I took her home and let her soak in a warm bath for a little while. My bath tub is not deep enough so I have her down-stay while I gave her bits of kibbles.
February 13, 2010
1/12/10 - First time off leash
I took her home and let her soak in a warm bath for a little while. My bath tub is not deep enough so I have her down-stay while I gave her bits of kibbles.
February 9, 2010
2/8/2010 - Post OP X-rays




I put on her bootie (with coins inside) when I took her to the clinic. He likes the idea and he sees that it helps.

It's been almost 17 months since I noticed her first hopping. I can't believe a young Border Collie could put up with this so long. Such a patient girl she is.
January 11, 2010
1/11/2010 - Suture removal
Final xrays in 4 weeks.
Muscle atrophy:
Left thigh - 13 inches, Right thigh - 10.8 inches
December 30, 2009
12/30/2009 - Post surgery



I was expecting something similar to post-TPLO. It was so much easier with this surgery. She was able to go potty right away. It took her almost a day after TPLO. She was awake (no morphine patch) and happy. The best part was that I didn't have to put the e-collar on her at all. They put a bandage on the surgical area so she cannot lick it. That was a HUGE help. It did take a bit longer for her to start putting weight on the leg - 4-5 days. Pain killer, anti-inflamatory and antibiotics for 2 weeks.

December 29, 2009
12/29/2009 - Patella Surgey

Update:
He did NOT have to do TTT. Turned out she had both medial and lateral luxation. The patella was sliding to both sides. He did limbrication (tucking in the ligament) and Trochleoplast (deepening the groove) then removed the TPLO plate/screws. Her meniscus was healthy and he didn't see any arthritis. (GREAT news!) I was actually surprised that they were in good shape considering how long she had this condtion for. Maybe the supplements helped? She stayed overnight. I was miserable without her.
More info on Luxating Patella on the web:
http://www.marvistavet.com/html/medial_luxating_patella.html
LATERAL IMBRICATION (ALSO CALLED LATERAL REINFORCEMENT)
This procedure alone may be adequate for a mild case but is often used as an adjuctive procedure to supplement one of the other surgeries. When the patella slips out of its groove, the joint capsule surrounding it is stretched to allow this motion. Imbrication simply involves taking a tuck in the joint capsule. The tightened joint capsule does not allow for the slipping of the kneecap and the kneecap is confined to its proper groove.
TROCHLEAR MODIFICATION
The patella rides in a groove at the bottom of the femur (thigh bone). In toy breed dogs this groove is shallow which allows the patella to slip. If the groove is deepened, the patella stays where it belongs. The normal groove in the femur is lined by slippery lubricated cartilage, called “hyaline cartilage”. This cartilage is peeled or cut away, the bone underneath is sliced out to form a deeper groove, and the cartilage is replaced. Techniques that do not preserve the original cartilage are no longer recommended.
TIBIAL CREST TRANSPOSITION
If the knock-kneed conformation has already started to set in, the tibias (or leg bones) will have rotated. In particular, the crest on the tibia where the thigh muscle (the quadriceps femoris) attaches, may have migrated inward. If this is the case, the crest will have to be removed and pinned back where it belongs to straighten out the leg. Severe rotation of the tibias may involve actually cutting through the entire bone and de-rotating it back into place.Grade 2 luxations occur when there is occasional spontaneous lameness but the
patella returns to normal positioning easily enough that the dog usually isn't pained much by it. This is typically the dog that occasionally carries a rear leg for two or three steps on occasion but then puts it back down and goes as if nothing was wrong.
Most veterinary orthopedic surgeons recommend repairing dogs in Grade 3+ without question and advocate fixing grade 2 dogs frequently. So a 2.5 grade is probably one in which the examining veterinarian is leaning towards thinking surgery is necessary. That is just my best guess on the interpretation, though. It is better to ask the vet who made it. I think that most dogs generally get worse over time and move from Grade 1 to Grade 2 or from Grade 2 to 3, for example. The changes may not happen until later in life, though. A lot of dogs with Grade 1 or Grade 2 patella luxation early in life will have pretty stiff knee joints when they are 14 or 15 years old that probably are at least partially this way due to arthritis from the years of luxating patellae. There is a lot of other wear and tear in a long life so this is only a partial contributor but I know that some surgeons really feel that when the whole lifetime is looked at early surgery looks better. On the other hand, there are dogs who have bad 0utcomes from the surgery, too. I lean towards leaving knees alone until the Grade 3 stage, personally.
December 23, 2009
12/23/2009 - Warm water rehab #2
December 18, 2009
12/18/2009 - contacted OS for surgery options (Patella)
Hopefully she only need limbrication and/or Trochleoplast (deeping the groove) and not TTT. That seems too invasive.
December 14, 2009
12/14/2009 - Very sore
December 13, 2009
12/13/2009 - First warm water rehab

