Bocán is WALKING Again!

Today, Bo is walking! He is fully bearing weight on the most recently repaired leg, and not limping at all!

What a great way to end this lousy year, with a glimpse of better things to come!

Atta Boy, Bo!

More pictures soon.

I've deliberately avoided posting the last few days, because we got more bad news on Monday. The culture came back on the infection on his left leg (the one that was repaired with TPLO surgery in October), and the bacteria is a strain resistant to the "normal" antibiotics he was prescribed for the surgery on his right leg. So, we now have him on a much more serious antibiotic to kill that infection. One that will likely screw up his probiotics, so we added yoghurt to his broccoli regimen. Seeing him continue to use his left leg, and now begin to use his right leg, confirms that he is a fighter and he'll get through the worst of this in a few more weeks.

He's Bearing Weight on the Right Leg

Bo has slowly started putting more and more weight on the right rear leg (the one that got the recent TPLO surgery) and today while he was outside doing his business, he took several steps on the leg. A little bit of a limp, and it tired him out fast, but he was walking on it.

This is about five days sooner than the first one. Hopefully, by Monday, he'll be walking on it regularly. Monday is his two-week post-op exam with the surgeon...

In the photo at right you can see where they shaved his left leg to remove all of the hardware, and part of his right leg, which they shaved entirely for the new TPLO surgery. You can also see a little snow - we got close to four inches last night, but this part of his dog run is covered...

A Christmas Gift

Bo slept well last night with no sedatives, just pain killers.

Looks like he'll be sleeping in our bedroom tonight, instead of in the family room. That means I will sleep in my bed tonight for the first time since Tuesday! I've been sleeping on an inflatable mattress on the floor next to him, but he graduates to the cross-pen in our room tonight. Bo's Christmas gift: sleeping with his whole pack again.

Last night, we had a fantastic dinner with friends, but we were a little concerned, leaving him alone for several hours. He was fine.

We enjoyed a great, quiet Christmas with Susan today, and a really nice roasted turkey breast dinner with butternut squash and a wonderful spinach, mushroom and celery dressing. Bo got some of each with his dinner, too...

Bo Supervised the Tree Trimming Last Night

With bells on!

We moved his bed into the living room, so he could watch...

Home Again and Doing Well

My sister Susan is visiting for Christmas. She helped me get Bocán home yesterday afternoon, and I am happy to report that he is doing remarkably well.

When I learned that they had removed all of the hardware from his left leg, in addition to performing the osteotomy and installation of hardware on the right leg, I frankly expected him to be incapable of walking. I know I would have been!

However, he is walking (or rather, hopping) about as well as he did last weekend, although his range between rests is only a few dozen hops. That's enough to get outside to do his business, and make it back to the bed.

In this photo he is resting with cold packs on both legs, after a long massage. He was actually quite comfortable and slept for a while afterward.

He is doing so much better today than he was after his first night back home last time. I'll get another picture of him later today.

Overnight

I spoke with the evening nurse last night.

Bo ate his dinner and actually used his left rear leg (the first TPLO, in October), during elimination walks!

I'll post more later this afternoon, hopefully we'll have him home by about 3:00 PM.

Second Surgery Today

I just spoke with the surgeon. Bo has come out of the anesthesia and is stable. The second TPLO went well, faster than the first because there was very little damage to the soft tissue around the stifle joint. This was expected because the time between the injury and surgery was only a week, instead of nearly a month.

They also opened up his left leg, to remove the long pin that runs at an angle through the bone splice (see XRAY). This was recommended as a possibility at the 8-week check-up; the surgeon thought it might be causing some discomfort. However, when we scheduled the second TPLO, the surgeon said we should just do it, since Bo had to be anesthetized anyway. But, when they opened up the leg, they discovered the beginning of a bone infection, and decided to remove ALL of the hardware (the plate and screws, as well as the pin), flush the wound and culture the fluid.

