Need help deciding on CCL surgery: what would you do?

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IloveBlu
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Need help deciding on CCL surgery: what would you do?

Postby IloveBlu » Thu Mar 31, 2011 5:42 pm

So, the surgeon confirmed yesterday that Blu has a partial cruciate tear in his left knee. We are pretty sure we will operate on it.

The surgeon I consulted with does the traditional rubberband (extracapsular?) and the TTA. She does not do the TPLO. I received a quote for the TTA and felt confident that is the way we should go given his weight (50lbs), age(~5.5) and activity level.

However there is something that makes me nervous about the metal being inside him...forever. She also said if the incision gets infected, the metal becomes infected and has to be removed.

Blu has recurring staph infections and post-operative infection makes me very nervous. He is currently taking staph lysate injections and seems to be responding but it's too early to tell.

My other dilemma is this: recoup is anywhere between 8-10 weeks, barring no infection/complications. My boyfriend and I are going on vacation for June 1- June 5 (already paid for). Blu will be staying with my mother. There is no way she can handle him not being able to jump,run or do stairs. No. Way. I know there's medical boarding as a possibility but I really, really don't want to do that to him for that long. The surgeon said he would almost be recovered but not fully by then.

Is it bad to wait until we got back so I can ensure his recovery? He's stabilized now and bearing weight on it again but the surgeon said it could be set off again.

I feel terrible because he presented with the same symptoms in the summer of '09 shortly after we adopted him. I took him to a vet that we no longer use, he was given rimadyl and told me it was a sprain. After rimadyl course, he was back to normal *from what I could see.* However, he always lifted it up when he ran down the stairs (not up). Since he was otherwise not symptomatic, we focused our money/attention on his insane atopy/skin infections. The surgeon told me yesterday that was most likely the same partial tear :oops: Also, since he had always been on low-dose pred., the problem could have cropped up but the pred. alleviated the symptoms. How terrible am I? So dumb of me to not look into it sooner.

What do I do?!?!

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Kingsgurl
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Re: Need help deciding on CCL surgery: what would you do?

Postby Kingsgurl » Thu Mar 31, 2011 9:52 pm

IMO, it is better to wait on the surgery until you can control the healing/rehab 100%. The success of the operation (whichever you choose) depends on it.
Good luck. The metal plates and bone sawing freaked me out too (TPLO) Just such an invasive surgery. Martin had Bi-Lateral Extra-capsular (meaning both legs at once) and I've been very, very happy with the results, but know most tend to want the 'newer, more improved' options.

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lilangel
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Re: Need help deciding on CCL surgery: what would you do?

Postby lilangel » Fri Apr 01, 2011 11:33 am

Prognosis is very good, especially with only a partial tear if you use a custom orthopedic brace. For me that would be a no brainer. No way I would opt to chop up and reconstruct a knee joint for a partial tear. JMHO. With a brace, no surgery necessary. No doctors playing god. Body can heal itself.

My dog has full ruptures in both knees. One knee we had surgery on. The other we used a brace. The surgery knee is more stable of course, but has been the source of constant pain. The braced knee is less stable but stable and does not bother her at all. She no longer needs the brace and gets around pretty well for a dog her age with her injuries. Goes up and down a full flight of stairs 5-10 times a day, cruises around the property no prob.

Just something to consider.

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laiinkyree
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Re: Need help deciding on CCL surgery: what would you do?

Postby laiinkyree » Sat Apr 02, 2011 10:19 pm

Spud is 2 1/2, and had his first TPLO surgery last septmeber. He just had his second TPLO on his other leg two weeks ago. His first knee is completely back to 100%, it doesn't bother him except when it's really cold out. He's already thinking he's all better from surgery #2, almost always weight bearing on the leg and trying to run.

Personally, I would wait until you come back from vacation and have it done. We had to wait a couple months for Spud's second surgery. The vet let us get a prescription of pain killers for him until we could do it.

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Re: Need help deciding on CCL surgery: what would you do?

Postby Savage Destiny » Sun Apr 03, 2011 8:32 pm

Go for the TTA. Riddle had hers done about 1.5 years ago, and its healed fabulously. She never limps on it now, not even after a hard run. The "rubberband" or "fishing line" surgery is a waste of money on bigger dogs.

Do wait until you get back though. If you're going to do surgery regardless, it won't make a difference whether or not you wait a bit.

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IloveBlu
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Re: Need help deciding on CCL surgery: what would you do?

Postby IloveBlu » Wed Apr 06, 2011 8:05 pm

Thanks everyone. We will be waiting until the summer.

This is so hard. He is walking normally on it on no pain meds or antiinflammatories...do you think he should be on them? The surgeon didn't mention anything but maybe I will call and ask. He does not exhibit any signs of pain....but he never did. Can I assume he's in pain regardless? The surgeon said only the inital tear is truly painful.

I am practicing reasonable resting for his leg...about 15 minutes of walks total per day and limiting (but not prohibiting) his stair use. I really hate to restrict his activity so greatly...and for so long (plus the recoup after the surgery!). But I have no choice, right?

Anything else I should be doing?

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laiinkyree
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Re: Need help deciding on CCL surgery: what would you do?

Postby laiinkyree » Wed Apr 06, 2011 10:14 pm

What you're doing is great so far :)

From my experience with Spud, he either blocked the pain out, or wasn't in that much pain at first. It was more off and on sore it seemed. The pain got worse over time (we had to wait almost three months to get the surgery), but he would still want to run and play and wrestle with other dogs. He just had a shorter temper if a dog ran into his leg or something.

