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Thread: Sam's second TPLO. The feedback.

  1. #1
    Join Date
    May 2013
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    Sam's second TPLO. The feedback.

    Sam's operation went well and she should be getting home tomorrow. I've been emailed her discharge papers. There are some big differences from the last time.

    Sam’s joint was inspected, there was complete rupture of the cruciate ligament and a tear in the medial meniscus. The meniscus was trimmed. A TPLO was performed where we cut the bone with a special saw and apply a plate to hold the bone. The wound was closed routinely and the skin staples can be removed in 2 weeks time by your vet.
    So far much as the last time.

    • Absolute room/cage rest for 6 weeks. No jumping/playing/stairs/slippery floors. Out to the toilet on a lead. IF Tyler BECOMES MORE LAME OR DETERIORATES CONTACT VETS NOW REFERRALS IMMEDIATELY.• After 6 weeks he can have 10-15 minute lead walks 2 to 3 times daily.
    I'm ignoring that they are calling her Tyler but "absolute" cage rest for 6 weeks. It is only about 6 weeks since her last operation and after two she needed held down to stop her running about.

    • Metacam 32kg dose once daily with food for 6 weeks (please ask your vet for more if you run out) Stop if diarrhoea/vomiting/tarry faeces and contact us.
    • Noroclav 500mg one tablet twice daily for 1 week.
    Painkillers for 6 weeks? Last time it was only 10 days.

    Please check any wounds at least once daily for the next 7-10 days. If marked swelling, redness or pain develop, or if you see any unexpected discharge from any wounds, please contact us immediately.
    • To facilitate wound healing and reduce the risk of post-operative problems please keep all incision sites clean and dry, and prevent your pet from scratching or licking them. Use the buster collar at all times for 10-14 days
    • A dressing was applied post-operatively and can be removed tomorrow if it is still in place.
    Last time ime the cone of shame did not even stay on till we got to the car. I can't see this time being any different.

    The usual progress for dogs after this surgery is as follows:
    • At 2 weeks, they are toe touching but not weight bearing
    • At 4 weeks, some weight bearing with each step
    • At 6 weeks, 50% weight bearing
    • Maximum improvement is about 5 months after surgery
    Sam should steadily improve in limb function. If you do not see this, or if the lameness becomes worse after initial improvement, please call for advise immediately.
    What! Last time Sam was putting some weight on the leg as she left the vets. I'll be pretty disappointed if that is not the case this time too. I'd be pretty worried if it is 4 weeks before she starts weight bearing after the previous progress.

    PROGNOSIS:
    The prognosis following this type of surgery is good, with 85% to 90% success rate (good to excellent limb function at 5-6 months postoperatively). Sam would benefit greatly from hydrotherapy to begin in 6 to 8 weeks time.
    Although this procedure has a complication rate reported as 18.8-28%, most of the complications are minor, with 93% of owners being satisfied with the outcome. 2.5% of patients have multiple complications, and a second procedure is required to manage complications in 5% of cases.
    Complications within 2 weeks of surgery include soft tissue swelling, seroma, wound breakdown, wound drainage and wound infection.
    Complications greater than two weeks after surgery include tibial tuberosity fracture, late meniscal tears, delayed union, patella desmitis, osteomyelitis, pivot shift, loose implants, broken screws, fibular fracture, patella luxation, and patella fracture. Most of these are due to inadequacy of rest.
    I was planning to swim Sam from the two week mark or thereabouts by 6 weeks I was expecting her to be back to her bouncy self.

    Either this time the operation is dramatically different or this vet has a far different view of how the recovery goes. I'm hoping it goes as the last time as that was not too bad.
    John

    I started at the bottom and I like it here

  2. #2
    Join Date
    Jun 2013
    Location
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    I wouldn't worry too much about the instructions, it reads like a standard info sheet (i.e. one size fits all type of thing) given to everyone both to give the dog(s) a maximum chance of recovery & to cover themselves from any post operative complications should the owner fail to follow the instructions to the letter. Every dog is different as are their recovery times, Sam being a young healthy dog with out weight problems will obviously recover quicker than say an elderly overweight mutt,
    I would do as you did after the first op, see how it goes, I'm sure Sam will show you how she is progressing such as needing pain killers after 10 days or putting weight on her leg & should you have any worries or querries, you can always telephone your vet for advice.
    Sorry I can't be more helpful but do try to stay optimistc, after all there isn't really a reason why things shouldn't go as well as they did after the first op....
    .
    Properly trained, a man can become a dog's best friend.

  3. #3
    Join Date
    May 2013
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    Lochwinnoch
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    I had the same sheet last time but it had less stringent advice on it. I'm hoping it is just the different vets standard sheet.

    Anyway, Sam back home now but still pretty zonked. We will see how she is tomorrow after a nights rest.
    John

    I started at the bottom and I like it here

  4. #4
    Join Date
    May 2013
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    Her first day back she was pretty subdued all day.



    She looks more sorry for herself in that picture than she really was. Today she is a lot brighter and moving about more. It won't be long before we are struggling to keep her restrained again.
    John

    I started at the bottom and I like it here

  5. #5
    Join Date
    Jun 2013
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    France
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    How is Sam getting on John ?
    Properly trained, a man can become a dog's best friend.

  6. #6
    Join Date
    May 2013
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    Lochwinnoch
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    I'd say she is back on track to how she was the first time. She is starting to get too active for her own good. She is back on couches when you turn your back and if not stopped would be up and down the stairs often.

    I think she was a bit active on Friday but over the weekend we managed to keep her pretty subdued. All signs are this leg will recover as well as the other so looking good so far.
    John

    I started at the bottom and I like it here

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