The antibiotics that he'll take to avoid infection of the osteotomy of his right tibia should kill the infection in his left leg, but the culture will ensure that it's not some new virulent strain* that will need more advanced drugs.

*Side rant: over-prescription and ESPECIALLY MISUSE of antibiotics have created some terrifying "super-bugs".
PLEASE: avoid antibiotics when inappropriate and FOLLOW THE DIRECTIONS (take them ALL!) whenever they are needed.

Bottom line is that his left leg will be pretty sore too, but the discomfort from the TPLO will be the worst pain. So, lots of pain meds and low expectations for weight bearing in the first two weeks. 2009 ends with one last blast of fun, I am SO ready for 2010!

We should still be able to bring him home tomorrow...

Better Living Through Chemistry

Amazing what some Carprofen and Codeine Sulfate did for him!

An anti-inflammatory and a buffered opiate got him to at least balance on the repaired leg long enough to do his business without me holding him up, tonight.

I'll need to hold him up for every step for several days after the surgery, but perhaps over this weekend he'll enjoy a tiny bit of independence, and Ann and I will sleep well tonight, knowing he's enjoying an opiate-induced snore-fest...

What a freaking roller-coaster!

Rough morning - looking ahead

Bo is having a rough time using his recently repaired left leg to hop, while holding his more recently injured right leg up. He tried three times to get up this morning, and fell back on his bed each time. I had to practically carry him from the bedroom to the dog run, using a belly band, and when we got outside he had to lie back down to rest.

It depresses all of us that he's so helpless. But, I count my blessings that we now know how this all works, that we have the second surgery scheduled for Monday morning, and we have high hopes for him to be walking again by January. RUNNING seems so far away now, but I'll be thrilled to seeing him walk again...

My sister Susan arrives on Tuesday and she'll be here to help with the worst few days post-op. We expect him to be completely unable to walk, or even stand for a few days, and will need to carry him outside a few times a day to do his business. Fortunately, he'll be doped out on codeine and won't be too aware of what's going on. Having my sister here to help lift my spirits will be a big help, too!

Looking forward to Saturday, December 26 - hoping the worst will be over by then...

Feeling a Little Better

I think Bo is feeling a little better, but he seems to know it's going to be another long road back to walking -- again.

We have to hold him up with a belly band to get him anywhere. He's very good about that indignity (especially during his more intimate business), but he's not exactly thrilled about needing help to do everything.

We let him out of his cell last night for a little while, to hang with us while we watched some TV, and he stuck to Ann's feet like a magnet.

I wish we could get him in for the surgery tomorrow - waiting until next Monday is difficult.

We're grateful that we could get him out for short walks for a couple of weeks.

We hope to be back to that point by early February.

Sad news

Today is the 8-week anniversary of Bocán’s TPLO surgery to repair the ruptured CCL in his left rear stifle joint (the equivalent of the ACL in the human knee). For several weeks now we’ve been walking him several times a day, and a little further every few days. He’s shown steady improvement; we got him up to a little over a mile on Sunday.

His 8-weeks post-op exam was this morning, and as I’d hoped, his repaired tibia has completely healed and the meniscus (and other soft tissue surrounding the joint) is healing well. We got a bright green light to ramp up his activity, and even let him sleep on our bed again!

He hopped into the car and driving home, I was so happy!

But, when we got home, he was reluctant to get out of the car, and when he did, he was walking oddly. As soon as we got in the house, he collapsed on the kitchen floor. When I got him to walk, he was holding his RIGHT leg up and hopping very reluctantly on his recently repaired left leg. He made it about four feet and collapsed again. My heart skipped about twelve beats as it dawned on me what had happened, and then it sank like the Titanic.

Ann and I took him back to the surgeon tonight, and he confirmed our fear; he completely ruptured the CCL on his right rear stifle joint, and the only recourse is a second TPLO surgery.

We’re the sort who always looks for silver linings, and we found a few:

• At least he didn’t do this a few weeks ago, before his repaired leg had healed.
  
