# TPLO One Dog's Experience



## EdA (May 13, 2003)

OK we'll try this, for those who missed the original thread go to

http://www.retrievertraining.net/forums/showthread.php?t=35849

Surgery was performed Tuesday February 3, 2009.

I picked Chef up at Dallas Veterinary Surgical Center high Noon Wednesday February 4. 

His first night home was uneventful, he has been very good and has not bothered his bandage which will be removed in 2 or 3 days. He slept in a crate last night after eating a hearty dinner, he did not need the Elizabethan collar which was a blessing for us both (he is very dangerous when he is wearing it, watch out for you knees and shins).

We had an exciting airing this morning, difficult to imagine that he can almost break into a full run on a 6 foot leash, he will spend the remainder of the day lounging in my office. His rectal temperature has remained normal and he feels really good. After we remove the bandage I will try to take some pictures.

I have a Power Point presentation that I presented at an Iams symposium several years ago that describes typical post surgical home care and pictures and narrative of the roading harness that I will begin using in 3 months. Maybe I can post some of those pictures as well.


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## Lady Hunter (Mar 13, 2003)

Might be easier to follow the recovery process if you can set up the thread as a Sticky.


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## Shayne Mehringer (Jan 3, 2003)

It's not Honcho III, but this is good stuff!

Thanks Dr Ed and best of luck to the Chef boy.

I'll probably get to visit him next week when i bring Boogie in for x-rays.

SM


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## Gwen Jones (Jun 19, 2004)

Dr. Ed,

Was the Iams seminar at Auburn? I think I was there listening to you and some of the others talked nutrition. Janet put me onto the roading harness when my first dog had TPLO. It works wonders. Best of luck with Chief.

Gwen Jones


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## MBH (Jul 28, 2005)

Would you please elaborate on the roading and harness. One of my dogs is three months post TPLO. We do a lot of walking and climbing hills, but I would appreciate other strength building ideas. You can PM me.

Thanks!
Michelle


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## Montview (Dec 20, 2007)

So glad that surgery went well, and that your boy is doing so well!  Looking forward to more updates!


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## lablover (Dec 17, 2003)

MBH said:


> Would you please elaborate on the roading and harness. One of my dogs is three months post TPLO. We do a lot of walking and climbing hills, but I would appreciate other strength building ideas. You can PM me.
> 
> Thanks!
> Michelle


When Dooey was in late rehab, Dr Sherman had me purchase a dog backpack with pockets. The procedure was to insert weights (about 5 lbs on each side) in the pockets and walk him slowly for 1/4 mile on the local school track. As he gets used to this you speed up the walk, but don't run. Then add 10 lbs to each side and start over. I think we did this for about 3 weeks. This helps muscle rebuilding and strengthing of the effected leg. Now he "runs like a deer".


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## Keith Stroyan (Sep 22, 2005)

EdA said:


> ...Surgery was performed Tuesday February 3, 2009.
> 
> I picked Chef up at Dallas Veterinary Surgical Center high Noon Wednesday February 4.
> 
> His first night home was uneventful, he has been very good and has not bothered his bandage which will be removed in 2 or 3 days. He slept in a crate last night after eating a hearty dinner, he did not need the Elizabethan collar which was a blessing for us both (he is very dangerous when he is wearing it, watch out for you knees and shins).....


Thanks. I hope to never need this knowledge, but am very interested in the progress.

Pearl (Homer's sister) got a stick or piece of switchgrass in her paw that migrated up to the "ankle" behind the paw and made a nasty infection. She was operated on 29 Dec, and my vet was lucky to find the needle-like piece of vegitation. But she opened the (rather loose, for draining) incision jumping, later pulled the staples out one day when I thought she was being good. She got the second staples out yesterday and has one more day with the bucket on her head. Knees, shins, cabinets, ... and an un-happy dog.

Just to make it more "fun" she went into heat. At least Chef won't do that.

Best wishes with your bucket brigade regards,


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## Andy Carlson (Jan 3, 2003)

Glad to hear all is going with with Chef. Like Keith, I hope I never have to experience this with any of my dogs, but I am thankful that you are sharing updates and information regarding this surgery and rehab.

Andy


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## lablover (Dec 17, 2003)

Andy Carlson said:


> Glad to hear all is going with with Chef. Like Keith, I hope I never have to experience this with any of my dogs, but I am thankful that you are sharing updates and information regarding this surgery and rehab.
> 
> Andy


You cannot believe how fast your heart hits your feet once you know your dog needs TPLO surgery. You feel so helpless.


