Winston got his staples out at 14 days and that visit went well. He is able to go up and down the ramp by himself now. We started walking at 2 weeks for 5 minutes 3-5 times a day. 5 minutes isn't very far when you think about 2.5 minutes away from your house and 2.5 minutes back. In my neighborhood, that's about 3 houses in either direction. I thought that would bore Winston, but he's just thrilled to get off of our property for the first time in 2 weeks. Josie also seems pretty happy with the frequency of these walks, even though she's still going for a longer walk in the evenings. We've had to sneak out with her so that Winston doesn't know what we've done until we get back (I'm sure that Josie tells him!).
We took the exercise pen down and Winston spends most of his time on one of the dog beds or a couch. He's allowed on the couch because he's so tall that he can just step on and off of it as a lateral move rather than a jump. We have a baby gate across the bedroom door because even though he can walk onto the bed, he jumps off of it. We also have a baby gate across the stairway so that he can only go up or down the stairs on a leash.
At week 3 post-op, we increased our walks by 5 minutes each time. We are only doing 3-4 walks each day now. Winston was excited about it the first day -- we actually got to cross a street!. On the third day after we moved to 10 minutes, he seemed sore and more limpy, so we cut back to 5 minutes for his last walk that day and all the walks the day after. Then we moved back up 10 minutes again and he seemed to do fine.
We went for our second physical therapy visit and since his incisions were fully healed we attempted the underwater treadmill. He barely fit into the harness. I'm actually not sure what the harness was for, but it had a handle on top, so I'm assuming it was so we could grab him if we needed to. Have you ever tried to grab a 200 pound dog? It doesn't work so well if he's not cooperative. For example, Winston hates to get on a scale to be weighed. I think mostly because he really doesn't fit, but I'm not sure of that either, all I know is that he sees the scale and he flops onto the floor and goes totally limp so that no matter how you try to drag him it's nearly impossible. It usually takes 3 people to get him onto the scale when he does this. Passive aggressive little (big) bugger!
Anyway, we got him into the treadmill and filled it up and found that even though he was all the way forward, he still bumped his back legs on the back door of the tank as he walked, so it didn't work so well. We didn't keep him in it for long. She showed me how to do bending exercises (hold a treat at his hip and make him bend around to take it). We're supposed to do 3 reps at each hip 2-3 times a day. She also wants him to do a series of sit-down/stand up exercises (5 times in a row twice a day). She showed me how to massage his legs and back to help with muscle tightness.
At week 4 post-op we increased the walking time again by 5 minutes so we were up to 15 minutes 3-4 times a day (thankfully I work at home, so I can take breaks during the day). He got sore after the first few walks, so we backed off again for a few walks and then we were able to bump it back up.
December 31, 2008
December 10, 2008
December 10, 2008: 9 days post-op
Winston has suddenly developed a lump at the surgical site. I can push my finger into it and it feels squishy. It doesn't seem to bother him when I do this, but I called AMVS to see what they think. They told me to bring him in so that they can look at it.
When I got there, they determined that it's most likely a seroma that has formed over the fiber tape because it's a foreign body. It should go down over the next several weeks, and could take up to 12 weeks to go away.
Winston has no other symptoms, and he's eating well and walking on his leg. I'm just supposed to watch for changes and call them if something changes.
December 9, 2008
Dec 5-9, 2008 Day 4-8 post-op
Winston is doing really well. He's eating normally, though we've cut his food back because he's not getting any exercise. Normally he eats 7 level cups of Iams lamb & rice, I've only cut him back to 6-6.5 cups of food and he seems to be doing ok on that. His leg is healing nicely. He let me know when it was time to stop with the ice pack. At first it was like he was saying, "Ah... that feels good." and then it started feeling like he was saying, "What the heck are you trying to do to me?" So I stopped, and when we took him for his first physical therapy appointment, they confirmed that it was good to stop at that time. The discharge instructions said to ice it for 3-5 days, and he's ready for it to stop at 3 days (2 days after he came home).
