Dog Knee Pain

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Hello fish people, I know there are dog people here too, so I’m asking advice/opinions. (Dog forum has next to zero activity)
I’ll try not to make this too long but no promises. Our 112 pound, 2 year old American Bulldog has had some on and off limping for months. He’s already been diagnosed with a herniated disk so we assumed after hard playing/hiking that it was this bother him, let him rest a few days then he’s fine. Well, last week was severe, he’d take 4 steps and collapse, awful. Made him a vet appt but it would take 2 days to see him. I gave him cbd treats to ease the pain, limping improved by the next day. Another vet was able to see him before our original appt (nothing wrong with a second opinion anyway) That vet did a small exam, no xrays, just touch and feel. Strongly recommend surgery! In both knees, when we thought it was just the right. Anyway, research all day and night and this seemed so scary. Get to our usual vet appt and he says Floki is slightly overweight, put him on a diet and remadyl for pain. (We did not say anything about other vet) At this appt, he wouldn’t even limp, like I was lying! Lol (had been on cbd) It’s been 4 days now that I quit the cbd for the Rx, remadyl. Back to limping, lethargic and had a head tremor. He has had tremors in the past so may be unrelated but that was over a year ago. I’ve decided today to quit the prescription and use cbd again. I can’t help but think I’m wrong for not taking doctor advice but I want so bad to do right by my dog. Also, they wanted to do bloodwork after 2 weeks to see how he’s handling remadyl... I feel concerned about that. Give him something, look for damage then decide? Any ideas, opinions, experiences would ease my mind right now. Please and thanks!
 

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Maybe it's arthritis or something. I'd go with the blood work just in case there's another factor at play, especially with tremors.
Did the one vet say why your dog needed surgery? What's the condition and diagnosis?
Being overweight is a big concern for a dog with joint problems as it puts more weight and pressure on already problematic joints. Definitely work on his diet since he can't exercise at least right now.

I had a dog (had to be put down several months ago at age 3 or 4) who had arthritis in one leg due to an improperly healed injury we never knew about. We couldn't allow him to run much or do any really taxing physical movements and had to feed him less due to the decrease in exercise. He and his sister have some bad genes as well that caused muscle/bone/something/spinal issues, too.
He was given a prescription supplement to help him.
 

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Well I would have asked about getting the two different opinions and why no xrays. It's 100% predictable that with knees, one goes out then the other one. Because they're transferring the weight on to the opposite leg.

What was the diagnosis? They don't just say "take pain meds".

Did you decline the xrays? I never heard of a vet just not do any. Unless when you say "feel" he had a luxating patella. You can feel that. (like a trick knee)

But usually with that, they keep the out of joint knee up in the air and won't walk on it but Bulldogs are tough.

I would never be just treating him myself with my home made remedies, sorry! He's too young for all this.

They have to do the bloodwork because there are side effects/adverse reaction to the Rimadyl. You can google that. It's controversial - with "sudden death".

HOW will anybody know what's wrong without xrays? A patella problem sometimes comes and goes but with these big dogs? It's iffy.

(I'm a pet sitter)
 
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Maybe it's arthritis or something. I'd go with the blood work just in case there's another factor at play, especially with tremors.
Did the one vet say why your dog needed surgery? What's the condition and diagnosis?
Being overweight is a big concern for a dog with joint problems as it puts more weight and pressure on already problematic joints. Definitely work on his diet since he can't exercise at least right now.

