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!