June 28, 2009: 4 wks post-TPLO & house paint

Tomorrow will be 4 weeks since Winston's surgery. He's doing great and his leg looks good. He's actually gaining some leg muscle back on both hind legs. Since he was only using his left hind leg for so long, I would have thought that leg should have gained some size to make up for not using the right hind leg, but I guess it makes sense that he would have overall atrophy since he wasn't getting any regular exercise at all. The only time he got to walk around was to go potty, and the rest of the time he was laying down. He even ate laying down. I haven't paid much attention to his front legs, but I suppose he lost muscle there too. Swimming will be good for him once he's healed up enough to be able to do that.

Today we moved him out of his room in the "lobby" of our split-level house and into the main part of the house. I moved both of his beds upstairs and removed the baby gate from the lower stairway. We have a baby gate up at the top of the upper stairs so that once he's upstairs, he can't go back down unattended. Hopefully at his 8 week check we'll be able to take the baby gate down and let him have stair privileges again -- depends on whether they say the bone is fully healed or not. He's managing the stairs really well. He walks up them with each leg, even the TPLO leg, and I have to have him on a leash to go down since he would go too fast on his own, but he's also placing each foot on the stairs as he goes down -- HOORAY!!!

We just re-painted the exterior of our house this weekend. We're not quite done, but most of the body color is done. We have the east side of the garage left and some brush-work to do where we had to put tape on the siding itself (it doesn't stick to the bricks very well), and all the trim color is still waiting for us, but wow -- what a difference a new color makes! We're on a corner so the house is more noticeable... it used to be this ugly light green color on top with reddish multi-tone (some darker, some lighter) bricks on the bottom -- not a good combo if you ask me. Anyway, the house used to just jump out at you and I wanted to find a color that would recede into the background. I picked out a pretty rust color that complimented the bricks. It was pretty on the paint chip anyway. Then I bought a quart of it to try out in different areas. I painted a couple of pieces of wood that I could put in different places to catch different lighting. It still looked pretty good, but was a little brighter than I expected.

We have these two huge doghouses (that have never been used by either of these dogs...) that used to be on our back patio, and we decided to move them underneath our deck, since they wouldn't take up useable space, and they'd be in a location where if the dogs got stuck out in unexpected weather while we were out and about, they MIGHT use them. Probably not, since we've got a covered porch that they'd probably hang out under instead, but hey, the dog houses are well insulated and heated, so we don't want to get rid of them just yet since future dogs might use them. So... before we moved the dog houses under the deck, we painted them the "new house color" -- uh oh. They looked ORANGE and not a color orange that most people would want on their house. We live in Denver Broncos country, so neighbors might have thought we were the biggest Broncos fans on earth. I sure didn't want to be known as living in that orange house on the corner. Time to find another color!

I tried a bunch of other "rust" tones and ended up buying 6 quarts of different rust tones, and none of them looked good on all sides of the house. Some looked ok under the coverd porch but got shockingly bright in the sun, and some looked ok in a small area, but when we re-painted the dog houses with the "ok" color, it was still not something I wanted on my house. That was always the ultimate test -- if it looked ok on the dog houses, we could paint the house. I finally had to give up on the rust color. I went for 2 more quarts -- one that was more red toned and one that was more brown toned. Don finally gave me the OK to actually put some paint on the house, so I went around all sides and put some of each color onto the siding. Both looked good. I painted one doghouse red and one doghouse brown. hmmmm.... I like them both. I finally decided to go with the more brown tone because I think the red would have been too much with the brick. Well, now the house is pretty brown looking, but I think it will be fine once we get the cream trim color up. And... the best part is that the house really does recede into the background. I always heard that, but never actually saw a house change so dramatically right before my eyes.

June 23, 2009, 3 wks post TPLO & foxes

The rest (and pain pills?) seemed to have helped Winston. I stopped the Trammadol on Sunday, but gave him Rimadyl until this morning.

