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Dog "needs" knee surgery - looking for experiences/opinions

Discussion in 'Off-Topic' started by DMWB, Jan 5, 2014.

  1. DMWB

    DMWB

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    Good evening,

    Our 50lb. pittie/hound mix Shelby began experiencing symptoms of patellar luxation in her right hind leg when she was approx. 11 months old. The symptoms manifested as weakness of the affected leg with limping that usually followed exercise and difficulty rising from rest. Although the condition appeared fairly acute at first, she appears to be "recovering" lately although from what I understand patellar luxation is a disorder that generally gets worse over time without intervention. That being said, we consulted our vet and friends and have decided to have the condition repaired surgically. The orthopedic specialist who will be performing the surgical procedure advised during the consultation that Shelby's condition is rated at "2" in a scale of 1-4. She is scheduled for surgery in a few weeks, but in the meantime I was hoping to hear from others who may have experience with this disorder. A few questions:

    -Did your dog recover fully, and if not, was the prognosis originally very good?
    -How long was the overall recovery time?
    -What did you do to help the dog cope with restricted activity?
    -Approximately what were you charged for the surgery?

    Thank you in advance.

    Sincerely,

    Shelby's Dad (not shown)

    shelby_smile.jpg
     
    Last edited: Jan 5, 2014

  2. JCV

    JCV

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    I have no advice for you, sorry.

    But she's a beautiful pup, and hope she ends up 100%
     
  3. Rotaryrocket

    Rotaryrocket NES Member

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    Maybe flexophile on here can help out with questions. I hope the best for your pooch.
     
  4. bullseye

    bullseye NES Member

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    I put my dog on 3 times a day dosage of Oxycontin 30 mg, all she did was sit in the corner and drool, never had to worry about surgery.

    Seriously, what is the vet your going to and have you sought out a second opinion. I was from CT and the Bolton Vet Hospital. , Bolton CT. is an astounding place with resources that saved our Belgian Shepherds broken femur, saved his leg from amputation due to the location of the break, how high up it was towards the hip. This was 6 years ago. They bring Doctors up from UCONN's Veterinary school for tough situations. It cost us almost 7 grand for our puppy and it was well worth it!!!!!!!
    Search for options! And may the good lord bless your pup!
     
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  5. DMWB

    DMWB

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    Thank you, she sends a friendly lick.

    Ah good point, I was hoping there is a Vet on here somewhere. Thank you!

    Sometimes I'd like to undergo that particular treatment, and not for my knee!

    Anyway, her primary care vet (PCV?) is Dr. Handy @ VCA Lancaster and the orthopedic specialist is Dr. Dudley @ VCA Northborough.

    We had planned to take her to Central Animal Hospital in Leominster for a second opinion but cancelled the appt. after discovering they do not have an in-house orthopedist.

    We are in Central MA. Your pup's treatment and recovery is heartening, glad to hear he or she is doing well. Thank you!

    EDIT: My wife informed me that Bolton (CT) Vet Hospital also saved her cat (Havoc) when she had a respiratory infection as a kitten. So that's two NES members' animals saved by Bolton Vet Hospital!
     
    Last edited: Jan 5, 2014
  6. atilla

    atilla

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    you're in/near lancaster? check out the wachusett animal hospital there... they are great folks and have a super nice building right down the road from the depot rd exit on rt.2.
     
  7. dogdoctor

    dogdoctor

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    DMWB - there may be more to this issue than you're aware but please read: Medially Luxating Patellas

    Grade II's are not one that I usually associate with the symptoms that you are seeing, unless it is of the progressive variety and your dogs size and weight might play a huge factor into that. That is why I make the statement above. If you do have more serious signs, either there is more arthritis there already or there is often a traumatic event (not congenital) that lead to the luxation and is a result of some forms of injury to some of the ligaments of the knee - ACL/MCL/meniscal tears etc.

    As a result, a dog that has more severe signs of lameness and weakness to a knee is often referred for orthopedic consultation +/- Rads/MRI to try determine the exact cause of the lameness and the subsequent correction. Sometimes that is not completely known until you are in surgery. I have known many a dog that needed not only trochlear wedge resection (or other options) for patellar replacement, but also needed ACL repair at the same time.

    I don't think it will hurt to get a second opinion if your aren't sure or confident in the preliminary diagnosis. If you are to get a second opinion, get an orthopedist's opinion.

    Prognosis: That all depends on the severity of the disease and arthritis present at the time of surgery, as well as surgery type performed and of course the skill level of the surgeon performing said surgery.

