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Maddie's TPLO surgery
click on any image below for a larger version. |
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At one year old, Maddie was starting to have trouble
sitting up straight. She would throw her back legs out to the side and
sit on her hips. She also seemed to have some difficulty on long walks.
She would get tired very easily. We took her to the vet who said that
she could possibly have hip dysplasia but nothing could be certain without
x-rays. She suggested waiting to see how Maddie’s development continued.
At this same time, we lost one of our precious cats to diabetes and liver
disease. Within a short time the second cat went into kidney failure.
(We think it was related to the loss of his lifelong friend.) Needless
to say, Maddie’s “problem” was moved to the back burner. It took another
year to regulate the cat’s kidney issue. With the help of two kittens
to cheer him up, he seemed to be on track to recover. |
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At two year’s old, Maddie was very happy with the addition
of two kittens who would play all day and snuggle her at night. Maddie had always hated being outside by herself. She
would have preferred to be an indoor only dog. Her displeasure with the
outside seemed to be increasing and she was showing signs of stiffness
and less activity. After playing with another dog, Maddie would actually
drag her back legs and have difficulty getting up and down until she rested
for a day. These symptoms increased and Maddie was spending more and more
time inactive, resting on her bed. Throughout all of this, Maddie was
happy and playful in spurts. |
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In July of 2002, at age 2 ½ and 80 pounds, we returned
to the vet with Maddie’s symptoms. Maddie was prescribed Rimadyl and scheduled
for x-rays. Maddie’s x-rays showed that it was her knees not her hips
that were the problem. At this point we needed to see an orthopedic specialist.
In November, the specialist determined torn cruxiate ligaments in both
knees and recommended TPLO
surgery as soon as possible. |
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After learning about the cost ($2600 per knee) and the
rehabilitation time (16 weeks per knee), we determined that we were unable
to do it at the time so we took the opportunity to get a second opinion. In February, I took Maddie to UC Davis Veterinary
Hospital. The orthopedic specialist and his resident agreed that TPLO
was the best procedure to repair the damage done to Maddie’s knees. Again
they stressed that there was increasing damage done daily to the meniscus
and the surgery should be done as soon as possible. Maddie was developing
severe arthritis. We switched from Rimadyl to Deramaxx as an anti-inflammatory
because it seemed to be easier on her stomach. |
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We decided to schedule the first surgery for June. There
are not a lot of qualified doctors to do this surgery and we felt lucky
to have a qualified doctor in town. In
May, I called the veterinary hospital to set the surgery date. I was upset
to hear that the surgeon was leaving the practice and there was not a
replacement to do the surgery. I started searching for other options and
found that there would be a 2 month wait to get back into UC Davis. This
would not leave us able to complete the rehabilitation time before summer
vacation ended and I had to go back to teaching. Short of hiring someone
to sit with the dog and take her to the bathroom when needed, this was
not an option. We were extremely lucky that the surgeon was able to make
arrangements to go ahead and do Maddie’s surgeries. However, she would
not be available for any follow-up or emergencies. We would have other
veterinarians for this purpose. I would have preferred to work solely
with one doctor but it seemed that we had no options to keep to our time
frame. |
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The First Surgery |
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The first two weeks she tried to do as many “normal activities”
as possible. We were worried that she was too active and had to create
activities to entertain her and keep her still. She alternated days of
really wanting to be active and wandering around the family room with
days of just wanting to sleep at my feet. If I left the room, she would
pace until I returned. The goal was to keep her rested and as inactive
as possible. Maddie never whined or showed any signs of acute pain. She
did not take the pain medication. |
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On day 15, Maddie had the bandages and sutures removed. The doctor said that everything looked good and she was on track for recovery. She didn’t seem to have any interest in the suture area and hadn’t licked at all at the bandaged leg, so we were hoping to only use an e-collar when she was left alone or at night. The very next day she had rubbed open the whole suture area and was bleeding and oozing from her wounds. A trip to the emergency room later, they cleaned her up and put her back on antibiotics. The doctor also suggested Benadryl to help with the itchy skin near the suture site. The shaved hair was growing back and her skin was really dry. I gave her the Benadryl that night and immediately had zombie-dog. She was awake and resting but not moving. We also decided upon her wearing the e-collar all the time for at least a week. Again, Maddie alternated moments of activity with hours of deep sleep. She began having obvious muscle spasms in her right leg. They would stop as soon as I put my hand on her leg. This of course was causing her distress and she would only rest if she was near me. There were a few days of her pacing again if I left the room. |
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At 4 weeks, Maddie was walking almost normally. She did however seem to develop some ear difficulties as long as she was wearing the e-collar. I wiped out her ears every day. The suture line healed and we could finally remove the e-collar. Her ears got better within a few days. Maddie was still restricted to one room and only going outside on leash to go to the bathroom. Maddie however felt as if she should be able to return to all of her normal activities. It was getting hard to keep her quiet and confined. But, we didn't want to take any chances with her healing. We felt that this was the time to move on to the surgery on her left knee. We found out in the middle of week five that the surgeon that we had been counting on would not be able to return to the veterinary practice to perform the second surgery. We had to find a new doctor! We felt that we really were pushed by our timeline to have the worst part of the procedures done while I was home on summer vacation. Maddie was really hurting on her left because she had been favoring her right. And now we were starting over. I got recommendations from a couple of different veterinarians. I was lucky to talk to our original veterinarian about the credentials (and personalities) of a few doctors in the area that were qualified to do the surgery. In week 6, we had an appointment with a new surgeon. He looked over the right leg and agreed that she was making very good progress. He looked at the left leg and agreed that she was really bad off on that leg and needed surgery as soon as possible and lucky for Maddie, he had an opening that afternoon. Maddie had also developed a rash on her right leg and stomach. (We never did figure out where it came from). |
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Maddie's Left Leg The fourth week of July Maddie had TPLO surgery on her left knee. Again, she spent one night in the hospital. I picked her up the next afternoon. This surgeon did not use any bandaging and we noticed that this incision was a lot shorter and all stitches were internal dissolving stitches. Maddie came out of the back room at the vet's walking on all four legs. Within ten minutes, Maddie was holding her left leg up and doing a three legged hop to get around. I think that the bandaging on the other leg had prevented her from doing this hop after the first surgery. The doctor seemed to think that this was normal so we didn't make a big deal of it. Without bandaging, we also got to see the extent of the swelling. Her whole leg was swollen with the majority of the swelling residing at the ankle and for the first week and a half she continued to hold the leg up as she walked. Maddie had been switched to Baytril as an antibiotic and Torbutrol for pain. This doctor decided to keep her off the Deramaxx for a while so that Maddie would have better knowledge of her limits. He felt that the Deramaxx masked the pain and would make her feel like she could do too much too soon. She took the Torbutrol the first three days and slept a lot. |
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Week 7 (Right) Week 1 (Left) The swelling went down except at the suture sight. She walked on all four feet when on the carpet or the grass. However, she held her left leg bowed in as she walked. She seemed to be better about resting and keeping herself inactive. We went through a few nylabones and tennis balls but she spent most of the first week after the second surgery sleeping. |
| Photo pages - click below for more images. |
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Week 1: Week 2: Week 3: Week 4: |