December 30, 2009: Day 28 The ice is melting

The ice on our street has melted enough that we have a clear path for 3 houses before we have to cross a short patch of packed snow to get to the clear path on the south side of the street for 3 more houses.  This works out pretty well for our 5 minute walks, but we're going to increase our time by 5 minutes on one of our walks tomorrow, so I'm not sure what we'll do -- 2 laps in the same area? 

Maybe tomorrow morning we'll try the other direction and see if we have a clearer path down the street on the west side of our house.  It's a busier street, so there's more dry pavement, but there's more of a chance of meeting a car and since Winston wants to chase them, I try to avoid that while we're practically in the middle of the street. 

Decisions... decisions....

December 28, 2009: Day 26, Close call with the ice

The ice on our street is starting to melt, so if we can make it across the middle part of the street, we can walk on clear pavement.  Before today, it hasn't been bad; the ice is crunchy and has traction.  Unfortunately today that changed. 

I bundled up the dogs into their coats before we left the house and we walked down the driveway to the street.  The driveway is totally clear of snow and ice, but there is a thick patch of ice on the street right at the end of our driveway.  Once Winston stepped onto that, all of his feet slipped.  Luckily his reaction to slipping was to immediately sit down.  I was't sure if he could stand back up safely, but I also wasn't sure how to get him back onto dry pavement so I tried coaxing him back toward me.  As soon as he started to stand back up, his feet slid again and he sat back down.  I finally ended up grabbing the neck and tail ends of his coat and dragged him back towards me.  He slid so easily it was like he was on wet glass.  Scary!  I got him to the edge of the ice and he stood back up and we walked back up the drive to go into the yard instead. 

Winston doesn't think walking around the yard "counts" as a walk, so he's been bugging me to take him out for a real walk.  He stands at the baby gate across the top of the stairs and stares at me.  Then he'll walk to me and walk back to the baby gate (just to make sure I understood what he was asking).  Once we get downstairs, he goes to the front door and isn't happy when I tell him we;re going out back.  Of course, once we're out there he's happy enough to walk around both the back and the front yard -- it just doesn't count as a walk.

In the house Winston doesn't really walk on his leg.  Outside, he puts weight on it, but in the house he's still treating it like he did before his surgery.  I'm not sure if this is just habit or if there's some other reason, but I suspect that it's habit.

December 26, 2009: Day 24, All is well

We've had a pleasantly uneventful holiday.  No new snow yesterday but it was COLD.  We bundled the dogs up into their coats and got them out for three walks in addition to regular potty breaks.  At this point there's not much difference between our walks and their potty breaks other than for a potty break we don't put their coats on (trying to encourage speed there...) and Josie isn't on a leash.  They both circle the yard sniffing all the smells.  In the snow, I can see tracks of everyone who's been in the yard.  Cats, rabbits, and even a fox.  The "backyard rabbits" are living under our shed, we can see the hole that they've dug to get under there.  One of these days I'll have to make a little one-way trap door and see if we can get them out of there and finish putting rocks around that side so that they can't easily dig their way under there again.  I just don't have the heart to do it right now when it's so cold and snowy.

Today we woke up to snow.  It showed just enough to cover the bare asphalt on our driveway before it stopped and then it got sunny.  Sunglasses were a must for me on our walks today.  The dogs don't seem to mind, but I'm sure the glare must still affect them.  Our street is snow packed and icy in places.  I could see Winston slip a little every once in awhile.  I tried to keep him walking in the middle rather than towards an edge since that seemed to be more snow and less ice.  Hopefully we'll warm up enough to melt the street soon.  If we don't, I'll have to resort to doing laps in the yard.  I'll open the gate to the front yard and we'll walk the entire perimeter.  It's not bad when we're only walking 5 minutes, but gets boring when we're aiming for 10.  Luckily we're still at 5 for most of this coming week.  Towards the end of the week, we'll start increasing one walk to 10 and then after a couple of days I'll move that to two and then in a couple of days we'll do all three walks at 10 minutes each.

December 24, 2009: Day 22 Merry Christmas

We've broken out the dog coats to walk in the snow for the past couple of days.  Today the snow has stopped and it's bright and sunny and beautiful.  The snow on our street is still fluffy and "safe for Winston to walk on", so we've already been out a couple of times today.  We're all so happy and thankful.

Merry Christmas to everyone!

December 22, 2009: Day 20 -- GREAT NEWS!