  
• He was a trooper and recovered quickly, so he will do so again.
  
  
• We know the drill, and we still have all the borrowed equipment. If it had to happen, perhaps sooner is better.
  
  We would always have been fearful of a second CCL rupture, and now it’s happened. If he’d only had the one injury and repair, we probably would have restricted his activity, and would have been reluctant to let him jump or turn hard when running. What fun is that?
  
  But now, the other shoe has dropped! Once he has recovered from the second TPLO surgery (around the Spring Equinox?), the surgeon says we may allow him to do anything he’s comfortable doing, including leaping for the frisbee, and even COMPETITIVE AGILITY and FLYBALL. We were discussing both of these activities last summer, just before the first CCL injury occurred.

• Another “good” thing; most dogs who sustain CCL injuries suffer slow tears, often enduring months of sporadic lameness and minor improvement. This causes significant wear on the joints and usually leads to premature and severe arthritis. Both of Bo’s ruptures were in single, traumatic events, and getting the TPLO surgery soon afterward drastically reduces the joint wear. So, if we can keep him healthy after these issues, we should all enjoy another 6 - 9 years of creating new, wonderful memories.

We don’t know when the second injury occurred, but it was likely when he jumped into the car. He probably used the right leg for most of the lifting, and it just couldn’t take it – whatever issues led to the first injury also contributed to this second one.

His second TPLO surgery is scheduled for Monday, December 21st, the Winter Solstice. The surgeon is unavailable for a few weeks after that, so we decided to do it ASAP – and Mondays are “TPLO days” for this surgeon.

We hope and will strive for another speedy recovery, and look forward to seeing him back to mile-long walks by the Vernal Equinox. Perhaps we’ll be playing frisbee by May or June, and looking into agility training by the 4th of July? A true "Independence Day" for Bo will be running off-leash!

We're all a little depressed tonight, especially Bo ~ he's back in the cage for many more weeks. So different from the way the day started out...

Thanks for your continued positive thoughts, interest and kind words. If you could please send a little more our way next week, it will mean more than you could ever imagine!

PS - That's his LEFT leg up in the picture (taken tonight) ~ notice how well the fur has grown back!

Walked nearly a mile today, and up a small hill!

Today we walked about 9/10 of a mile and it included a moderate hill!

We've been home for an hour now, and no ill effects!

Later this afternoon we'll do a shorter walk, with a little trotting.

On Sunday we'll make it a full mile, if the predicted snow and freezing rain have melted. He's not ready for slippery stuff, yet.

Hopefully, we'll get a good sticking snowfall late in the season (February?) so he'll have a chance to play in the snow this winter. He loves snow! This picture is from January 2007...

Close to Another Milestone!

Next Monday is Bo's 8 week post-op anniversary and X-Ray, to see how his tibia is mending.

He is up to 2-3 moderate walks each day, and he no longer has any recovery time after each. He's even trotting a little bit.

So, I am confident we will get a green light to ramp up his physical therapy, exercises and walks.

By springtime, perhaps he can play in the yard off leash again...

Nasty Scare This Morning

At 6:15 this morning Bocán wanted us up and atom - HE didn't know it's the Friday after T-day...just another day for him! That's OK, I had work to do, so I reluctantly got up to let him go pee.

When I let him out of his enclosure, he ran out of the bedroom, slipped on the turn and fell on his butt. Then, he immediately held up his leg and started hopping, just like a month ago. I wasn't even awake yet, and I thought he'd re-fractured his leg.

But, after a little while he started using it again, and now he seems fine.

YIKES, scary for a while there!

Almost Five weeks...

Tomorrow will mark five weeks post-op, and Bocán's walks are getting longer. We're going almost a 1/4 mile round trip now, and of course he wants to go farther. We're increasing his "maneuvers", too. Having him sit and then immediately stand back up ("puppy squats", to strengthen his atrophied thigh muscles) and "figure eights" (to get him to pivot on his back feet more). By Friday, we hope to try some light trotting!

