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.