 It's supposed to snow tonight, so I figured if we were going to get Winston's bandage changed again this week, we'd better get it done today otherwise it will be too hard to get him loaded and unloaded safely.  When we got to AMVS, he started shaking like a little dog.  Poor guy, I feel bad that he's so scared to be there again.  There was a while that he didn't mind going -- hopefully we'll get to that point again.

They took him back to remove the bandage and next thing I knew Dr. Flynn came out and asked if I'd seen the seroma lately.  I said that I'd been peeking at it but that it was hard to get a good look or perpective while it's in the bandage.  He said that it was pretty small and that he didn't think that they could get the bandage tight enough to put enough pressure on it.  He thought it would be a better idea to get Winston moving so that the lymphatic fluids can do their thing (my words, not his).  I know that Winston would rather be walking than laying around in a bandage so this sounded good to me.  Dr Flynn thought they were putting a new bandage on so he went back to see.  He said if it was already on, I could take it off in a day or two.

A few minutes later he came back out with an unbandaged Winston.  The seroma does look smaller.  I felt it and it feels totally different than it did last week.  It's all firm and lumpy with no thin patches that feel like I could poke a finger into it.  HOORAY!

We went for a five minute walk as soon as we got home.  I also let him try going up the stairs.  No problems there.  Later on he had no problems going back down (that's the scary part), so I decided to move him upstairs permanently.  I moved his bed up there and both dogs settled in a circle around his bed like yin and yang.  I tried to get a picture, but by the time I got the camera, Winston sat up and watched our neighbor walk her dog by.  It's a happy picture anyway.

December 21, 2009: Day 19 -- It's going to be a long week...

Today was the longest day ever..... I worked downstairs next to Winston's pen so that he doesn't have to have the e-collar on and all he's done all day long is pace and pant and push at the pen.  Occasionally he's played with a toy, but mostly he's just been telling me over and over how much he wants to be OUT OF HERE. 

The bandage hasn't moved any farther down and the top part is above the seroma, so I think we can wait until tomorrow before we think about a bandage change.  I triple bagged his foot and took them out for a short walk.  It's the first we've done besides potty breaks since the bandage went on.  By the time we got back, the outer bag was totally worn through and the middle bag had a bunch of holes, but the inner bag (a quart-sized freezer bag) had stayed whole.  What a process!

December 20, 2009: Day 18: Trying to keep the bandage another day

Winston has stayed pretty quiet today.  He hates having the e-collar on, but every time I take it off, he licks his toes and the bottom part of the bandage.  Ugh!  I spent most of the day in his pen with him again so that he can have the e-collar off.

The bandage has slipped a bit, but the stiffer upper edge is still above the seroma and whenever his leg is bent (most of the time), it's tight across the seroma so it seems as though the bandage will make it to tomorrow.  We're taking it day by day.  I doubt it will make it to Friday, but you never know.

December 19, 2009: Day 17, Bandage slipped

I set the alarm for every 3 hours last night but Winston was so restless that it never actually went off.  I'd hear Winston get up and thump around and I'd get up and check his toes and then reset the alarm for another 3 hours, and Winston would get me up again before it went off.  Needless to say that neither of us got much rest.  There was no change in his toes all night -- they stayed all snuggled together just like they were supposed to.  The lower part of the bandage also looks good and hasn't shifted at all.  The upper part of the bandage has fallen down his leg and the soft padded part has also curled over so that now I can see half of the seroma over the top of the bandage.  Obviously it's not doing what it was meant to do, so I called AMVS and asked them if I should bring him back.  They said that I should so we went back in for a bandage change.

They wrapped thick sticky tape around the upper part of the bandage.  It didn't seem to be sticking really well to his fur, but it definitely made the top edge of the bandage a lot stiffer and taller than the first bandage.  As soon as we got home, I encouraged Winston to lie down and I brought a book and my Crazy Creek chair into his pen.  Every time he started to get up, I'd tell him to lie down.  Less movement = less bandage slippage.  Eventually he got the hint and went to sleep.  I read for awhile (Dan Brown's "The Lost Symbol") but found myself nodding.  Eventually I grabbed a huge throw pillow and lay down next to him and napped a bit as well. 