Four Weeks Post-Op

Bo is walking almost exclusively, now. He still holds the repaired leg up and hops when he's on slippery surfaces, like the kitchen and laundry room floors, or when he's in a hurry, but he walks everywhere else.

He wants to jump up on the bed, and wants to run, and he's more confused than ever that we're still preventing him from doing these things. In many ways, the second four weeks will be a lot harder than the first four, as we must continue to restrict his activities for a full eight weeks. Now that he feels like doing these things, and is capable of trying, it's difficult to prevent them without constant supervision...

Here's Bo, taking me on a very short walk, on the trail adjacent to our driveway. Every day we'll add a few more steps.

Abendessen!

Bo already knew "Frühstück" (breakfast - he learned that a few years ago).

Now we're working on "Abendessen" (dinner ~ or, literally "evening food").

We're also working on "Imbiss" (snack, which is usually "Brokkoli" see Oct 28, below).

Three Weeks Post-Op and All is Well!

Bo just returned from his first post-op exam. The surgeon gave him an A+ on incision healing and an A- on progress with weight-bearing. He said it's not uncommon for dogs that suffered a single traumatic CCL rupture (like Bo, as opposed to a slow tear) to take a little longer, initially, to put weight on the repaired leg. But, the surgeon said they typically "catch up" by the crucial eighth week, when the bone has nearly mended, and activity can be ramped up.

The other good news is that Bo has lost three pounds; no small feat considering his near inactivity. He weighs 51 pounds today. He weighed 54 on the day of surgery; he'd put on a few pounds since the injury occurred. We kept him around 50 pounds for years, and his long-time vet said he was the perfect weight in July. However, we were continuing to feed him the same amount since he ruptured his CCL, even though he was no longer running around all the time! Glad to hear that our efforts, and Bo's sacrifices these last three weeks have paid off.

The surgeon said an optimum weight for him, now that we're trying to prevent a rupture of his right CCL, is 45 pounds! YIKES, that's another 6 pounds to lose! He hasn't weighed that little since he was 2. We have him on a great diet now, and thankfully, he's still loving all the broccoli and squash, so wish us luck!

Our target weight for week 8 is 48 pounds, and a few pounds less by late Spring, when we hope he can run again! Maybe this picture of him as a dorky little puppy will help inspire us!

Now comes the hardest part, keeping the little guy from going mad (and/or injuring himself) while we continue to keep him caged up (and on a strict diet) for 5 more weeks. I have started teaching him some German words (links und rechts, sitzen und bleiben, herkommen, hinlegen ~ guter Hund!) and some German names for his favorite toys. He loves learning new words.

Ann will teach him some Spanish...

Bocán's First Steps!

14 days after his surgery, and 39 days since his injury, Bo took his first actual steps on his repaired leg today.

We were out on a pee break, and he just started walking! I've only seen him hop on 3 legs for almost 7 weeks, so it took a minute to realize something was different; his butt wasn't bouncing up and down!

While I was trying to figure out how much weight he was actually putting on the leg, he showed me! He lifted his GOOD rear leg, (bearing all of his hind end weight on the repaired one), and really took his time! Atta boy!

Thoughts of him hiking with me in the spring are beginning to seem probable again...


At right are Lucky and Bo, taking a break on a trail along the McKenzie River a couple of years ago. Lucky was such a good hiking companion ~ Bo has big shoes to fill! And, we have a LOT of physical therapy and healing ahead of us...

Incremental Improvements

A little more use of the leg today, still mostly for balance, but a few times he actually touched the ground during a step!

Step-by-step, he is still showing signs of incremental improvement!

Today should have been his two-week check-up by the surgeon, to ensure his incision site is healing properly and that there are no signs of infection. The surgeon is out of town today, so the appointment is for next Monday, three weeks out. However, we determined that he is 100% free of infection - another milestone!

He's beginning to use his leg!