She limped quite a bit after the session. But the OS told me that's expected.
December 2, 2009
Another visit with OS 12/2/2009
He felt that her knee cap was still loose. It is not even grade II. He explained to me different surgeries to correct LP but he suggested to wait. Since her muscle is weak and the ligament is looser, he suggested really working on building the muscle. Possibly it could help tightening the ligament. I recently found a warm water rehab place up in Spring TX. I had been looking for dog friendly pools with no avail. OS told me swimming and running would be good for her.
So no surgery yet. He ordered swimming for treatment...sounds good to me!
October 26, 2009
New videos
one of her worst day - few weeks ago. She usually gets better the following day.
I sent this video to my OS #2.
September 18, 2009
6 months mark after TPLO
I will say that I am finally starting to feel okay about letting her run. I still cringe everytime I toss a ball. I am still very cautious when I let her play. Last weekend I let her fetch a frisbee for the first time in almost a year. She jumped and fetch gracefully a dozen times then failed to catch. I was only tossing it 5-10 feet away from me. She missed to catch and landed somewhat awkwardly. It was not a big "Oops" fortunately. I let her rest and gave her Deramaxx for a few days and she is back to where she was last week. I do encourage her to play tug with my other dog for wegith bearing but I micromanage. We walk off leash and do incline walks on leash. We do controlled freestyle as part of her rehab. We are really enjoying this.
I was really hoping that she would be back on rubble pile by now. Not sure if she'd ever get there again. Or maybe it just takes a little bit longer for her because of her muscle atrophy. When I did joint mobilization last night, it didn't seem to bother her knee at all. She was much more tense on the hip area. Maybe it's her hip or arthritis... OK, better stop before I get depressed.
August 1, 2009
Almost 4 months Video - Incline on Treadmill
July 9, 2009
3.5 months post TPLO update
She has been doing so well except for the hopping and occasional soreness. The same hopping that got me noticed the partial tear in the first place. She does it mostly when trotting, stopping or turning. This is the only consistent thing in the past 10 months. Her bone is healed and I didn’t understand why the hopping was still there. Worried that there might be some other issue, I contacted my OS. Via email I explained her condition and my concern. They said that she could be having a plate sensitivity and removing it could possibly fix that. I didn’t notice any swelling or infections but if that’s the case, let’s have it removed.
I took her to the OS yesterday. He was actually very impressed with the way she was using the leg. He agreed that there was no sign of infection, therefore not to remove the plate. He also said that only about 5% of TPLO dogs end up removing the plate. So it’s not that common. He checked the mobilization, her illiopsoas and other areas to rule out other issues. He concluded that it was a habitual hop. She’s been doing this for so long, it has become a habit physically and mentally. He told me to basically let her run and play more. She needs to stop thinking about the leg and just use it. It is only natural for her to be sore until she builds up the muscle. (by the way, she gained back about ¾ of 2 inches of muscle in the last 3 months) Just like humans, the dogs will be sore after exercising. I thought about the pain on my inner thighs after the horse riding the other day… He told me to give her NSAIDS before or after the exercise. I decided to give that a chance. I’m still scared to throw a ball. She takes fetching very serious (Border Collie) and I don’t want her making the quick turns. Yesterday I let her play in sprinkler while I watered the lawn. That’s one of the few ways she’d trots and run lightly. She likes to run and catch the falling water.
June 12, 2009
10 weeks post op - 15 minutes of heaven
She has been on treadmill everyday, working on the muscle gradually. I decided to take her to a quiet dog park and let her run for the first time. It's been over 10 months since she runs freely. She did really well, no limping or skipping. I let her spalsh in the pond but no chasing a ball yet. The OS said to let her run or chase balls straight line. That's a little hard to control. So I just dropped a ball in the pond so that she can pounce on it. The best 15 minutes in months!!! I've been watching her after the exercise and she doesn't seem to be sore at all.

