April 23, 2009, infection and tightrope removed

I still try to offer Winston food but today even if I put it in his mouth he tries to spit it out. I'm closing his mouth and trying to make him swallow it, but I don't know how long I'll be able to standing doing that when he's so miserable.

AMVS called and the lab culture came back positive, so there's an infection in the joint. They want him in right away so that they can do surgery to flush the infection from the joint. I called Don and asked him to come home and help me load him up. He came right home and we took him to AMVS but I had to ask for an estimate on how much this was going to cost. They said that an infection has to be treated as an open wound (I didn't really understand what that meant at the time) and that the whole situation is fluid because they don't really know what they'll find once they go into the wound. They gave us what they thought was the high end of about $1800 for the wound treatment through Saturday. I don't want to go into debt, but Don said that he would pay for the treatment (I guess I should add that even though we've been married forever and have joint accounts, we pretty much manage our money separately). We agreed to the wound treatment and they took Winston off to surgery and said that they'd be keeping him overnight.

AMVS called after they finished his surgery and said that they had to remove the Tightrope implant because the bacteria clings to the fiber tape and the infection couldn't be controlled if it was left in place. They had to make a small incision on the inside of his leg to remove the large toggle used on the lower leg bone. That toggle is also where the knots are in the fiber tape. They left the small toggle used on the upper leg alone because they were able to fish the fiber tape out of it and it would cause more damage to make another incision to get out a tiny piece of metal that wouldn't cause any issues (apparently bacteria doesn't adhere to metal). They explained the surgery as basically sticking a big bore needle down into the joint between the bones and flushing 3 liters of fluid through the joint to remove the pus and "chunks" and other infected gunk. Then instead of closing the wound, they pack it with lap sponge bandages because bacteria likes a wet environment so the bandages wick the moisture out of the wound.

I was very concerned to hear that they had to remove the implant because to me that meant that we just reversed the Tightrope surgery and we were back to square one. I asked more questions about this and they explained that he had been far enough along in the healing process that the fiber tape was loose and his body had formed scar tissue that was supporting the joint all on its own. They said that the joint was still stable so at this point, they were hopeful that it would remain that way.

They want to keep him overnight and do another surgery tomorrow to flush the wound again. Because they're actually going into the joint itself, they have to use general anesthesia for the surgery.