Carlin’s Bilateral TPLO

While we were waiting for word on how Carlin’s double TPLO went, the folks at the Sun Valley Animal Clinic sent us some x-rays to look at.

The first x-ray shows Carlin’s left knee joint, pre-surgery. To a non-professional like me, this is puzzling. It doesn’t appear to me anything is seriously wrong enough to warrant surgery. But I’m thinking that’s because x-rays don’t really show soft tissues, such as the CCL, the ligament that the vet tells me has ruptured. But I can see that the top of the tibia is slanted from upper left to lower right. And without the CCL to hold the femur (upper bone) in place, that femur is just going to slide forward on the top of the tibia. (The x-rays of the right knee look much the same.)

The second x-ray shows the left knee from the same angle as the first x-ray. You can see that the top of the tibia has been cut through in a curve. The cut section of bone is rotated so it’s tilted to the right and up. This provides a flatter surface for the femur to rest on, so it won’t (hopefully) go sliding back and forth. The new titanium plate will hold that chunk of bone in place until the two parts of the bone heal, fill in, and fuse together.

The third x-ray shows the knee joint from the front, I think. It shows the screws that are holding the titanium plate onto the bone.

This is so creepy. And it looks painful, which is why my poor boy will be drugged with pain meds, anti-inflammatory meds, and anti-anxiety meds. He’s going to feel bad and not understand what’s been done to him. The meds should control the pain and ease his anxiety so that the stress response doesn’t slow his healing.

But the x-rays also look amazing. I am so grateful when I think of what veterinary medicine can do, and what might have happened to Carlin if these treatments didn’t exist.

I am so grateful. And also scared.

I know the recovery will be long and arduous for all of us in our house. Keeping Carlin safe and happy. Making sure he doesn’t lick his stitches. Preparing his crate so the weeks (probably) of his staying in it can be at least somewhat comfortable. Making sure he doesn’t use his legs too much, too soon. Figuring out how to help him pee and poop when two of his 4 legs don’t work. Keeping up on the meds. Plus, doing whatever else the vet instructs us to do. As well as keeping our other dog, Grits, entertained and out of Carlin’s way and away from enticing him to play before his legs can handle it.

Soon we’ll meet with the surgeon again, and learn what she found and what she advises us to do next. If all has gone well, we’ll load our boy in his car crate, and drive the 3 hours down the mountains and back to our valley home.

And when we get there, we’ll get him out of the car somehow, and the next phase will start.

Read Full Post »

Tibial Plateau Leveling Osteotomy (TPLO)

I’ve always wanted to go to Sun Valley. By the photos I’ve see, it’s a beautiful mountain area, home to a famous ski resort, second or third homes of celebrities, and host to an airport filled with private jets, several good restaurants and gift shops, and hiking trails.

And now, after 7 years in Idaho, I’ve finally made it to Sun Valley. But I never imagined that I’d start crying once I got here.

Russ and I are here to take Carlin to the Sun Valley Animal Center in Ketchum, Idaho, so that he can get a diagnosis and maybe surgery on his left knee. Somehow or another, Carlin injured one of his cranial cruciate ligaments (CCL). It’s the band of tissue that helps stabilize a dog’s knee joint. When the ligament is torn or totally ruptured, the femur (upper bone of the leg) shifts forward instead of staying in place on top of the tibia (lower bone). The shifting is painful, and to mitigate the pain, the dog tries to not put weight on that leg. This puts more pressure on the other back leg, back muscles, and spine.

Some times, that added pressure tears, or even ruptures, the CCL on the other leg. If that happens, the dog can’t walk well at all.

We don’t know how Carlin injured his knee. Last Fall, I noticed that he was “off”. He wasn’t able to concentrate on his scent work as well as he had in the past, and we failed 3 out of the 4 Detective searches we entered. He limped from time to time, but never cried or whined. He jumped and played with Grits as usual, but sometimes he’d snap the air to tell her to back off. I also noticed that he really didn’t want to stand for long on the grooming table, and I often had to hold his back end up because he couldn’t seem to do it himself.

I took Carlin to our regular veterinarian last October. They did an exam, and prescribed carprofen and gabapentin. They thought that maybe it wasn’t more than arthritis. But then, on Saturday January 20th, Carlin stopped using his left rear leg altogether.

That’s bad. And that’s when I took him back to my vet. She did another exam and took x-rays, and said she thought Carlin had injured his left CCL and likely needed surgery. She advised a second opinion, and recommended a surgeon who could help us decide what to do. He, of course, did yet another exam, and concurred. The CCL was injured and needed help. We discussed multiple possible procedures. The problem? The surgeon didn’t have any openings to do anything until early March.

I just couldn’t make my dog wait that long.

So many dog people here in Boise suggested we consult the surgeons at the Sun Valley Animal Center. Apparently lots of folks, even from surrounding states, travel to Ketchum for orthopedic treatment for their dogs. Including performance and hunting dog people. So we called that clinic, and we got an appointment for today, January 31.

So here we are in a Ketchum coffee shop. We dropped Carlin off earlier this morning, where we talked with the surgeon, looked at new x-rays, and listened to the explanation of why they recommend the TPLO. With three opinions all saying the same thing, we agreed, left our boy in the clinic’s hands, and went to the coffee shop to decompress a bit.

And that’s where I started crying. Why? Because while we were there, the clinic called us to say that the CCL in the left knee was not just injured. It had completely ruptured, and the CCL in the right knee was torn and about ready to rupture, too. Carlin, they said, needed TPLO in both knees.

We agreed. Doing both at once will mean only one session of anesthesia, one (but longer) period of recovery and rehab, and a little less money. So now we wait to hear that it’s over, how it went, and how our boy is doing. And while we wait, I cry.

Read Full Post »