Pre-Op: Read about the days that led up to Kodi's second TPLO surgery ...
In any case, he's doing fine and we're somewhat more at ease, although we're dreading the long weeks of recovery ahead.
He has a modified Robert Jones bandage on, which was either not used last time or was removed prior to our taking him home. His incision healed so well last time -- it required no care from us at all -- that I think I'd rather not have the bandage, although it probably doesn't matter either way.
We can pick him up tomorrow.
Fortunately today looks like a turning point. He looked slightly better this AM, but I thought it might just be wishful thinking of my part. But now it's early evening and the redness is clearly receding. I also saw him lie on the recovering leg for the first time, something he did early on in the first recovery. Two of the staples are still buried in the swollen skin, but it looks like that's slowly getting better too.
I am sorry to say that I am responsible for the difficult time he's had. When we picked Kodi up at Tufts, Dr. Pike mentioned that the degree of swelling was consistent with a dog receiving steady doses of aspirin or another anti-inflammatory prior to surgery. I had no explanation because I knew he rarely gets aspirin. It wasn't until the next day that I finally realized the ArthriSoothe supplement we give him has yucca, green-lipped mussel and Vitamin E, all of which have an aspirin-like effect that can thin the blood, leading to increased swelling after a surgery. I had reported to Tufts that Kodi gets a chrondoitin sulfate supplement but never thought about the other ingredients. ArthriSoothe has been very helpful with Kodi's first TPLO recovery, but he should never have been on something like that going into surgery. There should be no long-term effect but this poor start to his recovery is probably a direct result of my mistake. :-(
He is still reluctant to put any weight on the leg but Dr. Pike is confident that will pass as the swelling continues to go down.
The incision looks normal again finally, and he no longer needs the e-collar. Now it's just a matter of keeping him quiet and away from the stairs, couch and bed. We have that down to a science at this point!
He seems to be feeling fine, but we are concerned about the way he's using the right leg. After the first surgery, once he started putting weight on the leg, he started walking normally very quickly after that point. This time around, he's still doing a lot of toe-touching, and when he does walk on the leg, he "hitches" or walks bow-legged much of the time. I don't know how concerned to be about this yet -- it's still early, I guess.
We are planning to take both dogs for a long weekend in Vermont -- should be a nice change of scenery for Kodi. He won't be able to do much -- sitting on the deck at the inn taking in the fresh air will be about the extent of it -- but even that will be a lot of excitement for him. Poor guy has been sitting in our living room pretty much all summer now.
We're also starting to ramp up his activity, although he hasn't had x-rays yet to confirm bone healing. I think his gait is normal or close to normal, and he hasn't shown any sign of discomfort over the last few days of walks (all short and on leash of course), so I'm feeling good about where he's at right now. I think x-rays would show he's healing up nicely.
I do think there's something different about his gait on his right leg (the one most recently operated on). After the first couple weeks of recovery on the left leg, his gait was completely normal -- you'd never guess he'd just had surgery or that his ligaments were no longer there. His right leg looks good (the average person wouldn't notice a thing if he walked by), but something is just slightly off about it. It's a little straighter than the left, maybe. Since he doesn't seem uncomfortable in the least, has no trouble getting up from a nap and is moving well otherwise, I'm not worried about it. It may even be related to muscle tone and as he gains more strength it will disappear.
Thank you for following along with our story, and thanks to the many people who have shared and continue to share their experiences here on this site. I will update and expand the site for as long as there's a need for information about the TPLO. Good luck!
August 8, 2000 (10 weeks post surgery for TPLO One, Surgery Day for TPLO Two)
Kodi had a "routine" TPLO today and is doing fine, Dr. Pike reports. The angle of Kodi's right tibia was 23 degrees (prior to the surgery -- the TPLO essentially changes that angle to something like 4 degrees). I was surprised to see the difference between the right and left tibial angles -- Kodi's left angle was 27 degrees. I have no idea if a difference of four degrees between the two knees is normal or not. Slocum Clinic felt that given his left tibial angle, it was fairly certain we'd have to do the right leg at some point, but I don't think 23 degrees is considered that steep. Yet he clearly had a tear in the ligament and needed the repair.