    Times: Any procedure that results in cutting of bone - 6 to 8 weeks is the standard recovery time, but that can often extend further with physical therapy.

    Activity Restrictions: You will need to follow the surgeons recommendation but most people use crates, small bedrooms, remove furniture (to prevent jumping) and drug sedative as needed to keep them quiet during the healing process. In terms of coping - dogs are resilient. There isn't much to keeping them happy other than treating them like you always do, but following the directions of the surgeon.

    Cost: Unfortunately that can be all over the map. Based on surgical skill, surgical need (1 form of repair or 2), and your location. Geography plays a huge part into the cost. Most orthopedic repair surgeries I see now are running and average 2500-3800 in the greater Boston area. If you don't mind posting, what was the estimate for that you were given.
     
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  8. MaxStravinsky

    MaxStravinsky NES Member

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    My little one was supposed to have this done last week, but I rescheduled because the owner of the vet hospital was out with an injury and I didn't think the staff was on their A game with him gone (they made several stupid mistakes in the prep work-up).

    I was quoted about $1,500. My dog only weighs 8-9 pounds. I live on the northshore of MA.
    I've talked to a couple people who have gone through this with their dogs and were very happy with the outcome.

    What price were you quoted?
     
  9. Wrench75

    Wrench75

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    Quiet has mentioned working with shelters/rescues. He may have some contacts or info for you. Good luck. Cute pup.
     
  10. Cap

    Cap

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    Funny timing on this thread - I'm taking my ~55lb terrier mix to the vet tomorrow. After lying down she looks super stiff, walks like she has a hip problem, and tries not to use her rear left leg. After walking around for a bit the hitch seems to go away and she'll run and play like nothing is wrong.
     
  11. A1850

    A1850

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    My 10 year old (at that time) Pit tore her ACL running up the stairs. Surgery was going to be $3K+ and there was no guarantee it would work/hold. She's 14 now and doing ok. Had to limit her activity and eventually she healed up. Limping a bit now and still favoring the other leg but she is otherwise doing ok. HAs some arthritis but she is 14.
     
  12. shmich

    shmich

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    My Chihuahua had this done 6 years ago, and was fine until we had to put her down a few months ago. (Not due to the knee thing) We had it done in Northboro right near the rt. 20 split. She took a few weeks of being crated except to go outside (supervised leash only) and if she was sitting with us to recover. They didn't want her jumping at all. Cost around 2700. Probably 6 to 8 weeks total recovery. She was a grade 4/4 and would not walk on the leg at all, after surgery had no issues jumping on to the couch. (Pretty good for an 8" tall at the ears dog)

    Sent from my SCH-I545 using Tapatalk
     
  13. nissanaltima21

    nissanaltima21

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    my rottie 130lb had 2 acl surgeries. First one went fine 8 month recovery, he was only 4. Second one on the other knee took 14 months to recover, he was 6 at the time. Each surgery cost 1400, typical no jumping for 5-7 weeks. He still sometimes limps for a day or two if he worked himself hard.
     
  14. jsteele40

    jsteele40

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    I have a english bulldog who has had patella luxation surgey done on both of his rear legs. These dogs are notorious for having terrible joint structure. I was referred to townsend animal hospital. can't remember the vets name but he specializes in these types of surgeries. I strongly suggest you speak with them. My dog fred has been like a new dog since his surgeries. Not that long of a recovery period. I can't tell you how satisfied I was with my experience there. Cost of each surgery was around 2k. Good luck
     
  15. JayMcB

    JayMcB NES Member

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    We had a (then) 12 year old Golden who tore both ACL's on his rear knees. We had a surgical consult, and the vet told us the knees would be 2k each, and a new puppy was 900, so get a new dog. [angry]

    I was floored. The lack of compassion just left me speechless.

    We found a surgeon in CT south of Hartford, who did the knees 6 weeks apart 1500/knee. His post surgery activity was very limited, and we walked him around and did rehab with a towel under his belly to go out, etc. To be clear, we shopped for skill, not price.

    He lived until he was almost 16, and walked/swam right up until his last 2 months, when cancer slowed him down too much. Good luck with your pup.
     
  16. jsteele40

    jsteele40

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    Edit: Dr easley, Townsend Veterinary Hospital, 978-597-5828

     
  17. nhglock

    nhglock

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    We have to very good Veterinarian Hopitals in New England Tufts and Angel
     
  18. dogdoctor

    dogdoctor

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    That's horrible! I'm so sorry that happened to you. I'm glad you walked away and into another clinic.
     
