1 00:00:02,200 --> 00:00:45,679 Speaker 1: You were listening to Petlifradio dot com. 2 00:00:25,239 --> 00:00:28,399 Speaker 2: And good morning to everyone on it's fantastic Sunday morning. 3 00:00:28,399 --> 00:00:31,280 Speaker 3: I hope it's good for you too, and it uh here. 4 00:00:31,359 --> 00:00:33,240 Speaker 2: Well, the morning, I should say, here in Los Angeles 5 00:00:33,240 --> 00:00:34,320 till morning is nine o'clock. 6 00:00:34,799 --> 00:00:37,439 Speaker 3: For those of you back east, it's about noon. 7 00:00:38,039 --> 00:00:40,439 Speaker 2: So anyway, I hope you had a good morning as 8 00:00:40,439 --> 00:00:41,799 you approach the afternoon. 9 00:00:41,840 --> 00:00:43,840 Speaker 3: But we're having a good morning here in LA. 10 00:00:43,880 --> 00:00:45,359 Speaker 2: It's starting to cool down a little bit, which is 11 00:00:45,399 --> 00:00:48,079 good because it's been insanely hot. I think we're gonna 12 00:00:48,079 --> 00:00:49,840 have a you know, a couple of days where it's 13 00:00:49,880 --> 00:00:52,479 going to be very mild for us. That's in the eighties, 14 00:00:52,840 --> 00:00:55,039 and then they say by next weekend it's going to 15 00:00:55,079 --> 00:00:57,280 be a scorcher again. I think expecting in the mid 16 00:00:57,320 --> 00:01:00,640 tigh nineties. So anyway, we can do well. I'm not 17 00:01:00,679 --> 00:01:02,280 complaining too much. As long as you get snow by 18 00:01:02,320 --> 00:01:05,719 the wintertime in the mountains, I'll be okay. So anyway, 19 00:01:05,719 --> 00:01:07,519 you're here with doctor Jeff Werber ask The vets with 20 00:01:07,560 --> 00:01:11,480 Doctor Jeff are only live call in show here on 21 00:01:11,480 --> 00:01:15,239 pet Life Radio. And just let me reiterate the words 22 00:01:15,439 --> 00:01:18,560 call in show that means we want you to call 23 00:01:18,560 --> 00:01:21,120 in number is easy eight seven seven three. 24 00:01:21,079 --> 00:01:22,879 Speaker 3: Eight five eight eight eight two. 25 00:01:23,319 --> 00:01:25,959 Speaker 2: If you're really embarrassed to call, you can just log 26 00:01:26,040 --> 00:01:28,799 on to pet Life Radio, click on the ask the 27 00:01:28,879 --> 00:01:31,680 Vets tab with doctor Jeff and you can join it 28 00:01:31,760 --> 00:01:34,319 in the conversation. Or if you're really, really really so 29 00:01:34,560 --> 00:01:36,239 you don't even want to be live on the conversation, 30 00:01:36,560 --> 00:01:39,480 send me an email to Dr Jeff. That's doctor Jeff 31 00:01:39,640 --> 00:01:43,680 at petlifradio dot com and it will be forwarded to 32 00:01:43,719 --> 00:01:47,680 me live as we speak here on air. We make 33 00:01:47,760 --> 00:01:50,000 it so easy to get a hold of us, and 34 00:01:50,239 --> 00:01:52,079 we're here for you. We're here to help you with 35 00:01:52,120 --> 00:01:54,920 your pets. Answer questions, you know, go over some of 36 00:01:54,959 --> 00:01:56,959 the things a little bit more slowly with a little 37 00:01:57,000 --> 00:02:00,000 better understanding than your veterinarian may have. This is where 38 00:02:00,599 --> 00:02:04,200 it helps to give me a call, and so we 39 00:02:04,280 --> 00:02:06,879 need to just have you call me. We can kind 40 00:02:06,879 --> 00:02:10,159 of go from there, and also need to thank our sponsors. 41 00:02:10,360 --> 00:02:14,479 Our sponsors are pro sense pet products, veterinary quality products 42 00:02:14,479 --> 00:02:19,039 that you can get at your local mass retailer like 43 00:02:19,159 --> 00:02:21,719 your Walmarts and your Targets and your Walgreens. And I 44 00:02:21,800 --> 00:02:24,719 understand also some of them are in Kroger's, which is 45 00:02:24,759 --> 00:02:29,400 great and also Kong can't forget our cong toys. In fact, 46 00:02:29,680 --> 00:02:32,639 send us a question, send me an email, join us 47 00:02:32,639 --> 00:02:34,599 here on Live here on I Ask the Mats with 48 00:02:34,639 --> 00:02:37,840 doctor Jeff on pet Life Radio, and we will send you. 49 00:02:37,800 --> 00:02:39,639 Speaker 3: Out a pro sense product. 50 00:02:40,000 --> 00:02:42,520 Speaker 2: So what we've been doing over the last several weeks 51 00:02:42,960 --> 00:02:46,840 is going through some of the conditions that there are 52 00:02:47,400 --> 00:02:49,759 a lot of choices to make. There seem to be 53 00:02:50,080 --> 00:02:54,919 traditionally much confusion, and I'm I'm talking confusion even amongst 54 00:02:55,000 --> 00:02:58,159 veterinarians how to handle. You know, one of the things 55 00:02:58,159 --> 00:03:00,719 that I often say, and I'll pup repeat this a 56 00:03:00,800 --> 00:03:03,840 zillion times through the course of my shows, and that 57 00:03:04,000 --> 00:03:08,159 is that I think the young veterinarian and bless their hearts, 58 00:03:08,159 --> 00:03:10,000 I think they're amazing and they you know, they're smart 59 00:03:10,039 --> 00:03:11,800 enough to get into med school and that's great, but 60 00:03:11,919 --> 00:03:15,479 I think that in a sense they are being misled 61 00:03:16,159 --> 00:03:20,759 by as I call the ivory towers of the veterinary colleges, 62 00:03:21,159 --> 00:03:24,280 the teaching hospitals. And here's why. It's very simple that 63 00:03:24,479 --> 00:03:26,919 when you go through school, the case load that you're 64 00:03:26,919 --> 00:03:29,719 often seeing when you get into clinics. Now, let's face it, 65 00:03:29,759 --> 00:03:31,680 the book Smarts is great, and you learn a lot in. 66 00:03:31,599 --> 00:03:34,000 Speaker 3: Your books, but the way you're really. 