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Sunday, June 29, 2014

A TIBIAL PLATEAU LEVELING OSTEOTOMY (TPLO)

Typical indicator of torn cruciate ligament
Those of you who follow my posts may remember that not long ago, K-Lee was lame in her left rear leg and we concluded that it was a "soft tissue" injury--a sprain or strain.  A few weeks after the visit to the local vet --and about $300 later, the ailment returned after a moderate work-out.  K-Lee seemed fine when we ''cooled'' her and put her in the kennel for the ride home.  Later while unloading, we noticed that she tucked her left rear leg against her abdominal cavity and even after she worked through that, she had a limp and would rest her leg without pressure.  See picture at right.

I immediately put her on Cosamin DS and an anti-inflammatory drug.  She soon returned to "normal", but I  didn't believe it was "normal" at all. ( I had been down this sort of "road" with my German Shorthair, 'Taylor'.)  My breeder and my trainer both said that it sounded like a torn "ACL" (cruciate ligament). I decided to go to the next level.   I asked trainers at Merrymeeting Kennels in Brunswick Maine if they knew of a good orthopedic veterinarian in New Hampshire--or nearby.  They recommended Norway Veterinary Hospital in Norway,. Maine.  (http://www.norwayvethospital.com/)  

Dr Gauger was kind enough to schedule an exam and give me a second opinion. He took additional radiographs and after examining K-Lee and asking my wife and I questions, he spent quality time explaining what he found.  Both my trainer and breeder had guessed correctly--torn ligament. There were several options available to repair the joint, but the Tibial Plateau Leveling Osteotomy (TPLO) was the best option.  There was no pressure from the "veterinarian side".  I liked Dr. Gauger, the wonderful facility and the staff, so I jumped in.  "Let's do it" I said.  

Quite often cruciate ligament failure is a gradual process and not simply due to a single traumatic injury. As Dr. Gauger said, "Dogs don't play football."  Most dogs have a predisposing factor such as age-related ligament degeneration, or perhaps pre-existing inflammation, anatomical abnormalities, or excessive slope of the top of the tibia bone--which can cause ligament failure. It seemed that K-Lee's problem was excessive slope-- which in my opinion, is a "conformation" defect...perhaps handed down from some distant canine ancestor. 

It turned out that Doctor Gauger had an opening in his surgical schedule, so K-Lee was operated on the very same day, and her recovery began immediately. She will be recuperating for about sixteen weeks, and  is presently on a very restricted regimen.



She is shaved on the left rear leg, along the spine just before the rump and on one foreleg for an IV.  I think she's upset at me for that "look".  She will take treats from my wife, but not from me. 
(Once she get's better, I think we'll need to do a 'summer' haircut.)


There are other orthopedic vets out there, but for me, Norway Veterinary Hospital was definitely the way to go.

If you would like to know about the procedure, here are a few links:

https://www.youtube.com/watch?v=hGIxCPekppk

http://www.fitzpatrickreferrals.co.uk/our-services/surgery/conditions/hind-limb/cranial-cruciate-ligament-injury

http://www.vetsurgerycentral.com/tplo.htm



I'm really grateful for "pet insurance", but that's another story.


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