Friday, October 21, 2011

Luxating Patella Surgery - Post-Op Day 3

I suggest if you have a heart condition that you stop reading/looking right now, because this will break it. Also, I should let you know that if you have a problem with pictures of bandages or stitches, you also should stop..because today, it's all here.

My whole point in putting this info out there is so hopefully if someone else has to go through this they can find the information they'll need. I never could find a specific case concerning a pomeranian. There was quite a bit of info on forums and things about malteses and shi tzus, but nothing on poms.

Luxating patella, or slipping knee cap, is very common in Pomeranians, as well as other small breeds. I'm not really going to go into detail about what it is because there's tons of general information out there. Basically the knee cap slides around and out of the groove it's supposed to be in. This causes a skipping when the dog walks. Mostly it's not painful, but in Oliver's case it was becoming increasingly so. (I'm sure if we asked him, he would take that pain over what he's got now..but too bad.)

On to Oliver's story.
It was rapid onset, we were playing, then I guess something tweaked just the right way, he howled and wouldn't use his left leg. Same thing happened 2 weeks later, only this time it was his right leg. So now it's both legs. We got some opinions, and it needed to be fixed. Both of Oliver's knees were Grade 3.
We made our appointment with the MU Vet Teaching Hospital. Today is Friday, our appointment was Monday. We met with our student first, then the actual vet, Dr. Cook. He's a leading orthopedic surgeon...nothing is too good for my baby. Our appointment was short, they didn't really have anything to say that I didn't already know. Oliver was a candidate for surgery, in fact, Dr. Cook said that Grade 3 was really the best situation, because it was bad enough to need to be fixed, but not so bad that anything degenerative had set in he expects a full recovery. We left Oliver there. That night he had x-rays done and some blood work. Tuesday mid-morning he had surgery. Our student was absolutely wonderful in keeping me updated.
They did what they call the 4-in-1 on both of his knees. The deepened the groove, they loosened the ligament on one side, tightened the other side, and they cut and relocated part of his tibia. They also check the ACL while they're in there, since it can't be seen on an x-ray. They said they prefer to do both legs on small dogs, because they tend to recover so well, and you can just carry them.
When we went back to pick him up we had a new doctor (Dr. Cook wasn't in that day..which was Wednesday) and a new student, it was time for them all to rotate. This was sort of less than desireable, but I figure I can call them as Oliver gets better, because there was some conflicting statements between new Dr. and Dr. Cook, so we'll just have to wait and see. Anyway, he's on 2 drugs, Tramadol, the pill, and Meloxicam, which is a liquid. He gets the pill every 8 hours, and the liquid once a day. He's supposed to be on 6 weeks of crate rest. That's not a problem now, but I see it being difficult in the future.
In 6-8 weeks we go back for a recheck visit, where they will maybe do more x-rays, but for sure feel the knees to make sure everything is still in place. AND this I didn't know, I never read it anywhere, so I was surprised when they mentioned this in our discharge appointment. There are pins in Oliver's tibia (this I knew) ((and we got to see the x-rays..straight as a arrow!)) but these pins are smooth, and can work their way out of the bone. New Dr. said that in 95% of her rechecks that she sees, these pins have to be removed. They do it there, under heavy sedation. This was news to me.

So, on to the photos...

He's definitely a sad pomeranian. He likes his crate, so that's working out for now. He can't really walk, and the drugs make him really sleepy. We pretty much get up to go out every 2 hours or so, then he goes back to sleep. It's only post-op day 3, so hopefully he'll feel better as we go along. He looks like a Chinese Crested, they shaved his butt fur.

Right after the surgery they had pressure bandages covering these. But those came off Wednesday morning, leaving this sticky mess. During our discharge appointment, they made it sound like these would come right off (we hadn't seen Oliver yet) with a warm washcloth or something...yeah, that is not true. This was Thursday night, after his meds, so he was drugged up...we started (carefully) peeling the tape off, and he was just throwing a fit! We weren't making any progress either. It's sticky like packing tape. As you can tell, it pretty much covers his whole legs, and his thighs. I can't say I blame looked painful. We had to remove the devil tape so we can look at the incisions, to stay on top of any infections. So what does it take to remove the tape? It takes, 2 college educated adults, a 50 something second career nurse, a cone of shame, 2 giant dog cookies, part of a can of puppy EZ-cheese, adhesive remover pads, and it has to be 10 o'clock at night.

And this is what you get. Poor Oliver was so snappy and snarly (I can't really blame him, I'm sure it hurts a lot)((he bit both me and Jon)) that we only removed enough to see the stitches. This is his right leg, which was worse. He doesn't stand on this one at all.

This is his left leg, the wound looks much better on this one...well the other one doesn't look bad or anything. He'll balance on this leg when he's out in the yard.

We're going to work in the next few days as he's feeling better at removing the rest of the devil tape. I suggest if something like this is in your future, that you make sure they don't send you home with a dog that had this crap on their legs...for what you pay, they should take this stuff off...and I'm sure they would, but MU is 2 hours from here.

Turns out, Oliver maybe has a career as a circus dog.

Actually it was pathetic. We got home sort of late Wednesday night, well, at least it was dark. They had told us that he was still refusing to walk on this back legs, and that we might need to use a sling to help support him to potty. Well....we tried that, with no success. We were trying to hold him up with a piece of fabric under his legs, while trying not to bump his knees. Turns out this is impossible with a boy dog. The bits get in the way. We gave up, went in side and regrouped. Tried again, and turns out, all you have to do is set him on his front legs first, and he'll take off on his own. I'm really glad the sling isn't something we have to keep using. It really is amazing, because this was the practical part I was worried about, the dreaded potty time, with only 2 working legs. He mostly just takes off like nothing is wrong, balances on the back left leg when he goes, then picks it back up to walk back to you. He gets tired really quickly, and you have to pick him up and start over if he hasn't gone yet..but so far we haven't had any potty problems.

So far it's going pretty well. He's slept for the 2 days we've been home, but he seems comfortable and fairly happy.

I'm glad it's over with, that's for sure. I plan to have more updates on his recovery, so that anyone who wants to know can see what it's really like. If you fall into that category, feel free to contact me with any questions, and I'd be happy to tell you anything you want to know.


1 comment:

  1. hi, my pom might have to have this same surgery in a few months. I am worried that the fur on his legs or behind area where it is very fluffy will not grow back in nicely or at all. How has it been on your Pomeranian?