TPLO Surgery

[Nancy]

I was wondering if anyone here has a dog who had to have TPLO Surgery, which is treatment for Cranial Cruciate Ligament Disease.  Oliver had an appointment with an Orthopedic Specialist yesterday for ongoing lameness in his rear right leg and it has been determined that surgery would be his best option.  I was looking for feedback from someone who has been through it.  I was told that the recovery period is 16 weeks total, 4 weeks of nothing more than going out to potty and after that short leash walking with increase in weeks following.  I am feeling so bad for him and not looking forward to this, especially since I also have Ivy and Oliver will not understand her freedom and not his.  I have tried to search and for this topic and for some reason, whenever I try to search for anything, it doesn't seem to work for me.  Photo  for cuteness.

[Karen, Jasper and Jackdoodle]

Nancy, the main search feature doesn't work. You need to search in the forum itself and/or in the health group. We have had a number of members whose dogs have had this surgery. 

To search the forum, just click the "Forum" tab in orange at the top of the page. You'll get a little box in the upper left right under "Forum Discussions" where you can type your search term.
And here is the link to search the discussions in the Health Group. (To get it, you go to the group, scroll down to the bottom of the discussion list section, and click "View All".)
https://doodlekisses.com/group/healthandmedicalissues/forum

[Karen, Jasper and Jackdoodle]

Here's what I got when I searched the forum for TPLO:
https://doodlekisses.com/forum/topic/search?q=TPLO

[Karen, Jasper and Jackdoodle]

And here's what I got from a search for "cruciate":
https://doodlekisses.com/forum/topic/search?q=cruciate

[Karen, Jasper and Jackdoodle]

Here is a big discussion on this same condition and surgery from the Health group:

https://doodlekisses.com/group/healthandmedicalissues/forum/topics/...

[Nancy]

Thank you Karen!  As usual you always have the answers.  Just so you know, and I'm sure others will agree that you knowledge and willingness to reply and offer assistance to others is greatly appreciated!  So after browsing through ( and I will go back and actually take the time to read in more detail), I decided to call another Orthopedic Specialist and make an appointment for a 2nd opinion.  I really feel like the first one was "pushing" for surgery.  Oliver's issue has been going on intermittently since last May.  It has seemed to get completely better with rest and anti inflammatory meds and just recently returned again after some excessive ball fetching.  He had XRays last May of his hips and knees and all showed completely normal with no signs of fluid or arthritis.  The first Ortho examined him and said that he had pretty good mobility (extension, flexing, etc.) but there was definitely some stiffness and wasn't sure if there was an actual "tear".  Her recommendation was to get another set of XRays and wanted to sedate him to do so.  I told her that he was NOT sedated for the first XRays, but she said that was how they did it.  When I spoke with the 2nd Ortho, he said that additional XRays were not necessary.  He said he would be able to determine by manipulation if there was an actual tear or if it could be something else such as a groin issue.  He said that if he determined that it was a tear and that surgery was needed, he would do an XRay the day of the surgery.  

I can't help but feel that there is that possibility that Oliver's injury may be able to heal without surgery and because he is 8 years old, I would rather try the more conservative route first.  I have read that complete rest, no stairs, running, jumping, etc and anti inflammatory meds and a brace could possibly work.  He definitely gets better with the meds, he definitely puts weight on it, he WILL run and jump if we allow and does all of this with no issues.  It is not until after he lays down for a while, he is lame getting up and limps a bit.  Thoughts???

 

[Karen, Jasper and Jackdoodle]

Well, I'm of the mind that if you can fix something once and for all, rather than having to live with meds, restricted activity, & other palliative treatments indefinitely for the rest of the dog's life, it's better to just fix it. I have always regretted going the conservative route with JD's spine issues instead of doing the surgery, and he was close to Oliver's age at the time it was diagnosed.

Anti-inflammatory meds have a lot of side effects, and using them long term, even if it's on and off, carries its own risks, among them gastrointestinal issues from the NSAIDS like Rimadyl and/or immune system/kidney/liver issues from the steroidal meds. That was a major problem for us.

I think you also have to think about the chances that it will get worse or cause other problems with time. (With knees, I think they always say it's only a matter of time before the other knee goes.) I know that with certain kinds of soft tissue injuries in humans, a strain or weakness is often predictive of a tear a little further down the line. And many types of orthopedic conditions contribute to the development of arthritis later on, too. Of course, nobody can know these things for sure, but I think an accurate diagnosis helps with predicting future concerns. And of course, the sooner you do surgery, IF you're going to do it, the better the outcome in many cases.

So it's a hard decision, and I don;t think there is a clear cut right or wrong choice re: conservative vs aggressive treatments. Both have pros and cons. But I do think you need to know exactly what is wrong before you can decide how to treat it. 

