I took Katie to the vet today for knee surgery. She had been limping some since after our first dog hike in November, but I thought she was just stiff or sore (like I was). When it didn’t go away I took her in to the vet. They gave her some anti-inflammatory steroids (I’d given her some Advil before) but it didn’t seem to do much good. When I scheduled a follow-up visit to take X-rays I wound up leaving her at the vet all day and they never got to her. Time for a new vet!
It was January by the time I got her to the new vet. They thought almost immediately that it was a knee injury to the cruciate ligament. It turns out this is about the same thing that my sister-in-law Jami had in both her knees after playing Ultimate for years. The CL in “torn ACL” is the cruciate ligament. The new vet did X-rays that day and referred me to an orthopedic surgeon since they couldn’t do this surgery.
There are two ways of fixing the knee. The ligament that is ruptured can’t be repaired but it has the important function of holding the knee together. So one surgery installs stretchy sutures along the outside of the knee to hold it together. After scar tissue grows in around the suture it all acts kind of like a new ligament, only on the outside instead of the inside.
The other surgery involves making a round cut along the knobby part of the tibia just below the knee and rotating it along that curved cut until you get a more favorable alignment of the knee. If you do it right, the leg fits together such that a ligament isn’t even needed, and in fact they don’t put one back in. I asked the doctor if that alignment is so favorable why haven’t dogs just evolved that way? He said it seems like they should have and he didn’t know. I don’t think he’s a creationist because he had Galapagos Islands pictures on his wall (in fact he was there just a few weeks after I was).
This bone-cutting surgery is called “Tibial Plateau Leveling Osteotomy” or TPLO. It was developed in Oregon and apparently there are only a couple of hundred vets in the US that have been trained to do it. It is patented, meaning it is very expensive. A metal rod is screwed onto the leg to hold the part of the bone that was cut in place until the bone knits back together, but they leave the plate in forever unless it causes trouble. This doctor has done over 100 and has enjoyed very good success with them. For larger more active dogs he recommends the TPLO and I agreed to go that route.
This evening the doctor called and said the surgery had gone well and Katie was coming around from the anesthesia. He had measured the tibia angle at 24 degrees and rotated it until he got it to 6 degrees which is about the ideal. I had read that the closer the angle is to 30 degrees the more likely that the other leg will need the same treatment. But he said the other knee seemed fine and didn’t display any sign of the arthritis or other secondary problems in the bad knee. He did say the meniscus was beat up and had to be trimmed while he was doing he surgery.
The bad part of all of this (other than the price tag which will pay for most of a return trip to the Galapagos for the doctor) is Katie will be out of commission for 8 weeks. She is supposed to stay confined to the house except to go outside. No walks, no running. So I am going to put up a mailbox temporarily so she doesn’t have to charge the mailman when he puts mail in the slot. And I’m moving the couch and my bed to the floor because she isn’t supposed to go up stairs or get up on furniture either.
They are keeping her tonight but I am supposed to go pick her up tomorrow morning. Some dogs have casts when this is done and some have to have a rope tied around their waist so you can pick the back end of the dog up like a suitcase and help them get around.
Meanwhile Clio isn’t sure about being an only dog, but she did enjoy the longer walk we were able to take (I’d gotten to where I only took Katie down the street for walks instead of our normal 2 miles to the lake). Once Katie makes a full recovery I will be able to exercise again so the surgery is as much for me as it is for her.
Read a follow-up posted after 4 weeks