67 00:03:33,680 --> 00:03:37,599 Speaker 2: Going to learn the essence the art of veterinary practice 68 00:03:38,120 --> 00:03:41,719 is in the clinics. It's hands on experience. So you 69 00:03:41,759 --> 00:03:44,840 have to ask yourself what kinds of cases do the 70 00:03:44,879 --> 00:03:47,719 clinics get When a case is referred by a general 71 00:03:47,719 --> 00:03:50,960 practitioner somewhere in central California and they want to send 72 00:03:50,960 --> 00:03:52,360 a case up to UC Davis. 73 00:03:52,560 --> 00:03:54,479 Speaker 3: What kind of case was that? A simple case? Was 74 00:03:54,520 --> 00:03:55,439 that a routine case? 75 00:03:55,719 --> 00:03:58,479 Speaker 2: And the answer is no, because why if it was, 76 00:03:58,719 --> 00:04:01,080 the doctor would have handled it perfect. It was a 77 00:04:01,159 --> 00:04:04,439 case that was as I called the zebra. And for 78 00:04:04,479 --> 00:04:06,400 those of you not familiar and those of you that 79 00:04:06,439 --> 00:04:09,000 have been listening, you know that great expression of mine, 80 00:04:09,080 --> 00:04:09,759 it's not mine. 81 00:04:09,800 --> 00:04:11,439 Speaker 3: I just heard it and I love it. And that 82 00:04:11,599 --> 00:04:12,560 is if you're running. 83 00:04:12,280 --> 00:04:15,560 Speaker 2: Along the beach in Malibu, California, and you hear beach 84 00:04:15,639 --> 00:04:18,839 chasing you from behind, what are you thinking? Horses are zebras, 85 00:04:19,120 --> 00:04:22,639 Hopefully the answers horses, And most of the cases that 86 00:04:22,639 --> 00:04:24,839 you're going to see, we're going to see in practice 87 00:04:25,160 --> 00:04:28,079 in our general practice level are gonna be the horses, 88 00:04:28,399 --> 00:04:30,720 and which cases do we need to send to the 89 00:04:30,759 --> 00:04:34,639 teaching hospitals, to the research institutions, to the veterinary school universities. 90 00:04:34,759 --> 00:04:37,920 We're sending them the zebras. The ones that are really bizarre, 91 00:04:38,040 --> 00:04:41,199 the ones that are regular standard testing can't figure out. 92 00:04:41,399 --> 00:04:44,120 The ones that are ultrasound we can't find it. We 93 00:04:44,279 --> 00:04:47,399 know something is wrong, everything else is normal. Wow, you 94 00:04:47,480 --> 00:04:50,120 scratch your head, this is a bizarre case. I'm going 95 00:04:50,160 --> 00:04:51,959 to send it to the specialist, or if you're near 96 00:04:52,000 --> 00:04:54,680 a university hospital, I'm going to send it to the hospital. 97 00:04:54,839 --> 00:04:58,279 So consequently, when these veterinary students are going through their 98 00:04:58,439 --> 00:05:02,000 rounds at the hospital, the cases they are seeing are 99 00:05:02,240 --> 00:05:03,160 really the zebras. 100 00:05:03,160 --> 00:05:04,000 Speaker 3: They are seeing some of. 101 00:05:03,959 --> 00:05:06,360 Speaker 2: These really bizarre cases. 102 00:05:06,560 --> 00:05:07,360 Speaker 3: So what happens. 103 00:05:07,600 --> 00:05:10,040 Speaker 2: What happens is when they're in practice as a young 104 00:05:10,360 --> 00:05:13,319 veterinarian and they see that limping dog, what are they thinking? 105 00:05:13,519 --> 00:05:17,879 Are they thinking the four pages of normal, regular, simple 106 00:05:17,920 --> 00:05:21,519 possibilities or that half a page at the very end 107 00:05:21,759 --> 00:05:24,879 of the zebras And unfortunately, because of their training, they're 108 00:05:24,879 --> 00:05:27,439 thinking the zebras. And it's not until they get out 109 00:05:27,639 --> 00:05:30,240 and practice for a number of years that they realize, 110 00:05:30,360 --> 00:05:32,439 oh my god, you know, I've never seen a case 111 00:05:32,480 --> 00:05:34,279 like that one again the ones I saw in VET school, 112 00:05:34,360 --> 00:05:37,160 and chances are you're not gonna ah. You might find 113 00:05:37,160 --> 00:05:42,199 anyia rarely. But so I think that the tendency when 114 00:05:42,240 --> 00:05:46,000 you see a problem case, especially with a young veterinarian, 115 00:05:46,079 --> 00:05:50,439 in practice, it's to immediately follow the course that they 116 00:05:50,439 --> 00:05:54,160 have followed from vet school. Really, and they really never 117 00:05:54,439 --> 00:05:57,199 mastered the art of how to do your rule outs, 118 00:05:57,240 --> 00:06:01,120 how to make a decision without the benefit of the tests, 119 00:06:01,480 --> 00:06:04,120 how to