delilah: Post TPLO arthritis +non-surgical CCL management + chronic paindue to spine OA

14 yr, Female, 40lb lb Heeler Mix

Delilah hurt her knee as an older dog …

History

• Left knee surgery (TPLO) years ago

• Now full tear R CCL + limping

• Trying to avoid surgery due to age

• See is fearful of touch along her back

• She is uncomfortable with play and walks

• It is painful to get up and down

• CBPI Pain severity score by owner: 7

• CBPI Pain interfering with mobility: 7

Exam

• Maladaptive pain - fearful of touch

• Atrophy of the quadriceps

• Super stiff lumbar spine muscles

• Limping in both back legs (knee pain)

• Painful to sit square over rear end

Diagnostics/Treatment

• Stifle + spine radiographs

• MRI/Diagnostic Ultrasound of her stifle

• Stifle injection - PRP (Platelet Rich Plasma) from Vetstem

• Stifle injection with Synamid/Arthramid

• Stem cell therapy annually with Anicell

• Shockwave spine, hip, and stifles

• Acupuncture and chiropractic care

• 1-2x weekly rehabilitation therapy x 4 mos

Outcome and Timeline to Recovery

Delilah desperately needed relief from chronic pain to be able to rebalance her body and allow non-surgical rehab for her CCL deficient knee. We managed her the first few years with minimal medications, but she does need some medications and regular care to keep playing and climbing in our gym! Many thanks to her physical therapist Kelli for her special manual therapy and exercises at the Animal Care Center of Castle Pines.

• CBPI Pain severity per owner: 3/10

• CBPI Interference score: 4/10

She comes to rehab 2x/month indefinitely to maintain her comfort and for specific exercises!

Maintenance Plan

She absolutely needs regular exercises and regular acupuncture to keep her pain at bay. She gets shockwave every 3-6 months and joint injections and stem cell therapy every year.

She takes Adequan and Caneva, CBD, and Galliprant, and Amantadine when needed for her back pain.

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