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Q: My 5-year-old Labrador retriever has been limping for three months. I took her to the vet two months ago, and he said she had an ACL tear. An anti-inflammatory drug was prescribed for two weeks and that helped a little. The limping became more subtle but was still there, so the vet prescribed Tramadol (for pain relief) and glucosamine/chondroitin (to deter further deterioration) for 4-6 weeks.

A specialist confirmed that my dog has a partial or complete ACL tear, and suggested surgery, but I don’t have the $3,000 fee. I’m paying for my own health issues. My dog isn’t whining or crying or limping now. I may sound like a horrible dog owner because I want to know if surgery is absolutely necessary. Any advice? – J.W., Cyberspace

A: Clearly you’re not a horrible dog owner; it’s obvious that you care a great deal. Dr. Daryl Millis, a board certified veterinary surgeon and specialist in veterinary sports medicine and rehabilitation, is a professor of orthopedic surgery at the University of Tennessee College of Veterinary Medicine, Knoxville. He says that based on your veterinarian’s suggestion and the confirmation by a specialist, he assumes your dog really does have an anterior cruciate ligament (ACL) tear. The ACL provides stability for the knee.

“There’s no question that surgery is ideal,” says Millis. “Having said that, your dog may improve for some time on her own (as apparently has begun to happen). Still, dogs don’t always tell us they’re in pain.”

Millis adds that your greatest challenge may be to minimize your dog’s high-impact activity, and at the same time maintain her weight. Being overweight will place pressure on her knee. The best exercise is swimming because it burns calories and at the same time is non-weight bearing. At least, based on your dog’s breed, she enjoys the water.

There are prescription diets (from Hill’s and Royal Canin) which have elevated levels of Omega 3 fatty acids (which support joint health), however they’re also high in fat. Depending on your dog, your veterinarian may instead just suggest Omega 3 supplementation. Injections of a drug called Adequan and/or a chewable product called Dasaquin could help your dog deal with pain. Acupuncture may help some dogs.

Your dog may have painful flare-ups, which a nonsteroidal anti-inflammatory drug might subdue.

With careful management and good luck, your dog’s quality of life can be darn good without surgery.


Q: My 15-year-old cat was diagnosed as hyperthyroid in December 2011. She was put on a prescription diet called y/d, but today she barely eats the food, and her breath has gotten terrible. I can’t mix the food with something the cat really likes because when a cat is on y/d, that’s all the pet can have.

The veterinarian says my cat also has liver problems. I’m not sure if the bad breath is from the food, her teeth, or her liver. I don’t believe that in her current condition she can have a scaling (dental) procedure. Any advice? – N.L., Laval, Quebec, Canada

A: Please see your veterinarian as soon as possible; there’s a lot to sort through here. New York City veterinarian Dr. Mark Petersen, a renowned expert on feline endocrinology, says it’s important to measure your cat’s thyroid levels. If the prescription y/d diet isn’t doing the trick, another option can be considered, such as medication or a treatment called radioactive iodine. Often, uncontrolled thyroid can wreak havoc on the liver. Those liver values are also important for your veterinarian to know.

There may be a medical explanation for your cat’s lack of appetite. It’s a concern for many reasons, and definitely a sign that something may be wrong. Actually, thyroid disease (left untreated) may typically cause cats to be hungry. One guess (based on the bad breath) is that there may be a serious dental issue or another problem in your cat’s mouth. However, there are many other possible explanations, including kidney disease.

If it does turn out your cat simply finds y/d unacceptable, and you switch to a thyroid medication or radioactive iodine, your cat could transition to a diet she prefers.

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