Today, Bo began touching the floor with his repaired leg quite a bit. He's not putting any weight on it yet, but he's started using it for balance. Prior to this, he was only doing this while pooping, now he's using it while standing.

The picture at left shows how he usually holds the leg - foot well up off the floor (usually much higher than this).

The picture at right shows him touching the floor for balance. Notice his right front paw is just off the floor...

Some dogs start using the leg the day after TPLO surgery, most by the end of the first week. Some don't begin using it for several weeks, and a few never regain use of the leg - there are no guarantees with this procedure... So, we're trying to remain patient as he continues to hop on three legs whenever he moves around. Step by step ~ literally!

You can also see how thin his upper leg muscles have become. Now that he's begun using his leg again, we can increase his passive range of motion therapy and then introduce exercise.

Notice too how well his fur has begun to grow back. It's nearly covered the incision area, as well.

Oh, and YES, that is SUNSHINE on the floor, it's pouring in today through the atrium skylight!

Who'd Have Thought?

Because Bocán's activity has been severely restricted, another challenge we face is avoiding weight gain. In fact, he needs to lose a little weight; since his injury he's already put on a few pounds. Once he's healed, we'll need to maintain him at a healthy weight to further decrease his odds of suffering the dreaded second CCL rupture, in his other stifle joint. The thought of going through this all over again is agonizing, but sadly the probability exists...

We found a low calorie, grain-free dog food that he likes, but he's pretty dissatisfied with the skimpy portions needed to drop his weight with such low activity. Since eating is one of the few things he has to look forward to, it's quite a challenge.

In researching options, we decided to try everything we could think of, and discovered he LOVES broccoli, squash and sweet potatoes. So, we're now adding a lot of broccoli, some squash and a little sweet potato to his meals, and he even looks forward to steamed broccoli as a snack!

Now, we're all eating more broccoli! We also love squash, so we're cooking both nearly every day. Bo loves the thick woody broccoli stems and he even eats cooked squash skin.


We're all eating better!

Any other suggestions for low calorie foods to try?

Bo's New Bed

Continuing to improve! Still not putting weight on the leg, but it's only been 9 days since the surgery so that's not unusual.

We got a new bed from Costco so he has a good bed in both the family room and the bed room....no more carrying one back and forth at bedtime and in the morning!

Busted - by the Bear Bell!

On Sunday, Bo continued to improve. We enlarged his family room enclosure so he can choose between his bed and the floor (he often prefers the floor - see picture) and so he can start moving around a bit, which we hope will encourage him to begin to bear weight on his repaired leg. We also moved it to where he can see us when we're cooking and when we walk around other parts of the house.

Ann came up with an excellent solution to his tendency to occasionally try to lick his incision site. She attached my bear bell to his collar. This is a large "jingle bell" that I wear when I hike in bear country, (something I used to do regularly, but not so much lately). It has a pleasant, low tone and only jingles a lot with intense motion. It definitely gets our attention when he jerks his head around to lick his rear leg!

I've added washing the incision site with anti-bacterial soap to his thrice daily routine of warm compress, massage, PROM and walking for potty breaks. We've stopped the cold packs, since there was never any bad swelling, and his bruising is all gone. Warm, moist heat is good for helping circulation as his muscles continue to atrophy.

Next milestone will be when he begins to put a little weight on his repaired leg. We're being really partient, his surgery was just a week ago today!

The Whole Pack is Sleeping Together Again

Bo's sleeping in our bedroom again! I think he'll enjoy that part of his life being back to normal, and I KNOW I will - I've been sleeping on an air mattress with him in the family room all week.

Thanks so much to all of our generous friends, neighbors and colleagues for loaning us equipment to get through this long haul. We're particularly happy to have several different playpen type enclosures. Now that Bo is feeling better, we're setting up separate confinement areas in several different rooms, so he can be wherever we are: family room, bedroom and my office, and when the weather is nice - outside...

Bruising Nearly Gone !