I had a dog (had to be put down several months ago at age 3 or 4) who had arthritis in one leg due to an improperly healed injury we never knew about. We couldn't allow him to run much or do any really taxing physical movements and had to feed him less due to the decrease in exercise. He and his sister have some bad genes as well that caused muscle/bone/something/spinal issues, too.
He was given a prescription supplement to help him.
Oh I’m sorry yours had to be put down. I’d absolutely lose it when his time comes. Isn’t arthritis something you can manage? I mean, obviously you don’t want a dog in a lifetime of pain but...
Also, we did do bloodwork last year for his tremors. Nothing found, chalked up to “idiopathic” tremors. Just found it odd it happened again after this med, they would want to do this bloodwork to see if the remadyl is affecting his liver or kidneys.
First bet mentioned possible CrCl injustice (human equivalent to the ACL) I did drastic research and it sounds scary, yet necessary IF all natural therapies fail to work. I’ve put him on a low carb diet (I should say he’s very finicky and barely eats anyway) We started multiple, short, leashed walks to keep him moving but can’t let him do his desirable zoomies. I’ve just started glucosamine supplements in addition to the cbd...fingers crossed. I just know the vet rolls eyes at natural remedies that don’t fill his wallet. Besides that, I like him.
 

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I just learned recently how valuable a second opinion can be. I don't have dogs,just a 17 year old cat. He had a really bad episode one day with breathing. I took him to my regular vet and she announced that he had congestive heart failure and needed to be put down. I adamantly said NO. Give him lasix or something and I will take him home over the weekend. By Monday he was better and I made an appointment with another vet who did blood tests, x-rays, etc. and determined no congestive heart failure. It was likely an asthmatic reaction to a flea medication I had put on him. Anyway, he is still with me enjoying life as a really spoiled cat. He has spent quite a few years training me!! I wish you luck determining what the problem might be.
 
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Well I would have asked about getting the two different opinions and why no xrays. It's 100% predictable that with knees, one goes out then the other one. Because they're transferring the weight on to the opposite leg.

What was the diagnosis? They don't just say "take pain meds".

Did you decline the xrays? I never heard of a vet just not do any.

I would never be just treating him myself with my home made remedies, sorry! He's too young for all this.

They have to do the bloodwork because there are side effects to the meds. You can google that.

HOW will anybody know what's wrong without xrays?

(I'm a pet sitter)
I didn’t mention to my regular vet about the first as I didn’t want to suggest anything and they just roll with it. The first vet said he didn’t want to charge me for x-rays when he’s almost certain he needs the surgery and the surgeon would then charge me for this anyway. Also, in a torn CrCl, you cannot see any torn ligaments on an x-ray, just the bones. I’m aware once one knee is out the other takes the toll and in most cases both knees need repair.
Second bet diagnosis is possibly his weight straining his knees (he needs to lose 10-12 pounds) He said he doesn’t suspect torn ligament as he wasn’t limping that day. So yes, actually he DID say “take pain meds” to help him endure walking. Plus diet.
I agree, he’s too young for this, bad genes, I’m sure. However, I disagree that some home remedies are not as bad as taking every pill a doctor prescribes. I do believe there are cases when it’s absolutely necessary and maybe it will be for him too. Until then, fingers crossed.

I just learned recently how valuable a second opinion can be. I don't have dogs,just a 17 year old cat. He had a really bad episode one day with breathing. I took him to my regular vet and she announced that he had congestive heart failure and needed to be put down. I adamantly said NO. Give him lasix or something and I will take him home over the weekend. By Monday he was better and I made an appointment with another vet who did blood tests, x-rays, etc. and determined no congestive heart failure. It was likely an asthmatic reaction to a flea medication I had put on him. Anyway, he is still with me enjoying life as a really spoiled cat. He has spent quite a few years training me!! I wish you luck determining what the problem might be.
Oh wow, I’m so glad you got a second opinion! I’m so happy for you and your kitty! See? Never hurts.
 

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I was editing my post for clarity before you replied

Yes they say "just take pain meds" in say, the case of a luxating patella while you decide what you want to do.

My point was they clearly told you what they thought the problem was that needed surgery and pain meds weren't the long term solution.

Nobody on a fish forum can guess what's going on without all the facts haha. I can't imagine going to a second vet and not asking about what the first vet said but to each their own.

Anyway, I said it all up there...^^^
 

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I'm unsure why you stopped rimadyl. Did you ask your vet about using it in conjunction with CBD? Rimadyl is an anti-inflammatory drug that will help his joints not destroy themselves if it is osteo-arthritis. Think ibuprofen but for dogs.

