A Sarah Saga – TPLO

Priorities.

Soulful Sarah (seen here in her secret garden), our precocious cuddler, our 100 pound Alaskan Malamute has over the past several weeks exhibited an increasingly pronounced limp that is obviously the result of some “issue” with her right rear leg. She has gradually eased off the natural imperative to distribute her weight equally on her four legs and has relegated her right rear leg to that of an appendage only, not capable of bearing weight…almost useless.

Sarah’s twice daily ten, fifteen, twenty or more block walkies have gradually shrunk to what was today no more than half a block. Indeed, the unnatural, non-fluid whole body jerky accommodation to the useless rear leg consumes her energy to the extent that, even on a half-block walkie, she needs to rest before she is able to hobble back home.

This morning her short walk produced a clicking sound from her right leg, near the knee joint. Decision made: No further walkies until this problem is corrected.

Backing up here.

More than three weeks ago, when it became obvious Sarah was not physically 100 percent and her appetite was dwindling, I took her to her regular vet who, predictably, concluded arthritis the culprit and prescribed Rimadyl, an anti-inflammatory. And, Sarah and I were sent on our way.

To be fair, Sarah does not present well in the presence of a veterinarian. Whether it’s her stoicism or stubbornness or just simply her love of people, when she has had physical issues before–and certainly through this current saga–she seems to charge-up with beta-endorphins, thus masking the symptoms David and I see at home. So, what the vet sees is a pretty healthy dog whose daddy is, well, maybe just a little too concerned about what clinically appears to be a rather minor problem.

Okay. So, a week goes by with me sticking those huge “chewable” Rimadyl tablets down her throat (Chewable!!! Yeah!! Right!!). Her limp gets worse and, by Saturday, David and I decide to take her to the emergency hospital. And, once again, Sarah presents to the vet a slight limp and some tenderness around her knee joint. The emergency vet takes two x-rays (they gave her morphine in order to splay her out for one of the x-rays). We wait about an hour and the vet comes out and concludes that the x-rays shows some minor incidences of arthritis in some of the usual places. His conclusion: arthritis. So, he gives us a different anti-inflammatory called Deramaxx (once again a “chewable” tablet), and also some medication for pain called Tramadol.

Back home we go. Another week passes. Limp gets worse. Sarah stops eating altogether and begins having squirty, completely liquid diarrhea. I make an appointment with Sarah’s regular vet for Saturday–exactly a week after the emergency vet appointment. But, this time, during Sarah’s early morning Saturday walkie, I get out the movie camera, David takes the leash, and I film the limp, the reluctance to put any weight at all on that leg which is producing a tortured gait (she’s always had such a fluid lope). We all three head for the vet with the intention of exposing Sarah’s worsening problem as captured on video tape…lest she conjure up those beta-endorphins again and fool the vet into thinking she’s fine, it’s her daddy who needs a little help.

So, I go into the vet by myself with video camera in hand, leaving David and Sarah in the car. The vet came in–we have a wonderful female vet, by the way–she watched the video and concluded, okay, we need to do something a bit more affirmative here. She suggested three orthopedic surgeons and urged that Sarah be seen by one of the specialists as soon as possible. She also prescribed an anti-diarrheal (an organic “chewable” that didn’t work) and also suggested we give Sarah a Pepsid once a day. She also gave us more pain medication.

The Saturday we saw Sarah’s regular vet for the second time was the Saturday of the long Memorial Day weekend. Which, of course, meant I couldn’t begin my search for an orthopedic surgeon until Tuesday.

On Tuesday, I began the day deciding to stop all medications I was giving to Sarah. She hadn’t eaten in weeks. She’d had diarrhea for two weeks. And, clearly–at least for me–the cause was the meds.

