Pre-Op: Read about the events and decisions that led us to this point ...

May 31, 2000 (surgery day)

The Surgery. I got the call from Dr. Kraus at 1:30 in the afternoon. He had just finished up. The procedure went very well -- "textbook" according to Dr. Kraus. He saw very little arthritis in the joint. He did say he wasn't surprised the cruciate was torn -- the tibial angle was "steep." I asked if that meant Kodi had poor conformation in the knee and he said he wouldn't say "poor," but that clearly his knee structure was putting a lot of pressure on the ligament. That may not look good for Kodi's other knee if the structure of that one is the same, but we'll see.

June 1, 2000 (1 day post surgery)

A friendly med student named Edward called with an update on Kodi while I was in the drive-through line at Dunkin' Donuts this AM -- had to pull out and park so I could talk to them! He said Kodi is doing great, apparently woke up very quickly from the anesthesia yesterday. He's on pain med so seems comfortable, although he's not eating. He's been going potty with help from someone supporting his belly. By the time I get him tomorrow, he'll be off all meds (wow) and will be able to walk just fine on his own. So as long as he gets through today and tonight without bloating or anything, and as long as I can get him home and settled without banging the leg on anything, we're in business. The worst is over.

June 2, 2000 (2 days post surgery)

Kodi comes home. I arrived at Tufts at 4:30 PM to pick up Kodi. I had asked several times in the days prior if I could see his pre- and post-op x-rays when I picked him up, and had been told several times that I should just ask someone to pull the chart when I arrived. Of course it was total chaos when I arrived, no one could find the chart, and no doctors were to be found. Eventually they dug up the chart and Edward, the student who'd been giving me updates on Kodi's condition, was nice enough to walk me through the x-rays. As Dr. Kraus had said, there was no arthritic damage visible in the films, just the blurry white effusion indicating a tear. The after-surgery shots were a bit shocking. Based on the diagrams I'd seen, I guess I expected the fractured bone to line up perfectly, but of course if you cut something at an angle and rotate it, one end will stick out. It looked alarming to a layperson, but Edward assured me that calluses would form over the ends and that all would be fine. The metal plate and the five screws were clearly visible in the xray -- no metal detectors for this dog. :-) We walked Kodi out to the car, supporting his back end with a sling, but he was in good spirits and went readily up the ramp into the car. The Bill. The total bill came to just over $1,400. Not bad given that the estimate had been $1,600 - $1,700. Drove home through nightmarish traffic and a monstrous thunderstorm. Kodi watched me from his bed in the back, not sleeping but not upset. At home I pulled the car into the garage and placed the wider ramp so that it ran from the side door right into the foyer, perfectly level. He strolled across like royalty and flopped onto his new dog bed in the foyer. I sat with him for a few minutes but he didn't seem to need me -- he was clearly tired and just wanted to rest. Later I brought Maddie down to greet him. She sniffed him intently all over, then licked his face, happy to see him again. She won't see much of him for the next six weeks -- she's rambunctious and tends to leap on him, so they'll have to be kept apart. I'm considering leaving her to sleep in the foyer with him at night, once he's well into his recovery, but will have to see. After a quick potty, we left Kodi to sleep and headed upstairs.

June 3, 2000 (3 days post surgery)

Kodi on his new dog bed in the foyer, 3 days after surgery. All better, Mom! Went down to check on Kodi early, and he was sitting up waiting for me. We went out to potty, using the wide ramp which is now angled from the front door over a tiny porch step into the yard. Kodi is already putting weight on the leg, surprisingly. When we came back in, he marched to the baby gate blocking the stairs and looked back at me -- "OK, I'm ready to go upstairs now!" Sigh ... he hasn't even been home 24 hours and he thinks he's done with the foyer. Oh boy is it going to be a long recovery. I ate breakfast while Kodi whined in the foyer (he'd never been separated from us in the house before). Then I brought my laptop down and sat in a beach chair in the foyer, working on his Web site. The company made him feel better and he snoozed through the morning.   Kodi is able to sit, stand and lie down comfortably.   The Knee. Haven't really touched his knee yet -- I'm sure he'd rather I left it alone -- but it doesn't look too bad from the outside. The incision is just inside the curve of his knee and looks clean and dry. He's shaved like a Poodle but that will grow back pretty quickly. He doesn't seem to have any trouble bending the leg -- he flops from one side to the other on his dog bed, curling the leg underneath him or stretching it out when someone scratches his belly. I thought we'd find him more reluctant to move it around, but I guess not. Supplements. Kodi has been on Fresh Factors for a while (chrondoitin sulfate, kelp, liver, biotin) and we believe it has been helpful. We're increasing his dosage and adding a supplement called ArthriSoothe by NaturVet. It also contains chrondoitin sulfate (total dosage from both supplements will be 1,400 mg/day), along with green-lipped mussel extract and yucca, both believed to support and improve joint/cartilage function. We've decided to start Maddie on some supplementation as well. She's been extremely sound, especially compared to poor Kodi, but we want to make sure she stays that way! Both dogs already eat a natural diet based on raw meaty bones (chicken necks and backs, turkey necks and backs) plus veggies, fish, eggs, oils and a few supplements.