Like all NSAIDS there is a risk (even for humans) of serious side effects. This is what the blood tests are for: to make sure that his kidneys and liver were handling the drug. If CBD oil helps your dog, I'd talk to your vet (or a vet) about it, mention how it was working when Rimadyl was not and then go from there. I doubt any vet wants to stick a dog on a long-term pill for pain, and if CBD is considered safe by them and helps, they'll probably just tell you to keep using it. If not, find a better vet.

If his joints are really bad, your best bet for exercise is swimming. It's much easier on his joints since he isn't putting weight on them, and can help him lose weight. I used to help my older dogs float for arthritis relief.
 
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Well I would have asked about getting the two different opinions and why no xrays. It's 100% predictable that with knees, one goes out then the other one. Because they're transferring the weight on to the opposite leg.

What was the diagnosis? They don't just say "take pain meds".

Did you decline the xrays? I never heard of a vet just not do any. Unless when you say "feel" he had a luxating patella. You can feel that. (like a trick knee)

But usually with that, they keep the out of joint knee up in the air and won't walk on it but Bulldogs are tough.

I would never be just treating him myself with my home made remedies, sorry! He's too young for all this.

They have to do the bloodwork because there are side effects/adverse reaction to the Rimadyl. You can google that. It's controversial - with "sudden death".

HOW will anybody know what's wrong without xrays? A patella problem sometimes comes and goes but with these big dogs? It's iffy.

(I'm a pet sitter)
Yes, I just saw your edit. Luxating patella is exactly what first doc suspects. He does bear weight on it now though, not that day. The exact controversy you mention is my fear.

I'm unsure why you stopped rimadyl. Did you ask your vet about using it in conjunction with CBD? Rimadyl is an anti-inflammatory drug that will help his joints not destroy themselves if it is osteo-arthritis. Think ibuprofen but for dogs.

Like all NSAIDS there is a risk (even for humans) of serious side effects. This is what the blood tests are for: to make sure that his kidneys and liver were handling the drug. If CBD oil helps your dog, I'd talk to your vet (or a vet) about it, mention how it was working when Rimadyl was not and then go from there. I doubt any vet wants to stick a dog on a long-term pill for pain, and if CBD is considered safe by them and helps, they'll probably just tell you to keep using it. If not, find a better vet.

If his joints are really bad, your best bet for exercise is swimming. It's much easier on his joints since he isn't putting weight on them, and can help him lose weight. I used to help my older dogs float for arthritis relief.
Hm, well I did tell them he’s on the cbd when they prescribed it, though I never specifically said “is it ok to use both.” I’ll certainly ask that. Was worried about the combination. I’m so concerned that blood tests will show he’s not handling well and then the damage is done? Not true?
 

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Yes, I just saw your edit. Luxating patella is exactly what first doc suspects. He does bear weight on it now though, not that day. The exact controversy you mention is my fear.


Hm, well I did tell them he’s on the cbd when they prescribed it, though I never specifically said “is it ok to use both.” I’ll certainly ask that. Was worried about the combination. I’m so concerned that blood tests will show he’s not handling well and then the damage is done? Not true?
Rimadyl is one of the safest NSAIDS you can give to dog. The side effects are serious, but so are the side effects of ibuprofen etc. They usually only show up after a long period of use if ever. They're probably just being cautious, which is a good thing. If you don't think it was helping him at all, then by all means stop until your next visit as long as he is doing okay. That way you can be sure and tell them that CBD is effective. I wouldn't think that CBD will interact with Rimadyl, but I can't say for sure. The vet should know though.
 
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I was editing my post for clarity before you replied

Yes they say "just take pain meds" in say, the case of a luxating patella while you decide what you want to do.

My point was they clearly told you what they thought the problem was that needed surgery and pain meds weren't the long term solution.

Nobody on a fish forum can guess what's going on without all the facts haha. I can't imagine going to a second vet and not asking about what the first vet said but to each their own.