He's much quieter today and seems to finally get that he's not going to be walking while he's got this thing on his leg.  The only time he got up was to go out for potty breaks.  He's even been eating while lying down.  I took a break from his pen in the evening and when I came back downstairs I found that he'd been licking and chewing on the bottom (around his toes) of the bandage.  I cut away the padding and wet edges and put his donut on, hoping that would be enough to keep him from trying that again.  No such luck.  I heard licking pretty soon afterward.  That's probably the only time I appreciate Mastiff jowls; there's definitely some noise when they open their mouth and the sounds of licking carries up into the living room.  Busted!  We broke the big cone e-collar back out again and now he's got that on.  He hates it.

December 18, 2009: Day 16, Physical Therapy and back in a bandage

Winston's attitude is great and he's happy to be walking.  I had to go to the office yesterday so Don watched the pups in the morning and my mom came to sit with her "granddoggers" as she calls them.  Winston didn't get a walk until I got home, but by the time we went to bed, he got three walks so we're still right on schedule. 

When I got home yesterday it seemed as if his seroma was slightly larger than it has been.  It's so hard to tell when you look at the thing every day.  That's why I end up taking a lot of pictures so that I can compare pictures to each other.  It also looks different when he's standing up than it does when he's lying down.  Best to compare it when he's standing up.  Anyway, when I did the hot compresses for the rest of the day, it seemed as though there was a real thin spot in his skin.  It almost felt like I could push my finger right through it if I tried. 

Today we went in for physical therapy and the therapist also noticed the thin spot and she wanted to have the surgeons look at it.  After our therapy session we saw Dr. Duerr and he thought that they should bandage the leg to put pressure on the seroma and give the tissues a chance to seal.  They put the full-leg bandage on and I'm supposed to watch it closely for either slippage where his toes get covered or separation of the two middle toes which would indicate swelling.  I'll be setting the alarm tonight so that I can check on him every few hours.  If I see either swelling or slipping, I'm supposed to take the bandage off and call them (and we'll probably get a new bandage put on).  If all goes well, they'd like to see the bandage stay on for a week.  I doubt we'll make it that long before we'll have to go in for a change just because it gets all bunched up, but we'll sure try. 

December 16, 2009, Day 14 - We're walking again!

Today we started our walks.  For the next two weeks we will walk 2-4 times per day and 5 minutes per walk.  Both pups are really excited to start walking together again, but can't understand why we're turning around so soon.  Winston is walking on his leg better than he was before his surgery and when I told him that was as far as we're going he gave me a look like, "My leg feels better now than when we used to walk around the block... how come we have to go back?"  We walked 4 times and he seems ready for more.

We stopped giving him pain pills yesterday and he seems fine.  I would rather have him be a little bit sore so that he's more careful, but so far I can't tell whether he even feels sore.  Yesterday he came upstairs twice and we had to scold both dogs because Josie was trying to instigate a play session.  She did the puppy tail tuck and started running around the living room and kitchen trying to get him to chase her.  Uh... there's not enough room for two mastiffs to race around any part of our house, nevermind his leg.  Luckily Don was petting Winston while Josie started this so he held on and kept Winston from following.  We told Josie "No" a couple of times and finally she settled down.

Today Winston has come upstairs 3 times in addition to his 4 walks.  He's chewing on chew bones and wandering around the living room to check out all those smells that he didn't get to smell for the past two weeks.  He's also able to get onto the couch which he hasn't been able to do very easily since October.  We let him on the couch because he's big enough to be able to just step sideways off of it.  We don't let him on any beds because he will jump off of them.

The seroma is still there.  It seems like it gets smaller overnight and then as the day goes on it gets a little bigger, but it's still no bigger than it has been.  I'll keep hoping for the best.

December 15, 2009: Day 13, staples out

We took Winston to AMVS to have his staples (and stitch) removed and for his 2 week check.  He was scared to be there, but handled it fairly well.  There was some big dog shivering going on.  Poor guy!

Yesterday morning Winston's seroma was nearly gone, but by the time he went to bed, it was larger again.  I did the hot compress thing again last night.  This morning it was down a little, but definitely still there.  When Dr. Flynn brought him back to us after they removed the staples, he asked me about it.  I told him what I've been seeing.  He said that it might be joint fluid leaking from the bone tunnels, and that the incision might open up, and if it does, they can do something about it otherwise they just want to leave it alone because they don't want to risk introducing an infection.  Hmmmmm...... Definitely not what I wanted to hear.  For now, he said to keep doing the compresses and keep watching it.  Now I get to worry worry worry again.  If I think about it too much, I get a bad feeling in the pit of my stomach.  UGH!  I'll keep doing the compresses and hope for the best (and try not to think too much about it).