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## EdA (May 13, 2003)

MBH said:


> Would you please elaborate on the roading and harness. One of my dogs is three months post TPLO. We do a lot of walking and climbing hills, but I would appreciate other strength building ideas. You can PM me.
> 
> Thanks!
> Michelle


I cannot find the roading harness I now have, fortunately we bought several of them, most recently from Dressler's Dog Supply which no longer carries that particular harness. The one most similar is carried by Gundog supply....

http://www.gundogsupply.com/scott-padded-roading-harness.html

I attach a 30 inch bungee cord to each D-ring on the side, then attach 6 feet of 3/8" chain to the bungee cord (the flat rubber kind), I put snaps on both ends of the bungee so it is easy to put them on and take them off and it is easy to add larger chain 5/8" if you want to increase the pulling load for further conditioning.

here's the info from my Power Point



30 TO 40 INCH BUNGEE CORDS 

FOUR HARNESS SNAPS 

NYLON ROADING HARNESS 

3/8 IN &/OR 5/8 IN CHAIN IN 3 TO 6 FOOT LENGTHS 

3/8 INCH CHAIN = 1.25LB/FOOT (6ft=8LB) 

FOR CONDITIONING A DOG CAN PULL 25-30% OF HIS BODY WEIGHT 

BEGIN WITH SHORT WALKS (5 MINUTES TWICE DAILY) AND WORKUP TO 30-45 MINUTES DAILY 

FOR VERY ADVANCED REHAB ONLY e.g. 16 TO 20 WEEKS POST CRANIAL CRUCIATE REPAIR


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## EdA (May 13, 2003)

Today was bandage removal day, so far he has not bothered his incision hence no lamp shade to wear. The incision is on the medial (inner) portion of the stifle, there is quite a bit of brusing adjacent to the surgical site which is normal and expected.

Thanks to Jeff T. we started using the JRTs Flexi leash which we both like better. His gait when walking is essentially normal.


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## MBH (Jul 28, 2005)

Thanks for the ideas--both the backpack and weight pulling. I will start with the backpack since I have one, and shop for a harness.


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## MBH (Jul 28, 2005)

Also, best wishes for quick and successful healing! Those first weeks are the worst and then time goes quickly.


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## jeff t. (Jul 24, 2003)

Sinner did some weight pulling as part of her conditioning program following her shoulder injury.

We bought the harness at Cabelas.

Here's a posed pic of her in harness











She pulled 15 pounds of chain (she weighs a bit less than 50 lbs) at a walking gait for 12 minutes twice a day, every 3rd day. This pic is posed on our gravel driveway..actual pulling was done at a local school yard on very short grass.


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## kjrice (May 19, 2003)

I learned the hard way to never wear shorts around a wild one wearing an Elizabethan collar. The dig in the back of your achilles hurts too! Good luck to Chef.


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## 1st retriever (Sep 2, 2008)

How is Chef doing?


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## EdA (May 13, 2003)

1st retriever said:


> How is Chef doing?


He is doing very well, he is anxious to qualify for leash walking in one week.

Fortunately he has not even noticed his incision hence no Elizabethan collar or bandage. He is still receiving Tramadol and Deramaxx. I will remove skin sutures later this week. 

I will begin passive range of motion exercises and icing today or tomorrow (although he is using the leg so well I'm not sure that it is necessary), I should at least follow my own advice and the advice I give my clients.


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## JKOttman (Feb 3, 2004)

While Sherman did the rehab -- and did a great job, my local vet also advised putting Sophie in a harness (bought at a local pet supply store). Then you walk her on a lead with her out in front, and you lean back to create some resistance and in effect help shift her weight (equally) to her hind legs. It was odd for both of us to have her walking out in front of me like that, but as a technique, it worked very well. 

Good luck with the rehab Ed!


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## EdA (May 13, 2003)

JKOttman said:


> my local vet also advised putting Sophie in a harness (bought at a local pet supply store). Then you walk her on a lead with her out in front, and you lean back to create some resistance and in effect help shift her weight (equally) to her hind legs. It was odd for both of us to have her walking out in front of me like that, but as a technique, it worked very well.
> 
> Good luck with the rehab Ed!


all of them may be sled dogs at heart, they do adapt to and seem to like to pull things


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## Bubba (Jan 3, 2003)

Let me know if you need help hooking up the emergency brake.

Just trying to help out in the worst way regards

Bubba


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## FOM (Jan 17, 2003)

Dr Ed,

Any updates?

FOM


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## EdA (May 13, 2003)

FOM said:


> Dr Ed,
> 
> Any updates?
> 
> FOM


He's doing great, sutures out tomorrow, one more week until leash walking begins


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## EdA (May 13, 2003)

Chef baby had his sutures removed today, he pleaded for a leash walk and his wish was granted after 3 sets of 10 reps of passive range of motion.

His surgeon and physical therapist continue to caution against excessive physical activity..........