use that history and physical to your advantage 120 00:06:04,279 --> 00:06:07,920 to rule out ninety percent of things on that list 121 00:06:07,959 --> 00:06:10,560 of possibilities, leaving you with only ten percent to have 122 00:06:10,639 --> 00:06:14,120 to really diagnose. So what we've been talking about in 123 00:06:14,199 --> 00:06:16,519 weeks past have been a lot of them. We started 124 00:06:16,519 --> 00:06:18,959 with the vomiting issues and lately we've been talking about 125 00:06:18,959 --> 00:06:21,319 the limping issues. And in the limping issues, we've gone 126 00:06:21,600 --> 00:06:24,000 through some of the growth related diseases that we see 127 00:06:24,000 --> 00:06:28,519 in dogs. We've gone through the arthridities, the arthritis hip displasia. 128 00:06:28,079 --> 00:06:29,000 Speaker 3: For example, for one. 129 00:06:29,399 --> 00:06:32,519 Speaker 2: Trying to clarify a bit as to how much you 130 00:06:32,600 --> 00:06:35,839 have to worry when you see your dog limping. So 131 00:06:35,879 --> 00:06:38,199 the next thing I promised we were going to talk about. 132 00:06:38,360 --> 00:06:41,600 We just touched on it last week. We started the knees, 133 00:06:41,639 --> 00:06:46,800 the stifles, and we got into the patella luxation, which 134 00:06:46,879 --> 00:06:51,439 is a congenital disease, or certainly a congenital predisposition where 135 00:06:51,480 --> 00:06:54,839 the kneecap, the patella that is supposed to sit nice 136 00:06:54,879 --> 00:06:58,560 and tightly on a groove at the lower part of 137 00:06:58,600 --> 00:07:03,199 the femur called interestingly enough, the femeral or pateller groove, 138 00:07:03,560 --> 00:07:06,879 where it has a tendency to luxate to the inside, 139 00:07:07,000 --> 00:07:10,759 especially in small young dogs, and that's because a number 140 00:07:10,759 --> 00:07:14,240 of reasons, the groove not being deep enough, the upper 141 00:07:14,360 --> 00:07:18,240 ridge on the medial aspect is too shallow, and because 142 00:07:18,279 --> 00:07:21,920 of the tibial crest how it has a more of 143 00:07:21,959 --> 00:07:27,040 a medial positioning, and therefore, since the patella ligament attaches 144 00:07:27,519 --> 00:07:31,680 from the patella to that tuberocity the top of the 145 00:07:31,680 --> 00:07:36,040 tibel crest, it has a tendency to migrate to the inside, 146 00:07:36,240 --> 00:07:39,600 thus media pateel luxation. Depending on what grade it is, 147 00:07:39,639 --> 00:07:42,519 as we discussed, there four grades, grade one, two, three four. 148 00:07:42,600 --> 00:07:46,160 Grade one leave alone, Grade two early two you probably 149 00:07:46,160 --> 00:07:48,480 can leave alone as well. But if the two becomes 150 00:07:48,519 --> 00:07:49,800 more of a two and a half to a three, 151 00:07:50,319 --> 00:07:53,480 or a three becomes a four, definitely it's a surgical disease. 152 00:07:53,800 --> 00:07:57,680 So the other knee problem that we see quite often 153 00:07:57,720 --> 00:08:00,959 in the larger dog now, media patella luxation is usually 154 00:08:01,040 --> 00:08:04,600 a small dog problem. But we also have a large 155 00:08:04,720 --> 00:08:09,680 breed problem and that is called a cruciate ligament tear 156 00:08:10,120 --> 00:08:13,639 or rupture. Now, in people, it's referred to as the 157 00:08:13,800 --> 00:08:18,199 anterior cruciate or ACL, and just watch a football game 158 00:08:18,199 --> 00:08:20,680 on any Sunday they will be talking about or you 159 00:08:20,680 --> 00:08:24,759 will clearly see an ACL injury in the making. Now 160 00:08:24,920 --> 00:08:28,720 with dogs and just the nomenclature, it still is referred 161 00:08:28,759 --> 00:08:32,519 to as the anterior cruciate, but typically more appropriately we 162 00:08:32,559 --> 00:08:36,559 call it the cranial cruciate ligament as opposed to the 163 00:08:36,720 --> 00:08:41,279 caudal cruciate ligament instead of the anterior posterior. So we 164 00:08:41,320 --> 00:08:44,480 have a CCL. It's called and it's abrupture or tear. 165 00:08:44,759 --> 00:08:49,080 The reason it happens really are very similar to that athlete. 166 00:08:49,279 --> 00:08:54,159 It is a hyper extension injury, or it is an 167 00:08:54,200 --> 00:09:00,159 injury of a very sharp lateral shearing force. It's when 168 00:09:00,240 --> 00:09:04,159 that football player gets blindsided and he's hit on the 169 00:09:04,320 --> 00:09:07,320 outside the lateral aspect of his knee and that can 170 00:09:07,360 --> 00:09:10,639 snap the cruise it, or if he's hit from the front. Now, 171 00:09:10,799 --> 00:09:12,600 as you know, when we bend our knees, we can 172 00:09:12,639 --> 00:09:15,960 bend our leg backwards in relation to the knee when 173 00:09:16,000 --> 00:09:20,039 your leg when you're standing straight, totally straight, you cannot 174 00:09:20,240 --> 00:09:23,080 bend your leg your knee in the opposite direction where 175 00:09:23,080 --> 00:09:25,600 the knee goes behind your ankle. 