| Maxx's story |
|
Owner: Marilyn Date posted: October 12, 2000
My dog Maxx's TPLO surgery was Friday, October 6, and all went well. The vet did the left knee as it seemed to be bothering Maxx the most. He found the meniscus (pad
in the middle of the knee joint) to be all jumbled up, so he had to remove a good bit of it. Thankfully, the TPLO surgery technique isn't dependent on the meniscus like the wire or fishing line techniques. I found a really great vet (in Charleston, SC), and his staff seem to be a very caring bunch of people. He has an emergency 24 x 7 clinic and a rehab hospital, complete with pool in a separate building.
The vet called me Saturday morning and said Maxx had been up walking on his own and was eating well. When I called down there yesterday to check on him, they said he's a real talker (and he is!) and would sometimes howl when his kennel-mate would howl. They said he was a really sweet dog -- so I know they are interacting with him. I told him to suck up to them and he'd get more attention. Ha!
He starts rehab today for 5 days - then I'll pick him up Friday. He'll do physical therapy at home for 3 weeks, then go back for more extensive rehab for another 2 weeks. This vet firmly believes rehab makes a difference in their ability to return to tip-top shape.
In fact, when I had a consult about Maxx at the University of Georgia, the vet there said there are 3 factors that determine the success of ACL surgery:
(1) The dog's weight -- He/she must be skinny-thin
He lectured me on it. Unfortunately, UGA doesn't do any rehab -- the dog owner is required to do it all, but he said I would be "hounded" by them to do it. This vet was trained on TPLO and recommended it for Maxx ... but didn't do it himself, most likely because he's in an academic environment and the procedure is
patented. He said he didn't know of any TPLO surgeon that did rehab. Thank God for the Internet - I found one.
Maybe we can be influential in the vet community. Wouldn't that be cool if we could be instrumental in revolutionizing animal care after surgery? The surgeon that did Maxx's surgery feels so strongly about it, that he has a catalog of rehab products for animals that he markets. I don't know if his primary interest is money or helping the animal - but I think it's the latter.
I met with the physical therapist last week and she showed me some of what they do. (Electrical stimulation for pain management, massage, stretching, swimming, walking, etc.) This clinic has 2 physical therapists and each animal gets assigned to one of them.
To be honest with you, because Maxx is so large (111 lbs), I'm glad they are doing a lot of the rehab. They are more knowledgeable and can handle him better than I can. I'll still have to do it while he's home, but I have more confidence in them doing much of the rehab.
Thanks to all of you for helping Maxx and I through this!
Details on Maxx's physical therapy program
Days 1 - 6 Post-Op. Maxx spent the first 2.5 days in the hospital with a pain patch and then was moved to the Physical Therapy unit next door. He was walking on the leg the morning after the surgery, as his surgeon (Dr. Paul Shealey) called to give me the good report. Dr. Shealey takes great pride in his work; I observed his enthusiasm with other patients while I was in his hospital and could sense his enthusiasm for Maxx's progress over the phone.
Maxx began physical therapy on the 3rd day. Michelle, his physical therapist, worked with him for 5 days -- primarily providing neuromuscular electrical stimulation. This modality is used for pain management and also helps limit muscle atrophy, as it stimulates muscle contractions while the leg is experiencing limited use. While some owners visit their pooches every day, I had to return to Atlanta, so spoke with Michelle via telephone each day for a progress report.
Day 7 - 8 Post-Op. I checked Maxx out of the Rehab unit a week after the surgery. Like in human rehab hospitals, Michelle had documented her goals and objectives for Maxx, then her actions to get him to that point and his progress. Once he attained those goals, she'd document a new set of goals. She also provided me written instructions for home PT including copies of photographs on how to stretch his leg to keep the joints and muscles in good working order.
Helper-Steve had taken Maxx out for his last walk while I checked him out ... then Maxx saw me and he was "outta there." It was heads-down and 4 paws digging into the sidewalk like 4-wheel drive tires on a muddy mountain road. He showed no signs of pain. Steve and I loaded him up his ramp into the Expedition. He was bright-eyed and happy for the whole 6 hour ride home. His excitement must have blocked out all the pain -- as he wasn't on any pain meds.
Day 8. Keeping him confined is my biggest challenge. While he favors the leg when walking, he has no problem standing up and laying down. He expects the freedom to play and roam the house and yard as he did prior to the surgery. He's bored and eager to do something.
I had him confined to the den with my husband while I went upstairs to take a shower. Ten minutes later, he was in the bathroom. He'd rammed the French Doors with his head, circled around through 3 other rooms to the foyer and plowed right up the stairs to the shower. No problem. (Drs. orders were "no stairs.") It doesn't appear as though he's injured himself, however the vet warned me that keeping him confined so the leg could heal would be my biggest challenge. He'd hoped I'd keep him in a kennel. Because he's so large (112#), I'm trying alternatives first. Three weeks from now, he'll return for follow-up x-rays/exam then to the Rehab Unit for 2 additional weeks of physical therapy.
Additional Note: I investigated Dr. Shealey's interest in promoting rehabilitative medicine. He clearly has a passion for it and would welcome conversations with other vets in an effort to promote animal healing across the country. If you are unable to have the surgery done in Charleston, SC, you can have your vet reach him at the Veterinary Specialists of the Southeast: (843) 747-1507. (Tell him "Maxx from Atlanta sent me!")
4 weeks post surgery
Back to rehab for 2 weeks. I don't know if I can live without him that long! But I know they can do things with him that he wouldn't let me do -- so it's in his best interest. They took x-rays before re-admitting him to rehab, and said the x-rays showed the bone was healing as it should. (They did not sedate him, but lifted 111 pounds of squiggling dog up on a table and somehow got him to hold still.) At this point in his
recovery, he's walking well but getting up slowly. His leg frequently trembles, but it doesn't seem to bother him, as he just ignores it. I wonder if that's because of his stubbornness -- or because of the pain management techniques that were used on him with the electrodes. The vet said the trembling is either from pain or from the weakened muscles.
6 weeks post surgery
I picked Maxx up from his 2-week rehab therapy session. He is doing so well. He's strong and doesn't appear to have any pain, except for an occasional trembling of the leg. While he was anxious to go home, he didn't appear traumatized by it all. I watched them do his final swimming session with him. He loves the water and swims like a fish. The physical therapist reviewed and gave me a copy of a report on his progress and my homework instructions (stretching, walking). I'm supposed to keep him on a leash for the next 4 weeks, but instead, I'm keeping a watchful eye. If he gets "mindless," I'll do that.
7 weeks post surgery
The "trembling" is completely gone now. He's back to enjoying his weekly visits to a local park where he bounds through the meadow looking for birds to chase or a french fry left by a child. He favors the healing leg when he runs, but doesn't limp at all. The sparkle is back in his eyes and he's back to his old self again.
I had asked the vet about doing the other leg -- since the ligament is completely ruptured. The meniscus isn't apparently damaged, as he doesn't seem to be in any pain. The vet said not to consider it before 12 weeks from the date of the first surgery and then it's a quality of life issue. He said repairing the other leg won't make him live longer, but should curtail the progress of his arthritis and give him better quality of life. For now, I'm just going to enjoy having my ol' Maxx back.
|