This is kind of my "blog" about my (and my dog's) experience, that I'll update as I go. Much of my inspiration came from this website:
http://home.earthlink.net/~tiggerpoz/index.html
(though I am researching all info as thoroughly as time allows.)

My 2 1/2 y/o male GSD had significant surgery for bilateral elbow dysplasia at 1y/o. Since that time, the left elbow healed fairly well, the right elbow has not "fused" correctly, and moderate arthritis is already present in the joint. This dog follows a fairly limited exercise plan: 10-20min slow treadmill walking in the morning, generally 2-3miles/day walking, 5-10 minutes fetching the ball (a game he loves), and ocassional longer hikes/ swims as schedules allow. When the hike or swim is rather long/ vigorous, I give him Metacam before to help with soreness in the elbows. He has been full of energy, and with a min-mod amount of apparent soreness/ lameness after 7 or 8mile hikes.

~9/01/08, I went to cut Cerbie's nailes, and noticed a couple toenails on the left rear leg were worn down. Mentioning it to my s.o., we began to notice he would ocassionally drag his left rear leg a bit, usually by the end of his 2-3 mile walk, but not all the time. Unsure how long this has been going on for. Began to notice a slight limp at times in that left rear leg.

9/22/08 S.O. played a vigorous game of fetch with Cerbie, longer than usual, and Cerbie began visibly limping on left rear leg, able to partially bear weight on it.

9/24/08 Visit to a new regular vet, recommended by friends. Fearing DM or hip problems, vet fairly certainly ruled out neurological problems such as DM, felt a thickening by left knee joint, observed Cerbie holding leg and behaving as if leg was painful. Xrays recommended (to rule out other orthopedic abnormality) and surgery for ACL/CCL repair discussed. CCL tear in dogs fairly common problem, and usually progresses in large dogs to arthritis. Very high likelyhood of same problem occuring on the other side. Surgery only option. Surgery available at this vet's office. Exact details of surgery and estimate to be mailed.

9/26/08 Had appt with orthopedic surgeon (highly regarded) who performed elbow surgeries. Thorough physical exam performed; this vet also came to the conclusion that a partial CCL tear was most likely the culprit. Negative drawer test, joint still very stable, no arthritis noted. Hips appear in good condition bilaterally. Right knee appears normal. Thickening noted at the left knee joint, possible fluid or tissue buildup. Xray for definate diagnosis (to again r/o other unlikely orthopedic problem) recommended, and surgical options discussed. This vet highly recommends the TPLO surgery to stablize the joint. Not emergent surgery. Feels the course of this injury will be that Cerbie will develop scar tissue that will temporarily re-stablize the joint, but he will continue to keep re-injuring it, possibly leading to meniscal problems and severe arthritis. Another concern is that his favoring the left rear leg forces a lot of his weight forward onto his opposite (right) elbow, the one most affected with arthritis so far.

Medical management discussed: continue Cosequin and Adequan and Metacam as needed. Rest; no running/ jumping. Possible knee brace.

Surgery highly recommended as being the only good treatment option at this point, with TPLO being the surgical option of choice for this size dog. He WOULD do this surgery on this dog if he were his.

My feelings so far: We will wait for a couple of months, restricting Cerbie's activity, to see if things improve. Neither the S.O. or I feel surgery is a good option for this situation. We don't want to put this dog through more significant surgery/ rehabilitation, especially due to the fact his front elbows are already not in the best shape, and we highly believe he will have a limited life span due to the lameness that is sure to progress in those elbows. Also, the risks of surgical complications (the metal plate breaking, infection) are significant enough to consider. He did manage to break the screw in his right elbow, a complication that was rarely expected with his last surgery. There is no guarantee that this would end up being his last surgery. THere is a high likelyhood his right ligament could tear as well, possibly requiring surgery. More research required, but the TPLO does seem like extreme surgery. Cutting the bone so it fits a "better" angle just seems wrong to me. As my s.o. tried to ask the vet, doesn't evolution create angles in animals that make the most sense? The vet couldn't really answer that.

Our hope is to medically manage him, and try to give him the best quality of life we can for as long as we can. We'll somewhat further restrict his activity (no ball chasing, unless in the water while swimming) and very seriously limited jumping.

9/28/08 Limp very mild and intermittent now. Cerbie enjoys having his left rear leg massaged. Activity has been only potty breaks, loose around house (but kept calm) and very short (10 min) walks. Metacam given daily up until today; will re-assess later today to see if he needs it.

A good trial route: Cosequin, Adequan, massage and Metacam (or Deramaxx) sounds right.

Good for you.

10/1/08 On leash walks have increased a little bit. Limp is still mild and intermittent. Giving Metacam just about every other day. Unfortunately as fall hiking is now underway, Cerbie won't be able to come along.

Received procedure estimate from the regular vet, only $975! I have no idea what procedure he is referring to, as he never told me what procedure he would perform. I am assuming perhaps the one where they attach the wire to his leg, to act like a new ligament?? The orthopedic specialist told us that procedure wouldn't be the best for this dog, due to his activity level, there was a very good likelyhood he could break the wire and have complications from that. If we were to go the surgery route (which we aren't), I'd want a specialist to do it. I would never compromise on health just because of cost.