I guess when I think about it, it makes sense that he wouldn't want to use his leg if it was really sore. He's got no leg muscle to start with and then if we went too quickly to a 10 minute walk, the muscle would be really sore and he wouldn't want to stand on it. I can remember when I started Deep Tone (www.deeptoneonceaweek.com)... I swear I couldn't walk or sit or stand up without yelping for about a week. Then every time the routine changes, we're all sore again!

We went for four 5-minute walks yesterday and he is fine today and seems to be using his leg more normally. He doesn't totally straighten it out behind him as he walks, but he's got less of that "seat to short" bicycle action going on. He actually stood on the bad leg today for about 2 seconds to lift his leg, then went back to the horse-pee squat.

He's also doing better at home on the stairs. Up through the weekend, we only let him up and down the 7 steps once a day, but we tried twice yesterday and he seems fine. He's using the bad leg and he's no longer hopping down the stairs on three legs. I keep him on a leash to help support him and to keep him slow.

Today when we went out for our late morning walk there was a fox lying down in the yard across from our driveway. I was lucky that I was the only one who noticed him! I have to stick to the back yard when I take Winston out in the mornings. We've had a bunny population explosion this year and that seems to have caused a fox population explosion too. I'm sure that there were at least two litters if not three in the neighborhood. We've lived here just about three years and up to this point I've only seen them out at dusk, night or very early morning, but nowadays it's not unusual to run into one on a mid-day walk. They see us coming and if there's cover, they duck behind a tree or a bush and watch us as we go past. One night we ran into one where there was no cover and it just laid down in the grass and waited for us to pass by. There's one cheeky big guy (I think it's a guy) that comes over in the evenings and sits just outside the fence while Josie barks her head off at him. He's got this look on his face like he's just laughing at her.

June 20, 2009 - 3rd PT visit

Well, Winston still seemed pretty sore. He's still mostly toe-touching in the house instead of using his leg. I can't tell if his left leg feels hotter than the right leg... maybe??? It doesn't look any different than it did before, so.... I'll wait and see if things improve. We didn't walk this morning before our PT visit.

Don is helping some friends move today, so I was on my own getting Winston to and from AMVS for his PT appointment. He didn't think a biscuit was enough motivation to go up the ramp by himself, so I got to carry his back end up it for him. Silly thing. Going down the ramp is no problem, though he was still mostly on 3 legs for that. No pressure on the repair, so I'm fine with that.

PT went well, he doesn't mind the laser therapy, and he seemed mostly ok with her picking up his other leg. She only had him stand on the "bad" leg for 2 seconds, and she repeated that 3 times.

Got him loaded up and unloaded at home, no worries and he went up the stairs and lay down for a long nap. I was reading when he suddenly bolted off his bed and hopped across the room on 3 legs. Then he stood there all hunched up and gave me the sad eyes. What is up with that? I told him to lie back down but he wouldn't and so we went outside. He was on 3 legs down the stairs (there's 7 steps) and then toe touching outside. This really made me wonder and of course, worry. What else is new? I decided I'd better give the vet a shout. They wanted me to bring him in so they could look at him. Got him loaded up and headed back to AMVS.

Good news there, they took his temp and it was normal, and the vet who saw him (one of the emergency vets on staff) said that he didn't seem to mind having his leg manipulated, and she couldn't see any signs of swelling, and the tissue looked pink and healthy. They took an x-ray and compared it to the same view as one of the x-rays taken right after surgery and everything looked the same, with the exception that the swelling inside the joint has gone down (hooray!). She thinks it was overuse and sent us home with some pain meds and instructions to rest and then start walking again slowly and for only 5 minutes at a time. If he doesn't get better, call back on Monday when the surgeons are back in the office.