December 14, 2009: 12 days post-TPLO

The seroma on the outside of Winston's leg is mostly gone today.  He's continuing to do better and walking better on the leg when we go out to go potty.  He's definitely ready to start his PT.  Today after he went out for his late morning potty break, I let him try going upstairs to see if he was interested.  He was and actually went up them pretty easily.  Going up is usually harder than going down because he can go down them on three legs.  He just ate lunch and seems like he's going to settle in for a long nap. Once he goes back downstairs, I'll leave him there, I don't want to do the stairs too often at this early stage.

Tomorrow we go get the staples out.  It's a big milestone, but he's got enough scabs still that he'll have to continue wearing the donut until they all fall off.

December 13, 2009, 11 days post TPLO

Today it looks to me like the redness on the inside of Winston's leg is gone.  He's not cooperative about letting me look, so I have to try and sneak peeks as he's walking around on potty breaks.  He switches off lying on one side or the other and I keep hoping that when he's lying on his left leg, I'll be able to look at the inside of it, but no... he keeps it tucked way up under himself.  I finally asked him to sit and pushed him around a little so that his leg was sticking out like a bat wing and I grabbed the camera so that I can compare photos.  The lighting isn't great at this time of day.  Just got it uploaded, and you can see for yourself there's no more redness.  HOORAY!

His attitude is better.  Meaning that he's more active and there are no signs that he's not feeling well.  He's standing up quite a bit to look out the front door and to push at the pen with his nose to let me know that he's tired of being in it.  He's chewing on his nylabones (he has a chicken flavor and a beef flavor one) and he's been squeezing the heck out of his tennis ball.  So far it's intact, but that's only a matter of time before it breaks in half.  We buy a cheap bag of them every once in awhile since he breaks them in half pretty regularly.  He's bored and letting me know it, but there's not much we can do about it yet.  I just have to pet him or talk to him and distract him.  Not much longer before we get to start walking and I think we'll get to carefully take him upstairs.

December 12, 2009: 10 days post TPLO

There's no real change in Winston's leg from yesterday.  I've been using hot compresses on both sides of it.  Winston doesn't mind this on the outside, but is unhappy about me doing this on the inside area where the little reddish patch is.  I was talking to my mom about having to do this.  Ok, I'll be honest -- I think I was whining a little bit and how it didn't seem to make any difference last year.  My mom said, "But you don't know that it didn't make any difference.  If you hadn't done it, you don't know what might have happened."  Hmmmm... my mom is a wise woman.  So.  I'm continuing with the compresses even if there's no obvious difference this year too.

His attitude is the same or possibly better.  He's been standing up to eat for several days now, and prior to yesterday he would remain lying down until I actually put his food dish down in the plant stand that we use to raise the food dish off the floor.  Then he'd get up and eat.  Last night when I came downstairs he was already standing up waiting for me.  Same for breakfast and lunch today.  His leg must feel better for this change.  Hooray!

December 11, 2009: 9 days post-TPLO, Deja vu -- it's a seroma!

I just realized that it was 9 days after Winston's Tightrope surgery on this leg that he developed a seroma.  Today is 9 days after the Tightrope implant was removed and he's definitely developed a seroma.  It's smaller (so far) than the one last year (see December 10, 2008 photo).  So far it's not worrying me too much because the skin color looks good and it's not that big.

On the other hand, I am a little worried about a spot on the inside of his leg near the TPLO incision.  It feels like a little fluid pocket too, and it's red  I don't remember there being a red area before today, but I also couldn't swear that there wasn't.  I took a picture of the incision on the 9th, but that part of his leg is in shadow, so I have nothing to compare it to.  I'll have to compare today's picture with how it looks tomorrow.

I called AMVS to see what they think and they said that I should try warm compresses and watch for any changes for the worse.  Unfortunately I've been through that scenario already so I know mostly what to look for, but if something new pops up or I'm just not sure, or I've got questions, I don't hesitate to call them.   They're open 24x7 so I can take him in anytime if I need to.  They also want me to call them back on Monday with a status if everything stays the same or gets better.