Then I began calling the offices of the orthopedic surgeons. Of the three, there was one who had an opening on Friday, the 30th. I told the young woman on the phone that I really needed to get an appointment before Friday; that if Sarah didn’t get some relief, some professional attention she’d have to be seen on an emergency basis as she’d had diarrhea for two weeks, she wasn’t eating, she’d probably need I.V. fluids, meds, etc. This kind person on the other end of the phone then said something like Well, let me look at something else here. And, she looked at something else and WALLAH! there was an opening the next day, Wednesday.

This past Wednesday, Sarah and I headed south (I’d never been on E470) and east and finally arrived for our appointment. I had video in hand, x-rays taken at the emergency hospital and documentation of current meds. This part can be one of those “long story short” things. The old doc–he’s been performing veterinary surgery for thirty-six years–knelt down, felt Sarah’s leg, elicited a little whimper from her when he manipulated her knee and, in less than a minute he smiled, stood up and said, “Cranial cruciate ligament rupture. She’s torn the ligament at her knee. She’ll need surgery.”

And, the surgery–scheduled for next Thursday, June 5th–is called, “Tibial Plateau Leveling Osteotomy (TPLO).” (This link is probably as good as any on the subject. Besides, it provides a few good images that graphically describe the problem and the surgical solution. You might have to enlarge (+) the document in order to see the first image.)

The surgeon told me that this type of injury is very common in dogs…not so much with cats. In fact, he told me that he sees about fifteen of these types of injuries a week. So you dog lovers out there beware. If you dog limps for longer than a day or two and you KNOW FOR SURE (either because x-rays were quite unremarkable with regard to the presence of arthritis–as was the case with Sarah–or you just have that animal lover’s instinct that something potentially serious is going on causing the limp, then be aggressive with your vets. Because if your dog is suffering from CCL, the longer it’s not repaired, the more damage to the knee will occur including eventual debilitating arthritis.

So, give a little thought to Sarah this Thursday. My thanks in advance. It will probably be up to sixteen weeks before she’s 100% again. That alone is a scary prospect.

Anyway, my priority for a while is clear.

P.S. A sincere hope this saga turns out better, more positive than her prior veterinary saga.

Chronicle of this whole process is here, here, here, and here.

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This entry was posted in Critters, Sarah, Scribbles, TPLO and tagged . Bookmark the permalink.

5 Responses to A Sarah Saga – TPLO

  1. Jean says:

    Doesn’t the vet know there should be a “wash out” period before substituting one NSAID (such as Rimadyl) for another? Such as Deramaxx.
    In my opinion and experience, your dog needs immediate attention by a vet well versed in the dangers of drugs such as Rimadyl, Deramaxx, Etogesic, Metacam, Zubrin, Previcox, etc. PLEASE read the Client Information Sheets provided by the drug manufacturers You should have received the CIS when Rimadyl was prescribed.
    http://www.fda.gov/cvm/Documents/NSAIDBrochure.pdf

  2. georgeindenver says:

    Thanks, Jean. Yes, the vet should have advised a “wash out” period. I now know the dangers of these drugs…something that each pet owner should take it upon themselves to understand.

    As I noted in the post, I took Sarah off all NSAID drugs–Rimadyl and Deramaxx–and have additionally stopped giving her the “pain” medication Tramadol. As a consequence, her appetite has returned and she no longer is experiencing diarrhea. I suspect, after her surgery and once she is ready to come home, there will be a vet imperative to certainly provide pain meds and, most likely, to reintroduce a NSAID. But, now I’m prepared to intelligently discuss the introduction of NSAIDs. Thanks again for your comment.

  3. maggie says:

    My dog died after being put on Rimadyl. There are safer alternatives to this dangerous drug.

    If you look at the Senior Pet Project you will find many alternatives, including for pain management.

    One thing you might try to help your dog is magnets. I thought this was an odd suggestion but have been amazed with the results. Try getting a magnet cover for your dog’s bed.

  4. Suz at Large says:

    Hugs and best wishes to all three of you.

    Suz (and Jasper)

  5. georgeindenver says:

    Thanks, Suz, Jasper.

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