We went home and had a quiet day in the yard and in the house. It's WONDERFUL now that his incision has healed so he can spend time out in the grass while I pull weeds. Ok, this is my life right now with this yard.... but that's another story! Maybe not so exciting an activity, but we're outside listening to the birds and watching for the bunnies and foxes. Winston is on a cable, and I have to keep him pretty close to me so that I can stop him before he jumps up and does something silly if people walk by.

June 19, 2009 - Physical Therapy

Winston is so eager to walk, we've been walking more than 5 minutes for each of our walks. He does pretty well during the walk, but still has kind of a "bicycle seat is too short" pedaling motion rather than a normal reach with his leg.

Our physical therapy visit was pretty short today since Winston is too long for the underwater treadmill. We did another laser treatment and she evaluated how he's doing. In another couple of weeks we can start some of the same exercises we did after the tightrope surgery. In the meantime I should walk Winston in clockwise circles since that will force him to use the leg. Also I'm to start an exercise where I lift his left hind leg for a few seconds so that he's standing on the right hind leg. She also recommended that I increase the frequency of the walks rather than the time. I've read this before with other people's experiences. Since I work from home, that's possible for me.

She said that she didn't think there was much swelling or fluid, just a tiny bit at the bottom of the incision. I asked about the "lump" that I'd noticed from time to time on the outside of his knee and she poked and prodded and said that it was hard and she thought it was scar tissue from the way it healed after the infection. Basically she told me to try not to worry too much. I had mentioned that I was worried about another infection. She said that it seemed that Mastiffs or any of the really large dogs seemed to have a harder time with that. She said she'd read about a theory that it was because they were under anesthesia longer.

Since our appointment was so short she asked if we could come back tomorrow for another quick laser treatment. Sure, but Don is busy helping a friend move, so I'm on my own. Can I get him unloaded by myself? If he can walk down the ramp, I can.

After we finished our appointment, I stopped by the front desk and mentioned that Dr. Trousdale wanted one of the surgeons to take a look at Winston while he was there to check on his leg. Dr. Hanzlik was there and she had scrubbed into his surgery so she was familiar with how his leg looked on the inside. She said he had a lot of scar tissue, which was the whole point of the Tightrope, but it's unfortunate that it had broken down in such a way that his knee wasn't supported. She thought the knee looked good and he didn't seem bothered by any manipulation. Hooray!

We used the ramp to unload him from the car and he went down it mostly on 3 legs. That's ok. It doesn't put any unnecessary pressure on the TPLO repair.

Once we got into the house, he seemed very sore and hardly used his leg at all -- just toe touching. Hmmmm. I decided not to walk him again and see if he was better in the morning.

June 17, 2009, 2.5 weeks post-TPLO

Ever since we came home from the vet on Monday, I've been worrying about the fluid around the incision. Is it getting bigger? I have a hard time telling since I see it every day. They wanted me to call if anything changed. Well, yesterday he was up and restless all day and when he walks around "his room", he's limping pretty good. Is this a change? Is this just because he hurts because we're walking and that's new? I would expect some pain when walking on a newly broken leg.... When we go for a walk, he uses it really well, and he seems less sore while we're out there, and he also isn't as slow on the way back as he was on Monday.

Yesterday afternoon I called AMVS back and asked if they could give me some more specific instructions about what I'm supposed to look for. They clarified that if I should see more of the knee become swollen, or swelling traveling down the leg, or if he starts limping during our walks, or stops putting weight on it while he's in his room. Whew! I'm not seeing any of that yet.

I also asked about stairs. Since we live in a split-level, he's stuck down here in the "lobby" of our house. I don't want him to do anything that he shouldn't do yet, so I figured we might have to wait for awhile, but they said if we're very careful and keep him on a leash we can try the stairs. Take it slow... only try it once one day and see how that goes. If that goes well and doesn't seem to bother him, maybe we can do it again the next day and so on. They just don't want him doing it a lot -- no up and down the stairs several times a day to go potty.