I've been doing range of motion exercises with him and he seems to have full range of motion. I go really super slow with it and never force the movement when he flexes or tries to "take over". I just stop until he relaxes again.
I've noticed that he lies on the surgical leg a lot. I would have thought he'd always be on the other side, but it seems like he's about 50% on either leg.
The swelling has gone down and with support from us, he is going up and down the 7 stairs so that he can be in the main living area with us. We moved the exercise pen to the "dining room" where I usually work at the table. On the stairway, we don't lift his back legs, but we have the sling around his belly with some upward lift to it.
December 4, 2008
Dec 4, 2008 Day 3 post-op
Winston is eating normally and drinking normally. His leg is a little swollen but otherwise looks good.
He doesn't seem to mind me icing his leg with a towel between his leg and the ice pack. He even pooped this morning -- hooray! I know from my own surgical experiences that this isn't usually the case, and I've read the same about the pups who've had surgery. The poop was pretty hard and tarry looking. I felt bad for him because it looked like it hurt, nevermind him getting into the proper squatting position looked pretty uncomfortable too.
He's no longer leaking urine and he isn't asking to go potty all the time. He's spending a lot of time sleeping which is good.
December 3, 2008
Dec 3 2008: Day 2 post-op
I picked Winston up at 11am. The surgical nurse met with me to go over his discharge instructions. She gave me a whole bag full of medications along with a nice little report folder with customized instructions and information for Winston's care. It even has a nice picture of him on the cover! Nice touch :)
I went to set up the ramp into the back of the car while they went to get Winston. It was cold and icky outside but not snowing yet. When they brought him out he was actually walking on the leg but they were still supporting his back end with a sling. It took all three of us women to get him up into the car. When I got home, I had to get him out by myself. Good thing I've been lifting weights for the past few years! I sure needed both arms to support his back end going down that ramp. Luckily we'd worked on teaching him how to use the ramp a few months ago (we've had the ramp for years but never used it until now), so he knew to just go straight down it rather than trying to jump out of the car or go over the side of the ramp.
I didn't know (or had forgotten) that he'd be getting an epidural for the surgery. They said he was a "little dribbly" when they walked him out to the car. I didn't put 2 and 2 together and after unloading him, found that there was a huge puddle in the carpet of my car. When we'd gotten him into the back, he wasn't fully on the bed I'd put back there. I didn't realize that he'd be so leaky. I soaked it up with an old towel and poured white vinegar onto the soaked carpeting. My car smelled like pickles for several days, but it neutralized the urine odor.
We'd set up an electric heater in the "lobby" of our house since it's got 3 doors it's a bit chilly there in the wintertime. Then we set up the exercise pen in half the room and put his orthopedic bolster bed in the pen and put some old sheets over that. I'm glad we did that because the sheets absorbed most of the pee that kept leaking out of him. The discharge instructions said to only take him outside to go potty 3-4 times a day. He was so full of fluid that he'd get up almost hourly to go out and pee. He was walking on his leg, and I made him go slowly. Luckily he had to go so bad that he didn't go far from the door before he stopped and peed. After about midnight that slowed down so he only got up every 4 hours. I worried that he was getting more exercise than he should.
I slept on a thermarest camp pad with a sleeping bag on the floor next to his pen. Anytime he got up, I took him outside to pee. I also set a fairly quiet travel alarm clock to wake myself up to give him pills. I don't think the vets thought about regular schedules when they started their pill cycles because I was supposed to give him a dose of antibiotics at 3am. Over the course of several days I was able to get that adjusted to more like 6am, 2pm, 10pm, but at first I just sucked it up and set an alarm.
I went to set up the ramp into the back of the car while they went to get Winston. It was cold and icky outside but not snowing yet. When they brought him out he was actually walking on the leg but they were still supporting his back end with a sling. It took all three of us women to get him up into the car. When I got home, I had to get him out by myself. Good thing I've been lifting weights for the past few years! I sure needed both arms to support his back end going down that ramp. Luckily we'd worked on teaching him how to use the ramp a few months ago (we've had the ramp for years but never used it until now), so he knew to just go straight down it rather than trying to jump out of the car or go over the side of the ramp.