This is incredible! We were told we should BEGIN to see an improvement in the bruising and swelling by his fifth day post-op, which is today. There was very little swelling at all and by this morning, the bruising had nearly vanished! The massage, PROM and cold packs have done wonders.

Compare this image with the one I posted yesterday, which was taken Thursday evening. Incredibly, the inside of the leg looks just as good, and that's where most of the work was done. The surgeon is truly gifted, and Bocán is obviously a healthy athlete in his prime. A (human) friend of mine had arthroscopic knee surgery two weeks ago, and told me yesterday that his knee is still purple and swollen!

Bo is still barely touching the floor with that foot, as there is clearly still some pain, but the incision site and skin look great.

Already, he wants to run around (still on THREE legs) and play, and doesn't understand why we will not allow it. This part will get a lot worse, as we have to severely restrict his activity for several MONTHS, to let the bone heal.

We've backed off slightly on the codeine and switched to an anti-anxiety drug during the day, and will only use the tranquilizer to help him sleep through the night.

It's a beautiful, sunny day here in Portland (after a week of mostly gray and some rain), so I'm going to get some much needed yard work done; picking the last of my tomatoes and composting the plants, raking leaves (the vine maples have started dropping theirs) and see if I can fix the hot tub. I'm going to uncover the grill and roast a turkey breast for dinner. It just won't be the same, doing these chores without my little helper out there with me, but I'll check in on him a lot and remain motivated by our desire to have him ready to go outside off leash, next spring!

HUGE Improvements Today

He's definitely feeling better. We are rapidly entering the "reigning him in" phase, as he thinks he's better than he actually is.

A generous and thoughtful neighbor friend delivered a gift bag of chew toys today! Thanks Terry (and Gabby & Sarah)!

It's great to see him playing again, the challenge is getting him to play lying down...

Milestones!

Bocan's CCL rupture injury was four weeks ago today. Where does time go?

Last night on Leno, Nick Thune did an amusing bit about SPENDING some of the time we've "saved" since 1918 (with Daylight Savings Time).

I'm all for THAT!

Bo (and therefore, ALL of us) slept very well last night, and this morning he is showing the best overnight improvement since he came home on Tuesday. His eyes are clearer and brighter, and he seems a lot less anxious. His biggest enemy now is boredom.

The incision area shows no signs of infection, and the bruising on the inside of his leg didn't get nearly as bad as I expected, nor did he seem to experience much swelling at the stifle or hock. He's a trooper; he's getting through this without any of the horror stories we read about. The massages, passive range of motion exercises and especially the cold packs, have helped immensely.

WARNING - the image at right is pretty graphic, if you're squeamish, you probably don't want to click on it for the larger version. However, it's probably the worst his bruising will get, so it's demonstrating good news. This picture was taken last night (Thursday), but it looks about the same today. The nurses said we should notice improvements by his fifth day post-op, which is tomorrow.


Onward with gently increases physical therapy sessions and all the patience I can muster, plus finding ways to keep his mind from turning into oatmeal ...

Update

He showed interest in his chew toys tonight, for the first time since Sunday! Now he can take his frustration out on his bone, which seems fitting...

Just "tranqed" him for the night, wishing him less and less pain each day forward!

Third Day Home - Reality is Setting In

I think Bo is entering the acceptance phase of his confinement, and in the "damned sick of it" phase of his discomfort and drugs.

We look forward to this weekend, when we hope he will begin to feel better. Meanwhile, I am giving him the maximum level of safe chemical relief. It sure hurts me to see him hurting...

Thoughts of the long-term benefits ~ like seeing him playing in the snow again ~ are keeping my spirits up!

Better Second Night

We gave him a larger dose of the tranquilizer Acepromazine last night, which gave us all more sleep...

His appetite is fully intact, he was all over breakfast this morning!

Bo's New Hardware

Here are the XRAYS showing Bo's TPLO hardware. He's being incredibly stoic, considering. If they had just rammed that many screws into my tibia 2 days ago, I'd be a wreck.

