A summary of the two weeks after Ochoco's double TPLO knee surgery
(Tibial Plateau Leveling Osteotomy)
May 16th, 2012.
It was a long and arduous decision process, especially deciding to do both knees on the same day, including consultations with a number of vets and looking at all the possible options.
A description of exactly what a TPLO is can be found
here. But basically they cut the head of tibia bone off in a curved manner, reposition it and screw it in place for healing with a steel plate and six screws.
Ouch! Can you say amputation!?! Really that's about what it is...
Here are some x-rays of what it looks like inside the dog's knee.
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| Side View: Note the curved cut in the bone. |
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| Front View: Note the screws! |
Ochoco completely tore the ligaments in both knees, one last November 2011 which we tried healing up with a "Conservative Management" approach and the second in March 2012. Surgery for various reasons became the only option for such a young dog with a long life ahead of her of running and playing, which she had not been able to do since November 2011.
Ochoco also has some issues with generalized anxiety and so that played a big part in our decision to do both knees at once. As it is much more common to do one knee and then 6 weeks to several months later do the other knee. For her the benefits of having only one surgery/recovery experience outweighed the risks associated with doing both at once.
At this point everything is going so well that we are VERY glad we did it this way for our dog and our situation. Yours may be different!
We sent our other dog Peaches "away on vacation" to a good friends house for the first five days Ochoco was home from surgery. As much as we missed having Peach with us it was the best thing to do for Ochoco.
Below you will see daily progress reports, photos (don't read on if you are
squeamish as there are close ups of her incisions) and videos of how she has progressed each day.
The most amazing thing is that she was actually putting weight on both legs the night after surgery. She spent the first night at the vets and came home about 3:00 pm the day after. While we had a front and rear harness on her, she walked into the house on her own 4 legs! (Wobbly and slow, but essentially on her own.) We had no idea, we thought she would be unable to stand or walk for several days after surgery and then only minimally. What a surprise.
Her surgeon was Dr. Tim Munjar, he has been fabulous to work with, came highly recommended by a lot of other dog people and other vets, and we are very happy with his work and so far amazed at how well Ochoco is doing. At only a week past surgery she gets up with more ease than she did before surgery.
Here are some
photos and
videos of Ochoco and Peaches when her knees were in "good working order" and you can see why we wanted to get her back to that. She has so much fun running and playing.
Here is a video of her after her injury in November, the injury in March was worse yet.... She got better with time after the initial injuries, but she was obviously in discomfort.
No-chew donut! Ochoco is trying out her donut to keep her from chewing on her incisions, we actually have not yet had any issues with her wanting to do that yet.
Scotch! We were having a shot the night before surgery just to calm us down, well Ochoco wanted some too! (No she did not get drunk, nor do we give our dogs booze... she had just one lick—she actually liked it and would have had more if I had let her!)
Surgery day! We got to sit with Ochoco for an hour or so at the vet's office until they were ready to take her back, she had already been given sedatives and was pretty dopey. We made arrangements for them to do her surgery first thing so she would have less time to be anxious waiting around in the back.
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| Dopey Dog! |
Surgery went well according to Dr. Munjar's call to us after he was done. It took about an hour longer than he expected, but otherwise went smoothly.
We brought Ochoco home just about 24 hours after her surgery was completed. When we went to get her Dr. Munjar did a a great job of explaining everything, showing us the x-rays of the plate and and making sure we understood post surgery care.
Ochoco is now home, we set up my office on the main floor as her "home" for the next 8-12 weeks. We made a ramp out to the backyard and had both front and rear harnesses at the ready for getting her home and outside to potty.
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| Ochoco, Cosmos and Potey (Jon) sittin' with O right after she got home. |
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Not a very happy dog, this was the day we brought her home.
She is still pretty drugged up. About 30 hours post surgery. |
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| Using a blanket to help keep the ice packs in place. |
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| Incision the first day, left side. |
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| Incision first day, right side. |
Her first day home and she is actually putting weight on both legs. We had no idea she would be able to do that, we figured we would be carrying her around in the double front and rear harness for at least several days post surgery.
Going potty proved to be the most difficult thing. While she was able to move and walk, she did not want to go outside, it was too scary. So the first five days home she would not poop and it took 36 hours after she got home for her to finally feel OK about going pee. In this video she tried once but never actually peed! These two videos were shot about 36 hours post surgery!
Getting her down the ramp was very difficult and even though I had it installed about a week before surgery, I did not have as much time to train her to use it as I would have wished. I would change that next time (!) and well before surgery made sure the she was totally OK going down the ramp. It would have helped a lot with the worry post surgery and our backs. The first few days we ended up carrying her with the harnesses down the ramp because she literally had the brakes on with all four legs and we worried that was not a good thing for knees at all. So carry her we did!
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| Lots of sleeping! Here again I am using the quilt to hold the ice packs in place. I would not leave the room with the quilt on top of her in case she tried to get up, too risky for her to trip or get caught up in it. |
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| Again, amazing that she is putting equal weight on both legs, about 34 hours post surgery, |
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| Left leg, 5" incision is just past the edge of the knee. |
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| Right leg, notice the Fentanyl patch, she had one on each side for pain relief. |
More video of her up and moving about 30-32 hours post surgery.
