April 30, 2009, our new reality

Winston is finally home and we don't see any surgeries in his immediate future. We're just working on trying to get him healthy again after his knee infection. He's here with his pegleg bandage.

He finds it hard to walk with because he can't bend the knee enough to keep from dragging it behind him. That looks awful and really uncomfortable. I try to use the sling to help him out, but that doesn't seem to work very well either because the only way for me to get the leg up off the ground is to totally lift his hind-end and he hates that.

I'm trying to feel his toes. I can barely even find his toes, and the only part of them that I can feel is the horny calloused bottoms of the two middle toes. Are they cold? It's hard for me to tell because I am usually cold these days so when my cold fingers are feeling the rough part of the two toes, I don't feel much difference. It doesn't feel warm to me. Is that cold? Or am I just "normal cold" and so is Winston. I (of course) worry about this, but decide that since they don't feel a lot different from my finger temperature that they're probably fine -- my fingers are fine and not ready to fall off.

He's eating today. He ate about a can and a half (those 5.5 oz Mighty Dog cans) of food for breakfast, so at lunchtime I thought I'd add a little kibble to it. I added about a quarter of a cup of kibble to a can of food and he ate it, but wouldn't eat any more. He did the same at dinner time, but then before bed he ate another can of food.

April 29, 2009, 12 weeks post-op

We dropped Winston off at AMVS again for what we hope is his last surgery for the infection in his knee joint. Later in the morning Dr. Trousdale called to say that they were unable to push fluid through the joint (he told me this is a sign of healing) and that he trimmed away the granulating tissue on the edges of the wound so that he had a good bleeding edge to sew together. After a wound has been open this long, I guess there are other concerns about whether all the layers will heal to each other and whether the wound will stay closed. He seemed pretty concerned, but since I don't have any experience with any of this, it's hard for me to really understand all that could happen. All I know is that if my vet is concerned, I should be too.

He said that the knee is still very unstable and that's probably how it is going to stay, but our first priority right now is to get him out of the woods with the infection before we worry about next steps. They'll be sending him home with antibiotics for 2 more weeks, so that he'll be on them for a full month, then we have to wait another two weeks to see if the infection comes back. At that time, we'll see where we're at.

We picked him up this evening and took him home with a "pegleg" bandage on his leg. It fully covered his leg from the tips of his toes (which did just peek out from the end) all the way up to cover most of his thigh. We got to watch Dr. Trousdale put it on, and I thought the process was pretty interesting. They want us to try and keep the bandage on for at least 3 days, and hopefully 5, but said that we could remove it if it got wet or really started to bunch up behind his knee. We're also supposed to feel his toes a few times a day and if they feel cold, we're supposed to remove the bandage. Don paid the final bill for today's care.

April 28, 2009, 12 weeks post-op

We picked Winston up this afternoon from AMVS. He's got a couple of extra meds to take because of the stomach irritation caused by the bandage. They said that he wasn't interested in food for them. Other than that he seems happier. I am resigned to the fact that this is going to hurt us for awhile financially, so I put Saturday through today's bill up to this point on my credit card.

He's not groggy from surgery and that's kind of a nice treat for us. He's got a huge satellite dish e-collar on when they bring him out and you can tell he just hates it. We get him loaded into the car with it and get him home. He pretty much just lays down with his head flat since he can't stand to have it bobbing around on the top of his head.

I went to find some food and took the e-collar off while I tried tempting him with it. He's willing to eat and eats an entire (tuna-sized) can of dog food. I opened a second one hoping that he'd eat that one too, but it's too much after not eating for so long. I'll try again later. I brought a crazy-creek chair into his pen so that I could sit in there and read next to him so he didn't have to have the e-collar on for awhile. He seemed happier. When I left, I put it back on him. This is the new reality for him.

I tried more food again later that night and he ate another whole can -- HOORAY!