So... what are the signs of a change for the worse you ask?  I check for skin color changes and wound seepage and whether it feels like the area is hot.  If it feels hotter (or I'm just not sure), I'll take his temperature -- he just loves that (kidding!).  Every dog is different, but Winston's attitude is one of the first things to change, so I've found that to be the most important thing to pay attention to.  When he doesn't feel good he won't eat, or he won't stand up to eat (hmmm.... I guess we all like being served a meal in bed when we're sick, don't we?), and he won't play with his toys. Some dogs will be more restless or lethargic too, but that doesn't seem to apply to Winston; his restlessness or lethary all seems to be centered around the time of day and what he thinks should be happening at that time.  He does like to stick to his schedule. 

As far as doing warm compresses, it's really important to keep the leg dry and clean, so I soak a thick washcloth in really hot water and then put it inside a gallon-size ziploc bag.  Then I wipe the outside of the ziploc bag off so that there's no moisture on it.  Then I put that onto the seroma until the washcloth cools down.  Winston doesn't always like me doing this, so sometimes I just have to tell him that it's happening whether he likes it or not.  Last year I did the compresses several times a day for a week and there was no change to the seroma, so I figured I'd just have to live with the lump until it disappeared.  It did eventually go away on its own.

December 10, 2009: 8 days post-TPLO, boredom sets in!

The good thing for today is that we could finally stretch the tramadol to every 8 hours without appearing to affect how Winston feels.  This is great for me since now I don't have to get up to give him pills between 10pm and 6am.  The bad thing for today is that Winston is REALLY bored, no matter what I've done to entertain him.  He's tired of being in his pen and he wants to walk.  He doesn't care about any of the toys, and even the tennis ball (usually a favorite because he squeezes them until they burst in half) only held his interest for a few minutes at a time.  He's been very whiny and has kind of an attitude.  He's even been pushing at the pen with his nose.  Mastiffs do this short sharp poke with their nose if they think you're not moving along fast enough ("get going" is what they're saying).  He's doing it to the pen today, "Take this thing down and let me upstairs."

Josie is even bored today and has been whining at the door.  I'm going to change into some warmer clothes and we'll see if we can sneak out and take a short walk.  That only helps her, and not Winston. :(

December 9, 2009: 7 days post-TPLO

Yesterday Winston was walking almost normally when we went out for potty breaks, and I thought it seemed almost too good to be true.  Today he's limping again, but hey, it was 16 degrees below zero this morning so even Josie said that her feet were freezing off.  She ran out and peed and ran back to the door and hopped from foot to foot saying HURRY HURRY HURRY to us.  Winston, on the other hand, stretched the time out as long as he could because he is bored in his pen.  He peed then went to the far corner of the yard to think about pooping.  Then got distracted.  Then started to wander so I told him we were going to go back inside which put him back into the, "oh but I have to poop" mode.  So he searched again for just the perfect spot and started to circle.  Then got distracted again.  We headed back toward the house 3 times before he finally found the perfect spot and assumed the position.

I'm doing range of motion and "bicycling" exercises with his leg.  He's not overly happy about them, but at the same time, doesn't seem too concerned about them either.  His leg feels pretty stiff when I try to stretch it out.  I'll have to do some more work on that.

I think that Winston has also permanently graduated from the cone of shame to the donut e-collar.  Yesterday Don put the donut on him after he went out at 7pm  for a potty break.  Winston went to sleep and stayed asleep longer than I expected.  I woke him at 10pm to give him his antibiotics and then at 11pm to give him his tramadol.  He woke me up at 3:30 this morning needing to go out.  After we got back inside, I attempted to put the cone on him (seems like it would be more comfortable to sleep in than the donut) but he kept ducking his head to avoid it.  I put the donut back on and we all went back to sleep until 6am.  The donut makes me a little nervous because I know that he can still get to his incisions if he really wanted to, but so far he hasn't showed the slightest interest.  I spend each day working down here so that he can have company and no e-collar, and he's never even sniffed at his leg.

Today we were out for our afternoon potty break and I saw how Josie was with Winston, I realized that the really sad part in all of this is that all the animals seem to think this is normal: every few months Winston has some kind of surgery and we all have to do/not do these things or act this way....

I sure can't wait for the day that this isn't normal and it's all some distant memory for all of us.  I have a good feeling about this surgery.  It's the same good feeling that I had with the last TPLO.

December 8, 2009: 6 days post-TPLO

How quickly things change! The little swollen patch on the outer incision that I thought was turning into a seroma yesterday is pretty much gone today, probably because even more of the swelling in the leg is gone. You can see some definition around his hock in the lower picture. There is still a little bulb of fluid on the back of the callus on the hock itself. It jiggles when he walks.