I told them that he seemed to be doing really well with the walks, and they said I could increase either the time or the frequency by little bits as long as it doesn't bother him. Since I've already been through 2 surgeries and an infection, I think I can judge pretty well how he's doing, so I bumped him just past 5 minutes and I might try adding one more walk (5 minute) walk into our day and see how he does with that.

Today he hasn't been restless at all. I kinda think the restlessness yesterday was because of the sudden change to his schedule. He was up and hoping for a walk all day long. Silly boy!

June 15, 2009, staples removed & 2 wk evaluation

Winston got his staples out today. Ever since his TPLO surgery, I've been really happy with his progress and pretty excited that everything seemed to be going so well. They burst my bubble :(

Dr. Duerr was in an emergency surgery so Dr. Trousdale did the evaluation and he noticed that there is a little fluid pocket along the line of the incision. He was happy to see that Winston is walking on the leg and actually puts it underneath him when he walks, but the fluid pocket may indicate the presence of an infection. I guess this is pretty likely since we just battled an infection, so he's going to be more prone to another one. It's not really what I wanted to hear or even think about. I've been watching the swelling go steadily down ever since surgery, so I thought it was just a normal part of the healing process. I didn't realize that he shouldn't have any swelling anymore.

He said that a little clear fluid leaked out when he removed the staples. Clear is good, but still....

Dr. Trousdale asked us to put hot compresses on the incision 2-3 times a day for 3-5 days, and to call them if ANYTHING changes at all. I'm guessing that the hot compress will also cause the infection to come more to the surface if there is one? Our last 2 doses of cephelexin are today, so I asked whether we should extend that, and he said no because if there's an infection present, it's resistent to that anyway.

Ugh! I hate this.

After we got home, I soaked a washcloth with hot water from the faucet and put it into a zip lock bag and held it against his leg for about 10 minutes. I'll be doing this about 3 times a day from now until Friday.

We walked again a couple more times and Winston is definitely putting his weight onto his leg and wants to go farther than he's allowed. It's hard to get him to turn around. At the same time, he's a little slow on the way back, so I think we're going far enough for now.

June 14, 2009, our first walk post-TPLO

This evening Winston got to walk off of our property for the very first time since April 17th. All of us were pretty excited. We walked for 2.5 minutes out and it took us just a little bit longer to walk back. He seemed to do ok. His leg moves a little differently than it did before, so I think there's going to be a little bit of a learning curve for him on how to use his leg.

As soon as he got home and had a drink of water, he slept for awhile. Not much stamina yet! After that he seemed pretty sore when he first stood up and walked inside his room, but when I took him out to go potty, it seemed to work itself out after a few steps.

June 13, 2009 - 1.75 weeks post-TPLO

Almost all the swelling is gone is gone in Winston's leg, and he's walking on it pretty normally considering he's got so much atrophy in that leg.

We go to AMVS on Monday to get the staples out. He's still got some small scabs, so he's going to be stuck with the donut until the rest of those fall off, but it shouldn't be long. I'm excited to start walking again. Even though we'll only be able to go about 3 houses in either direction, it will be the first time he's left the property on his own four feet since mid April. He is going to be SO HAPPY!!!!!!!!! I can't wait.

Josie is also going to be happy since she misses walking with him.

I'm unsure of when we will be allowed to help him up and down the stairs. With the Tightrope, we were able to start taking him up into the main part of the house at 1 week. I suspect that he might be down in his room for awhile yet. I'm going to guess at least 4 weeks post-surgery, but I won't be surprised to hear that they want to wait until 8 weeks. It seems that each surgeon has a different opinion. We'll ask about that when we go on Monday.

We took down the exercise pen today and put baby gates across the stairs. Now Winston has 2 beds, and a bunch of floorspace to choose from. It's not as good as being able to "live upstairs like normal" but there's enough room for Josie to hang out with him, and there's enough room for me to work down there during the day with the two of them at my feet. Life is good!