176 00:09:25,919 --> 00:09:27,279 Speaker 3: So think of it this way. 177 00:09:27,279 --> 00:09:29,440 Speaker 2: It's a sensation that I'm sure all of us has 178 00:09:29,440 --> 00:09:33,360 felt at one time. You're walking along and you're engaged 179 00:09:33,399 --> 00:09:37,000 in thought or in conversation, not really paying attention to 180 00:09:37,120 --> 00:09:39,200 the street or the road ahead of you, and you 181 00:09:39,279 --> 00:09:42,399 don't see that curb. So your brain, we don't think 182 00:09:42,440 --> 00:09:45,200 when we walk, we don't think about our foot placement. 183 00:09:45,559 --> 00:09:48,799 It's natural when we're walking on a flat surface, we're 184 00:09:48,840 --> 00:09:50,600 not even thinking how we're placing our foot. 185 00:09:50,759 --> 00:09:51,639 Speaker 3: So what happens. 186 00:09:51,639 --> 00:09:55,080 Speaker 2: What's that sensation when you don't see that pothole, when 187 00:09:55,080 --> 00:09:58,080 you don't see that curb. So you've put your foot down, 188 00:09:58,399 --> 00:10:01,240 but your brain tells you you are putting it down 189 00:10:01,279 --> 00:10:04,200 at the same level of the last step. So you're 190 00:10:04,240 --> 00:10:06,799 prepared because that's what you're expected to do. But all 191 00:10:06,840 --> 00:10:09,240 of a sudden, that pothole is there, that a hole 192 00:10:09,240 --> 00:10:11,919 in the grass is there, that sprinkler hole, that. 193 00:10:11,879 --> 00:10:13,559 Speaker 3: Curve that you didn't know was coming. 194 00:10:13,799 --> 00:10:15,879 Speaker 2: So you're all of a sudden when you land that 195 00:10:16,000 --> 00:10:20,000 foot a few inches six inches five inches longer deeper 196 00:10:20,039 --> 00:10:23,039 than your brain told you. You hit that ground with 197 00:10:23,200 --> 00:10:25,679 that ow and you feel it a little bit in 198 00:10:25,679 --> 00:10:28,919 the back of your knee, Well, magnify that, and that's 199 00:10:28,960 --> 00:10:31,519 what happens to the cruciate tear. So we see it 200 00:10:31,600 --> 00:10:37,200 frequently in large breeds, especially breeds that are just extremely 201 00:10:37,679 --> 00:10:41,879 well muscled in the thigh. That little cruciate ligament in 202 00:10:41,919 --> 00:10:46,559 relation to the thigh musculature is no match. So when 203 00:10:46,600 --> 00:10:50,200 these dogs pivot, when these dogs are running, they're playing aggressively, 204 00:10:50,639 --> 00:10:54,759 whatever the case may be, that ligament can easily snap. 205 00:10:55,080 --> 00:10:59,480 And what's so interesting is there is such a predisposition 206 00:11:00,240 --> 00:11:03,840 on genetics that we often tell a client that if 207 00:11:03,960 --> 00:11:06,159 this was truly an injury, I mean truly he was 208 00:11:06,200 --> 00:11:09,519 blindsided the same thing, hit a pothole, he pivoted, but 209 00:11:09,559 --> 00:11:11,360 this foot got kind of stuck in the grass. But 210 00:11:11,399 --> 00:11:14,000 the rest of his body. Didn't you just got that sheer, 211 00:11:14,120 --> 00:11:16,159 that twist that can tear that ligament. 212 00:11:16,320 --> 00:11:17,279 Speaker 3: It could be an accident. 213 00:11:17,559 --> 00:11:20,440 Speaker 2: But for dogs where it happens just kind of, it 214 00:11:20,600 --> 00:11:23,799 just happens, and we won't doing anything amazingly difficult or 215 00:11:23,879 --> 00:11:27,440 challenging or having some severe stress on that knee. 216 00:11:27,559 --> 00:11:28,360 Speaker 3: It just pops. 217 00:11:28,559 --> 00:11:32,320 Speaker 2: We tell them that now knowing this, there is a 218 00:11:32,440 --> 00:11:35,799 seventy five percent chance that the other leg is going 219 00:11:35,879 --> 00:11:37,720 to go, and it's going to go for a lot 220 00:11:37,759 --> 00:11:41,000 of reasons. And as a matter of fact, insurance companies 221 00:11:41,399 --> 00:11:43,879 will ensure well, I would say all of them. Many 222 00:11:43,919 --> 00:11:48,279 of the insurance companies will ensure the first injury because 223 00:11:48,279 --> 00:11:50,799 it could have been just that an injury. But if 224 00:11:50,840 --> 00:11:53,679 it happens again, and since we know that about seventy 225 00:11:53,759 --> 00:11:56,600 five percent of dogs that tear a cruciate are gonna 226 00:11:56,600 --> 00:12:00,519 tear the other one because of a genetic predisposition, and 227 00:12:00,720 --> 00:12:05,159 since insurance companies won't typically cover conditions where there is 228 00:12:05,200 --> 00:12:08,120 a genetic predisposition, you got away with the first one, 229 00:12:08,159 --> 00:12:11,080 but they're not going to cover the second one. So 230 00:12:11,759 --> 00:12:13,799 time for that break, time goes so fast. When we 231 00:12:13,840 --> 00:12:16,679 come back, we are going to talk about diagnosis. We're 232 00:12:16,679 --> 00:12:19,240 going to talk about treatment options and there are a 233 00:12:19,320 --> 00:12:21,720 number of them out there, and what happens for the 234 00:12:21,759 --> 00:12:24,720 small dog versus a large dog when they tear their 235 00:12:24,720 --> 00:12:28,159 cruciate ligament, as well as checking out their meniscus in 236 00:12:28,240 --> 00:12:30,759 surgery just like a person. So you're here with doctor 237 00:12:30,799 --> 00:12:32,720 Jeff Werber has to bets with doctor Jeff here in 238 00:12:32,759 --> 00:12:33,480 pet Life Radio. 