Knee Repair

[Lady B]

Well, my sweet, brave Lady-B underwent her second knee repair, having had the right knee repaired some 2 l/2 years ago. Mom is putting up a brave front but despite the decision to do this surgery her heart aches when Lady cries out in pain. We are just 48 hours out and have nearly 6 months to go for recovery.

I was so fearless in deciding on her first surgery, a TPLO. Not so this time. The TPLO did not give us the results we had hoped for, Lady now has severe osteoarthritis in that knee. So I spent much time researching procedures, surgeons and the biggie, costs. The surgeon we found is a wonder as vets go. He has all the qualities I want for my babies. Humble, kind, caring, highly intelligent, very cautious and a beautiful heart as well.

From a technical stand point the procedure is quite interesting. The anterior (front) cruciate ligament is removed; the meniscus (that fibrous shock absorber in the joint) is examined and if partially damaged only the damaged part is removed, if completely shot then totally removed. Two 6 millimeter holes are drilled into the tibia and upper part of the patella, approximately where the ACL used to attach. Fascia (muscle sheath) is removed from the quadriceps muscle and formed into a tube and then run through the two holes. This is then attached with titanium screws. Titanium is the only metal which integrates with bone and causes no complications.

The healing process is lengthy -- 6 months lengthy. The first 8 weeks (phase) is defined by short walks in the backyard to eliminate only and then total rest in a crate. The second phase is started with leash walks for 1 block only. If, after 3 days, the dog does not demonstrate pain or limping then add a block every three days. If pain or lameness occurs crate rest for 1-2 days and then start over. No high impact on the joints. So hydro therapy would work wonders here (IF I can find a swimming pool or tank we can lower Lady into). The last phase is another 8 weeks of a very slow return to normal activities.

Lady is in pain but not so pronounced as last night. She was on morphine for the first 36 hours with a Fentanyl patch. Tonight I will remove that and give Rimadyl 1/2 tab twice a day for a week. Then Monday we start back up with the acupuncture. She refused to eat until this morning when I bribed her with Cat food. Guess it smelled just too good . Lady has progressed to her scoobie treats (laced with antibiotics and Rimadyl) and other goodies. We are slowly returning to normal. So normal that I am amazed at how fast she can move with only 3 functional legs to get to the backyard for a pottie break! I have every confidence this procedure will give Lady the quality of life I want for her.

I've been up most of the night with her so it's nap time for Mom .

[Lady B]

I've had a good night's sleep (from 8 PM to 3 AM). Lady needed a potty break and then wonders she ate almost all of her regular rations at her feeding station! She also must be feeling pretty good with half dosage of Rimadyl. She climbed up on the bed and then the couch (her usual Queen-B thrones). Mom put a towel under her belly to assist her down and back to the crate. I have to watch her like a hawk or keep her crated -- she is quick for a tripod!! There isn't as much swelling from this surgery compared to the last. Interesting.

Apparently there isn't a medicalese name for this surgery, at least neither vet gave me one, just stifle repair. The orthopaedic vets at WAZZU vet school had heard of this surgeon and are very impressed with his success rate and surgical technique. Actually what was said is "In his hands this procedure is nothing short of a miracle". Working in the medical field I have seen the same procedure performed by different surgeons with varying results. I've come to the conclusion that surgical success is determined by technique, patient compliance and belief in success and the surgeon's level of involvement with the patient. It is one thing to be a good technician quite another to be a good healer. It's what I would call putting your heart into your work. Although I am sure many in the medical field would argue the point.

Lady is back to her old self -- she even wanted to play a game of tug in her crate. We both will make it and come this summer she will be chasing Baron 'round the shrubs and bugging me to throw the ball just one more time.

[Lady B]

Well -- we are a week out from surgery. Lady has gone from being pretty calm to the itchy/lick it stage. So much so that I had to get a foam collar for her (the cone collar wouldn't fit in her crate!). She HATES it, hates me to the point that when I put it on after meals and her potty break that I get the worst snarling out of her throat I've ever heard. She has even gotten very finicky about what she will and won't eat now. Oh yeah and the passive range of motion exercises elicit the same response. A friend was over while I was doing this and she thought Lady was going to rip my head off. I'm not too sure about her bite threshold during this process so have been using scoobie treats while doing the PT. It holds her for the 2 minutes I'm working her leg.

She is pretty swollen in the hock area but that was to be expected. Lady moves fast for a tripod -- I just caught her trying to sneak up on the couch and the minute she saw me she tripoded it right back to her crate without a word from me. She must think I'm the Christmas grinch reincarnated!

[Lady B]

UPDATE: Lady is now 2 months out from her surgery. The first two weeks were hell. She refused to eat, she refused to go out for pee breaks, she refused, she refused whatever.

After the 1st month she started knuckling it and slowly moved into using her pad. She would bunny hop down 3 steps into the backyard and bunny hop back up. I was still feeding her in the laying down position.

But she has since moved back to her feeding station, eating right along with Baron. She also has moved back up to the "Queen's throne", the couch. We took the crate down after two weeks to encourage her to use the leg more and generally encourage her back to normal rather than hiding out in her crate.

Tomorrow I get to start her walking outside the yard for slow, short walks. I am really excited that we are now progressing into this stage. And I am sure Lady will love the release from her boring life in the yard and house.

If nothing else we both have learned more patience this time around. The last surgery I had to hold her back constantly. Perhaps it is Lady's mature age of 5 today. We are celebrating today with home made scoobie treats!!