[Karen, Jasper and Jackdoodle]

(And thank you for the very kind words.)

[Lee Seidman]

Our Billy had surgery on right rear leg and it turned out pretty good, Surgeon told us that he will probably need surgery on other leg within a year. He was right, Billy tore the other side, required surgery and another ten week recovery. He still has a limp and developed arthritis in left leg. He is on meds for it. We chose surgery after investigating other options

[Nancy, Ned, Clancy, and Charlie]

Yes, we've been through it twice with our Springer Spaniel.  Highlights from my memory: We created an area for him to be with us but separate from the other dogs using ex-pens and a short hallway. When he was at the next level, we kept him leashed to our chairs. We used a support (like a beach towel but this one was supplied by our vet) to help him go up our stairs to bed at night (also in ex-pens). While he still had the bandages on his leg, we kept a baby sock on his foot to keep it clean. (We put a dog poop bag over the foot with a sock on top when we took him out to potty.)  When he was at the rehab level, we walked him next to the curb so he had to go on and off the curb (be sure he does this on both sides). We were told that our hilly area was better to walk him than flat areas.

[Lucy & AnnaBelle's Mom]

Your situation sounds very similar to the situation that we had with our Lucy.  She would start limping and we would rest for several weeks.  The she would be playing again and it would happen all over.  We were told probably a partial tear.  Finally, she started not wanting to put any or hardly any weight on it at all.  That is when we went to the Ortho Dr.  What we were told is that in small dogs you can possibly get one to heal with the conservative measures, but with the larger dogs, they just keep re-injuring it.  You rest it and it gets a little better and then you let them go back to regular activity and it happens again.  We didn't do the TPLO but what they call a suture procedure. They have the same long term results I believe.  The suture procedure just happened to be the type that the Ortho we went to specialized in.  I believe you had to be a little more careful in the beginning than with the TPLO.  It was a 12 week recovery process similar to what you mentioned.  We used an x pen (like Nancy mentioned) as well.  That was the first 7 weeks, with potty only.  Then she was allowed off leash in the house only for 6 more weeks, with short walks starting at 15 mins and adding 5 mins a week.  At 12 weeks she was allowed off leash outside.  FYI, the first time we took her out she walked out and laid down.  We thought she would go crazy, but she just laid down in the grass.  I don't think there is anything wrong with getting a second opinion.  However if they feel it is torn as well, I personally don't think the conservative treatment of resting is going to work for you long term.  I've always heard the if one goes the other one will, but in our case so far that has not been true and it has been 7 years.  My folks also had it done on their lab and she has not had a problem with the other one either.  We also had another doodle and it didn't really seem to bother Lucy to be confined.  Sophie would lay beside the x-pen.  So, just do your homework and make the right decision for you and Oliver.  

[Nancy]

Thank you Karen, Nancy and Lucy.  I've read the articles and I'm pretty sure that the surgery is most likely the way we will end up going.  I admit, I just hate the thought because of the recovery process.  Oliver is a very sensitive and soulful boy and I don't want to see him sad, but I also don't want to see him in pain.  He want so much to play and run and we are doing our best to keep him quiet, of course it makes it more difficult when Ivy drops the ball at my feet, Oliver goes and gets another and does the same!  It would be much easier with one dog but I'm sure it will work out.  We also have hardwood flooring and we have several area rugs but it is impossible to cover every spot and I cringe when I see him slip.  We have an appointment on July 2nd for the 2nd opinion and will definitely go with what is recommended.  Just from the conversation, I'm leaning toward that facility as opposed to the first one.  Thanks again, will keep you updated and I'm so happy it worked out for your dogs.

[Adina P]

Boca has had both knees done, but NOT with TPLO.  We opted for the more old-fashioned "lateral suture."  She had her left knee done 3 years ago and it has been fine.  Her right knee was done 8 weeks ago and her recovery is continuing.  The general recommendation is for dogs over a certain weight that it's not "good enough."  Boca is 60-or-so pounds and she is on the upper end, possibly slightly over and it has worked out for us.  The recovery isn't as intense.  We had to do "potty only" for 2 weeks and then gradually increase short walks.  We also kept her off of stairs (using a ramp either in the front yard [closer to her crate] and later backyard) during the first 3-4 weeks.  We also kept her tethered to a couch or heavy kettle bell in the living room after the first 2 weeks of crate rest and that kept her quiet and able to be near us.  It's something to think about, though I think if you live in a big city where all the docs do TPLO, then they will push for it.  

There are some fancy brace companies that swear by putting a stifle brace on the effected leg and using that for a period of time until the dog heals (scar tissue forms to stabilize the knee), but that seems super cumbersome.