June 1, 2009
PT plan for the next 3 weeks & Measurement
- Treadmill – incline 0.5, speed 3.0, duration start at 7 minutes then add more at 1 minute increment
- Back leg exercise – walk over my legs forward, backwards, sideways (up to 5 minutes)
- Push-ups – Sit/Down/Stand
- Walking – 10-15 minutes on leash
- ROM
9th week
- Treadmill – incline 0.5, speed 3.0, duration start at 7 minutes then add more based on progress
- Back leg exercise – walk backwards, sideways (freestyle)
- Stand on back leg, paws up on a stall
- Balance – Sit pretty on unstable surfaces
- Walking – 15 – 20 minutes on leash
- ROM
10th week
- Treadmill – incline 1.0, speed 3.0, duration start at 7 minutes then add more based on progress
- Back leg exercise – walk backwards, sideways (freestyle)
- Stand on back leg without stall
- Stairs with harness for support
- Walking – 5-10 minutes off leash!
Measurement of her thighs
6/1/09
Middle of thighs (laying on the side)
R: 10.5 inches L: 11.5 inches
Top of thighs (laying on the side)
R: 12.5 inches L: 14 inches
Top of thighs (standing)
R: 11 inches L: 13 inches
Below are videos from her previous PT (illiopsoas strain)
Beg position on an unstable surface (for the core muscle)
Banzai (Stand and beg) on an unstable surface
May 29, 2009
8 weeks - PT begins

