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....

Tightrope repair failure?

I've been off line for awhile because we went on vacation and some home improvements have been taking my off-work time.

For our vacation, we decided to take a camper trip to Texas. It wasn't quite what our Hawaii cruise would have been, but it was warm and not that far away, and best of all we could take the dogs. For the most part it was relaxing and what we could afford.

Winston seemed to be recovering from his 3-legged incident and was able to walk and stopped limping. The first stop on our vacation was an overnight stop at Torrie Lake State Park in New Mexico. This was Josie's first camping trip, so we didn't want to drive too far each day until we were sure that she was ok with all the driving. Once we got settled, both dogs were eager to get walking out to the lake. It's pretty dried up, but the setting was much nicer than stopping at a KOA. The Sandhill cranes were migrating, so we got to hear them flying nearby as the sun set and then again the next morning.

We drove to Bottomless Lakes State Park in New Mexico the next day and got to spend a good part of the day there. The lake right at the campground has very clear water and the visitors center was closed, so both dogs were able to walk up to their bellies in the water and try to catch the little fish that came too close. It was nice to relax and just take them for walks every few hours.

The next day we drove on to one of our favorite parks in Texas: Davis Mountains State Park. We didn't plan ahead and get tickets to the star party at McDonald Observatory, but our Texas state park pass doesn't expire until next summer, so maybe we'll go back in the spring and do that. There are javalina and deer there, which makes things a little interestng with the dogs. Our dogs sure wanted to "get those critters" but were willing to behave. We walked them on a few of the trails, and they were both happy. By this time camping seemed like something Josie has done all her life, and Winston has done it all of his life, so he was happy to get back to "normal". We stayed for a few days at the park and while we were there, we heard that the Mexican government was opening the flood gates to Lake Amistad (our next destination) because of the hurricane so all the campers who had been near there had moved farther away. We decided to change our plans and start heading more north.

We drove to Abilene State Park next which I'd never been to. It's beautiful. It's also very close to Abilene and an Air Force base, so you have to be prepared for jets flying low overhead. We didn't mind -- I got some nice pictures of an F18 coming in for a landing. We decided to stay for a couple more days. Since it was off season we pretty much had the place to ourselves and it was nice to go hiking with the dogs on the trails there. Near the pool there is an area that is nearly fenced in, it just has a single opening instead of a gate, so we decided to let the dogs off the leash and I'd guard the opening so they couldn't get out. They both ran, and suddenly Winston's left leg (the tightrope side) collapsed and bent in such a way that it interferred with his TPLO leg which caused him to fall. He got back up and then lay down again. After resting a few minutes he got back up and when he walked he definitely had a limp, but was putting weight on the left leg so we got him back to the camper and gave him some Trammadol. By nightfall he wasn't putting any weight on it.

I hoped that it would be like the last time and after a few days he'd be back to normal. Josie and I walked for the rest of the trip, but Winston was restricted to very short potty strolls only. On our way home, we stayed at Copper Breaks State Park, Caprock Canyons State Park and finally Palo Duro Canyon State Park. Winston's right leg (TPLO) seems fine and he's actually learning to depend on it more which up to this point he hadn't since it has been his problem leg. When I compare the size of each back leg, his left leg is now more atrophied than the right leg, so the TPLO repair seems like it's been more successful than the Tightrope.

When we got home, I was a little concerned about our stairs, but Winston managed them just fine. He was slow going up but went down them on 3 legs at first. Now he is starting to put a bit of weight on the left hind leg, and he's walking on it again but has a significant limp. He also seems to be ok without any pain medication, but that could change as time goes by if the knee is unstable. He is bending it normally and we don't see any of the "sitting with the leg straight out" behavior like we did before either of his surgeries. Before we got home, we decided the best course of action was to start the recovery process over. He's got no off-leash privileges and he was restricted to potty walks for 2 weeks and then we'll increase the walking time by 5 minutes every 2 weeks if it seems possible (so far so good with that).

We need to take him back to AMVS and find out what's happened to the tightrope repair. We've been going through a lot of "what if" scenarios. We don't know what we'll do. I think that's why I haven't already taken him in. I'm also going through some of those "I wish" scenarios. I wish I'd just done the TPLO repairs in the first place. I am also feeling guilty for making a bad decision that Winston has to suffer from. Sigh...

Three-legged dog for a day

Friday evening Winston seemed very sore on his left (the tightrope side) hind leg. By late night he was only toe touching. The temperature outside had dropped dramatically (down to 15 according to our digital weather station), so we figured the soreness was due to the change in the weather since that always seems to affect him. We put the baby-gate up across the stairs and decided to watch him to see if he got better in the morning.

Saturday morning he struggled to get off the bed and ended up going off like "super dog" (back legs stretched out behind him) and didn't walk on his left hind leg at all. I had to support him as he went down the stairs. He's not used to depending on his right hind leg (the TPLO side). We went outside to go potty on the leash and when he came back in he refused to go up the stairs. I brought a bed down to the entryway so that he could get comfortable. I gave him some trammadol left over from his surgery and he ate breafast lying down. Josie had a 7:00am appointment with Dr. Courtley, our regular vet, so she and I left for the appointment and we talked about Winston's situation. He's not an orthopedic surgeon, so he suggested waiting until Monday to see the specialist. That's exactly what I was thinking.... if we took him in, no matter where we went, we would be told to go back to the surgeon.

When we got home, I took his temperature (I'm always concerned about an infection with the tightrope...) my thermometer isn't digital, so I'm not sure of the exact temp but it was around 101.1 or 101.2. No fever. Hooray!

Winston rested all day, eating lunch lying down. I gave him trammadol at 2pm and then again at 10pm. It seemed to help because by evening he wanted to go upstairs to eat dinner (standing up) and by bedtime he was walking on the leg again though with a significant limp.

This morning he is still walking on it, and he isn't struggling as much to stand up today either. It's possible that he strained it playing in the yard on Friday and we just need to take it easy for a few days. Now that he's getting around better I'm debating the need to take him in for a check, so we'll wait another day or two and see how it goes.

If I could go back in time and do things over knowing what I know now, we would have done TPLOs in both legs instead of trying the tightrope procedure. That's just us with a huge dog.