Anyway, I said it all up there...^^^
Dr suggesting surgery gave no meds. That was my second vet who says he may have mild pain for being overweight. I’ve already explained why I didn’t mention the first diagnosis. Also I realize no one on any forum can solve this (all the facts are listed) ...I was asking opinions, that’s all.
 
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Rimadyl is one of the safest NSAIDS you can give to dog. The side effects are serious, but so are the side effects of ibuprofen etc. They usually only show up after a long period of use if ever. They're probably just being cautious, which is a good thing. If you don't think it was helping him at all, then by all means stop until your next visit as long as he is doing okay. That way you can be sure and tell them that CBD is effective. I wouldn't think that CBD will interact with Rimadyl, but I can't say for sure. The vet should know though.
I’ve emailed to ask just that and gave all my concerns. I certainly appreciate your reply to this, gives me something to think about.
 

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Hello fish people, I know there are dog people here too, so I’m asking advice/opinions. (Dog forum has next to zero activity)
I’ll try not to make this too long but no promises. Our 112 pound, 2 year old American Bulldog has had some on and off limping for months. He’s already been diagnosed with a herniated disk so we assumed after hard playing/hiking that it was this bother him, let him rest a few days then he’s fine. Well, last week was severe, he’d take 4 steps and collapse, awful. Made him a vet appt but it would take 2 days to see him. I gave him cbd treats to ease the pain, limping improved by the next day. Another vet was able to see him before our original appt (nothing wrong with a second opinion anyway) That vet did a small exam, no xrays, just touch and feel. Strongly recommend surgery! In both knees, when we thought it was just the right. Anyway, research all day and night and this seemed so scary. Get to our usual vet appt and he says Floki is slightly overweight, put him on a diet and remadyl for pain. (We did not say anything about other vet) At this appt, he wouldn’t even limp, like I was lying! Lol (had been on cbd) It’s been 4 days now that I quit the cbd for the Rx, remadyl. Back to limping, lethargic and had a head tremor. He has had tremors in the past so may be unrelated but that was over a year ago. I’ve decided today to quit the prescription and use cbd again. I can’t help but think I’m wrong for not taking doctor advice but I want so bad to do right by my dog. Also, they wanted to do bloodwork after 2 weeks to see how he’s handling remadyl... I feel concerned about that. Give him something, look for damage then decide? Any ideas, opinions, experiences would ease my mind right now. Please and thanks!
This is pretty long winded, but in the end, I think it may help you make some decisions and choices for your big guy a little easier.
First, Rimadyl can affect liver and/or kidney function. Regular blood tests are important to monitor liver/kidney function while your dog is taking on that drug.
I think you did the right thing taking him off the Rimadyl if it didn't seem to be helping. There are other medications available that may work better in some dogs. CBD seems to be one that works well with some animals and not for others.
Is either vet aware that he is getting CBD for pain?
Did either vet, ever do x-rays of his knees?
Did the vet that recommended surgery say exactly what condition the surgery would treat?
Did the other vet say what condition he thought was causing the knee pain?
Is either one of the vets who saw him an orthopedic specialist?
It's important to be honest and open with your vet, just like you would be with a doctor about a child with health problems.
It kind of sounds like you don't really trust either vet and are suspicious of their objectives/motives? One vet says 'weight loss and pain meds' and the other vet says 'immediate bilateral knee surgery'. Believe it or not, they both may be making the right recommendation, for the same problem! Your dog could have any one or a combination of problems. You said he already has a disk issue because he's so active. You also admitted he's overweight. It's not unusual for dogs, especially big dogs to develop patellar subluxation (dislocated knee cap) whose symptoms can, early on, come and go. American Bulldogs have a genetic predisposition for ACL (anterior cruciate ligament) tears. These can also have symptoms that come and go. Both problems are usually detectable by physical examination and x-ray may or may not reveal additional information about the problem (ie if arthritis developing in the joint as well).
One vet saw a problem and felt that an aggressive approach (surgery) was necessary possibly because most knee problems do progressively get worse over time-especially in a large breed, active dog. The second vet may have seen the exact same problem and opted for a more conservative approach-weight loss, anti inflammatories and 'let's see how he does with that' because sometimes, in young overweight dogs, weight loss, temporary activity restriction and antiinflamatories can delay, sometimes for years, the need for surgery.
In that case, my suggestion would be to take your bulldog to an orthopedic specialist. Have both knees examined thoroughly, including x- rays and bloodwork if indicated, get him on a weight loss program. Limit exercise to low impact exercises (walks on a leash, swimming). If you have access to a pool, pond, lake or other safe body of water, swimming does incredible things for dogs joints. Bulldogs typically aren't great swimmers so a flotation vest for his size would be a good idea and would give him confidence in the water.
Discuss pain and inflamation remedies with the orthopedic vet including your observations of his pain relief response to both Rimadyl and CBD.
After you get a recommendation, then you can take your time making a decision and by getting your dogs weight down, he may have fewer problems, less pain, and will recover from surgery better, if that is the choice you make. Good luck!
 