I didn't know (or had forgotten) that he'd be getting an epidural for the surgery. They said he was a "little dribbly" when they walked him out to the car. I didn't put 2 and 2 together and after unloading him, found that there was a huge puddle in the carpet of my car. When we'd gotten him into the back, he wasn't fully on the bed I'd put back there. I didn't realize that he'd be so leaky. I soaked it up with an old towel and poured white vinegar onto the soaked carpeting. My car smelled like pickles for several days, but it neutralized the urine odor.
We'd set up an electric heater in the "lobby" of our house since it's got 3 doors it's a bit chilly there in the wintertime. Then we set up the exercise pen in half the room and put his orthopedic bolster bed in the pen and put some old sheets over that. I'm glad we did that because the sheets absorbed most of the pee that kept leaking out of him. The discharge instructions said to only take him outside to go potty 3-4 times a day. He was so full of fluid that he'd get up almost hourly to go out and pee. He was walking on his leg, and I made him go slowly. Luckily he had to go so bad that he didn't go far from the door before he stopped and peed. After about midnight that slowed down so he only got up every 4 hours. I worried that he was getting more exercise than he should.
I slept on a thermarest camp pad with a sleeping bag on the floor next to his pen. Anytime he got up, I took him outside to pee. I also set a fairly quiet travel alarm clock to wake myself up to give him pills. I don't think the vets thought about regular schedules when they started their pill cycles because I was supposed to give him a dose of antibiotics at 3am. Over the course of several days I was able to get that adjusted to more like 6am, 2pm, 10pm, but at first I just sucked it up and set an alarm.
December 2, 2008
December 2, 2008 left leg Tightrope surgery
I dropped Winston off at AMVS early this morning, it was hard knowing that he's got a big surgery in front of him, and I'm nervous because as much as I've read on the internet, it's actually happening to me now and it's a little different when it's actually US going through it now.
Winston stays overnight at the hospital tonight and comes home tomorrow. I'm taking tomorrow off work so that I can pick him up and take care of him. Don is self-employed and is swamped and can't take any time off right now, so even though he'll help out when he's home, most of the work is going to fall on me.
Josie (Winston's sister) is following me around. We got her in October after losing our first mastiff to a ruptured tumor. She's always had other dogs around, so this "being alone" thing is totally new to her and she's not sure what to think. It seems like most of the day has gone by and I still haven't heard any news. Finally they call to say that Winston is fine and there was no damage to the meniscus, and the surgery went really well and they set up a time for me to get him tomorrow.
Winston stays overnight at the hospital tonight and comes home tomorrow. I'm taking tomorrow off work so that I can pick him up and take care of him. Don is self-employed and is swamped and can't take any time off right now, so even though he'll help out when he's home, most of the work is going to fall on me.
Josie (Winston's sister) is following me around. We got her in October after losing our first mastiff to a ruptured tumor. She's always had other dogs around, so this "being alone" thing is totally new to her and she's not sure what to think. It seems like most of the day has gone by and I still haven't heard any news. Finally they call to say that Winston is fine and there was no damage to the meniscus, and the surgery went really well and they set up a time for me to get him tomorrow.
November 13, 2008
Tightrope repair?
I found information on a relatively new CCL repair procedure called a Tightrope. It sounds like it's hard to find surgeons who do it though, so we might have to travel somewhere to get it done.
I called AMVS to find out if they knew of this procedure. It turns out that they do it, but have never done it for a dog as large as Winston. They contacted Dr. Cook to get his recommendation for a dog Winston's size. He said that there should be no issue at all.
I heard/read somewhere (can't remember the source, so take this with a grain of salt) that the fiber tape was strong enough to tow a volkswagon beetle.
I really like the idea of NOT cutting the end of a bone off and then bolting it back on in a different position. Merely drilling some holes through the bone seems like a much better option to me. The main problem that the surgeon had was that there is no long-term data available for tightrope repairs. I'm gambling that everything will turn out ok. I'm willing to take that risk and hope for the best outcome.