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## mdegra (Jul 11, 2008)

Great thread. My youngest, Bones, has at least a partial CCL tear. He's 10 months old now, and just had a great fund-raiser HT showing. It killed me to call Chuck McCall and tell him Bones was going to be out for a while. It does stink when you know your dog has to have a TPLO. I'm an orthopaedic surgeon for 2 legged animals, and fortunately my step-brother is a vet. So I have some resources. Stinks just the same. I'm going to try to sneak him into the MRI at one of the local hospitals to image his knee in the next day or so. He was just about to start pile work. Maybe he's faking it to come home and get some belly-rubbing for a while.


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## Rudd (Jan 9, 2008)

What is your advice on icing and passive range of motion exercises? Is it normally three days of icing then the exercises?


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## 1st retriever (Sep 2, 2008)

Glad things are going well! Can you post any pics?


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## EdA (May 13, 2003)

Rudd said:


> What is your advice on icing and passive range of motion exercises? Is it normally three days of icing then the exercises?


stretch, exercise, then ice

I like to do 3 sets of 10 reps repeated 2 or 3 times daily

also weight shifting if they are non-weight bearing

I usually advise clients to flex to the point of resistance (discomfort) and no further, begin sometime 3 to 7 days post surgery


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## Shayne Mehringer (Jan 3, 2003)

EdA said:


> stretch, exercise, then ice
> 
> I like to do 3 sets of 10 reps repeated 2 or 3 times daily
> 
> ...


Can i send Boogie to you for rehab? I'll take Fred with me so that you won't have an increase in dog count.

SM


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## Rudd (Jan 9, 2008)

So no post surgery icing?

My poor girl came out of surgery on Tuesday and I have been icing her down three times daily. She is slowly putting weight on the leg on her own but it is also complicated by the FCE (affected the entire right side) she suffered four months ago. Since the FCE we have been doing passive range of motion exercises, weight shifting, walking with all types of contraptions to help her walk properly and the water treadmill.

Seems like the rehab is very similar except the icing portion.


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## EdA (May 13, 2003)

Rudd said:


> So no post surgery icing?
> 
> My poor girl came out of surgery on Tuesday and I have been icing her down three times daily. .


definitely post surgery icing, that is excellent, I was negligent in that area with my own dog (you know the cobbler's children thing) primarily because there was so little post surgical trauma and no post surgical swelling

when I do extracapsular repairs I ice them as soon as the surgery is complete and advise clients to continue that

a good icing solution is mix 2 parts water with 1 part isopropyl alcohol, put in a ziplock bag and freeze, it forms a slurry which can be molded around the joint


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## EdA (May 13, 2003)

Shayne Mehringer said:


> Can i send Boogie to you for rehab? I'll take Fred with me so that you won't have an increase in dog count.
> 
> SM


this is where my dog is headed for rehab, maybe Boogie can hitch a ride.......

http://www.findretrievers.com/marketplace/viewlisting.php?view=8


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## Ted Shih (Jan 20, 2003)

EdA said:


> this is where my dog is headed for rehab, maybe Boogie can hitch a ride.......
> 
> http://www.findretrievers.com/marketplace/viewlisting.php?view=8


Nothing like good family relations


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## Shayne Mehringer (Jan 3, 2003)

EdA said:


> this is where my dog is headed for rehab, maybe Boogie can hitch a ride.......
> 
> http://www.findretrievers.com/marketplace/viewlisting.php?view=8


I can't afford to send Boogie to Tarrant County Community College, much less to see Jan at Auburn.

FYI - His scope is scheduled for Monday. It's amazing... you call up the referral clinic and start dropping the Aycock name and people make things happen.... either that or they are really slow right now. 

SM


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## EdA (May 13, 2003)

Ted Shih said:


> Nothing like good family relations


made her promise to keep him at her house and treat him as an outpatient, I do not think he would approve of being hospitalized.......


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## tshuntin (Mar 22, 2003)

EdA said:


> a good icing solution is mix 2 parts water with 1 part isopropyl alcohol, put in a ziplock bag and freeze, it forms a slurry which can be molded around the joint


Ed, thanks!!! That is fantastic to know...


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## EdA (May 13, 2003)

Anyone who has a dog with an orthopedic problem requiring icing for an extended period might be interested in the products made by Canine Icer

http://www.canineicer.com/

they make neoprene wraps with pockets for small frozen gel packs, the carpal brace and the stifle brace are particularly useful


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## jeff t. (Jul 24, 2003)

EdA said:


> Anyone who has a dog with an orthopedic problem requiring icing for an extended period might be interested in the products made by Canine Icer
> 
> http://www.canineicer.com/
> 
> they make neoprene wraps with pockets for small frozen gel packs, the carpal brace and the stifle brace are particularly useful


I can also attest to this. 