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This is pretty long winded, but in the end, I think it may help you make some decisions and choices for your big guy a little easier.
First, Rimadyl can affect liver and/or kidney function. Regular blood tests are important to monitor liver/kidney function while your dog is taking on that drug.
I think you did the right thing taking him off the Rimadyl if it didn't seem to be helping. There are other medications available that may work better in some dogs. CBD seems to be one that works well with some animals and not for others.
Is either vet aware that he is getting CBD for pain?
Did either vet, ever do x-rays of his knees?
Did the vet that recommended surgery say exactly what condition the surgery would treat?
Did the other vet say what condition he thought was causing the knee pain?
Is either one of the vets who saw him an orthopedic specialist?
It's important to be honest and open with your vet, just like you would be with a doctor about a child with health problems.
It kind of sounds like you don't really trust either vet and are suspicious of their objectives/motives? One vet says 'weight loss and pain meds' and the other vet says 'immediate bilateral knee surgery'. Believe it or not, they both may be making the right recommendation, for the same problem! Your dog could have any one or a combination of problems. You said he already has a disk issue because he's so active. You also admitted he's overweight. It's not unusual for dogs, especially big dogs to develop patellar subluxation (dislocated knee cap) whose symptoms can, early on, come and go. American Bulldogs have a genetic predisposition for ACL (anterior cruciate ligament) tears. These can also have symptoms that come and go. Both problems are usually detectable by physical examination and x-ray may or may not reveal additional information about the problem (ie if arthritis developing in the joint as well).
One vet saw a problem and felt that an aggressive approach (surgery) was necessary possibly because most knee problems do progressively get worse over time-especially in a large breed, active dog. The second vet may have seen the exact same problem and opted for a more conservative approach-weight loss, anti inflammatories and 'let's see how he does with that' because sometimes, in young overweight dogs, weight loss, temporary activity restriction and antiinflamatories can delay, sometimes for years, the need for surgery.
In that case, my suggestion would be to take your bulldog to an orthopedic specialist. Have both knees examined thoroughly, including x- rays and bloodwork if indicated, get him on a weight loss program. Limit exercise to low impact exercises (walks on a leash, swimming). If you have access to a pool, pond, lake or other safe body of water, swimming does incredible things for dogs joints. Bulldogs typically aren't great swimmers so a flotation vest for his size would be a good idea and would give him confidence in the water.
Discuss pain and inflamation remedies with the orthopedic vet including your observations of his pain relief response to both Rimadyl and CBD.
After you get a recommendation, then you can take your time making a decision and by getting your dogs weight down, he may have fewer problems, less pain, and will recover from surgery better, if that is the choice you make. Good luck!
Wow, you said every thing so perfectly, I can never seem to do that no matter what. Thanks!
First, I will totally admit not telling my usual vet about the first was a bad idea. I know now that was wrong because how do I go back? I really just didn’t want him to imitate a friend’s position. Let me say I live in a very tiny mountain community where they’re all friends and refer each other.
Now let me see if I can answer your questions...
Neither vet did xrays...
Vet suggesting surgery says CrCl tear (surgery needed most likely)
Usual vet says maybe it’s his weight, start there.
Neither vet is an orthopedic surgeon...first vet gave me a referral if/when I do the surgery.
I do believe both bets are being helpful with just different approaches. Obviously I’m going to want to do the less invasive one first. I have since emailed with all my concerns and we will see what he says. (Usual vet, I really do like him)
I do need to get him to the lake, he has a life vest because he cannot swim, but loves to try. We are taking multiple, short walks per day to get the exercise along with his new diet. Oh yes, both vets aware of cbd.
Again, I truly appreciate your reply
 