We set a pre-op appointment where they took x-rays and drew blood to make sure that Winston didn't have any other health problems that might cause us to change our minds about doing surgery. Everything checked out fine.
I've ordered an exercise pen and an orthpedic bed, a sling and an inflatable e-collar from Drs Foster and Smith. They should be here within a week.
Winston's first Tightrope surgery is scheduled for December 2, 2008. His left leg is worse than his right leg, so we'll start with that one.
Once we got the sling and the e-collar, we made him wear the e-collar (aka "the donut") for a few hours at a time for several evenings. He was never happy to have it on, but he accepted that we put this weird thing on him and he started ignoring it pretty quickly. We live in a split-level house so once you come in the front door or the back door, you come into about a 10'x10' room. From there we have 7 steps to get up into the main part of the house or 7 steps to go downstairs to a family room and laundry. We figured we'd end up having to use a sling at some point to help him up and down the stairs. He has weighed as much as 210 pounds, but once he started having problems we worked on getting his weight down, and he's about 195 now. Even the back half of him is a lot to lift when he outweighs you! Anyway, we also did some practice "helping" him up and down the stairs with the sling before surgery. Again, he didn't like it much but since we weren't actually trying to pick his feet off the ground, he seemed to accept it.
I called AMVS to find out if they knew of this procedure. It turns out that they do it, but have never done it for a dog as large as Winston. They contacted Dr. Cook to get his recommendation for a dog Winston's size. He said that there should be no issue at all.
I heard/read somewhere (can't remember the source, so take this with a grain of salt) that the fiber tape was strong enough to tow a volkswagon beetle.
I really like the idea of NOT cutting the end of a bone off and then bolting it back on in a different position. Merely drilling some holes through the bone seems like a much better option to me. The main problem that the surgeon had was that there is no long-term data available for tightrope repairs. I'm gambling that everything will turn out ok. I'm willing to take that risk and hope for the best outcome.
We set a pre-op appointment where they took x-rays and drew blood to make sure that Winston didn't have any other health problems that might cause us to change our minds about doing surgery. Everything checked out fine.
I've ordered an exercise pen and an orthpedic bed, a sling and an inflatable e-collar from Drs Foster and Smith. They should be here within a week.
Winston's first Tightrope surgery is scheduled for December 2, 2008. His left leg is worse than his right leg, so we'll start with that one.
Once we got the sling and the e-collar, we made him wear the e-collar (aka "the donut") for a few hours at a time for several evenings. He was never happy to have it on, but he accepted that we put this weird thing on him and he started ignoring it pretty quickly. We live in a split-level house so once you come in the front door or the back door, you come into about a 10'x10' room. From there we have 7 steps to get up into the main part of the house or 7 steps to go downstairs to a family room and laundry. We figured we'd end up having to use a sling at some point to help him up and down the stairs. He has weighed as much as 210 pounds, but once he started having problems we worked on getting his weight down, and he's about 195 now. Even the back half of him is a lot to lift when he outweighs you! Anyway, we also did some practice "helping" him up and down the stairs with the sling before surgery. Again, he didn't like it much but since we weren't actually trying to pick his feet off the ground, he seemed to accept it.
October 29, 2008
Is TPLO the only option?
Don reminded me that we'd already paid for a long vacation (we'd booked a cruise from LA to Hawaii and had taken some time at each end of the trip) and that we had gotten travel insurance. He said he'd rather take care of Winston than go on vacation. Duh! Vacations are important to me, but I have to agree with him on this one. I cancelled the trip and filled out all the paperwork to get our money back. It was an easy process so I'd have to say that I'd use TravelGuard again.
I've been out on the internet reading all I can about TPLOs and other people's experiences with it. I found sites that recommended it, sites that said to stay away from it, more info that describes it, and some other blog sites where people wrote in great detail about their experiences. I'm pretty conservative so I really hoped that we could go the "conservative management" route where the knees will just heal on their own if you keep the dog quiet enough.