  19. PDixon81

    PDixon81

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    Seems to be a trend. My 8 yr old Am Staff was injured on New Year's Eve playing outside with another dog . Woke up Wednesday and she couldn't put weight on her real left leg or walk at all. She kept falling over. Brought her to Tufts in Grafton. The ER dr said she had a torn ACL. We made an appointment with the orthopedic surgeon to have it fixed. Met with the orthopedic doctor and he think it's neurological. The neuro dr thinks it sciatic damage or FCE (fibrocartilaginous embolism). Her rear left leg basically seems paralyzed. She doesn't turn over her foot when placed upside down. Dr sent us home for a week to see if it gets better. Have our follow up appointment Thursday.

    Good luck with your pup
     
    Last edited: Jan 6, 2014
  20. kc6623

    kc6623

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    check for lime will cause same symptoms
     
  21. dogdoctor

    dogdoctor

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    FIFY [grin]
    But always great advice when dealing with any dog lameness in Mass. Unless you see the dog get into a traumatic event which results in said lameness, always check for Lyme.
     
  22. dogdoctor

    dogdoctor

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    Interesting - and I mean that in the nicest way. Let us know how it turns out. How is she now?

    ACLs are so common in larger dogs and it they can happen so fast. They are, I think the, top traumatic injury to the back leg of dog in terms of percentages. As such when dealing with a back leg injury odds are in some way there is an ACL injury in there. In your case though, once you start talking neuro deficits - the "interesting" diseases start to pop up. I'd be curious. I've never seen an FCE - only read about them.
     
  23. captainbly

    captainbly

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    My lab tore both ACL's My vet sent her to a specialist who wanted to do the tpo? surgery. She was already 7. Decided not to do the surgeries as the recovery for both legs at the time was almost 2 years and I did not have 7 grand. Went back to the vet and discussed other options. She prescribed deramaxx and rest. I limited her activities for a couple of months, and then slowly increased her exercise. She is doing very well now and is 10 years old. She currently takes no meds. There are other options.
     
  24. PDixon81

    PDixon81

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    I think we are more traumatized that she is. She is locked in a room sleeping on a bed all day. On anti inflammatory meds twice a day. I bring her out to go to the bathroom a few times a day then right back upstairs. The knee joint feels very stiff. When she is outside the leg stays straight with her foot upside down as she drags it.
     
  25. dogdoctor

    dogdoctor

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    It's a TPLO - Tibial Plateau Leveling Osteotomy - some very wealthy veterinarian years ago determined that if you could rotate the angle of the tibial crest to a precise angle, the physics pressures applied to the knee while standing make the joint stable. You don't even replace/repair the torn ligament. It's really cool. Of course he patented the curved bone saw and the technique and went on to make quite a bit of $ training other vets on how to do it.

    See the benefit of doing an ACL repair is to 1) make the dog feel better and 2) slow down the progression of arthritis. Once you damage a joint, you will get arthritis - it's inevitable. It's just a matter of how quickly will it form. The goal of the surgery is to slow it down to a near stop - but you can't stop it fully.

    Some dogs will "recover" from ACL tears - usually the smaller dogs. But some larger ones too. But those that don't have surgery have a markedly greater chance a severe premature arthritis. And sometimes it can be so debilitating it results in Euthanasia. It's sad in those cases as it might have been avoidable. I'm glad your dog did well. I would strongly urge you to use Cosequin/Dasuquin or some other over the counter joint glucosamine/chondroitan supplement for your dog especially as the years go along. I know it's controversial, but if it can help stave of inflammation and help lube the joints, why not right?
     
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  26. dogdoctor

    dogdoctor

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    Well that stinks - it sounds like you've got some serious nervous issues affecting that leg. I know it's not pleasant to watch them walk like that. If you can put a sock or a bootie on the foot to prevent her from scraping up her toes (if she is on hard surfaces like asphalt). What you describe sounds like extensor rigidity and FCE is a real possibility. An MRI might one of the next steps recommended. I'm really curious what Tufts will say on Thurs.
     
