Home sweet Home 6/30/2010

So happy to have my boy home! He is 9 months old today. He was supper excited to see me at the office....he missed his momma :P

I met with Holly, the discharge tech., who explained what life is gonna be like for the next 6-12 weeks. Let's just say its involved!!

• He is on Rimadyl (anti-inflamatory) for the next 2 weeks, Cephalen (antibiotic) for 5 days, can have Tramadol for pain med. when needed (prob. last 1-1.5 weeks), and will need to get adequan (helps protect against osteoarthritis) IM injections for twice a week for 4 weeks. I'll have to call the vet and see how much adequan injections cost, she will probably charge for administering them so I will prob. do them myself. Being a nurse is handy sometimes.:)


• When not suprivised he is to be crated or kept in a small space, and not allowed to run, jump, or play. He may have short leash walks to go outside for elimination only for the next 2 weeks. He must wear his elizabethan collar (lampshade) at all times unless directly suprivised.


• I have to apply a cold compress to his knee for 10-15 minutes at a time, 2-3 times daily , for the next 3-5 days. I have to start doing ROM exercises with him in 5-7 days post-op, 4 different exercises, 10 repetitions each 2-3 times per day. Cold compress post ROM excercises 10-15 minutes.


• 10-14 day incision evaluation and first apt. with rehab therapist. I will then learn his second set of at home exercises.


• Weekly apts. from then on-for rehab therapy and potentially start hydrotherapy at 6 weeks. Repeat xrays at 4 and 8 weeks.

Man I'm tired just rereading all that. At once that's all done it will be september and Doug is getting his surgery. Boy, I have my work cut out for me.

Synopsis of lead up to surgery

Since mid-May we noticed Guinness had been limping intermittently on walks and at the dogpark. We took him to the vet and they did xrays and an exam which revealed left sided hip dysplacia and bilateral patella luxation (Left-Grade II, Right-Grade I). They're recommendation was to do the FHO procedure to correct his hip dysplacia.

We spoke to our breeder: My husband called him when we initially got the xrays and first diagnosis, our breeder told us he would pay us what we paid for Guinness towards the surgery ($800) but we really should consider putting him down and he would give us another puppy. No way, Guinness is my baby!

We wanted a second opinion regarding what kind of surgery to do, so we went to VOSM (orthopedic specialist) and had a consulation with Dr. Lotsikas. After his examination (bilateral hip dysplacia, and bilateral patella luxation, same grading) and review of xrays his recommendation was to perform MPL surgery on Guinness' left knee.

So Doug and I were left with 2 different plans of care for Guinness. After hours of online research and questions to Dr. Lotsikas we decided to go with the MPL surgery. $2400-$2600.

Guinness' MPL Surgery 6/29/2010

Guinness has his MPL surgery today on his left knee, 6/29/2010. Doug and I took him to VOSM and got him all checked in, I hated saying goodbye, I told him see ya later and gave him some love. It was hard but I didn't cry like I thought I was. He weighed in at 27.2 lbs, the biggest he has ever been. He will be 9 months old tomorow.

So I went home and started cleaning the house, trying to take advantage of not having Guinness to entertain. :) I did laundry-including washing all of his bedding (3), sweeping/mopping, vaccumming and bathrooms cleaned. It helped but I still worried.

The nurses called around 3pm saying he had not gone into surgery yet (he was #4 in line of 6) but they had taken him outside a few times for walks and she said, "the staff love him, he so sweet." She told me that 4 hours after surgery they will take out his trach and try to take him outside to pee. Every 4 hours thereafter they will do the same, they'll get him up and walk him outside. She also told me that Dr. Canapp had seen Guinness (We asked that prior to surgery we wanted Dr. Cannapp to see Guinness and give his opinion of what surgery we should do). He agreed with Dr. Lotsikas that we needed to proceed with the MPL surgery, his evaluation however was that Guinness' left knee was a grade III. Dr. Lotsikas evaluation was that Guinenss knee was a Grade II, sort of relative but the conclusion is the same, that Guinness needed MPL surgery.

A little education for you in regarding the grading of patella luxation. There is a grading system of severity.

• Grade I- the patella can be manually luxated but is reduced (returns to normal position) when released
• Grade II-the patella can be manually luxatd or it spontaneously luxate with flexion of the stifle joint. The patella remains luxated until is is manually reduced or when the animal extends the joint and patella moves back into place. (intermittently luxates but stays in place more than out) This is typically the dog that occasionally carries a rear leg for two or three steps on occasion but then puts it back down and goes as if nothing was wrong.
• Grade III-the patella remains luxated most of the time but can be manually reduced. (stays out of place more than in) They have more frequent "skipping" episodes, may not want to jump up onto things, they may have pain and the patella doesnt alwasy return to normal positioning when it is deliberately pushed out of its groove during a physical exam.
• Grade IV - the patella is permanently luxated and cannot be manually repositoned.

Dr. Lotsikas called around 6pm and told us the surgery went well and he was very pleased. He said that it was the right decision. Once he saw the structures he said that Guinness barely had any patellofemoral groove, "it was nearly flat". The patella rests in the patellofemoral groove, if its shallow (in Guinness' case) then it is prone to luxate (dislocate).

This news makes me feel so much better about going through with the knee surgery instead of his hips. Doug and I were told by our original vet to do the FHO surgery on his hips (he also has bilateral hip dysplacia), then we went to VOSM and saw Dr. Lotsikas (orthopedic specialist) and his opinion was that we needed to correct his left knee with MPL surgery.

Around 10pm I called to check in on Guinness. She said that he did well with his first walk and went outside and peed. They did have to "tweek his pain meds" she said when asked if he had been whining, so I guess he needed a little more. She said that his vitals were stable and is doing well.