239 00:12:33,679 --> 00:12:35,159 Speaker 3: And when we come back, I want to hear from you. 240 00:12:35,080 --> 00:12:37,440 Speaker 2: At eight seven seven three eight five eight eight eight 241 00:12:37,519 --> 00:12:40,080 two because I'm sure one of you out there has 242 00:12:40,120 --> 00:12:42,679 had a horror story with your dog's knees. We'll be 243 00:12:42,720 --> 00:12:46,120 back in a minute. 244 00:12:47,240 --> 00:12:50,399 Speaker 1: We'll be right back right after these messages. Stay tuned. 245 00:12:53,200 --> 00:12:55,440 Speaker 3: This is my tired of itching face. 246 00:12:55,799 --> 00:12:58,960 Speaker 2: Does your dog suffer from persistent itching and scratching? Allergies 247 00:12:59,000 --> 00:13:03,639 and skin irritations caused by environment including pollens, insects, especially fleas, 248 00:13:03,679 --> 00:13:06,960 food and common household allergens are common problems and dogs. 249 00:13:07,000 --> 00:13:09,200 It's easy to alleviate your dog's is comfort at home 250 00:13:09,240 --> 00:13:12,320 with pro Sense. Pro sense its analogy products provide fast 251 00:13:12,320 --> 00:13:15,879 relief from symptoms like it's irritated skin, skin infections like 252 00:13:15,879 --> 00:13:19,480 hotspots and watery eyes. 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A download the iHeartRadio 274 00:14:24,879 --> 00:14:27,799 app and rockpet Life Radio on your phone on your tablet, 275 00:14:27,840 --> 00:14:30,600 on your Xbox, in your car, Pet Talk, Pet Tunes 276 00:14:30,679 --> 00:14:37,679 and Fun Pet Times, pet Life Radio and iHeartRadio positively Possum. 277 00:14:37,759 --> 00:14:40,600 Speaker 7: Hey there, pet parents, this is Christy Vaughan, host of 278 00:14:40,639 --> 00:14:43,279 The doggye Dish. Do you love your furry companion? Do 279 00:14:43,320 --> 00:14:45,720 you love making him or her healthy treats but can't 280 00:14:45,720 --> 00:14:48,679 seem to find the time? Great news, The Doggy Dish 281 00:14:48,720 --> 00:14:51,679 is the perfect show for you. Every episode is chock 282 00:14:51,759 --> 00:14:54,679 full of healthy and easy recipes that are made with 283 00:14:54,879 --> 00:14:57,960 ingredients you most likely have on hand. Tune into The 284 00:14:58,000 --> 00:15:01,399 Doggy Dish for yummy and healthy recipe piece for your canine. 285 00:15:01,080 --> 00:15:07,480 Speaker 1: Kids every week only on Petlife Radio dot com. 286 00:15:08,200 --> 00:15:12,360 Speaker 4: Let's Talk past, Let's pet Talk about Life Radio headline radio. 287 00:15:12,600 --> 00:15:33,600 Speaker 8: At live radio dot com. 288 00:15:33,639 --> 00:15:37,279 Speaker 2: And welcome back to pet Live Radio's astbet with Doctor Jeff. 289 00:15:37,279 --> 00:15:40,320 I'm your host, Doctor Jeff Werber, And before the break 290 00:15:40,519 --> 00:15:43,879 we were discussing some of the stifle the knee injuries. 291 00:15:44,120 --> 00:15:47,200 We covered the medial patella luxation last week, and here 292 00:15:47,200 --> 00:15:49,919 we're talking about the cruciated the cruciated ligament very very 293 00:15:49,919 --> 00:15:54,919 common injury, unlike the petilla problem, which, as I said, 294 00:15:54,960 --> 00:15:57,440 with a grade one and early grade two. You probably 295 00:15:57,679 --> 00:16:01,399 can get by with some medical therapy, pain medication, maybe 296 00:16:01,440 --> 00:16:04,159 some acupuncture, some laser treatment. There are a lot of 297 00:16:04,159 --> 00:16:07,039 things that could be done to alleviate the discomfort, the pain. 298 00:16:07,519 --> 00:16:09,600 And since it's a grade one or a grade too, 299 00:16:09,639 --> 00:16:11,919 it doesn't happen very often where the knee pops out 300 00:16:11,960 --> 00:16:15,519 of the groove, So it's okay. Different story with the 301 00:16:15,600 --> 00:16:19,799 cruciate cruciate ligaments. Well, the ligament has thousands and thousands 302 00:16:19,840 --> 00:16:23,360 of fibers, a very poor blood supply. These fibers are 303 00:16:23,399 --> 00:16:26,240 also under some tension, meaning they're kind of like stretch. 304 00:16:26,240 --> 00:16:28,840 A picture this picture here, here's a rubber band. Okay, 305 00:16:29,000 --> 00:16:32,080 if you're watching along time alongside as I'm speaking that 306 00:16:32,200 --> 00:16:34,279 you could see the rubber band. Now, if I were 307 00:16:34,279 --> 00:16:36,440 to cut this rubber band right there in the center 308 00:16:36,639 --> 00:16:39,279 and it's under a little stretch, what's gonna happen to 309 00:16:39,360 --> 00:16:41,039 the two ends? Are they going to stay right there? 