I used the canine icer carpal icer with Diesel and applied it after every training session. At tests and trials I kept their small gel packs in a small cooler with dry ice and iced him down after each series.

I hate it when I need their products, but they are well made and perform well too.


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## bull (Apr 9, 2004)

When can a dog be aired without a leash after tplo surgery?

Glad Chief is doing good.

Steve


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## EdA (May 13, 2003)

bull said:


> When can a dog be aired without a leash after tplo surgery?
> 
> Glad Chief is doing good.
> 
> Steve


good question for which I do not have a good answer, it somewhat depends on the dog, their surroundings, and how they react to external stimuli 

the objective is for them NOT to put their surgically repaired leg in jeopardy because they do not know what their limitations are

Chef is 12 days post-op and I have allowed him to be off leash to poop (probably against surgeon's wishes) but he is not particularly rambunctious and somewhat controllable when he airs

since I assume that Bull is even better behaved because of age and life experiences it's probably OK now


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## Shayne Mehringer (Jan 3, 2003)

Boogie is less hyper off lead. On lead, he bounces up and down with excitement - like he is about to do something fun.

I have found that letting him free in the house and airing him alone outside in our fenced yard keeps him the most calm.

SM


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## lablover (Dec 17, 2003)

When Dooey came home for 2 week periods, Dr Sherman had me walk him twice a day on a "tight lead". Translated that meant "no jumping or prancing" while walking. We would do a 1/4 mile walk at a high school track, very smooth surface, at a human's normal walking pace. We did "sits" every 25 to 75 yards, then resumed our slow walking pace.
I was told to lift him into and out of the truck, and no jumping on furniture, and to walk him up and down stairs either on a "tight lead" or by holding his collar.


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## EdA (May 13, 2003)

We are now 2 weeks post-op and his progress has exceeded my expectations. It is difficult NOT to accelerate his rehab however i know that would not be in his best interest.

We continue to struggle with airing, I have a small exercise yard which has gravel, he seems content to walk around and pee and poop without restraint and without running (or attempting to).

Yesterday morning I was preparing to pick him up and load him in the crate when he did a flat footed jump into the back of my truck....:shock:

We will begin limited walks with the roading harness but no weights this week.

Fortunately this is a dog who is content crated both in the house and in my dog box.


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## Shayne Mehringer (Jan 3, 2003)

EdA said:


> We are now 2 weeks post-op and his progress has exceeded my expectations. It is difficult NOT to accelerate his rehab however i know that would not be in his best interest.
> 
> We continue to struggle with airing, I have a small exercise yard which has gravel, he seems content to walk around and pee and poop without restraint and without running (or attempting to).
> 
> ...


Glad to hear Chef boy is on track!

SM


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## Tim West (May 27, 2003)

Ed,after going through what I did with Jefe's shoulder and the total time required for rest and ultimately surgery, would you say that a TPLO is a better injury for the FT dog than a banged up shoulder. Seems to me that a shoulder is so hard to diagnose sometimes that is just prolongs the ultimate treatment. I probably lost a whole year of trials with Jefe trying to figure out what was wrong.

My 2 year old Frank the Tank's TPLO was a dream recovery. I didn't do anything with him but walk him and then swim him some. I didn't do any of the things that you describe because the vets at OSU didn't have it on the prescribed treatments. And he was cleared for full training two weeks before they thought he would be.

Not that any of these are any good, but what do you think?


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## EdA (May 13, 2003)

Tim West said:


> Not that any of these are any good, but what do you think?


shoulders are troublesome because there are 7 major ligament/tendons involved in the joint, some injuries require rest, some require surgical intervention, some require both, and diagnosis is not always precise

tarsal (hocks) and carpal joints are without doubt the worst joint injuries of all

elbows (with the advent of arthroscopic surgery) are much less debilitating than they used to be (if they are repaired early) but they develop degenerative joint changes which can be more debilitating than the original injury

CCL tears are reasonably easy to diagnose and highly correctable with more than one procedure, given the options I'll take a CCL tear over an injury to a shoulder ligament every time.


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## Tim West (May 27, 2003)

Thanks, I concur.


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## EdA (May 13, 2003)

we are now 4 weeks post-op, we took our first 2.5 mile brisk walk this morning (on lead of course) and both the walk and the aftermath are/were uneventful


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## 1st retriever (Sep 2, 2008)

EdA said:


> we are now 4 weeks post-op, we took our first 2.5 mile brisk walk this morning (on lead of course) and both the walk and the aftermath are/were uneventful


You must be in shape if it was uneventful! I am glad things are going good for him and you!


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## bull (Apr 9, 2004)

Hi Ed

Glad that Chief is doing well. Bull will be at 8 weeks on Monday. What is the
rehab for the next 4 weeks? He is walking 4-5 miles per day now and going to 
aquatic therapy 3-4 times a week. He has been confined or on a short leash for
the past 8 weeks. And we are doing 20-30 sits per day but he still doesn't sit as straight
as I would like. Any suggestions?

