We are Susan and Alan Kowitz and we live in Sequim, on WA's Olympic Peninsula, USA. Just after the New Year in 1998 we took a family outing to the woods. Mercedes, our 1 1/2 year old Bernese Mountain Dog, ran all over the place, returning every minute or two to us and the kids with an "Isn't this great?" smile on her face. When we got home that afternoon she wouldn't put her right hind paw down.
Our local veterinarian diagnosed her with a cruciate ligament problem and had us keep her quiet for a week. On re-check she was no better, so he referred us to a veterinary surgeon, telling us that if surgery was necessary it should be done soon (within a week or two after the injury).
1/22/98 -- Mercedes had a procedure in which fascial tissue from her own thigh was used to create a new ligament through her knee joint. The strength of this method was described to us as being that no foreign material would be introduced into her leg. The vet wanted to keep her overnight, but as there would be no staff at the clinic and my husband, a doctor, would be able to check her sutures in the morning, I insisted on bringing her home at the close of the work day. She came home in a Robert Jones bandage with instructions to "keep her quiet for a while." We kept her in an ex-pen. There were no rehab instructions, though we had asked for some. We took her out to potty on leash and that was it.
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Mercedes three days after TPLO, with her boy Matthew. Scar from the earlier procedure is visible on her thigh. New incision goes over front of knee and down shin. No bandaging this time.
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1/28/98 -- Robert Jones Bandage replaced by a splint. Mercedes considered it a portable chew toy. Somewhere during this stage of things she came in season! She had to wear pants in the house and have them removed for her leash potties. She blew her coat and having nowhere to go on bedrest, it was all over her bed. We vacuumed a lot, used the slicker brush on her bed in between, gave her kitty furball medicine on dog biscuits, and generally felt just terrible for her.
2/12/98 -- Chewed splint replaced with a new splint.
3/10/98 -- New chewed splint removed and leg was left open. Mercedes cried in obvious pain this day -- so far she had not made a peep. Soon after, we got her spayed.
This initial repair never looked really good and finally she just wasn't putting weight on this leg anymore. We sought out a veterinary orthopedist, Dr. Mark Engen, whom we have grown to trust implicitly, in Kirkland, WA, about 2 1/2 -3 hours from our house. He saw Mercedes on 6/19/98 and was booked for surgery until 7/1/98, when he did a TPLO on her right knee. He noted that at the time of this surgery there were already some arthritic changes in the knee, but that the procedure had gone well. He also told us that because the knee had been operated on twice, there would be an increased risk of arthritis developing and recommended that we put her on glucosamine and chondroitin supplements. He also told us, as all other vets had, that there is usually a 50 -60% chance that the ACL in the other knee would rupture within a year or two.
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All better two years after the first of three surgeries. Mercedes, Susan and "kid brother" Bentley.
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Mercedes came home after two nights in a well staffed hospital with no casts, splints, or bandages and with very clear instructions: Complete bedrest for 6 weeks. Cold packs (we used bags of frozen french cut green beans, smashed around on the counter and wrapped in a dish towel) twice daily for 10 minutes each, followed by passive range of motion exercises for the first two weeks. Follow up visit at two weeks. Follow up x-rays at six weeks to ensure that the bones were healing up well enough to support short gentle leash walks. It was O.K. to have our local vet do these films and send them to Dr. Engen. They looked good so one block leash walks began twice daily. Each week one more block was added to the walk. Still no running or jumping. During the bedrest we were given sedatives which we gave half a pill of after lunch when she got bored and restless. These did not knock her out, but took the edge off of her energy level. It was hard to see her red droopy eyes, but harder to see her antsy to get out and play.
This process was slow, but successful. It was good to see the hair fill back in on her leg. She had looked like a patch work quilt after operation #2. The incision sites were in two different places and the stitches and scars were so hard to look at. By that fall she looked really good and it felt like she was a real dog again. (I had so missed tripping over her in the kitchen!)
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The smile says it all! Back to running around the beach as if nothing ever happened.
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One day in October I looked out the kitchen window at her, for she could now be in the yard off leash, and could see that she was limping on her left leg. My heart sunk into my shoes. This time I booked her for surgery as I made the office appointment. If she didn't need it we could always cancel and give some lucky soul our spot, but if she did, the wait would not be so long. Mercedes had a TPLO on her left knee on 11/3/98 and the rehab process began all over again. Again it was slow, but successful.
This whole process took about a year and a half of her now 4 year life and it has been hard to write about. I always wondered if I had done anything differently .... This is an injury which can occur in any breed and happens when a dog makes a stop, turn movement with the leg. Some of the articles this Web site links to do a nice job of describing gravity and the canine knee. Today Mercedes is well and active. The right knee, which was worked on twice, is still a bit stiff when she walks, but she is a high energy girl. She walks, runs, jumps, jack-rabbits through the water, and positively flies down the beach. We are so grateful.
But it ain't over yet! .... Once she was all better, we got her a kid brother, Bentley. As a young pup of 3 1/2 months he was busy chasing one of the cats around the house and guess what he did? Sprained his knee. Rested it for a month on Dr. Engen's advice and got better. Then resprained it playing with a friend's dog just before his first birthday. He's now 14 months old and we're keeping him quiet, though we just about always have, poor guy. No torn curciate yet, but you bet we're concerned.
We'll keep you posted and welcome e-mail from anyone going through this ordeal.