If you look closely at the side view (click on either for BIG versions), you'll see how they reshaped the top of the tibia, changing the geometry where it contacts the femur. This will compensate for the missing cranial cruciate ligament, allowing him to use the leg again. For the geeks, google "TPLO" or check here: http://www.cascadevrc.com/tplo.php.

Incredibly, he's already started touching the ground with his left rear foot, and has full range of motion in the joint. With luck, he'll be bearing weight on it in the next week or two.

First major hurdle is to avoid infection...

Rough First Night - Better First Full Day Home

We set up a playpen structure in the family room for Bo. It's about 33" x 66" and it will be his world for the next 8 weeks. His bed is in there, and he also has a little floor space to sprawl out on. Our house is heated with radiant floor heating, so it'll be nice and warm at night.

I've moved some of my computers to the kitchen counter, right next to him, so I can be near him most of the time. We slept next to him, on an inflatable mattress last night, because he's used to sleeping in our bedroom, and we knew he'd stress if we left him alone. A family camp-out, with narcotics!

The issues we thought would be big (elimination and stress) are minimal. We were told he'd likely be constipated from the narcotics, but he's been very regular. We have to put a sling under him whenever he stands or walks, and I though he'd have issues "going" with me standing there holding him up, but he barely noticed. The drugs are helping a lot with the stress.

An issue that is of concern is licking and chewing on the incision and shaved areas, as he heals. I'm sure it itches and hurts, and he's a bit of an obsessive "licker" anyway, so we need to keep him from doing this until the incision heals and his fur starts growing out.

They provided one of those "radar dish" plastic cones to wear, but he absolutely hates it. He sulks and mopes, bangs it on the cage, tries to remove it and won't lie down with it on. So, I removed it and slept with my hand on him and every time he messed with the wound, I gently got him to stop. We didn't sleep much!

Fortunately, today he is leaving the repaired leg alone entirely. I'm doing his physical therapy routine every 4 hours, and have included gently scratching his 3 shaved areas (front leg for IV, lower back for the epidural, and most of his left rear leg for the surgery). He likes that a lot - pre-emptive scratching! PT consists of full body massage (especially all the legs - as he's over-using 3 and not using 1), passive range of motion extensions on all 4 legs, a brief walk outside in the sling for elimination, and then cold packs on his repaired leg. He seems to like all of it (except the PROM extensions of the injured leg, which he doesn't "like", but tolerates well). He even left the cold packs in place while I got back to work, one under the leg and one on top, wrapped in towels (see picture).

It will be a very long, busy 8 weeks. I am sure looking forward to the Winter Solstice, when all of this is behind us! Please keep those positive vibes coming, we sure appreciate them!

Bo is Home !

He drank a little water and ate a little food, and seemed to keep it all down OK.

I gave him his first physical therapy session; a very gentle full body massage (which he loved). I'm sure he was stiff from being knocked out and staying in a cage for 28 hours. Next, some very gentle leg extensions, followed by a cold pack on his repaired leg (which he seemed to appreciate). That should mitigate the swelling and bruising, which has already started. More importantly, it should ease the pain that he's hiding so well.

Next, he got a codeine pill, which calmed him down pretty quickly. I have some tranquilizers to help him sleep a lot the next few days.

Kinda Spooky Here Without My Little Buddy

It's one of the first gray and dreary Autumn days here in Portland, and the house is awfully quiet (even a little spooky) without my little white "home office assistant"...

We lost our older dog "Lucky" (12?), and our cat "Monster" (17) earlier this year, so it's totally odd to be alone in the house. I'm used to going all day without seeing another human, but not being alone.

Sure looking forward to bringing Bo home later today!

Surgery Went Well

The surgeon said the procedure went very well; had his leg opened up for a very short duration, which means minimal chances of infection and a faster recovery of the incision site.