June 12, 2009: Standing straighter already

This picture sort of shows the muscle atrophy that has happened with the infection.  No picture that I've taken really does the "real thing" justice.  He has started putting some weight on his right leg now, so his back isn't as twisted as it has been for the past few months.

June 10, 2009, 1 week post-TPLO

I can't believe how easy Winston's recovery has been up to this point. We ran out of pain pills on Monday, and though we could tell that he was a bit more painful after that, it didn't look like he was too uncomfortable and he's still walking on the leg even more than ever.

He had some swelling around his hock last week, but that's all gone now and the incision looks like it's healing nicely.

He's eating just just his Iams Lamb and Rice mixed with a bit of water now, and even stands up sometimes to eat. I never have to offer him water anymore because he always gets up to drink now, so we're seeing definite progress.

He also hasn't shown any signs of being interested in licking or sniffing at his incision. We have been using the satellite dish e-collar up to this point, but I'm switching him to the donut today so that he can get a drink or chew on a chew bone if he needs to.

The passive exercises are just going ok. At some point during a massage of his thigh muscles, I must have pushed too hard and made him yelp. He now gets that worried look when I sit down next to him to start exercising his leg. He puts his mouth around my hand to stop me. I'm watching him closely, and he IS stretching and bending the leg quite a bit on his own, I just don't think that he's pushing the outer limits of the range, so I'm still getting some of that in.

June 4, 2009, 3 days post-TPLO

I almost feel guilty that I took 2 days off work, because taking care of Winston seems SO easy this time. I guess when you compare it to what we went through with the infection, it's pretty anti-climactic, but that's also a GOOD thing :)

The saran wrap stuff is peeling down at the top, but it's still sealed at the bottom, so it forms a perfect funnel along his incision. If he should happen to splash or otherwise "pee wrong", it looks like the urine would would just go straight down the funnel and pool at the bottom of the incision. While we were out on a potty break, I worked at peeling it the rest of the way off. He was ok with the peeling action on the front side of his leg, but VERY unhappy about any kind of skin tugging on the back half of his leg. He tried to grab my hand in his mouth to stop me. I kept peeling from the back going towards the incision, but no matter what I tried, he was unhappy. I finally took the "bite the bullet and just rip it off" approach. He didn't like it, but it was quick and then we were done.

I'm pleasantly surprised at how small the incision is. Somewhere I'd read about someone who's dog had a really huge incision, and I somehow expected that. I should have known better. This incision is no bigger than the main one on the outside of his leg from the Tightrope, and there is only one incision. Of course, most of what's going on with a TPLO is on the inside. Don kept telling me that Winston would be in more pain from this surgery because one of his friends who had TPLO on their dog said it cried nonstop for weeks. He kept telling me that Winston would be the same way. I'm happy to say that I haven't noticed any difference so far between this recovery and either of his Tightrope recoveries.

When I tried to ice his knee today, he kept trying to block me from getting near it with his head. He was also giving me the, "What the heck are you trying to do to me today anyway?" look. I figured it had been long enough.

We took him for his first phsyical therapy visit today. They did a laser treatment that is supposed to promote cellular level healing. It sounded like something a day spa would say. I was skeptical, but I didn't think it could hurt, so we went ahead and did it. She also showed us the proper way (and improper way) to do the passive exercises with his leg, so now I have a new torture for him. She said that his range of motion was nearly 100% but that he wouldnt' quite let her straighten his leg all the way. Then she said that it might be due to the 14 degree angle for the repair. I have no idea, but I could see how straight she was able to get his leg, and it's much straighter than you would think from her comments. It looks pretty straight to me.

June 2, 2009, 1 day post-TPLO

We went to AMVS at 2pm to get Winston. They gave us a bag of medicine and then went over his discharge instructions -- we got another report with his picture on the cover. It was color again, but they took it when he was groggy (either before or after surgery) and he looks really sad. Poor boy!