Ask your vet to put your pup on Rimadyl or another pain killer that's safe for that long of a time. Spud was on it for that whole three months with no adverse side effects.

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Re: Need help deciding on CCL surgery: what would you do?

Postby Savage Destiny » Thu Apr 07, 2011 10:36 pm

If you're doing the surgery 100% for sure... I wouldn't worry about restricting his activity too much. I mean, don't let him go all out crazy, but more than 15 minutes a day should be fine. Its all going to be repaired anyway. Our vet told us to let Riddle get her last hikes in before the surgery since she was going to be restricted for so long afterward. lol

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Re: Need help deciding on CCL surgery: what would you do?

Postby Misskiwi67 » Fri Apr 08, 2011 7:21 am

I think its fine to wait until after your vacation, particularly with a partial tear. When I had sheila's done, the surgeon actually called me a second time as they were rolling into surgery to make sure I was SURE I wanted to do surgery on a partial tear. I said yes because it was fall and I wanted her fully recovered before summer.

Sheila was a 65 pound, heavy jumping frisbee catching maniac, and we went with the TTA due to her size and activity level, and the proximity to a good surgeon.

I would restrict high impact activities, and encourage a lot of hand-walking and swimming. He will need that muscle mass after his surgery.

Keep him lean!!

I would keep him on glucosamine/chondroitin and fatty acid supplements until the surgery, don't worry about anti-inflammatories unless he needs them.

I do NOT recommend a brace long-term. Its fine in the short-term, or for dogs who do not have surgical options. I'm actualy shocked the person who recommended it hasn't had any issues with it. The conformation of the canine leg is not conducive to brace-wearing without extreme risk of pressure sores.

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IloveBlu
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Re: Need help deciding on CCL surgery: what would you do?

Postby IloveBlu » Mon Apr 11, 2011 5:30 pm

Thanks.

He just started Glyco Flex 3 and he takes 2,000mg of fish oil a day.

He was lean to begin with and when this incident happened, I decreased his intake a tad more. He's at 47lbs now and I think we're as low as we can go given his build.

He's not taking any anti inflammatories anymore. He took Rimadyl when the initial limping happened, and he had the starts of the rare excessive peeing/drinking side effect so the vet told us to stop.

He honestly is walking so well I sometimes can't believe he has a partial tear. He does have some kind of odd gait to his walk, but he always has to be honest. He still lifts the leg when he goes down the stairs. I'm giving him about 30min of leash walking a day now, and he's handling it fine. I'm not doing any fetch or frisbee though. I want to be cautious but I don't want to completely restrict him for being himself. I just hope he's not in any discomfort.

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Re: Need help deciding on CCL surgery: what would you do?

Postby Misskiwi67 » Tue Apr 12, 2011 11:45 am

IloveBlu wrote:He honestly is walking so well I sometimes can't believe he has a partial tear. He does have some kind of odd gait to his walk, but he always has to be honest. He still lifts the leg when he goes down the stairs. I'm giving him about 30min of leash walking a day now, and he's handling it fine. I'm not doing any fetch or frisbee though. I want to be cautious but I don't want to completely restrict him for being himself. I just hope he's not in any discomfort.


With a partial tear, there is still some stability in the joint, so he shouldn't be in any great discomfort. Keep doing what your'e doing, and get the surgery when you're able.

I actually like partial tears, they give you some time to plan ahead both schedule and expenses, and waiting doesn't cause any undue harm. Just know he could go from a partial tear to a full tear any day. Also know that restricting regular exercise won't change this, so do what you can to keep his muscle mass at top notch without running/jumping.

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Re: Need help deciding on CCL surgery: what would you do?

Postby randomroads » Thu Apr 14, 2011 9:23 am

I second the muscle mass bit. One of my parents dogs had both knees go partial tear within a few weeks of each other. They put her in a pool and swam her until she was exhausted every single day until they could get the surgery done. Her recovery time was minimal, which surprised everyone. A few years later she got another tear in her left knee, but she was older and had arthritis. She was unable to move around as much even before the tear, so they didn't exercise her as heavily. Her recovery time tripled from the last. Obviously older dogs heal slower, but the vet fully believes that the lack of exercise is the main culprit.

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IloveBlu
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Re: Need help deciding on CCL surgery: what would you do?

Postby IloveBlu » Mon May 30, 2011 6:23 pm

So we've decided on a TTA at the end of this summer. Blu has been doing fine, just keeping a close eye on him but not really restricting him (he's not exactly high energy enough to restrict).

HOWEVER, last night he began favoring his FRONT, OPPOSITE leg from the known cruciate injured leg.

He is reluctant to put the paw to the ground and is kind of ice skating out as he walks.

I called the orthopedic surgeon (who wasn't in) and spoke to the tech. She suspects it is from him overcompensating to one side. We decided to watch him today and tonight, and bring him in to the vet tomorrow. He is walking so terribly :(

We are leaving for vacation on WEDNESDAY. Of course this happens two days before I am leaving.

I just want him to be comfortable :( and I hope it's not another injury that requires surgical repair :(

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Re: Need help deciding on CCL surgery: what would you do?

Postby pblove » Mon May 30, 2011 7:53 pm

oh nooooo- not another issues for that poor guy
I hope you will one day be well Blu. :pray

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sara
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Re: Need help deciding on CCL surgery: what would you do?

Postby sara » Wed Jun 01, 2011 12:34 pm

lilangel wrote: One knee we had surgery on. The other we used a brace. .


Can you tell me more about the brace? Is this something you would need the dog to wear forever? Or just a recovery tool? Do you have a link to a company?


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