310 00:16:41,120 --> 00:16:43,519 Or are they going to fly in their opposing directions? 311 00:16:43,559 --> 00:16:45,840 And there's your answer, They're gonna fly. Now I can 312 00:16:45,919 --> 00:16:48,639 sit here with my under the same tension having cut 313 00:16:48,639 --> 00:16:50,799 this rubber band, and I could sit here for the 314 00:16:50,799 --> 00:16:51,639 next one hundred. 315 00:16:51,440 --> 00:16:52,600 Speaker 3: Years I can't. 316 00:16:52,759 --> 00:16:56,000 Speaker 2: Maybe somebody coder that could pass it on, and these 317 00:16:56,000 --> 00:16:58,960 two ends will never come together. The problem with the 318 00:16:58,960 --> 00:17:01,639 crucia ligament is sim that once those ends are snapped, 319 00:17:01,639 --> 00:17:03,519 they're not coming together. They're not finding each other on 320 00:17:03,559 --> 00:17:06,039 their own. And since the blood supply is so weak, 321 00:17:06,240 --> 00:17:09,160 we typically don't have the same healing response that we 322 00:17:09,160 --> 00:17:11,359 would hope to get just by leaving it alone. So 323 00:17:11,559 --> 00:17:15,920 all a partial tear leaves us with is a weaker ligament. 324 00:17:16,240 --> 00:17:18,599 Speaker 3: So the dog could be fine for now. 325 00:17:18,599 --> 00:17:20,680 Speaker 2: I mean they're going to go through an initial phase 326 00:17:20,720 --> 00:17:22,400 of pain with a tear, and let's. 327 00:17:22,240 --> 00:17:23,119 Speaker 3: Assume it's a partial. 328 00:17:23,359 --> 00:17:26,720 Speaker 2: That means it's not complete, only a fraction let's say 329 00:17:26,720 --> 00:17:28,759 ten percent of the fiber's tour. First thing, we're gonna 330 00:17:28,799 --> 00:17:31,559 we're gonna get some pain when it happens, because there's 331 00:17:31,599 --> 00:17:33,799 going to be some bleeding, and that bleeding is going 332 00:17:33,839 --> 00:17:35,480 to fill up into the joint space and we're going 333 00:17:35,480 --> 00:17:38,720 to see what we call joint effusion. Now, there number 334 00:17:38,720 --> 00:17:42,519 of signs that we look at in making the diagnosis 335 00:17:42,559 --> 00:17:45,119 the determination. Well, first of all, one thing we know 336 00:17:45,160 --> 00:17:48,279 about cruciate injuries, they're not slow progressive. So let's go 337 00:17:48,400 --> 00:17:52,200 back to the arthritis discussion with hip dysplasia. Dogs with 338 00:17:52,240 --> 00:17:56,599 hYP dysplasia rarely show up with an acute onset of lameness, 339 00:17:56,759 --> 00:17:59,200 so regardless of what the X ray shows, we discussed 340 00:17:59,400 --> 00:18:01,799 if the seat of lameness was sudden, and you take 341 00:18:01,839 --> 00:18:03,839 your x rays and you have bad hips, keep looking, 342 00:18:04,039 --> 00:18:04,640 keep looking. 343 00:18:04,960 --> 00:18:05,599 Speaker 3: It wasn't there. 344 00:18:05,960 --> 00:18:08,359 Speaker 2: I would say it wasn't, But more likely not, it's 345 00:18:08,400 --> 00:18:10,720 not the hips, because those hips look just as bad 346 00:18:10,880 --> 00:18:14,599 radiographically a week before, a month before, probably a year before, 347 00:18:14,920 --> 00:18:17,400 or more so, you gotta still look for Okay, why 348 00:18:17,440 --> 00:18:19,319 is this dog suddenly coming up lane? 349 00:18:19,400 --> 00:18:19,519 Speaker 3: Now? 350 00:18:19,599 --> 00:18:22,720 Speaker 2: Cruciate ligament is one of those injuries that they will 351 00:18:22,799 --> 00:18:25,759 suddenly come up lane. Sometimes in bad cases, it will 352 00:18:25,799 --> 00:18:30,880 even be preceded by a pretty aggressive vocalization, a yelp, 353 00:18:30,920 --> 00:18:33,400 a cry, a snap. And if any of you have 354 00:18:33,519 --> 00:18:38,000 ever snapped a muscle, whether it was a gastrocs and achilles, 355 00:18:38,480 --> 00:18:43,599 a severe ankle injury years ago, I actually snapped a 356 00:18:43,680 --> 00:18:46,759 it's a muscle that is part of the gastrocnemius or 357 00:18:46,839 --> 00:18:50,599 the calf group. And when those muscles snap, when that 358 00:18:50,880 --> 00:18:53,599 tendon tears, you feel it and you hear it I 359 00:18:53,599 --> 00:18:57,000 thought somebody threw a golf ball at my calf. It 360 00:18:57,039 --> 00:19:00,200 was a pretty plainful It's called the plan terrace. And 361 00:19:00,240 --> 00:19:01,839 when I talk to a friend of mine, and this 362 00:19:01,920 --> 00:19:04,160 is the difference of talking to a guy who is 363 00:19:04,640 --> 00:19:07,799 a seasoned doctor. He was an orthpeedic surgeon. He didn't 364 00:19:07,799 --> 00:19:09,759 even need to see me. I explained to him exactly 365 00:19:09,799 --> 00:19:11,319 what happened, how it happened. 366 00:19:11,480 --> 00:19:12,200 Speaker 3: He said, you. 367 00:19:12,279 --> 00:19:15,680 Speaker 2: Toria plant teris, and it's a very common injury in 368 00:19:15,759 --> 00:19:18,039 men over thirty five. At the time, I was thirty five. 369 00:19:18,200 --> 00:19:21,039 And everything that he said would happened happened, and it 370 00:19:21,079 --> 00:19:23,759 was fine. And I'm still back to playing ball many 371 00:19:23,799 --> 00:19:25,200 many years later, and it. 372 00:19:25,160 --> 00:19:27,759 Speaker 3: Was not a big deal. But you know, your dog knows. 