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Oh I’m sorry yours had to be put down. I’d absolutely lose it when his time comes. Isn’t arthritis something you can manage? I mean, obviously you don’t want a dog in a lifetime of pain but...
We were struggling with managing it, but he actually had to be put down because mid-surgery fixing a twisted intestine, they realized it was a lot worse than they thought, beyond repair. He would've had to eat soft foods only and would not be able to go to the bathroom normally. Combined with his arthritis, it just wouldn't have been a good life for 8 more years. No hard treats, no running, problems going to the bathroom, pain, medications...

Without x-rays, I'm not sure how they'd know exactly what's going on.
 

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It's probably worth noting that CBD is nothing but a well orchestrated charade, maybe it will be shown to have some beneficial medicinal property but this is equivalent to painting on the bull's eye after you've thrown the darts. The health care sector is definitely hyper-commodified, but the profit margins are better in the 'add a trivial amount of some arbitrary substance to a lollipop and sell it as a cure-all without bothering to do any research or even consider how it could be effective at anything, but still strongly insinuate that anyone who isn't a sheep blindly trusting in BIG PHARMA will queue up to purchase your magic lolli' game. Those could be badger saliva dog treats and there would be exactly as much research of high methodological quality indicating that they possess analgesic properties as there is for CBD.

I'm not trying to attack you, I just think it's irresponsible to allow exploitative pseudoscience to thrive as an unchallenged enthymeme.
 

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Rimadyl is one of the safest NSAIDS you can give to dog. The side effects are serious, but so are the side effects of ibuprofen etc. They usually only show up after a long period of use if ever. They're probably just being cautious, which is a good thing. If you don't think it was helping him at all, then by all means stop until your next visit as long as he is doing okay. That way you can be sure and tell them that CBD is effective. I wouldn't think that CBD will interact with Rimadyl, but I can't say for sure. The vet should know though.
Rimadyl has come under closer scrutiny -in the last few years because of the potentially serious and sometimes deadly effects it can have on kidneys and the liver. In many dogs, other medications are as effective and have fewer risks. Meloxicam, and the Cox II inhibitors deracoxib and firocoxib are possible alternatives.
Wow, you said every thing so perfectly, I can never seem to do that no matter what. Thanks!
First, I will totally admit not telling my usual vet about the first was a bad idea. I know now that was wrong because how do I go back? I really just didn’t want him to imitate a friend’s position. Let me say I live in a very tiny mountain community where they’re all friends and refer each other.
Now let me see if I can answer your questions...
Neither vet did xrays...
Vet suggesting surgery says CrCl tear (surgery needed most likely)
Usual vet says maybe it’s his weight, start there.
Neither vet is an orthopedic surgeon...first vet gave me a referral if/when I do the surgery.
I do believe both bets are being helpful with just different approaches. Obviously I’m going to want to do the less invasive one first. I have since emailed with all my concerns and we will see what he says. (Usual vet, I really do like him)
I do need to get him to the lake, he has a life vest because he cannot swim, but loves to try. We are taking multiple, short walks per day to get the exercise along with his new diet. Oh yes, both vets aware of cbd.
Again, I truly appreciate your reply
You are welcome! I have tons of experience with vets, both livestock and small animals unfortunately! Swimming is THE best exercise for just about everything! It will also do wonders for his back. We've taken a couple of horses to 'horse pools' for treatment of tendon injuries and strain. As far as the ACL, my niece in Colorado runs her dogs in agility competition -in the US and Europe. Her champ Australian Shepard Sophy had a devastating ACL tear during competition one year. They took her to an orthopedic surgeon, had it repaired and Sophy was back competing within a year! She was retired 18 months later (at age 9) at the top of her game and still has had no problems. She's 14 now. So get him down to his lean fighting weight, get him in good physical shape and odds are he'll do fine if he has to have surgery. Good luck and give him a kiss on his slobbery lips for me! I love American Bulldogs despite their problems...
 