June 4, 2000 (4 days post surgery)

I left Maddie in the foyer with Kodi last night to keep him company, but it didn't seem to help. He howled during the night a little and cried on and off during the day -- not from pain, as far as I can tell, but from the sheer outrage of having been abandoned in the foyer. We spend as much time in the foyer with him as we can, but it doesn't seem to help -- even when we're there, he whines and pants. It's awful to see his physical recovery being compounded by his distress. All because we don't have a walk-out entrance to our house! Noticed something somewhat alarming with Kodi's leg, but I don't know if it was like that all along or if I just happened to see it today. His ankle is really swollen. Not the knee, where the incision is, but lower down, around his ankle. There's so much fluid in there that when he lies on his side or his back, it kind of "pouches" and sags. What is that? Is it a sign of infection? He "notices" his leg a few times a day and licks it but doesn't seem to be fixated on it. The incision site looks the same, I think. It's red all around, and I'm trying to pay more attention now to see if the redness is changing or spreading. Sigh ... I'll have to call Tufts and ask about the fluid if it hasn't gotten better by tomorrow.

June 5, 2000 (5 days post surgery)

Called Tufts and received a voice-mail back from Dr. Kraus. He says swelling around the ankle is perfectly normal -- whew!

June 7, 2000 (1 week post surgery!)

Potty break.   First week of recovery completed! Kodi is doing great. The swelling is nearly gone and the redness is slowly receding as well. He seems comfortable -- flops on his dog bed, lies as easily on the left side as on the right, etc. Even better, we've solved the isolation problem. Bill figured it out and arranged to borrow the bottom half of a big VeriKennel. It's low on one end so Kodi can just walk in and lie down (the bottom has oilcloth to keep him from slipping) and then Bill and I pick it up and escort his Highness up the stairs. It's heavy and awkward for us, and Kodi's no fan of it either, but he stays put and lets us transport him from floor to floor.   The incision is healing nicely.   Within minutes of settling into the living room in his xpen, the panting and crying he'd been doing since he got home all came to a stop. All he wanted was to be near us, and we'd found a way. We can even transport him upstairs to the bedroom at night. It's going to be a hassle to keep up for six weeks (there's a whole series of xpen, baby gate, dog bed and water bowl maneuvers that have to be coordinated with each move), and of course we have to be hyper-vigilant that we don't trip or that he doesn't try to climb out while being transported, but overall it's a huge relief. The difference in him is incredible. Kodi in his chariot, waiting to be transported to the living room.

June 12, 2000 (12 days post surgery)

Kodi is in good spirits and the incision looks great. I can take him to our local vet to have the staples removed this week. It's hard to tell how much weight he's putting on the leg because he doesn't really get to use it -- just a few steps out to the yard and back -- but sometimes it seems like he's walking almost normally and other times he seems to "hitch" a little bit. We have all learned to hate the VariKennel -- I'll be surprised if Bill and I don't have permanent back issues from hauling His Highness around from floor to floor. Kodi's not too happy about it either -- he'll step in to the kennel and allow us to carry him, but he clearly dislikes it. It's difficult to go up the stairs without tilting the kennel, so he slides back against the end. He seems to understand that it's necessary, though, and has never tried to jump out. I'm going to increase the reinforcements (hot dogs, cheese) and work on making it more of a positive experience for him. We have at least another month of this to go, and then hopefully the doctor will say he can do some limited stairs.

June 15, 2000 (2 weeks post surgery)

The fur is coming back! The staples came out this morning. And Kodi's fur is growing back FAST. Two weeks down, four to go! Using the ramp to head outside.