Best news is that his right stifle looks good, indicating better odds that this will be his only TPLO. Alas, for many dogs, CCL ruptures often come in pairs. Once they've blown out one stifle, the odds are they'll blow out the other one within a year or two. We're planning to buck those odds with lots of physical therapy and supplements.

We've prepared his recovery suite in the family room, he should be home tomorrow afternoon. He's going to look pretty strange with one rear leg shaved; there IS a dog under all that white fluff!

Surgery Today

Here is a picture of Bocán from about a week ago. As the vet predicted, he's just beginning to touch the floor with his left rear foot, but still holds it completely off the floor when hopping around.

We dropped him off at Cascade Veterinary Referral Center early this morning for his TPLO surgery.

TPLO, or Tibial Plateau Leveling Osteotomy is a surgical procedure that will modify the geometry of his stifle (rear knee joint), so that he can regain the use of his left rear leg.

We hope he will be well enough to come home tomorrow afternoon, to begin a long recovery process. Meanwhile, we're getting his recovery area prepared...

Background

On Friday morning, September 25, I was on a ladder painting the house and Bocán, our 6 year old Border Collie, was roaming around the backyard. As he often does, he was running along the fence after a squirrel that was running along the top. He's usually very quiet, hardly ever barks, but he yipped once at the far corner. It was a louder and higher-pitched sound than anything I've ever heard him make; I knew he’d hurt himself. By the time I got off the ladder to investigate, he was limping toward me from the far end of the yard. At first, his limp was horribly awkward and he practically dragged his back end. I got him into the house and lying down, so I could examine his left rear leg. He didn't react to anything I did – nothing I touched seemed to bother him, but he would not put weight on it.

Within a half-hour, he had adapted to a rather efficient hop on his right-rear leg, keeping his left foot just off the floor. The first vet exam was inconclusive - maybe a sore foot, a pulled muscle or a torn ligament... He got an Rx for an anti-inflammatory, and we were told to give it a week to see if it heals on its own.

By the time we got him back from the vet on Friday afternoon, he was holding his left leg tucked up tight against his abdomen and kept it there whenever hopping around. When lying down, he rolled onto the "bad" leg as often as the good one, so it doesn't seem to hurt him, but he refused to put the foot on the floor when standing.

Unfortunately, by then I had a strong suspicion that it was a torn cranial cruciate ligament (or CCL, analogous to the human ACL). My friend John’s dog went through something that seemed eerily similar, which turned out to be a torn CCL, requiring surgery and a long recovery period.

The vet said to give it a week, but Monday morning (after 3 days) there was zero improvement. So, I called the surgeon that my friend used, and he examined Bocán late Monday afternoon. The surgeon instantly determined that the poor guy had indeed ruptured his cranial cruciate ligament, (similar to the ACL in humans). It will not heal on its own and it cannot be repaired in larger dogs with any reasonable success rate. Without this ligament, the knee can move in the wrong direction, causing pain when he tries to put weight on it. Apparently (according to the vet and Bo’s behavior) there is virtually no pain when he keeps the weight off it.

Some sort of surgery is the typical treatment, and the most common type of surgery is called TPLO. The ligament cannot be repaired, but they can modify the leg to work better without it. If we proceed, he will need to be strictly confined for 8 - 12 weeks afterward, walking only to poop and pee, and then go through very slow recovery therapy for what could be another 4-12 weeks. Bo LIVES to run 35 MPH and take flying leaps for the frisbee. He may never do that again, but we want him to be able to walk again and hope he can run again.

It all sounds awful, but at least we know what’s wrong and that there is a treatment for this, otherwise Bo would spend the rest of his life hopping around on one back leg. Not acceptable for such a young, athletic dog. We believe that he would want to go through this so he can be a Border Collie again, and have a higher quality of life for the many active years ahead.


After doing a lot of research, we decided to proceed with the TPLO surgery, and do our best to help him through a successful recovery with a lot of physical therapy.

We’ll keep you posted on our progress here.