Client Instructions BonnieÕs condition is not a medical or surgical emergency. Therefore, it is best to start Bonnie on a weight loss plan and schedule surgery in 2-3 months. We recommend putting Bonnie on the Ògreen bean dietÓ which consists of replacing one cup of her dry dog food with one can of green beans. Once she becomes adapted to this diet, an additional 1/2-1 cup of dog food can be replaced with the appropriate amount of green beans. Snacks should be limited. During this pre-surgical time, Bonnie will also be on pain medication to make her more comfortable. We will prescribe either aspirin, phenylbutazone, or Rimadyl which can be given as needed. Bonnie will be on a low enough dose of medication to ease her pain, but not make her feel brand new. This will help her self-limit her activity. The owner will have to make sure to limit BonnieÕs exercise to short leash walks. She should not be encouraged to play and, if possible, be kept crated while the owner is away. It would be wise to confine Bonnie to one floor of the house and restrict use of stairs. In 2-3 months time Bonnie will undergo surgery either in our practice or at a referral institution. The surgery will entail replacing the ruptured ligament with a graft of tissue from elsewhere in her leg. This graft will be secured using a screw and washer. Other structures in her knee will also be examined to make sure they are intact. If they are damaged they will be repaired. At this time, after the surgery, Bonnie will require strict care. After surgery, Bonnie should be confined to a cage, playpen, or crate for about 10 days. This is because there is minimal inherent strength in her knee until 6 weeks after the repair. Therefore, it is vital to follow these instructions in order to prevent the graft from failing. As time goes on, scar tissue will begin to form, helping to stabilize BonnieÕs knee. This growing support will allow her to take on increased physical activity. Two weeks after surgery, Bonnie will enter a controlled exercise program, entailing leash walking and swimming. Bonnie should be able to return to normal function 12 weeks after surgery and the screw and washer, placed during the surgery, can be removed six months postoperatively. Analgesia will be continued during this time to alleviate pain. The exact regimen will be determined based on BonnieÕs progress and the success of the surgery. Weight loss plan should be continued until Bonnie reaches her optimal weight. She should then be placed on a high quality, low-calorie maintenance dog food, such as HillÕs Science Diet. BonnieÕs prognosis is very good as long as the client maintains realistic expectations, Bonnie continues to lose weight, she follows the proper exercise regimen, and BonnieÕs attitude remains positive.