I went back to pain pills every 6 hours since stretching it to 8 hours didn't work yesterday. I did reduce the number of pills from 6 to 5, and that seems to be just fine. Winston is less restless and seems more comfortable today. It's all trial and error.

December 7, 2009: 5 days post TPLO

Winston is doing great so far. He has been standing to eat and drink as of yesterday and he wants to go out a lot more than he is allowed. He keeps standing up and trying to convince us that he really needs to go potty, but then doesn't do anything other than walk around and eat snow. There are times that I can't really blame him. If he's got the cone of shame on, he can't reach the bucket to get a drink. I'm trying to stay near him so that I can leave everything off of him so he can get a drink whenever he needs to. When I leave the house or go to sleep, he gets the cone of shame, and when I run to somewhere else in the house, I've been putting the inflatable donut collar on.

The swelling in his leg has gone down a lot, but now that it's gone down, I can see that he's got a slight seroma (or at least I'm going to assume it's a seroma for now) directly where the tightrope used to be. When we picked him up, they told me that incision was draining A LOT (more than they expected by the way they said it). Once the incision sealed up, there's no where for that fluid to go so it makes sense that he might get a seroma. He doesn't seem to mind me touching it, and it's pretty squishy just like the leg around it, so maybe it's still just part of all of the swelling that he's had. The tissue around the incision looks good and is a nice healthy color and the little bump out is not as large as the last seroma that he got on this same leg with the Tightrope procedure (see December 10, 2008 for a picture). I'm going to keep watching it closely as well as his attitude. If it gets larger I'll try hot compresses, but so far I'm just in the watch state rather than the total worry state :)

December 5, 2009, 3 days post-TPLO

Winston got me up at 3:30 this morning to go out and go potty and we've all been up ever since. I see a nap in my future. Winston's leg seems a little less swollen around the knee area but about the same in the hock area. He wasn't as happy today when I tried to ice his leg as he was yesterday. I think I managed only 5 minutes before he stood up. He definitely feels better because he has grabbed a Nylabone to chew on a couple of times already this morning and he is finding it easier to stand up. The standing up part isn't so good; he wants to go outside every time he stands up but I'm not letting him. He's gone potty twice since 3:30 (though no poop yet this morning which I know will need to happen sometime), but last time he convinced me that he needed to go out he just went out and ate snow and stared at our neighbor who is out doing something on his ATV again. Now every time Winston stands up I just tell him to lie down. I figure he'll whine at me if he's really serious. He's been trying the sad eyes so far and I'm not falling for it. I don't think he's figured out yet that if he whines I will take him out. Up to this point the only time he whines is when he REALLY needs to go bad.

I'm enjoying spending time in his room with him these days because we finished the remodel from the floor up in this room. The popcorn on the ceiling is gone, the drywall repairs are done, the walls and ceiling have been re-textured and painted, and all the new doors are in and the casing is up and the new light, and switch/outlet covers are all installed. I'm toying with the idea of putting up crown molding, but we've only got 8 foot ceilings, so I'm still debating. I got a short piece of molding to see how it would look and I think it will be ok. Anyway, as long as I don't look down, it's really nice to be in here. Too bad about the floors because we've got a heat mat that will go under the slate once everything is installed. Winston would have had a nice toasty place to lie down. The new flooring in this room has to wait until it's safe for everyone to go down the deck stairs since that's the only other exit from the house.

December 4, 2009, 1st Full Day Home

Winston did great overnight. He went out at 8pm and peed and pooped (hooray!) and then slept through the night until 5am when he needed to go out to pee again. I wish I could say the same for me. I slept on the couch at the top of the stairs so that I could hear him and every time I heard him I got up to see if he'd gotten up. He was only shifting in his sleep. By the time I felt exhausted and tried to really fall asleep myself Josie would thump her tail on the floor at my slightest move. I must have fallen asleep around 4am so I nearly slept through the 5am alarm but Josie got me up (good girl!).

When he went out for his potty break, his leg didn't leak at all so I think maybe we're beyond that now. I lay down again until 6am when he had more pills due and also breakfast. He wanted to go out to go potty again before I actually got him his breakfast and it was probably a good thing. He peed and pooped, but this time it was a bit loose. I decided not to include any canned food with breakfast and see how he did with his regular kibble with a bit of water and Flexicose. He ate it just like normal. I guess I should mention that he is still eating lying down. He had some water afterwards and I watched the weather report on the news (it was 2 degrees when we went out at 6am) and then went back to sleep.

