Tightrope repair?

I found information on a relatively new CCL repair procedure called a Tightrope. It sounds like it's hard to find surgeons who do it though, so we might have to travel somewhere to get it done.

I called AMVS to find out if they knew of this procedure. It turns out that they do it, but have never done it for a dog as large as Winston. They contacted Dr. Cook to get his recommendation for a dog Winston's size. He said that there should be no issue at all.

I heard/read somewhere (can't remember the source, so take this with a grain of salt) that the fiber tape was strong enough to tow a volkswagon beetle.

I really like the idea of NOT cutting the end of a bone off and then bolting it back on in a different position. Merely drilling some holes through the bone seems like a much better option to me. The main problem that the surgeon had was that there is no long-term data available for tightrope repairs. I'm gambling that everything will turn out ok. I'm willing to take that risk and hope for the best outcome.

We set a pre-op appointment where they took x-rays and drew blood to make sure that Winston didn't have any other health problems that might cause us to change our minds about doing surgery. Everything checked out fine.

I've ordered an exercise pen and an orthpedic bed, a sling and an inflatable e-collar from Drs Foster and Smith. They should be here within a week.

Winston's first Tightrope surgery is scheduled for December 2, 2008. His left leg is worse than his right leg, so we'll start with that one.

Once we got the sling and the e-collar, we made him wear the e-collar (aka "the donut") for a few hours at a time for several evenings. He was never happy to have it on, but he accepted that we put this weird thing on him and he started ignoring it pretty quickly. We live in a split-level house so once you come in the front door or the back door, you come into about a 10'x10' room. From there we have 7 steps to get up into the main part of the house or 7 steps to go downstairs to a family room and laundry. We figured we'd end up having to use a sling at some point to help him up and down the stairs. He has weighed as much as 210 pounds, but once he started having problems we worked on getting his weight down, and he's about 195 now. Even the back half of him is a lot to lift when he outweighs you! Anyway, we also did some practice "helping" him up and down the stairs with the sling before surgery. Again, he didn't like it much but since we weren't actually trying to pick his feet off the ground, he seemed to accept it.

Is TPLO the only option?

Don reminded me that we'd already paid for a long vacation (we'd booked a cruise from LA to Hawaii and had taken some time at each end of the trip) and that we had gotten travel insurance. He said he'd rather take care of Winston than go on vacation. Duh! Vacations are important to me, but I have to agree with him on this one. I cancelled the trip and filled out all the paperwork to get our money back. It was an easy process so I'd have to say that I'd use TravelGuard again.

I've been out on the internet reading all I can about TPLOs and other people's experiences with it. I found sites that recommended it, sites that said to stay away from it, more info that describes it, and some other blog sites where people wrote in great detail about their experiences. I'm pretty conservative so I really hoped that we could go the "conservative management" route where the knees will just heal on their own if you keep the dog quiet enough.

I was told that the sooner we did the surgery, the better since it would stop the progression of arthritis before too much damage was done, but that it didn't have to happen immediately so I had a little time. I tried to keep Winston quiet in October -- haha! He's such an active boy that didn't go over well at all. There's no way I could have ever keep him quiet enough for any real healing to happen, and even if it started to, he'd probably just re-injure it. I kept watching the insides of his legs for medial buttress formation. I thought I could see it starting, so I figured I'd better really get serious about surgery. Isn't there anything less invasive than the TPLO?

Winston's Diagnosis

Winston has been limping off and on for about a month now. It looks to me like it's his right front leg, but it's subtle. He's been having some pain issues off and on since May. We took him to our regular vet who couldn't find anything obviously wrong in an initial exam (we're both pretty conservative, so we didn't take any x-rays at that time). He prescribed Rimadyl and we decided to watch him.

Towards the end of the month we noticed that Winston was having a hard time standing up after sitting or lying down. A guest knocked over a chair and startled him and he was unable to get up in a hurry and ended up dragging himself across the room to get out of the way. I called my vet and he referred me to Aspen Meadow Veterinary Specialists for a diagnosis of the problem. Turns out that I was way off base -- he had partial cranial cruciate ligament tears in both back legs. He was trying to carry more of his weight with his front legs which is why it looked like he was limping with a front leg.

Dr. Duerr recommended that we do TPLOs on each of his legs to correct the problem. He got out a model and the plates and described the surgery in detail, but suggested that I do my research. A surgical nurse came in after I finished with the doctor to describe what to do to prepare for the surgery, what to expect when we dropped him off and then provided an estimate for the cost. I left there pretty much reeling... it was a lot to take in and I really needed to absorb it all. In all of our years of dog ownership, we've never had any sort of major vet bill and I'd never heard of torn cruciate ligaments. How could we possibly pay for this? Since Winston wasn't even 3 and other than these injuries he was healthy and happy, how could we not pay for this?

I went home and cried.