I was told that the sooner we did the surgery, the better since it would stop the progression of arthritis before too much damage was done, but that it didn't have to happen immediately so I had a little time. I tried to keep Winston quiet in October -- haha! He's such an active boy that didn't go over well at all. There's no way I could have ever keep him quiet enough for any real healing to happen, and even if it started to, he'd probably just re-injure it. I kept watching the insides of his legs for medial buttress formation. I thought I could see it starting, so I figured I'd better really get serious about surgery. Isn't there anything less invasive than the TPLO?
I've been out on the internet reading all I can about TPLOs and other people's experiences with it. I found sites that recommended it, sites that said to stay away from it, more info that describes it, and some other blog sites where people wrote in great detail about their experiences. I'm pretty conservative so I really hoped that we could go the "conservative management" route where the knees will just heal on their own if you keep the dog quiet enough.
I was told that the sooner we did the surgery, the better since it would stop the progression of arthritis before too much damage was done, but that it didn't have to happen immediately so I had a little time. I tried to keep Winston quiet in October -- haha! He's such an active boy that didn't go over well at all. There's no way I could have ever keep him quiet enough for any real healing to happen, and even if it started to, he'd probably just re-injure it. I kept watching the insides of his legs for medial buttress formation. I thought I could see it starting, so I figured I'd better really get serious about surgery. Isn't there anything less invasive than the TPLO?
October 12, 2008
Winston's Diagnosis
Winston has been limping off and on for about a month now. It looks to me like it's his right front leg, but it's subtle. He's been having some pain issues off and on since May. We took him to our regular vet who couldn't find anything obviously wrong in an initial exam (we're both pretty conservative, so we didn't take any x-rays at that time). He prescribed Rimadyl and we decided to watch him.
Towards the end of the month we noticed that Winston was having a hard time standing up after sitting or lying down. A guest knocked over a chair and startled him and he was unable to get up in a hurry and ended up dragging himself across the room to get out of the way. I called my vet and he referred me to Aspen Meadow Veterinary Specialists for a diagnosis of the problem. Turns out that I was way off base -- he had partial cranial cruciate ligament tears in both back legs. He was trying to carry more of his weight with his front legs which is why it looked like he was limping with a front leg.
Dr. Duerr recommended that we do TPLOs on each of his legs to correct the problem. He got out a model and the plates and described the surgery in detail, but suggested that I do my research. A surgical nurse came in after I finished with the doctor to describe what to do to prepare for the surgery, what to expect when we dropped him off and then provided an estimate for the cost. I left there pretty much reeling... it was a lot to take in and I really needed to absorb it all. In all of our years of dog ownership, we've never had any sort of major vet bill and I'd never heard of torn cruciate ligaments. How could we possibly pay for this? Since Winston wasn't even 3 and other than these injuries he was healthy and happy, how could we not pay for this?
I went home and cried.
Towards the end of the month we noticed that Winston was having a hard time standing up after sitting or lying down. A guest knocked over a chair and startled him and he was unable to get up in a hurry and ended up dragging himself across the room to get out of the way. I called my vet and he referred me to Aspen Meadow Veterinary Specialists for a diagnosis of the problem. Turns out that I was way off base -- he had partial cranial cruciate ligament tears in both back legs. He was trying to carry more of his weight with his front legs which is why it looked like he was limping with a front leg.
Dr. Duerr recommended that we do TPLOs on each of his legs to correct the problem. He got out a model and the plates and described the surgery in detail, but suggested that I do my research. A surgical nurse came in after I finished with the doctor to describe what to do to prepare for the surgery, what to expect when we dropped him off and then provided an estimate for the cost. I left there pretty much reeling... it was a lot to take in and I really needed to absorb it all. In all of our years of dog ownership, we've never had any sort of major vet bill and I'd never heard of torn cruciate ligaments. How could we possibly pay for this? Since Winston wasn't even 3 and other than these injuries he was healthy and happy, how could we not pay for this?
I went home and cried.
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