Thanks

Steve


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## HiRollerlabs (Jun 11, 2004)

Tim West said:


> Seems to me that a shoulder is so hard to diagnose sometimes that is just prolongs the ultimate treatment. I probably lost a whole year of trials with Jefe trying to figure out what was wrong.


NFC Willie had a shoulder problem that was finally diagnosed here in MN. He was treated for quite a while with cortisone and rest, but it wasn't a fix. Here in MN, Rorem took him to Dr. Levine (ortho surgeon) in St. Paul. Dr. Levine couldn't diagnose it, and sent Willie to an Ortho Surgeon who specializes in rehab. That surgeon took measurements of Willie's shoulders--both of them as I understand. By seeing where the atrophy was, she was able to determine he had a torn rotator cuff. Willie was on Eniva Glucosamine/Chondroitin liquid for his rehab, he had limited exercise, shoulder movement limited in a sling/thing, treadmill in water down in TX, etc. and recovered to train for the Nat'l--just in time.

Shoulders--agree, seems like torn "things" are hard to diagnose and fix. I suppose it's like breaks vs. sprains in humans. Sometimes sprains take longer to heal and are more problematic than a broken bone.


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## EdA (May 13, 2003)

bull said:


> the past 8 weeks. And we are doing 20-30 sits per day but he still doesn't sit as straight
> as I would like. Any suggestions?


keep doing what your doing, find a sand pit somewhere or a sand trap at a golf course and walk him there, set up some traffic cones and do serpetines, lots of step up step down (curbs or stairs), don't get too eager to work him, Slocum told me of a field trial Brittany that went back in training prematurely and ruptured his patellar tendon


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## kindakinky (Dec 11, 2008)

Thank you, Dr. Ed, for the info on TPLO. Had my first dog in 30 years have to have the surgery (U. of Minn.) after getting caught in a log jam duck hunting.

When he could walk a little bit, I used 2 by 4's placed so he had to use his hind legs to step about 2.5 inches vertically. (Had used this for a steeple chaser horse a long, long time ago we were trying to rehabilitate.)

One thing I did which may have been wrong or right (I don't know) was use a hair dryer to warm his muscles when I did the physical therapy on his leg. Low setting or I used one of those gel packs for muscle aches warmed in the microwave and put it on his leg before the therapy. I was thinking warming up his muscles before physical therapy was good? Maybe not? Is it good to warm up the muscles before PT or should the muscles be allowed to warm up naturally via PT?

He's doing great one year after surgery though he has not done anything hard like a 2-week South Dakota trip. (Will be 10 years next month so probably doesn't have a lot of 2-weekers in him anymore, anyway--LOL.)

Thank you for the wonderful posts about TPLO.


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## EdA (May 13, 2003)

Chef is 9 weeks post-op today. We made a trip to Auburn this weekend to leave him for 3 weeks of physical therapy. The osteotomy was healed at 7 1/2 weeks post-op so his activity restrictions have not been as severe.


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## Howard N (Jan 3, 2003)

Dr. Ed, the TPLO thread brought this to the forefront again.

How is Chef doing? You should have had him back ~3 weeks ago. Is he back, is he in regular training with no restrictions?


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## EdA (May 13, 2003)

Howard N said:


> Dr. Ed, the TPLO thread brought this to the forefront again.
> 
> How is Chef doing? You should have had him back ~3 weeks ago. Is he back, is he in regular training with no restrictions?


he was cleared for light training (wagon wheel) 3 weeks ago, he has been pulling weight for 3 weeks, his hair has regrown and it is impossible to tell which leg was surgically repaired, full training begins this weekend

Steve O'Connell's Bull was about 3-4 weeks ahead of Chef and also had an uneventful recovery thanks to some good rehab people near Steve, they must have done a fine job as Bull got 2nd in both the Open and Amateur this past weekend in Chattanooga


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## EdA (May 13, 2003)

Chef has been in full training since early July, he got a 1st and a 3rd in his last Qualifyings and finished the 2nd Amateur of his career at Cheyenne Labor Day weekend.

Today he became one of the 50% who injure the opposite side and is scheduled for a TPLO next week, this really sucks, 3 upcoming field trials and 3 SD pheasant hunts.......

but we know the drill and he'll be recovered to resume training in early February


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## 1st retriever (Sep 2, 2008)

I am sorry to hear that. Hope he recovers quickly!


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## Rick_C (Dec 12, 2007)

Wow, that's horrible news. I'm sorry to hear that.

I'm curious since 50% injure the opposite leg, and he did, once both are repaired, what is the risk of re-injury? Is it any more or less than any other athletic dog?