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It's probably worth noting that CBD is nothing but a well orchestrated charade, maybe it will be shown to have some beneficial medicinal property but this is equivalent to painting on the bull's eye after you've thrown the darts. The health care sector is definitely hyper-commodified, but the profit margins are better in the 'add a trivial amount of some arbitrary substance to a lollipop and sell it as a cure-all without bothering to do any research or even consider how it could be effective at anything, but still strongly insinuate that anyone who isn't a sheep blindly trusting in BIG PHARMA will queue up to purchase your magic lolli' game. Those could be badger saliva dog treats and there would be exactly as much research of high methodological quality indicating that they possess analgesic properties as there is for CBD.

I'm not trying to attack you, I just think it's irresponsible to allow exploitative pseudoscience to thrive as an unchallenged enthymeme.
Big pharma is trying to get a handle on the CBD trade but the bulk of it is still controlled by 'little guys'. And unless you don't believe in science, here is an article about benefits of Medicinal CBD from a handful of the hundreds of rigorous studies already done.
Cannabidiol (CBD) — what we know and what we don’t - Harvard Health Blog
Hemp and I at the farm in Colorado a month ago! (and NO, I don't color my hair. 63 and not 1 gray hair! LOL!)
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Daisytattoo

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My 2 cents. The vet is right recommending bloodwork if rimadyl will be used more than very short term. It absolutely can have effect on liver and kidneys, so getting a baseline and monitoring for changes is very important with any NSAID, which is what Rimadyl is.

As for the knee itself, could be luxating patellas which can be seen on X-ray, or cruciate ligament injury, which cannot. Ligament injury can be diagnosed with what they call a drawer movement, but is nearly impossible to do in large dogs without sedation. Ligament isn’t completely torn or he would be holding it up or toe touching all the time. Could also be just a strained knee. In every case, weight loss is going to help. I can’t tell you how many overweight dogs I’ve seen with cruciate injuries. I agree both vets are probably thinking it is the same issue. One is going with the most aggressive(and expensive) but more permanent approach. The other is going with the less expensive, this may work approach. Each veterinarian has their own way of dealing with the same problem.

Having said all that, I would go to an orthopedic specialist. I wouldn’t have any bone surgery done by anyone but an ortho vet. Any type of knee surgery, especially in large dogs, need to be done by someone who does it all the time. There are many different procedures and the ortho vets are more up to date on what works best. If money is an issue, I would work on weight loss and not allow jumping or running until you can see an ortho vet.

Good luck with your pup! I hope you find someone you can feel comfortable with in making this decision.
 

Mr. Kgnao

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Big pharma is trying to get a handle on the CBD trade but the bulk of it is still controlled by 'little guys'. And unless you don't believe in science, here is an article about benefits of Medicinal CBD from a handful of the hundreds of rigorous studies already done.
Cannabidiol (CBD) — what we know and what we don’t - Harvard Health Blog
Hemp and I at the farm in Colorado a month ago!
View attachment 576547
I'm not actually thrilled by the self-serving, industrialized, naive-positivism of contemporary 'science'. A study, created by people who desperately want grants/tenure/advances from publishers, which shows some correlation between two incidents isn't particularly compelling. To assume causation on this basis alone would be similar to the argument that a correlation between whiteness and swanness implies all swans are white.
 
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