When I got up, I iced his leg. Yesterday he didn't want me near it, but today he said, "Ah, that feels pretty good." It's definitely more swollen today and a bit bruised and when he stands up there's a little bit of fluid around his hock, but this is all normal. At 11am he wanted to go out again and peed. At 11:30 he wanted to go out again. I don't think he needed to go potty so I tried to get him to lie back down but he kept getting up. Finally he went over to the corner and drank some water from the bucket. I have a bucket in the corner so that he can drink standing up, but I also keep a bowl with water in it nearby so that I can offer it to him while he's lying down. Once he finished drinking, he remained standing up, so I figured maybe he wanted to eat lunch standing up. We were a little early, but not that bad, so I got his food and as soon as he saw it he sat down on his bed. I put it on the edge of the bed and ran back upstairs to feed the cat who was screaming at me that I'd forgotten him (he's old and getting a bit senile).

When I came back Winston was lying down and hadn't touched his food. It was cold by then, but I offered him some in my hand and he ate it. I kept trying to get him to eat from the bowl himself but he'd just put his head down so I ended up feeding him the entire bowl by hand and he ate it all. I figured I'd have to give the few pieces left to Josie when he suddenly decided that he'd lick the bowl by himself afterall. Not sure if it's because he doesn't feel good or he was hoping for more canned food. We'll find out at dinner.

After feeding them I put the e-collar back on and tried to grab myself some lunch. He whined a few times while I was upstairs but I couldn't see him so I figured he was still lying down. Once I headed back downstairs to him I found him standing up and whining again. He wanted to go out again. It had been an hour so I took him back out and he peed again and ate some snow. He was pretty restless when we got back inside, but since then has settled back down.

December 3, 2009, Home again

I met Don at AMVS at 11:30 this morning to pick Winston up. They went over his discharges with us and then Dr. Flynn came and talked to us for awhile. He didn't give us the angle of the correction (he said he'd leave that for Dr. Duerr), but said that it was better than the TPLO on the right leg. There was no damage to the meniscus (hooray!) but unfortunately there is significant arthritis in this knee now. We will have to keep him on joint supplements for the rest of his life. We have been using a product called Flexicose which is a grape flavored liquid that we add to his food each morning. It's worked out really well for us because we're big on convenience. Also his cranial cruciate ligament (CCL) was now completely ruptured, so sometime in the past year (at Abilene?) he tore it the rest of the way through even with the Tightrope in place.

We've been through this enough that I didn't have many questions, but the one that occurred to me last night was to ask about the bone breaking around the TPLO plate and if we need to worry about that in the future once Winston gets back to normal. He's a pretty active guy, so I wondered if we'd have to be really super careful with him for the rest of his life. Dr. Flynn said that usually happens if the post surgery recovery instructions aren't followed to the letter and the dog is allowed to be too active too soon. Once he's fully healed up it shouldn't be a risk any more than breaking a bone on his own. No worries there, we've got lots of practice going slow and keeping him contained. Dr. Flynn asked us if he had been dribbly with urine for his previous surgeries, and the answer is, "yes" (poor guy). Dr. Flynn said that they had expressed Winston's bladder so that hopefully he wouldn't be as bad for us when he went home. Guess he made a mess there?

Once we finished talking to Dr. Flynn, they brought Winston to us from the back. He had the huge satellite e-collar on and you could tell that he still hates it. "I do not like the cone of shame" is a perfect line from the movie "Up"! Obviously whoever wrote that has experience with the cone of shame. He's already walking on the leg better than he was two days ago and didn't seem to mind the sling. I backed the car up to the door since there was a nice patch of ice right under the hatch and Don and the nurse Joshua team lifted him up into the car.

By the time we got home, he was doing that moan whine thing like he had to poop. We got him unloaded and headed to the back yard with the sling. Nope, he had to pee REALLY BAD. He peed and then started back to the house, then turned around and paced a little. I thought he was going to squat, but instead he peed again. We headed back to the house only to turn around and he peed a third time. I was pretty eager to get him into the house by that time because it was only 17 degrees out and I think he walked too much. His leg was bleeding from the TPLO side and draining clear fluid from the Tightrope side (where they'd removed the fiber tape and the lower toggle).