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## BonMallari (Feb 7, 2008)

aw Doc sorry to hear that, especially after the very nice summer trial season that you had, I didnt follow the entire thread but I read you had him in Auburn, does that mean Cal Cadmus and will he be doing this surgery or is it being done locally in DFW...lets pray for a speed recovery


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## Howard N (Jan 3, 2003)

Dr. Ed you are right, *this really sucks*!

Hope Chef recovers from this one as well as he recovered from the last one. 

I think he'll be tearing up the circuit next spring.


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## EdA (May 13, 2003)

BonMallari said:


> I read you had him in Auburn


War Eagle!!, that would be Auburn ALABAMA, doing rehab with Professor/spouse and ace physical therapist

Dr. Radasch (ace orthopedic surgeon) at Dallas Veterinary Surgical Center (who did the other one) will do the surgery


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## tshuntin (Mar 22, 2003)

Very sorry Ed. Thoughts with you for a speedy full recovery.


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## aabraham (Dec 18, 2004)

If a dog ruptured the pateller tendon what would happen? Could he walk? How could you tell if this happened? If it did happen could the dog come back from that to be able to trial again?


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## Gun_Dog2002 (Apr 22, 2003)

EdA said:


> he was cleared for light training (wagon wheel) 3 weeks ago, he has been pulling weight for 3 weeks, his hair has regrown and it is impossible to tell which leg was surgically repaired, full training begins this weekend
> 
> Steve O'Connell's Bull was about 3-4 weeks ahead of Chef and also had an uneventful recovery thanks to some good rehab people near Steve, they must have done a fine job as Bull got 2nd in both the Open and Amateur this past weekend in Chattanooga


Oh bummer. I didn't know Bull had to have surgery. Glad to hear he recovered. I remember him as a young dog at the Lardy seminar.

/Paul


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## Gun_Dog2002 (Apr 22, 2003)

EdA said:


> Chef has been in full training since early July, he got a 1st and a 3rd in his last Qualifyings and finished the 2nd Amateur of his career at Cheyenne Labor Day weekend.
> 
> Today he became one of the 50% who injure the opposite side and is scheduled for a TPLO next week, this really sucks, 3 upcoming field trials and 3 SD pheasant hunts.......
> 
> but we know the drill and he'll be recovered to resume training in early February


Ah man. Sorry to hear it Ed. I went through the same with a little pointer bitch of mine that only needed 2 points to reach FC when she blew out the other leg. She didn't recover so well and I had to retire her. She's happy as pigs in Sheet just diggin holes in the field and chasing planted pheasants now. I wish you're pup the best. 


/Paul


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## MooseGooser (May 11, 2003)

Man Ed,,, wata bummer!!!

Goosers been kinda followin yer dawg. 

I didnt get a chance to watch him run,, sounds like a Great dawg!!

To bad !! Hope He recovers quickly!

Gooser


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## D Osborn (Jul 19, 2004)

oh, this stinks! I am so sorry!


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## Maxs Mom (Sep 17, 2009)

I am relatively new to this board. I am so sorry about your double TPLO, but I have an older dog who had both her knees done. I have NO regrets! She had her first knee done at age 8 after my lab T boned her like a car through an intersection. Sixteen months later her second knee went. I had always assumed she had arthritic changes etc before her surgeries so she had on an off meds for soreness. Post her second she has not needed ANY until very recently. She is now 12 1/2 and up until a couple months ago she was keeping up with my younger dogs. She now has cancer so that is what is making her slow down. 

These are pain in the backside issues, and expensive, but your dog should recover just as well from the second surgery and be back in the field in no time. It might take a little longer on the second knee to return to full. When the first knee is injured they have a "good" knee left. The second knee they try to protect both sides. They recover great just might take a bit longer. 

Good Luck.


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## Janet Kimbrough (Aug 14, 2003)

Dr Ed,

Not that anyone needs to tell you but I understand how you feel. My Wagars had to have his first TPLO in the fall of 2007 while training for the Fall Grand. Got him going good in the Spring and when training for the 2008 Spring Grand he blew the other knee. Totally distroyed the second one so off we went to Dr Daily for the second TPLO.

The recovery of each was totally different although Wagars seem to recover from the second on much quicker than the first one.

Good Luck with your dogs rehab and wishing for a speedy recovery.

Janet Kimbrough


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## Richard Fuquay (Jun 4, 2006)

Dang, based ln the reponses here doc I wonder if that 50% rate for the second CCL injury isn't really higher? Mac was released the first week of September after his second surgery during early June. Good luck.


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## EdA (May 13, 2003)

bayshooter said:


> Dang, based ln the reponses here doc I wonder if that 50% rate for the second CCL injury isn't really higher? Mac was released the first week of September after his second surgery during early June. Good luck.