June 21, 2000 (3 weeks post surgery)

Three weeks -- what a milestone! Kodi is walking normally almost all of the time. He looks and feels great -- now keeping him quiet is really starting to be a challenge. He's sick of the baby-gate/xpen/foyer routine and will bolt for any opening to freedom. He got away from us the other day and charged across the living room, but it didn't seem to have any immediate effect. So far he seems fine -- I'm hoping there isn't any damage in the joint that we can't see. Talked to some friends whose dog underwent a TPLO by the same surgeon at the same facility, and they used a sling to traverse stairs with their dog from the beginning. We'd love to stop using the hated Vari-Kennel, but we're unsure. Maybe now that Kodi is three weeks into recovery and doing well it would be OK to start using the sling ... ?

June 28, 2000 (1 month post surgery)

Four weeks down, two to go until the follow-up x-rays! Kodi is such a good sport about being confined. He was so active before, so the total lack of exercise must be really hard on him, but he's happy with whatever attention he gets. Raw marrow bones are our lifesavers -- they give him something to work on for hours at a time. We had hoped that Kodi could start a hydrotherapy (swim therapy) program this week but couldn't get a written referral from Tufts. This was one of the confusing areas where we seemed to receive conflicting information. The complete lack of physical therapy guidance in general has been strange, although I'm told it's not unusual for surgical practices to overlook PT and for teaching hospitals to be especially unhelpful on the subject. A friend in Dallas sent me the PT materials given to her by the hospital that performed a TPLO on her dog Buddy, and that's been very helpful. (See those materials here.) She's doing hydrotherapy and massage and believes Buddy has really benefited from it. We've been using the sling on some of our trips up and down the stairs and Kodi seems none the worse for wear. I had tried to ask Tufts about this but never heard back. We've found that going down is a lot easier than going up, since Kodi has all that momentum behind him and we can keep his back end entirely off the steps. Going up, he struggles with his front legs if we give too much lift in the back. We've been able to successfully keep him off the couch and the bed -- we have a blockade of chairs, baby gates and x-pens everywhere there's a potential jumping spot -- but he's gotten wise and will charge any opening. We've had lots of mistakes, which worries me, but he never seems any worse for wear.

Success! We had Kodi's six-week follow-up appointment today at Tufts. The x-rays show COMPLETE healing, which Dr. Kraus said was quite rare at this stage. The news couldn't have been any better. No one can say why he's doing so well (he certainly got away from us enough times to jump on the couch or the bed, so we don't get credit for keeping him quiet.) We have to believe his raw diet gives him the building blocks to heal. We were a little frustrated with Tufts -- the "consultation" was held in the waiting room in less than two minutes, and if I hadn't asked to see the x-ray it wouldn't have been offered. As it was I had to hold it up against the Coke machine to try to view it. I didn't realize until we'd paid and left that we were charged $65 for the privilege. (That $65 was solely for our two minutes with Dr. Kraus -- the x-rays and sedation were charged separately.) It may be that Tufts felt we'd want to take our groggy dog and scoot out of there as quickly as possible, but if they'd offered me the choice, I would have let Kodi rest a few more minutes and had an actual consult! Still, despite the lack of finesse in handling the humans, Tufts surely does a fantastic job with its furred and feathered clients. TPLOs are amazing -- given how invasive and major the surgery is, it's mind-boggling that the recovery can be so fast and painless. We have been instructed to steadily increase Kodi's exercise, doubling the length of each walk every few days. He must remain on a short lead for a month, then may graduate to a long lead or a Flexi for a couple of weeks. Then he may walk off lead with no distractions for a couple of weeks, and finally return to full function. (See the rehabilitation instructions.) And stairs are FINE -- as long as he does them under control, he's free to go up and down. Whew! Today was the "moment we've been waiting for" and we're so pleased with what we found out. Now if we can get through six more careful weeks, we're home free.

July 31, 2000 (8 1/2 weeks post surgery)

We have had a setback. Kodi's TPLO knee is doing great, but he's lame on his right leg. It could be a pulled muscle or a strain or sprain ... but somehow I don't think so. It looks like cruciate. Our worst fear. I had two choices for a Tufts appointment -- tomorrow AM or a month from now. I took tomorrow AM, so we'll head out there then and see what the doctors say. Read about the days leading up to Kodi's second TPLO surgery ... See how Kodi is doing now ...