June 2, 2003/Day 3 Post-TPLO:
Today my husband and I are both at work,
so we gave her half her ACE dose this morning, which helped a bit,
but when we got home for lunch, she was standing in her x-pen tearing
up one of her dog beds. She also has edema in the ankle of her
repaired leg. It was better after her resting yesterday afternoon,
but it is bad again. The orthovet is concerned about that--he feels
that she is on her feet too much. Well, how do we keep her off of
her feet short of drugging her and/or tying her down?
When we were home for lunch, I gave her two Kongs (cheese, carrots, peanuts, peanut butter & dog biscuits) and a huge rawhide, so hopefully that will occupy her until I get home in three hours, and she will remain laying down. I hate drugging her, but I don't know what else to do. I just hope she doesn't get too excited when the mailman comes. The smallest and oldest dog, Jasmine, is a chronic barker, who gets the two larger and younger dogs going.
Being silly, laying on her back, which was good for the edema.
June 4, 2003
June 3: 2003/Day 4 Post-TPLO:
Today, I called our orthovet and had them fax up a new
prescription to our local vet for more ACE for Nixie, since that
seems to be the only thing keeping her down--rawhides and Kongs only
keep her attention so long. I went to pick it up, and I noticed that
the dosage was less (instead of 40 mg. every 12 hours, it was 25 mg.
every 8). The vet tech at the local vet mentioned that "he" (I'm not
sure which vet) didn't want Nixie overmedicated (well, we don't want
to overmedicate her either). That made me mad and feel guilty that
we were medicating her for our benefit, not her's--grrrrr.
June 5: 2003/Day 6 Post-TPLO:
Yesterday (Wednesday), she was the most mellow as I've seen her. We
didn't give her any ACE, just morphine at bed time. However, sometime during the night, Nixie woke up in the x-pen. I woke up to her panting and whining--she had to go out. We have no idea how long she was up, but it was enough that the edema in her repaired leg got really bad. By morning, the ankle area was huge and taught, not just jiggly like it was prior. My husband stayed home from work to keep her still, and iced her leg.
I took her outside to pee, which she did, and then she limped back in the house. I honestly wasn't awake enough when I took her out to remember if she was limping on the way out or not, but she wasn't even toe-touching on the way in. We couldn't get her to lay down, so we moved her into the spare bedroom, with her futon mattress on the floor, and practically had to bulldog her to the bed--my husband had her front end, I had her back end, and we just lifted her up gently and laid her down--hard to do on a 33" tall Dane. She was in some serious pain. We then gave her ACE, and iced her leg. She wouldn't let us go near the surgery site with the ice pack.
She wasn't much better this morning, so we took her to our local vet. He hasn't seen any post-TPLO dogs, so he had no idea what to expect. She has a pretty decent range of motion on that leg. Her knee is more swollen than it was, but the ankle swelling has gone down a teeny bit over the last few days. She still is barely toe- touching, and is limping horribly. He told us to give her morphine throughout the day, not just at night like we had. My husband is home with her now, to make sure she doesn't get into any more trouble.
We have been following the care instructions to the letter--3 five minute bathroom walks (sometimes it becomes more like 5 three minute bathroom walks), icing the leg 2 - 3 times a day, and strict confinement. However, Nixie has not read all of the post-op literature that I have, so she didn't know that she shouldn't have been using that leg as much as she was.
Nixie, flaked out on the dog beds in the living room.
June 6, 2003/Day 7 Post-TPLO:
My husband stayed home from work yesterday (Thursday) and kept her
still. We increased her morphine to the maximum allowed, because
she seemed to be in pain. She ate very little, and drank some. I
spent the night with her on the futon and she was quiet until about
3 a.m. when she got a little restless, but she stayed down until 6
a.m. She was cold and shivering at 3 a.m. (she has no body fat or
undercoat), so she got an extra blanket.
This morning, the edema in her repaired leg had gotten worse, and her foot was the size of a baseball. I called the orthovet and they told us to bring her in. We drove the hour down there, and we saw one of the surgeons. Nixie's temperature was slightly elevated, so they put her on 625 mg. of Clavamox (antibiotic) twice a day (pricey!). They also told us to stop the cold compresses, and use hot three times a day. The surgeon said that the pain was from the edema--I suppose skin can only stretch so much. If we don't see a remarkable improvement by Sunday, we should call the orthovet's emergency line to find out what to do next.
It is 9 p.m. MDT, and the foot isn't baseball sized anymore, but it is still large. We've been trying to keep that leg elevated while she lays down, and getting her up every couple of hours so the blood circulates. We've increased her massages--up from the foot--and she doesn't like them, so it takes two of us to do them--one to hold her down, and the other to massage. She is toe-touching more than yesterday, but she still isn't back to where she was on Wednesday. So frustrating!
June 9, 2003: Day 10 Post-TPLO
She is feeling better, and off painkillers. Today she was out
grazing--picture a tall black horse. Yesterday, she was bug-rolling, which
totally freaked me out. She would sniff in the grass on a bathroom
walk, locate a bug, usually an ant, roll her head on it, and then the
shoulder went down, and then the rear end and the whole back. She did this three times--
twice on her good side, and once on her repaired side. Didn't seem
to phase her. Her back end didn't always go down, which is why I
didn't catch her in the midst of doing it the first time.
She gets her sutures out on Thursday. That area looks well--no redness, some swelling, and the bruising is all gone. I just wish she would get her ankle back, but I did feel bone in there today.
June 12, 2003: Day 14 Post-TPLO
We drove the hour to the orthovet's office today. The orthovet was running late...something to do with an accident. In the waiting room, there was a spazzy lab, who wasn't on a leash, and had a bandage on his foot. There was a sweet rottie girl, who must have had something horribly wrong with her, because her owner talked of euthanizing her if what they think is wrong with her, is. And, there was a dog with pins sticking out of his femur, all attached to a plate. We kept Nixie on her leash, with the sling under her belly, more to keep control of her, rather than for support.
Dr. Swainson saw her, removed the pink sutures, and stated that she looked fine. He said the other surgeons laugh at him for using pink sutures on black dogs, but he says that he can find them all if they are a contrasting color. Personally, I hate pink, and would have preferred teal, or some other color. There is a little swelling around where the suture line was, but that went away after a while.