Given their relatively short competitive careers if I had one tear a CCL this young again I would strongly consider doing both legs in the same time frame, this has basically been a lost year for Chef and one he may never recover


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## Richard Fuquay (Jun 4, 2006)

EdA said:


> Given their relatively short competitive careers if I had one tear a CCL this young again I would strongly consider doing both legs in the same time frame, this has basically been a lost year for Chef and one he may never recover


I agree in hindsight. We have been dealing with either the injuries, surgery or rehab for over 18 months of Mac's three years. This has wreaked havoc on his training. Of course in my case it would be a close call on what the biggest impediment was to his training, the injuries and delay or having me as a trainer.


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## EdA (May 13, 2003)

bayshooter said:


> I agree in hindsight. We have been dealing with either the injuries, surgery or rehab for over 18 months of Mac's three years. This has wreaked havoc on his training. Of course in my case it would be a close call on what the biggest impediment was to his training, the injuries and delay or having me as a trainer.


Whatever your self perceived deficiencies as a trainer notwithstanding, a sound dog with a mediocre trainer is significantly better off than an unsound one with a great trainer

Most of us (as trainers) are significant impediments to our dogs regardless of our committment

I hope that your's recovers as well as I hope mine will


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## wheelhorse (Nov 13, 2005)

bayshooter said:


> Dang, based ln the reponses here doc I wonder if that 50% rate for the second CCL injury isn't really higher? Mac was released the first week of September after his second surgery during early June. Good luck.


Actually, most of what I've read and heard discussed by the ortho specialists, the rate is closer to 80%.


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## Ted Shih (Jan 20, 2003)

EdA said:


> Given their relatively short competitive careers if I had one tear a CCL this young again I would strongly consider doing both legs in the same time frame, this has basically been a lost year for Chef and one he may never recover


 
I agree. If I had it to do again, I would have done both of Buffy's knees at the same time.

It would have saved me a year of her competition life

And about $1000-$1500 of surgery costs


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## 1st retriever (Sep 2, 2008)

Is it harder on the dog to recover if they are done at the same time?


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## Todd Caswell (Jun 24, 2008)

This is probably a stupid question (haven't done alot of research on this although it worries me every time we train, or run) but why is there such a high occurrence of the other knee going out??


And another "dumb " Question why would you have the surgery on a knee that was fine.. Other than the fact that 50 or 80% will need to have the other knee done in the future.


Sorry for the questions, I need to do some research because this doesn't make sence to me.


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## Ted Shih (Jan 20, 2003)

According to the specialists that I have spoken to, there is a slightly higher risk of infection and other complications if you do both knees. It will be harder on you the human, as you will need to support both legs of the dog when you take it out to air.

As for why do both ...

Most dogs that I know that have one go out, have the other go out within a year

As for why fix a good knee

You really have no idea whether the knee is good. Buffy's other knee was tight whenever the vet checked it, yet before the 2008 National Am, it was partially torn

As for what causes it

The specialists that I have spoken to believe that it is genetic, but they have not isolated the cause. They say that it does not appear to be:

- Angle
- Pinched in from rear
- Size, shape of hole through bone that ligament passes

They don't know yet what the physiological cause of the knee failure is


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## Janet Kimbrough (Aug 14, 2003)

Todd,

From my non-medical perspective, I think several factors enter into play:

I think the degree of slope that the dog is a factor on the other knee going just as it was with the first knee.

I found it very difficult to get the muscle tone back in balance on both legs regardless of what I did. I think they get use to "favoring" the leg and it is hard to get that stopped so they put more weight and pressure on the "good" leg.

JMHO for what it is worth. I am sure that Dr Ed could give a much better explaination.

Janet


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## EdA (May 13, 2003)

I have no doubt that there is a genetic predisposition to CCL ruptures. Those factors include (at least some of the following) slope of the tibial plateau, width of the intercondylar notch, tensile strength of the CCL, and possibly some immune mediated process which weakens the ligament. The same factors which contribute to rupture #1 also exist in the opposite limb.

In neither case was there any discernible episode for Chef's injury, it merely happened during the course of a normal day's training. 

His gait since last Friday has been normal except to a very scrutinizing eye. I told Dr. Radasch that when he watched him walk he would think I was crazy but I knew immediately what had happened. The stifle was tight under light anesthesia but there was a joint effusion evident on radiograoph. Arthroscopy revealed a frayed CCL so a TPLO was performed this morning. Due to the fact that this was a very recent episode Dr. R. described the joint as being in excellent shape and he expects a rapid and uneventful recovery.