373 00:19:27,559 --> 00:19:31,240 Speaker 2: When they tear, especially substantially tear the accruciate ligament. So 374 00:19:31,480 --> 00:19:32,839 a couple of signs we look for if it's a 375 00:19:32,880 --> 00:19:35,000 partial tear. Two of the things we are looking for. 376 00:19:35,039 --> 00:19:39,400 One is called an anterior or cranial drawer sign, and 377 00:19:39,440 --> 00:19:44,960 that is without the cruciate ligament by manipulating the knee itself. 378 00:19:45,000 --> 00:19:47,079 And usually what you do is you're gonna hold with 379 00:19:47,200 --> 00:19:49,519 one hand. The doctor's gonna hold the bottom of the 380 00:19:49,519 --> 00:19:52,559 femur and put a thumb sort of right at the 381 00:19:53,200 --> 00:19:56,880 ephemeral condyles, and then the other hand is going to 382 00:19:56,920 --> 00:19:58,680 go up at the top of the tibia, all right, 383 00:19:59,000 --> 00:20:03,359 and you're going to see a movement in between the 384 00:20:03,839 --> 00:20:06,680 two bones, the femur and the tibia, where in a 385 00:20:06,680 --> 00:20:09,559 normal dog they do not have. You'll be able to 386 00:20:09,599 --> 00:20:13,440 take that tibia and thrust it forward, all right. It's 387 00:20:13,480 --> 00:20:15,839 called a drawer signed cranial drawer, because you can move 388 00:20:15,880 --> 00:20:20,359 it cranially. What typically stops that cranial movement is an 389 00:20:20,359 --> 00:20:23,759 intact cruciate ligament, but if you only have a very 390 00:20:23,799 --> 00:20:27,400 partial tear, you may not get a cranial drawer. Likewise, 391 00:20:27,400 --> 00:20:31,039 A tibia thrust more difficult to explain, but it's something 392 00:20:31,079 --> 00:20:33,079 that happens if you put the leg in a certain 393 00:20:33,079 --> 00:20:35,160 position with your finger going from the top of the 394 00:20:35,200 --> 00:20:37,720 femur around the kneecap over to the top of the 395 00:20:37,759 --> 00:20:40,920 tibia where the kneecap inserts, and you push up, You 396 00:20:41,000 --> 00:20:44,319 push up on the heel on the hawk and again 397 00:20:44,400 --> 00:20:48,039 you'll feel that you'll feel your finger moving forward because 398 00:20:48,160 --> 00:20:52,119 of that tibial thrust. Again, if you have enough of 399 00:20:52,160 --> 00:20:55,680 your cruciate it's still intact. That may not happen. So 400 00:20:56,160 --> 00:20:58,599 in order to get the drawer sign of the tibial thrust, 401 00:20:58,680 --> 00:21:01,240 you need at least enough of the ligament torn, but 402 00:21:01,319 --> 00:21:03,559 the effusion will be there. So you take an X ray, 403 00:21:03,599 --> 00:21:06,759 and you always take an X ray both knees, lateral aspect, really, 404 00:21:07,000 --> 00:21:09,839 and you compare them. You will see effusion if you 405 00:21:09,960 --> 00:21:12,799 get some sort of thrust, or you get a cranial 406 00:21:12,880 --> 00:21:15,920 drawer that tells you two things. That tells you, yes, 407 00:21:16,079 --> 00:21:18,880 in fact, enough of the cruciate ligament was torn, and 408 00:21:18,920 --> 00:21:21,960 it also tells you that your poor dog is gonna 409 00:21:22,000 --> 00:21:24,240 need surgery. You can wait as long as you want 410 00:21:24,599 --> 00:21:27,240 for it to heal. It's never going to heal. And 411 00:21:27,279 --> 00:21:29,440 it's one of those diseases. And I think I mentioned this. 412 00:21:29,519 --> 00:21:31,599 I used to work with a board certified surgeon in 413 00:21:31,640 --> 00:21:33,640 my practice, and he was one of the more conservative 414 00:21:33,640 --> 00:21:35,920 surgeons that I'd ever worked with. If there was a 415 00:21:35,960 --> 00:21:39,240 medical way to fix something, he would his surgery. Even 416 00:21:39,279 --> 00:21:41,000 though he was a surgeon. They'd love to do surgery. 417 00:21:41,160 --> 00:21:43,319 He was never one to rush into surgery, but when 418 00:21:43,319 --> 00:21:46,799 it came to cruciate ligament tears, he would kind of chuckle. 419 00:21:46,880 --> 00:21:47,880 When the owner said, well, I. 420 00:21:47,920 --> 00:21:48,599 Speaker 3: Want to try to wait. 421 00:21:48,599 --> 00:21:50,200 Speaker 2: I want to see if he does, because he knew 422 00:21:50,480 --> 00:21:52,559 that sooner or later, I'm going to see this dog 423 00:21:52,599 --> 00:21:56,000 on my surgery table. And because of that, I recommend folks, 424 00:21:56,119 --> 00:21:58,920 it's got to be sooner. Why because the longer you 425 00:21:59,000 --> 00:22:02,279 wait and for nothing to happen, and trust me, nothing 426 00:22:02,319 --> 00:22:05,720 is gonna happen healing wise. That the more muscle atrophy 427 00:22:05,759 --> 00:22:07,480 you're gonna see in that leg, just like we talked 428 00:22:07,480 --> 00:22:10,759 about the grade three and grade four petelo ligaments, and 