April 27, 2009, 1 day short of 12 wks post-op, knee unstable again

We dropped Winston off at AMVS at 7:00am for his next surgery. I guess the silver lining for his lack of interest in food is that I don't have to feel guilty that he's hungry when we drop him off. Of course I still feel bad that he's going through this. Hopefully things will go well and they'll be able to close the wound today.

Winston is not normally a licker or a chewer on himself. We got lucky that he never did anything to himself with either of his tightrope surgeries. Towards the end of his 2-week e-collar stint on the second surgery, I watched him (with his donut e-collar on) reach around and nip at an itch on his leg "good" (left leg) right where the incision scar was. It was at that point that I realized that if he had been determined to get at his incisions, he could have done so despite having his donut on. My advice is to get the satellite dish style of e-collar.

They called in the afternoon to say that they were about to do his surgery and found him with no bandages on his leg. After looking around and asking around if someone had removed them, they figured that he'd eaten them. They took x-rays to confirm this (apparently there is something in the bandages that shows up on an x-ray) and luckily everything was still in his stomach so they'd be able to send a scope down his esophagus to pull them back out. There would be no charge for this and there would also be no charge for him to stay overnight at the hospital so they could watch him.

This is also a lesson to all of us... even when we think our dog is trustworthy (look what he's been through so far without ever doing anything like this), DON'T trust him. I have no doubt that AMVS will never trust another dog again and they'll ask that you bring your e-collar back with you each time. Since we were doing almost daily surgeries, I'd forgotten to bring it with me one time, and they'd told me that they had spares in the back. I got to the point where I just figured they would put one on him and stopped carrying it back and forth and Winston often had visitors while he was there, so they probably got to the point of trusting him since he was often being watched. That will teach us! Anyway, please don't hold it against them or think that they didn't provide excellent care, they did and they still do.

They called again when they finished his surgery to say that they'd been able to remove the bandage from his stomach and that they were still getting some gunk out of the fluid that they were flushing through his knee. They also said that they were still able to flush all 3 liters of fluid through the joint. I didn't understand the significance of this, but they explained that if it had healed enough, the fluid would be blocked from going into the joint, and would sort of "back up" or be really hard to push. Kind of like if you stuck a syringe into a piece of wood and then tried to push the plunger down. Either the fluid in the syringe would cause the needle to back out of the wood, or you wouldn't be able to push the plunger down at all. I guess that's what they're looking for when they determine if the infection has healed enough. So... we are going to skip surgery tomorrow, but we go get him then since they're keeping him overnight. And then we take him back again on Wednesday where hopefully they'll be able to finally close the wound.

Then... they had to tell us that today the joint wasn't stable anymore. I didn't know what that meant for long term prognosis. I asked if there was a chance that once his wound was closed up that the scar tissue would re-develop and hold everything together. I think I was grasping at straws. They had to tell me that there is a very small chance that will happen, but it's very unlikely that it will improve beyond what it is today.

April 26, 2009, 11.75 weeks post-op

The swelling is going down in Winston's leg. You can still see fluid around his hock in the top picture. The second picture shows where they removed the "big" toggle along with the lap sponge bandage doing it's thing. Notice how light colored the scar from the "middle incision" is now. The bottom picture shows how swollen his thigh still is, with the funny wrinkles across it where the skin is being pulled. It's hard to see in these pictures, but if you look closely, they show the little web of rubber bands holding the bandage in place.  Click on the picture to blow it up huge.

I tried him on food. He wasn't really that interested, but when I opened up one of those small cans of Mighty Dog and offered him a chunk of food covered in sauce he at least took it from me. YEAH!!! He took one more piece and then he was done. Well... ok, "sort of yeah". I try to feed him a couple of pieces of the canned food every couple of hours. He's not interested in more than that, but still... it's an improvement. He will also drink a little bit when I offer him water. I have to offer it to him because he does not stand up unless he has to go outside to pee.

No more accidents since the other day.