Anyway, I was surprised that the instructions are very similar to the Tightrope surgery. He's to be confined for 2 weeks and then we start walking. We aren't supposed to increase the lengths of the walks as often though. At week 2-4 we walk for 5 minutes 3-4 times a day and then weeks 5-6 we increase it to 10 minutes per walk, and so on. They have also changed the way they do physical therapy. Last time, our first PT visit was at least one week after surgery and we were supposed to do the passive excercises on our own before that. This time they want us to schedule the first PT visit 2-3 days after surgery so that the physical therapists can show us how to do the passive exercises. This seems like a much better way to do it because I was unsure of what I should and shouldn't do and I had to wait a week before the physical therapist could show me right and wrong ways to do it.

We were ready at home; we washed all of his bedding and vacuumed and mopped his room, and put the exercise pen back up, and I took 2 days off of work so that I can take care of him. Don isn't as busy, but will probably still go to work each day.

When they brought Winston out with his satellite dish on (he just hates that because he has to swing it around from side to side so that he can see!), we were pretty excited to see that he was already putting more weight on it than he has since mid April. Wow! Instant success. They had shaved a larger area on his back for the epidural and we laughed because he's got a tan line from his previous surgeries.

I was prepared with extra towels in the car for the urine leak issue, so it didn't surprise me that he was leaky. I'd wondered before we went to get him how we would try to keep the incision dry since it's on the inside of the leg, but I shouldn't have worried. They had some sort of plastic sheet over the entire incision. It looked like saran wrap. They said that it would eventually start to peel off on its own, and we could remove it once that started.

He gave out a loud moan as we turned onto the highway before our house, and kept whining for the next 10 minutes until we got home. Don thought he was in pain, but I recognized that as his "I've REALLY got to go potty NOW" noises. As soon as we stopped the car, we dashed around back and got him unloaded as quick as we could. He hurried into the yard and took (left) a big old dump and then peed for about 5 minutes. Poor boy! He seemed to feel much better once that was out of the way, and immediately went to bed and slept for several hours.

He's shifting from leg to leg as he sleeps again. First he'll lie on the surgery leg, and then he'll lie on the other one. When he's on the surgery leg, he keeps it kind of tucked up so that I can't get to the knee or even see the incision, so I have to wait for him to leave that side up so that I can ice the joint. He seems to say, "Ah.... that feels good" when I use the ice pack.

At dinner time, he's interested in food. I'm unsure how much to feed him so I try a cup of kibble and one of the 5.5 oz cans of Mighty Dog on top. He eats it all.

The pill schedule is off again, so I set my alarm for 2 am and get up to give him pills, but he didn't need to go out again until morning. That's odd, but kind of nice.

June 1, 2009, TPLO surgery

We dropped Winston off at 7am this morning (with his satellite dish e-collar and his sling). I'm beginning to feel like a pro at this. In the first two Tightrope surgeries, I chose to resusitate him if something should go wrong during surgery. This time I signed a DNR. I think he's been through enough. If something goes wrong, I think we should let him go, and Don is now ok with that. As I was signing the form, I had that little voice in my head question whether I was jinxing him, but I'm not superstitious enough to do anything other than acknowledge I heard it.

My co-workers ask all morning if I'm really nervous and so far that hasn't set in. I've got a really calm feeling about the whole situation. I think we've been through some pretty bad stuff so far and we've all come out ok, so I think we can handle whatever comes our way from this surgery. Of course, I still hope it turns out well!

I wasn't expecting anyone to call me until later in the day, but Dr. Duerr called later that morning and said they were all done and that it had gone well. There was no sign of infection, but there was a lot of scar tissue in and around the joint. He removed some of it but had to work around the rest. Because of all the scarring he was unable to get the "ideal" 5 degree angle, and instead got it to 14 degrees, which is still in the range of acceptable. He said that the knee was really stable and that the long term prognosis is good. I'm fine with the angle, I'm just happy that he's going to be able to walk on it again. HOORAY!

They kept him overnight, and I got to sleep in my own bed again. Such a treat!