Signs of a CCL Tear
Bella had been noticeably, but intermittently, limping throughout the summer. Something with her back left leg was bothering her. I toke her to the vet in November for xrays, but they came back inconclusive--no swelling, no sign of arthritis. The vet thought is could be something with her back, but since it was intermittent, I chose to hold off on other tests. And really, after going through back surgery with our former dog, Lucy, I just couldn't face it yet with Bella.By this June, however, her limping was continual. A second round of xrays showed inflammation and perhaps some arthritis. Although this type of technology won't shown a torn CCL, the indicators pointed in that direction. My vet, the wonderful Dr. Kate Schottman at Sunset Pet Hospital, recommended I go for a consultation with Dr. Jennifer Weh at Blue Pearl. Dr. Weh confirmed the diagnosis and within a few days, Bella was back for surgery. (I've been asked why an MRI wasn't performed. Dr. Weh said they are prohibitively expensive and also, inconclusive. Because they don't do many of them, not all veterinarian radiologists are adept at reading the results.)
The Surgery
No food after midnight and an early morning arrival at the hospital for Bella. For a Labrador Retriever, no food spells misery! Her surgery happened in the late afternoon; the hospital called both before she went in to surgery and after she came out. The surgery went sell and proved necessary as 70% of her CCL was torn. Thankfully, her meniscus was fine and there was little sign of arthritis. But this bring us to the rehab...Luckily, as a dog owner, you are never fully cognizant of what you're in for with TPLO surgery. You can read and read about it, but until you live it, you just don't know what you will experience with your dog. I don't need to explain the surgery as you can read about it on your own and your vet may recommend something else. In our case, Dr. Weh said it is one of the most common orthopedic surgeries performed on dogs and has an excellent success rate. As an owner, I was concerned Bella's predicament was caused by something we did, or did not do, but Dr. Weh said it didn't matter what the dog's age, athletic ability, gender or weight. A small peace of mind.
Initial Recovery
The first three days were brutal. Bella was anxious wearing a cone, anxious being sequestered and obviously in a lot of pain. Whimpering, lip-licking, drooling, yawning... So sad to witness, but I kept (and keep) telling myself the outcome will be so worth it.The vet tech was adamant we follow the protocols and because it's our girl (and the surgery isn't cheap), we're on board. Some things I've modified, but not the big stuff.
Drugs
Bella is on the following drugs:- 100 mg Carprofen / once a day (anti-inflammatory)
- 750 mg Cephlaxin / twice a day for seven days (antibiotic)
- 30 mg Codeine / every eight house (pain relief)
Feeding
Bella loves to eat. Getting food in her and pills down her has not been an issue with the exception of the codeine. I can't disguise it. I tried putting it in a ripe blueberry. Nope. Ripe cherry. Nope. The tech said not to use fatty things like cheese or peanut butter as it would slow the absorption, so I resorted to Pill Pockets (chicken flavor, thank you very much) and that did it.I also have stuffed and frozen Kongs with her meals (which I cut in size by about one-third). This gives her more to do throughout the day as she gets bored. And what a bonus! Five meals a day!
One of the odd things that has occurred is her disinterest in water. Normally, she is quite the drinker. With pain killers and no water intake, I knew her ability to defecate was going to be seriously compromised, not to mention the concern of dehydration (by Day 3, her gums were sticky--a sign of dehydration). So I've added some canned pumpkin (no seasoning, just squash) to water-soaked kibbles to help with fiber and water intake. I am also "lacing" her water with homemade, unsalted chicken broth. Boy! She's cleaning the bowl! I'm running out of the homemade variety and will have to use commercial, low-sodium canned broth, so a little more water, a little less broth. Hopefully, soon, I can just be giving her unadulterated water. Is it the drugs? Not sure. Another question for the surgeon or vet tech.
Crating and Cone
Unfortunately, she has to wear the Cone of Shame. What dog likes that! I debated whether to purchase an inflatable collar, but Bella is a long-bodied girl and I know she'd still be able to lick her leg. Luckily, she's very obliging and does not fight wearing a cone. She doesn't like it, but she doesn't avoid sticking her head inside of it--and by Day 5, she is "comfortable" sleeping with it on. Luckily it will only be for two weeks until her next appointment. If, when we go in for a recheck and all looks well, her stitches will be removed and the cone dispensed! |
| Comfortably sleeping in her kitchen corner. |
They recommended crating her, but we don't have one, so I've cordoned off part of our kitchen. It is an area where she already has a bed, so I knew she'd be comfortable with the area. It's also big enough that I could put a small chair within the boundaries and be with her. I swapped out her lumpy bed (I was concerned about her stability on it) for some memory foam. She wouldn't get on the foam prior to this, but seems to love it now.
As I mentioned the first three days home were awful. I ended up sleeping on the floor of the kitchen next to her and it helped both of us. I could monitor her closely and she didn't feel abandoned. It also helped that my husband was gone so I could devote 100% of my attention to Bella. During those three days, the codeine would wear off about an hour before her next pill was due and that made it difficult. I didn't want to mess with the timing of the pills, but I was anguishing over her pain and discomfort.
We're now at her fifth day home and there's incredible improvement. I noticed progress yesterday afternoon and today she seems remarkably better. Most importantly, she is able to sleep.
I bought an x-pen for her for the yard and a harness to help support her while walking, but don't feel I need either, so back they go. She'll be fine on a long line and has managed our two stairs to the back yard since the first day.
Last night we moved her bed into our bedroom and she slept through most of the night and I got to be in a real bed! She got up around 1AM and was restless enough that I took her outside to no avail. She was more quiet when we returned though. I am hoping tonight she'll sleep through the night.
Walking and Exercise
From the get-go, they wanted her to do limited weight bearing. I am allowed to walk her slowly (to get her using all four legs) for 5-10 minutes four times a day. Bella is putting weight on her leg. I doubt it's full weight, but she is using that leg. Initially five minutes was about all she could do, but she wants to do more than ten minutes now, although I don't allow that. As she won't defecate in the yard, I've been taking her up and down the alley. She'll only go once a day, but she isn't straining. |
| Bella's red ankle. |
The first two days, her ankle below the incision was swollen and brilliant red. Quite shocking. The red was probably razor burn, because it's fine now. They had warned about possible edema around the ankle and recommended some gentle massage to increase circulation. Her ankle was bloated and fleshy initially, but looks normal today.
They also recommended I do ten seconds of passive range of motion exercises with her leg three times a day. It's a basic bicycling motion. She didn't fight it, but I could tell she wasn't keen on it either. After talking to the tech, they said if she was standing and walking on the leg, that should be plenty, so I'm leaving it at that with just an occasional cycle movement.
Interestingly enough, she seems not at all bothered by sleeping on that leg. She's even used it to scratch her neck when the cone comes off!
Care of the Incision
Not unlike care of our wounds, they told me to ice her leg for ten minutes every six hours the first three days. This must have felt really good, because Bella didn't budge when I did this. I used frozen corn wrapped in a light towel. Sometimes I put it between her legs and other times on top of her injured leg. |
| Incision, Day 5. |
Obviously she is not to lick the wound which of course she really wants to do. Hence the cone. Periodically when I am with her, I do remove it and I can tell she really likes that, but any sign of licking I slip it back on. However, without the cone on, I do allow her to clean her crotch, an important ritual for her.
The surgeon would never qualify as a plastic surgeon. The incision will end up a scar, so I will check with them about massaging the area to break up scar tissue. I don't really care what it looks like (nor does Bella), but I think lack of scar tissue will allow better movement in the area. The incision, itself, looks clean. No weeping or smell.
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