  27. DMWB

    DMWB

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    Flex,

    Thank you very much for this insight. The more I consider her symptoms and read about other conditions, the more I think that our vet "diagnosed" the patellar luxation as a symptom of a potential ACL injury rather than the core problem at hand. To be clear, here are the facts about her situation:

    -No single injurious event, however she has yelped when overextending her hind legs e.g. losing traction while kicking off to run or turn
    -While the right hind leg was diagnosed as a Stage 2, her left can be manually manipulated out of place (Stage 1) which tells me the PL was a pre-existing condition
    -The right hind leg does show evidence of muscular atrophy, presumably due to favoring of the stronger leg
    -We were quoted @ $2700 for Trochlear Modification and (if necessary and with approval) $4100 for "TTA/TPLO" which I believe involved Tibial Crest Transposition (as per your link)

    Here are my main concerns going forward:

    Our primary care vet took radiographs and advised they would be sent to the specialist along with a radiology report. During our consultation last week, the specialist based Shelby's treatment plan on the radiology report and a physical workup because she had not yet received the radiographs. This is very concerning. I visited the specialist's location unannounced today to take possession of the radiology report and was advised they still have not received the radiographs. We are seriously considering cancelling the surgery given this situation - certainly I would not undergo orthopedic surgery by a doctor who diagnosed me without seeing radiographs/MRI. Or am I overanalyzing?

    Ultimately I feel like Shelby may have been misdiagnosed. Perhaps we will need to have another chat with the specialist once she has seen the radiographs. My confidence is not high at this time.

    So far I have purchased a larger crate and Kuranda crate bed for Shelby in preparation of extended bedrest. I have also purchased a lifting harness to aid in helping Shelby get around during the first few weeks of recovery.


    See above for quotes. Your price is one of the lowest I've seen. Thanks for your input and best wishes for your pup's recovery.


    That's the same exact primary symptom Shelby is experiencing - stiffness and lameness of the affected leg that clears up with exercise. Let me (us) know how you make out at the vet, and good luck.


    Interesting. Thank you for your input.


    That's the vet that we have scheduled for surgery. Good to know your dog was treated well there. Sorry to hear she's no longer around though.


    Wow that's a long recovery! Glad to hear he's doing well though. Who performed the surgery?


    Thank you very much for that input. Townsend is only about 25 miles away and, given they have a specialist on staff, we may ask them for a second opinion.


    Did the dog injure both ACLs through activity? Thanks very much for your input, and sorry for your loss.


    Got it, thanks!


    Wow, best wishes for your pup. Please let us know how you make out.


    Very interesting. I would be hesitant to have our dog on pain medication for the remainder of her (hoepfully very long) life but we'll see what path this takes. Thanks!
     
  28. BostonVI

    BostonVI NES Member

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    I know that many on here aren't fans of TNP, but he had a similar issue with his dog and documented her surgery and recovery. Might be worth a look.





     
    Last edited by a moderator: Nov 18, 2017
  29. pdm

    pdm NES Member

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    Butler Schein S3 Soft Chews. Available on Amazon and free shipping through Prime. Worked well for my pup.
     
  30. hock2025

    hock2025

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    My dog had surgery for a luxating patella. He would go lame on one of his rear legs while running around, wouldn't use the leg for a few minutes and then would be fine (until it happened again). Supposedly the kneecap would slide out and then slide back in again. It was weird seeing your dog go from 4 legs to 3 and then in a few minutes back to 4 like nothing was ever wrong.

    An orthopedic from Tufts, whose name I think was McCarthy, did the surgery at our vets office. No complaints and the dog seems to have a full recovery. The 6-8 weeks with minimal activity was tough, especially as he wanted to move around more. From watching him run around now you cannot tell which leg had the issue.

    I don't remember the exact length of time it occurred but for a long time after the recovery period he would favor the leg while using stairs. This caused me some concern, however in hindsight I think he may have learned to do that while it was uncomfortable for him and he then stuck with it for awhile. He does not do it any longer.

    One thing that my wife and I were not prepared for was the first night home from surgery. There was no comforting him. It was brutal. Almost constant crying and snapping at us if we tried to give him comfort or try to get him outside when he had to go to the bathroom. We have had tough nights with kids being sick but this was by far the worst night we ever had. It didn't seem right to send him home in that condition although I don't know if keeping him at a vets would have been any better for him. We did have him on medication as directed but it didn't seem to help, or at least didn't help as much as we would have liked.

    From what I can remember, with both the xrays before surgery and then after surgery I think it came in somewhere around $2.5k.

    Good luck. I will check in again if you have questions on what I said.

    Edit to add
    DMWB: I re-read one of your posts above. While our vet was fairly sure it was a luxating patella, we had an xray done and then reviewed by the Tuft's orthopedic prior to surgery. I was also told that the luxating patella is genetic - the dog just grew that way and it was not something that was caused or could have been caused by anything he did. Both knees were diagnosed as having the issue, both at the same level (i don't remember what it was) but we only had one knee fixed. I have seen the other knee pop out once in the almost two years we have had the dog so am not that worried about it at the moment. The knee that had the surgery was popping out almost every long walk the dog had.
     
    Last edited: Jan 7, 2014

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