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| About 36 hours post surgery. |
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| About 36 hours post surgery. |
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| About 36 hours post surgery. |
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| About 36 hours post surgery. |
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| About 36 hours post surgery. |
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| About 36 hours post surgery. |
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| About 36 hours post surgery. |
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| About 36 hours post surgery. |
| About 36 hours post surgery. |
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| Right knee looking good. |
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| Right knee. |
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| Left knee looking OK, just a hint of redness starting to show. This is about 60 hours post surgery. |
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| A little more redness on left knee. |
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| Next morning the left knee is getting pretty red. Fortunately we had an in-home acupuncture appt. scheduled and the vet said just to keep an eye on it and not to worry quite yet. This is Monday morning, surgery was the Wednesday before, about 4-5 days when the redness started. |
Acupuncture was great, she obviously felt better almost immediately, her first session was 5 days after surgery. Dr. Isabel Wyss was really wonderful with Ochoco, O trusted her immediately and she was very comfortable being handled by Dr. Wyss. She has had three sessions so far, about every other day, each seeming to help with not just the surgery but also her anxiety. We will now be moving to every couple of weeks for acupuncture sessions.
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| Left knee redness. |
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| Still getting redder. |
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| Right knee looks great, left knee is hot and red. |
It is still amazing that she is moving and putting both feet firmly and evenly on the ground. This is about 4 days post surgery.
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| Sleeping with our girl. We took turns just laying around and hanging out with her especially through out the first three or four days home. |
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| Right knee looking great, the hair is starting to grow over the incision. This is about 6-7 days post surgery. |
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| Left knee, the redness has reduced some, it took a good 18-24 hours. I was extra attendant about the icing schedule every 3 hours. I think that helped a lot. |
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| Left knee looking better. |
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| Both knees. |
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| Left knee looks great! |
This video is about 6 days post surgery.
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| May 25, 2012 (surgery May 16th) |
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| Right knee, May 25, 2012 (surgery May 16th) |
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Left knee, redness is all gone, the upper part of the incision is a little thick and ridged.
May 25, 2012 (surgery May 16th) |
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| May 25, 2012 (surgery May 16th) The little holes at her ankles are the spots where Dr. Munjar drilled holes in the bone to act as a "jig" to hold the bone in place while he made the cut at the top of the bone. Kind of icky and neat all at the same time. He put it something like biological carpentry! |
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Right knee, today we go get the stitches removed, two weeks and one day after surgery.
The hair is growing back! |
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| Check out how hairy the incision is getting! Right knee. |
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| Right knee looks great. |
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| Left knee, redness is all gone and has been for several days. |
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Left knee is looking so much better.
The incision is still a little thicker and more ridged than the right knee,
but I think that will flatten out just like the left knee did. |
Ochoco up and moving around 15 days post surgery! She has been confined to the office the whole time with only walks out to the back yard for potty time.
Just yesterday I put an x-pen "loop" out of the office door onto a rug so she can see out and get a little more "space".
We have kept the two dogs completely separate, they only get to visit each other by sniffing through the x-pen.
One of the things we were secretly hoping is that the surgery would "cure" the anxiety. I know, silly wish, but we were hoping the pain in her knees may have been contributing. While it may have been, her anxiety is still there. Now that she is off all the pain meds and anti-inflamatory meds and back to her regular alprazolam and peroxetine doses, the anxiety picture is about the same if not worse.
It does not help that we had two days of big (unusual for Oregon) thunderstorms, Memorial Day fireworks on two nights this weekend and then today the city is tearing up the sidewalk corners with huge jackhammers and other heavy equipment outside! It is loud and vibrating the entire house. Aargh! It's going to be a real challenge to get her out of the house and into the car for her first check-up appt. and to get the stitches removed today.
You can see her anxiety in the next two videos as well as how well she is moving at 15 days post surgery. We are thrilled though with how well everything has gone with the surgery and are so glad we did both at the same time. I was so worried about that, but in Ochoco's case it has proven to have been the best choice. (At least so far!)
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| Stitches are coming out in about 45 minutes! |
This video was shot just before we were leaving for her appt. with Dr. Munjar, isn't is amazing how well she is moving for it only being 15 days post surgery on BOTH knees!
May 31, 2012 Post surgery, 15 days.
June 5th, 2012, She is wearing a Thundershirt, yes we were having unusual thunder storms in Oregon! And no, she does NOT get to socialize with her "sister" this was just a quick "howdy". She has at least 4-5 more weeks of no interaction with our other berner Peaches and strict confinement in her room.
Can you believe she had surgery just 3 weeks ago! We are being told that this is not the norm... but we have also been SUPER diligent about following the recovery "rules".
June 15th, 3 weeks post surgery.
Updates will be fewer and farther between from here on out...
It's now 14 weeks post surgery and Ochoco has been released to "be a dog" again. This is not without some restrictions and we have to bring her muscle condition up slowly, but we can take longer and longer walks and go more places as long as we are careful about not letting her do too much. The bones are completely healed so that is not the issue, it's that we want to avoid muscle strain.
Ochoco plays outside! Some of her first ventures out after surgery!
A quick first trip to our local park, Aug 21st. She had fun and was not to anxious about being there, that is a good sign! Her anxiety is definitely less now that the pain in her knees is reduced/gone. We hope that continues.
Hopefully the next video will be of her romping at 1000 Acres! In September???
...
Well it's August 24th, 2012 and we took Ochoco (and Peaches) out to 1000 Acres for the first time since she torn the CCL in the second knee in March 2012 (surgery was May 16th). She was so excited to be out there, it's one of her favorite places to go! We had a hard time restraining her on the leash (usually they are off-leash romping a playing). It was such a delight to see her so happy, moving so easily and just having a ball. I am anxious to get her muscle tone back to normal so she can really play off-leash with her "sister" Peaches.
Just a back view of Ochoco walking. She got so hard to hold onto from excitement at being out at the park that we had to put the harness on!
The first beach trip in many moons!
The end!
Our sincere thanks to Dr. Munjar and his staff for their work with Ochoco and giving her back the wonder and sheer joy of running and playing, and just being a dog! Yea!