August 9, 2000 (1 day post surgery)
Dr. Pike reported that Kodi refused food when it was offered in a bowl this morning, but would eat it if someone stood there and offered it piece by piece. This makes us happy -- he's clearly feeling better and ready to be babied and admired in his usual fashion. :-)
August 14, 2000 (6 days post surgery)
We had a hard weekend with Kodi. After picking him up Thursday, he went downhill fast -- the swelling was intense and the skin all around his inner thigh grew to be an angry red. He wouldn't touch the foot to the ground at all, and by Sunday he was so frantic about licking his incision that we had to get him an e-collar. Meanwhile there was some oozing from the incision, where the skin was so swollen that some of the staples were invisible. Ugh!
August 17, 2000 (9 days post surgery)
Kodi is feeling and looking much better! He started putting weight on the leg for the first time two nights ago, and now is routinely using all four legs when walking (a little bow-legged with the recovering leg but that will gradually cease as it feels better and he trusts it more).
August 24, 2000 (2 weeks and 2 days post surgery)
Tuesday was a landmark day. Not only did Kodi have his staples out, the 22nd marked the two-week point on his last surgery ... and final day of recovery from the first!
August 30, 2000 (3 weeks and 1 day post surgery)
Three weeks down -- one quarter of the way there. Kodi's walking has improved a little -- but just a little. It's such a slow process: One day I might think, "Hmm, he looks like he might be using the leg a little more normally," and then it takes another day and the day after that to really be sure that yes, he has improved a little. It's so slight and incremental that it's maddening, but at least he seems to be on a general upward trend.
September 4, 2000 (4 weeks post surgery)
We just returned from our weekend away. Sometime between Friday and Monday, Kodi turned the corner. He's walking nearly normally now -- vastly improved from just a few days ago. Getting him out of the house for a few days was probably the best thing we could have done for him. He got away with a little more activity than I would have liked, including one charge across the inn's lawn with Maddie when I carelessly let them both out at the same time, but he's doing better than ever. I feel certain bone healing has started and his leg is working normally again -- it will be a couple of weeks before he goes for x-rays to confirm, but I think we're well on our way.
Maddie and Kodi at the Chesterfield Inn in New Hampshire
September 20, 2000 (6 weeks post surgery)
Six weeks down -- halfway there!! For the first time all summer, Kodi is experiencing some freedom of movement. We've put away some of the baby gates and x-pens and given him free range of the downstairs. Although he still can't be loose with Maddie outside, they're fine inside, and he seems ridiculously grateful for every little freedom.
October 3, 2000 (8 weeks post surgery)
So far so good! Kodi is moving nicely and we're up to 30-35 minute walks (on a Flexi) with no sign of soreness or lameness afterwards. He's been swimming every few days, and I'm hoping to get him in the water at least that often during the rest of his recovery. According to the handouts from the Slocum Clinic, we have two more weeks of leash walks, followed by two weeks of careful off-leash, before he's free to go. In one way a month seems like an impossibly long time, but in another way, the end of this long ordeal seems tantalizingly close! I'm trying not to think about it -- I don't want to let our excitement overcome the need to be cautious as he slowly gains strength and muscle tone.
October 18, 2000 (10 weeks post surgery)
Ten weeks was the magic number we've been waiting for -- we started some off-leash activity with him and are having a ball! Every little thing seems like a miracle. Kodi trotting along the trail, Kodi playing in the soft sand at the beach, Kodi and Maddie tugging on a stick together after an entire summer of me keeping them apart. We're doing 45 minute - 1 hour walks, mostly off leash now, which means we're just about back to normal activity. In fact we're doing more than normal activity -- last fall I wouldn't have dared walk Kodi on back-to-back days because he'd be sore later, but now we're walking 5-6 days a week with no sign of trouble.
November 9, 2000
I'm happy to say that we're out of recovery. Kodi is doing great -- moving well, looking and feeling good! Although he essentially lost six months of his life to the two surgeries and recovery periods this year, which is no small matter when you're talking about a short-lived breed like the Bernese, whatever time he has left will be pain-free and unrestricted, and we have no regrets about that. We'd make the same choices all over again. 