429 00:22:10,839 --> 00:22:13,759 the more strain they'll be putting on the other leg. 430 00:22:14,000 --> 00:22:15,839 And if that other leg is one of those legs, 431 00:22:15,839 --> 00:22:18,119 if their dog is in that seventy five percent that 432 00:22:18,440 --> 00:22:21,079 there is a genetic predisposition, they're gonna blow the other 433 00:22:21,160 --> 00:22:24,319 leg even before you fix the first leg. So it 434 00:22:24,400 --> 00:22:28,240 is insanity. I'm telling you insanity to wait on a 435 00:22:28,240 --> 00:22:31,440 cruise shit ligament tear. If it's bad enough to cause 436 00:22:31,440 --> 00:22:34,400 a limping, if it's bad enough for your veterinarian to 437 00:22:34,480 --> 00:22:37,680 elicit the drawer sign or tibio thrust and you see 438 00:22:37,680 --> 00:22:41,319 a fusion in the joint, you have but only one choice, 439 00:22:41,319 --> 00:22:44,960 and that is to see your veterinarian, and he or 440 00:22:45,039 --> 00:22:47,720 she may do the surgery. Chances are they will refer 441 00:22:47,799 --> 00:22:51,079 you to a surgeon for a surgery, but it has 442 00:22:51,160 --> 00:22:55,839 to be corrected surgically. You're only doing your pet a disservice. Now, 443 00:22:56,119 --> 00:22:58,920 if this happens in your pet is thirteen, and he's 444 00:22:59,119 --> 00:23:01,799 already a you know, a very large breed dog, and 445 00:23:01,839 --> 00:23:05,319 you said, hey, doc, he's thirteen, leave the poor guy alone. 446 00:23:05,759 --> 00:23:08,160 If sure, if we can eliminate some of the pain, 447 00:23:08,559 --> 00:23:11,200 if we can eliminate some of the inflammation, and there 448 00:23:11,200 --> 00:23:13,799 are things like acupuncture, and there's laser therapy, and there's 449 00:23:13,960 --> 00:23:17,480 non story anti inflammatories, there are things that can be done, 450 00:23:17,640 --> 00:23:21,079 then yes, if we can make them comfortable, then certainly 451 00:23:21,240 --> 00:23:23,640 you don't need to consider surgery. But if you have 452 00:23:24,200 --> 00:23:31,119 that younger, athletic, monstrous dog that is showing signs has 453 00:23:31,160 --> 00:23:34,160 the condition toward the cruise it, you don't want to 454 00:23:34,200 --> 00:23:37,079 wait too long. Get him in for surgery. I have 455 00:23:37,160 --> 00:23:39,559 one client I'm going to end with this, who fought 456 00:23:39,599 --> 00:23:42,200 me and fought me and fought me on his American 457 00:23:42,240 --> 00:23:46,519 bulldog and finally, finally, when the second leg went, he decided, 458 00:23:46,599 --> 00:23:49,880 let's do the surgery. And six weeks or eight weeks 459 00:23:49,960 --> 00:23:53,160 after the first surgery, he was knocking on our door saying, okay, Doc, 460 00:23:53,160 --> 00:23:53,759 I'm ready. 461 00:23:53,559 --> 00:23:54,079 Speaker 3: For the second. 462 00:23:54,200 --> 00:23:57,680 Speaker 2: Why because the surgery works and this dog felt so 463 00:23:57,799 --> 00:24:01,240 much better. So we will get to some different surgical 464 00:24:01,480 --> 00:24:04,000 options when it comes to the cruciate ligament. If not, 465 00:24:04,079 --> 00:24:06,000 next week is remember next week we're having our guest 466 00:24:06,000 --> 00:24:07,759 doctor Heather Lenser is going to be with us. We 467 00:24:07,759 --> 00:24:10,000 get to talk about a few things. We're also I 468 00:24:10,119 --> 00:24:12,359 just put on my list of things to do. And 469 00:24:12,400 --> 00:24:14,119 then the reason so is because it's happened to my 470 00:24:14,160 --> 00:24:16,200 own cat who's going in for treatment this week. I 471 00:24:16,240 --> 00:24:20,400 want to talk about hyper thyroidism in cats again. A 472 00:24:20,480 --> 00:24:22,119 lot of old medicine out there. 473 00:24:22,240 --> 00:24:25,119 Speaker 3: It bothers me. We need to teach you guys. 474 00:24:25,039 --> 00:24:27,960 Speaker 2: A lot about hyperthyroidism, and someone's going to do it, 475 00:24:28,079 --> 00:24:31,079 and that someone's going to be me. So next week 476 00:24:31,279 --> 00:24:33,440 we're back here on pet Life Radios. Asked bets with 477 00:24:33,480 --> 00:24:36,680 doctor Jeff, Join us with my special guest doctor Heather Lenser, 478 00:24:37,519 --> 00:24:39,880 and have a great week once again. Thanks to our 479 00:24:39,880 --> 00:24:43,759 sponsors pro Sens Pet Products con Toys. You know, no one, 480 00:24:43,839 --> 00:24:46,039 no one got their free product today because all of 481 00:24:46,039 --> 00:24:48,119 you are too afraid to give us a call next week, 482 00:24:48,119 --> 00:24:50,240 write this number down eight seven seven three eight five 483 00:24:50,480 --> 00:24:53,519 eight eight eight two and have a great week everybody, 484 00:24:53,759 --> 00:24:55,279 and give your pets a kiss for me. 485 00:24:55,279 --> 00:24:56,160 Speaker 3: We'll see you next week. 486 00:24:56,720 --> 00:25:01,799 Speaker 1: Let's talk bets every week on demand only on petlifradio 487 00:25:02,079 --> 00:25:15,240 dot com.