I have become much more aggressive about getting these acute first time injuries to surgery immediately. The fact that the joint is tight to palpation means little except that there is some ligament tissue still intact. The sooner the repair is done the less collateral damage occurs. The worst that could happen is that the dog would undergo a diagnostic arthroscopic procedure and find no evidence of CCL damage.

My comment about doing both the good and the bad leg (in a young dog) in a similar time frame is because of the very high incidence of injury to the other leg. Certainly it is not without risk, however given the length of time lost it is at least an idea worthy of consideration. 

My orthopedic surgeon was not so keen on the idea but he is also fairly conservative, a trait which I like. Hopefully I will not have to deal with this problem again in the two younger half siblings.

I am also certain that this problem is much more prevalent than it was 25 or 30 years ago.


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## Eric Johnson (Dec 23, 2004)

Would you do them both under one anesthesia or do the injured one, wait until the dog was partially recovered and then do the other? If the wait was six weeks, you'd have the effect of extending the recovery/rehab time by six weeks. That seems a fair trade considering the impact of having both done at the same time.

Eric


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## EdA (May 13, 2003)

Eric Johnson said:


> Would you do them both under one anesthesia or do the injured one, wait until the dog was partially recovered and then do the other? If the wait was six weeks, you'd have the effect of extending the recovery/rehab time by six weeks. That seems a fair trade considering the impact of having both done at the same time.
> 
> Eric


I would probably wait 2-4 weeks between surgeries if the surgeon was OK with that time interval


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## Eric Johnson (Dec 23, 2004)

I forgot to add...

"...and a big advantage over what you've had to suffer through of constant rehab for almost a year."

Makes sense to me. I'd always heard that the probability of the second operation was higher that 50%.

Eric


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## Thomas D (Jan 27, 2003)

"The stifle was tight under light anesthesia but there was a joint effusion evident on radiograoph."

Dr Ed:
Does the term joint effusion mean fluid build up in the joint? Would this show up as a light shadow in the radiograph? 

Thanks


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## EdA (May 13, 2003)

Thomas D said:


> "The stifle was tight under light anesthesia but there was a joint effusion evident on radiograoph."
> 
> Dr Ed:
> Does the term joint effusion mean fluid build up in the joint? Would this show up as a light shadow in the radiograph?
> ...


yes, increase fluid density in the joint capsule


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## Old School Labs (May 17, 2006)

Dang, Ed so sorry to hear about Cheffy Boy. He was on his way to do well the rest of this year. Hope recovery is fast and without and problems.


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## Janet Kimbrough (Aug 14, 2003)

Dr Ed,

My Ortho surgeon also believes that even though there is no documentation, that for the most part, it is genenic as well.

By collateral damage are you refering to the muscle loss etc? I ask because I had taken my guy to my vet who sedated and examined him but found the knee to be tight (as you stated). That was in April and he blew the CCL in early September. The muscle mass that he had lost during the months of slight favoring of that leg was amazing and I hadn't even notice. When the other knee went, the surgery was done much quicker as he destroyed everything but he muscle loss was much less.

Again, I hope that Cheif's recovery is speedy.

Janet


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## EdA (May 13, 2003)

the recent question about TPLO in performance dogs prompted this update

at Thanksgiving Chef went to Auburn for 3 weeks of physical therapy as part of a research project (my wife's project)

she declared him weight bearing equally after the PT and "better then he was at the same interval post op with the surgery on the opposite limb" which was done in February 2009

when he came home after Christmas I started roading him and he has been back in training for 2 weeks, he is very sound and it is impossible to tell which surgery was done more recently

so we lost 2009 but hopefully better things are ahead for Chef


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## PhilBernardi (Jul 17, 2010)

Dont know if Doc is still around on RTF, but my Nala is gonna have CCL surgery in the next 3-6 weeks and I'd like to know how Chef has been doing since the two surgeries.


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## EdA (May 13, 2003)

PhilBernardi said:


> Dont know if Doc is still around on RTF, but my Nala is gonna have CCL surgery in the next 3-6 weeks and I'd like to know how Chef has been doing since the two surgeries.


He is doing great! full throttle, one would never know that he ever had bilateral TPLOs


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## PhilBernardi (Jul 17, 2010)

Super! Thanks for the quick reply, Doc.

I'm so torn (no pun intended) about all this. My Nala is almost 6. 

I have so many questions: How old will she live? How many years of hunting will I get out of her after surgery? When will the other knee give out ('cause the probability is good that it will)? Should I just retired her and start anew? 

I hate all this!!


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## EdA (May 13, 2003)

PhilBernardi said:


> Super! Thanks for the quick reply, Doc.
> 
> I'm so torn (no pun intended) about all this. My Nala is almost 6.
> 
> ...


The age at which the first tear occurs seems to influence the likelihood of a tear in the opposite leg, dogs her age have a lower risk than do ones like Chef whose original injury was at 18 months


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