I fed him a small meal for lunch, which he ate and he slept for a few hours before needing to pee again. He settled back down on his bed and I iced his leg (wasn't too happy about that this time but he let me). He was falling asleep and would start to roll to the side and then jerk himself upright every few minutes, so I finally put the cone of shame back on and went upstairs so that he'd have total quiet for awhile.

He got up when Don came home, and got some hugs and pets before dinner. I fed him another small meal with some canned food in it. He ate it all and then drank some water and then velcroed himself to my lap while I pet him. He felt a bit cold. His back half felt normal but his ears and front legs were a little cold. I turned up the space heater that's in his room and Don went downstairs and started a fire. Pretty soon the room was toasty and Winston felt normal again.

December 2, 2009: Second TPLO Surgery

I was scheduled to drop Winston off at 9:00am for surgery. This is different than in the past. Before it wasn't a big deal to get up and get going instead of feeding them breakfast. It was pretty bad this morning to wake up to sad puppy eyes wondering where the food was. I was going to work until 8:30 when we had to load him up and get going, but I didn't think I could stand to have them looking at me for 2 hours. Plan B -- go out for breakfast so we didn't have to be home and see the sad puppy eyes.

Of course the weather decided to do winter today so it's cold and snowy and icy. We made it to breakfast and back and then had to load Winston up. He knew something bad was up because he refused to go up the ramp and I was on an ice spot so as he pulled back, he was pushing me backwards. Luckily Don was at his front end and we got him up into the car without too much hassle. I drove him to AMVS and got him unloaded by myself since Don had to head to a job site. Surprisingly Winston was willing to go into the building even though he saw the huge satellite dish e-collar that I was carrying. They got me checked in and I chose DNR again, but told Winston that I had chosen it last time and it hadn't jinxed him so I expected the same outcome please.

I went back home and set up Winston's room so that it will be ready for him when he gets home tomorrow. I could practically see a light bulb go off over Josie's head when I moved Winston's bed downstairs and started adding layers of blankets and sheets to it (protection against leaky dribbly issues). Then I "went to work" -- luckily the stuff I'm doing right now takes all of my concentration, so the day went pretty fast until 3 when I normally get off. I hadn't heard from AMVS yet, so I watched the minutes tick by very slowly even though I was trying to work. Ugh!
Finally at about 3:20 I got the call I'd been hoping for. Winston did really well in surgery and was recovering from the anesthesia. I asked Dr. Duerr what had happened to the Tightrope, and he said that it was just loose; the bone tunnels were a little enlarged, but other than that everything looked like it should (the knot was tight, the toggles were where they should be, etc.). He removed the fiber tape and the lower toggle, but left the small toggle on the femur in place just like last time. I was so interested in hearing about the Tightrope that I forgot to ask more about the TPLO, so I'll have to do that tomorrow when we go get Winston.

Once Don got home from work, we headed to PetSmart for Greenies Pill Pockets (these are absolutely necessary in my opinion) and some small cans of dog food in case I need to tempt him to eat.

Tightrope Failure Confirmed

I took Winston to AMVS this morning to get his leg checked out. We got there a little early so quite a few of the folks there got to visit with him while we waited in the lobby. One of the nice things about having a very large dog is that he can have some treats without having to worry too much about his figure. He wasn't happy about being there, but he was happy to see everyone that visited with him. He gave out a few big wet kisses, some of which included cookie crumbs -- eeeeeeeeeeeeeeewwwwwwwwwwwwwww!

They took x-rays and performed an exam. The x-rays look fine, in fact Dr. Duerr said that if there was a textbook picture of a successful Tightrope repair, we were looking at it in Winston's x-rays. The bone tunnels look fine and normal and the toggles are at the end of the tunnels just like they should be. It will be interesting to hear what has happened to the fiber tape.

Despite the way the x-rays looked, the exam confirmed that his left knee is unstable. Luckily his arthritis hasn't progressed too much, so I guess that was the good news in all of this. They also agreed with me that his right leg looks bigger and almost back to "normal" -- tomorrow will be 6 months from his TPLO surgery on that leg. The recommendation for his left leg is also a TPLO (as I suspected). They were willing to work with us on cost since we've been through so much with them. Have I mentioned lately that I love these guys?

Since cost was our biggest concern and that is (hopefully) going to be manageable, we're going to go ahead with the TPLO repair. It may not turn out perfectly but hopefully he'll get a chance to play and have some quality of life. I don't have any good reason to wait, so we scheduled it for tomorrow which will be one year to the day from the Tightrope repair on the same leg.

Stay tuned....