I added incline on the treadmill. She really need to work on that muscle. We'll continue with the other exercises as well.
May 26, 2009
7.5 weeks post-op xrays
May 12, 2009
VPI SUCKS!!!
I submitted a claim for Jazzy's surgery and out of $4600, they reimbursed only $300. On the benefit schedules, it says the allowance for CCL surgery is $1200+. I've heard insurance companies try to screw with you but didn't think this bad. I called them but they are having a 'meeting' and that I can only leave a message. I wonder if it's a norm and that unless you argue with them, you would only get the smallest money back. I've read something like that about other pet insurance companies but VPI was recommended by several people.
ETA: I finally got through with VPI on the phone. Turned out they made a 'mistake' and put it down as Hypertrophic pulmonary osteoarthropathy' instead of TPLO/CCL. yeah they are very similar condition, aren't they? Right... anyway, they will process the claim again.
May 10, 2009
Please let it be nothing...
The white dots on the mass are her hair. I shave around it so I could see it better.
May 6, 2009
5/6/09 - Exercises
Another trainer who teaches agility (very into back leg awareness) suggested that I let her walk over PVC pipes or flat ladder on the ground instead. Here I'm using my legs as the ladder. This is how she eats half of her dinner each night. I use luring to slow her movements. I tongue click the second she lifts the leg up. I think this helps to reinforce the use of the leg, weight bearing, and strenghten the muscle. I do this after a short walk, for about 60 seconds, followed by icing.
Shifting weight on sit
I leg her lick half tube of canned food (EVO) while I have her do a clean sit then shift the weight slightly towards the right side. I make sure her right paw and hip doesn't stick out. I tried the other weight bearing exercises but she didn't enjoy them. I'd rather do something fun for her.
May 4, 2009
30 days post-op - treadmill videos
Angle view/Speed at 2.7
Side view/Speed at 3.0
you can see her right leg extending slightly less than the left leg (use the plugs as a marker)
She walked for 7 minutes. I saw her leg lagging for a second so I stopped there.
*sorry about my fingers. Too lazy to edit them out.
Just for a comparison, here's one with speed at 2.0
(I learned that some dogs are just too uncomfortable at slower speeds on treadmill. I think that's why she walked funny two weeks ago)
Top view/Speed at 2.7
The surgery leg still pointing out
And I gotta post her cute little butt
April 29, 2009
scary post on orthodogs
Hello, my 11 y/o queensland mix just suffered a catastrophic failure of his TPLO and we are awaiting our surgeons verdict of amputation or repair. It looks very grim with the hardware failed,screws pulled out and multiple fractures.we were careful to keep him confined but were allowing 10 stairs at 4 weeks post op due to surgeon saying it was okay.we had an "oops" due to a short kitty chase and jump into a flower bed when he pulled off the leash. the stairs were only used 2x a day for potty breaks and seemed to be ok until this happened. I think the oops moment began the problem,no major symptoms but our boy seemed to not progress during the week following it then he collapsed on the stairs screaming(crying) in pain. Our hearts are broken and we feel totally responsible yet pissed at the surgeon who said stairs OK at the 4 week phase.All this days before the much awaited 6 week xray and possible return to his beloved walks at the beach.> I have read about the differing advice regarding stairs and write this to encourage others to NOT DO STAIRS! Also as I have read before here,... be hypervigilant for signs that progress has halted not just major signs like not weight bearing I think the oops moment with the kitty was what loosened things then the stairs finished it.> In conclusion has anyone else
experienced a TPLO failure of this type/magnitude and do you folks have any advice/referrals or any info about options here? Sorry for the bad news but really felt my experience would be good to post and we are desperate for info.
April 27, 2009
April 25, 2009
4/25/09 - more treadmill videos
ETA: Adela, I noticed that she is walking better in this video too. One thing I changed was the speed on the treadmill. First time was 2.0 and this time I set it to 2.5. It might have bee too slow the first time and that could be why she was walking awkwardly.
April 23, 2009
4/23 - Stress!
She finally stopped ringing the bell (her signal to go outside) at 3am this morning. I am assuming the Immodium did get absorbed after all. We finally got to sleep a little. She is staying at my second job during the day.
April 20, 2009
4/20/09 - very sore and walking funny
The doctor got back to me about Jazzy's gait/walk. He said based on what he saw on the videos/photos, he thought she was recoverying very well. I really hope this is only temporary... I started doing low step. I click and reward only when she uses the leg to go up, instead of hopping up. I use food as lure and click when she moves the legs separately. I also do weight bearing exercises but I can tell she is very uncomfortable. I hate this...hate to see her in pain. The worst part is I am the one who is giving her the pain during PT.
Sorry about the darkness but you can see how she points her right toes out more in this video.
It's at the lowest speed. She only walked for 60 seconds.
April 18, 2009
4/18/09 - Back to tethering/Weight bearing exercises
Still favoring the leg
She is still limping and not putting any weight on the leg. It's been going on since last Tuesday. I decided to limit her activity in the house to see if that's why. I take her out on short (3 minutes each) walks 5 times a day. If I let her loose in the house, she'd hop on three legs. It's really important that she learns to use all four legs evenly. I started doing weight bearing exercises.
(From orthodogs list)
- Walk on a short leash, VERY SLOWLY
- Stand with paws in a square position (front paws should be under shoulder, back paws should be under hips). Fix them if they are too far forward/backward, in or out.
Make sure al paws are flat and not bearing weight on wrong surface (ie knuckling). - Touch affected limb to desensitize to touch.
- Touch unaffected limb to “fake” him/her out.
- Place paw in palm and gently compress, so he/she feels weight into paws.
- Hold affected paw in your hand and stretch toe nails upward to stretch muscles of the pads.
- Perform range of motion exercises.
- Scratch bottom so he/she dances or wiggles gently (shifting weight from side-to-side).
- In standing gently/slowly rock hind end side-to-side:
With support under belly
Without support
With a folded towel under affected paw
With front limbs on a step - Don’t be afraid to ask them to sit.
- In standing, gently touch affected limb to encourage it to bear weight.
- In standing, gently pull at ankle/elbow to place paw on the ground.
- In standing push towards the non-surgery leg, to encourage a “push back” to the other side (to increase surgery leg weight bearing).
- In standing, have him/her look:
Up
Up and side-to-side - This will shift weight back and to the side. Treats may help.
· In standing, gently/slowly rock body forward and backward.
· While walking slowly on a short leash, gently but firmly push down on top of pelvis to increase hind limb use.
· Do not let both limbs move together in a hopping motion. Practice reciprocal steps.
· Discourage three legged gait as much as possible.
April 17, 2009
4/17/09 - Something is off...
April 15, 2009
April 13, 2009
4/13/09 - Cone Free!!! Several restrictions lifted

April 10, 2009
4/10/09 - Fighting the boredom
April 9, 2009
April 8, 2009
4/8/09 - Restricting activities
During the day she gets to stay at Rover Oaks

When I am in the kitchen, she is tethered - several tethering stations throughout the house

Jazzy's apartment.
The cone is off as long as I am there. Sometimes I stay in the pen with her and watch TV

In my home office - tethered

At night, she stays in a large crate, coned



















