjoy, 'We Must Secure Our Border.'
Plain City, OH -- Kloe Yutzy, besides having the best name in HS basketball, now has the greatest buzzer beater you will see this year. Yutzy, a senior for Shekinah Christian Girls Basketball, was on the Tree of Life floor trailing 41-39 with 4 seconds on the clock. Yutzy stepped in front of a would be steal by the defense on the last inbounds of the game before launching a three quarter court miracle.
The MLB Network decided to put in a hologram of Chris Russo moving his chair back and forth on Hot Stove to demonstrate the complete stupidity that is sports broadcasting.
Two teenage migrants were injured when they fell from an 18-foot border fence in Yuma, Arizona. One of the girls, a 14-year-old from Guatemala, was hospitalized with several broken vertebrae.
Two teenage girls were injured climbing a US-Mexico border fence into Yuma, Arizona. Video shows the first girl, a 14-year-old from Guatemala, falling 18 feet and struggling to crawl away. She was taken to a hospital in Phoenix with several broken vertebrae.
The second teen, a 17-year-old girl, fell and broke her ankle. They were part of a group of six migrants, two adults and four minors.
The Yuma sector has seen an increase in fence-related injuries since the recent surge of Central Americans illegally crossing the border to seek asylum in the US.
According to the Border Patrol, this video highlights the fact that the only safe way to enter the country is through legal points of entry. They say they have recently seen a spike in this type of injury in the area.
Taken to a hospital in Phoenix?........ More wasted taxpayer dollars. They should've been taken to a hospital in Mexico. And mom should be charged with child abuse.