TPLO 16 Week X-Ray
Halloween was not scary for me, thankfully as it was on the fateful Monday the 31st of October when I took ‘ol Bar back to the vet for his 16 week x-ray to see if his left rear leg, which was surgically repaired 16 weeks previous had made any progress in the getting better department. Lars underwent a TPLO way back on July 12 after it was determined that he had torn his cruciate ligament, which is basically the fastener that holds the femur and tibia in the correct position.
The TPLO procedure is one of the newest procedures to be developed by surgeons to repair what actually is a more common structural injury than I thought. When researching the procedure before Bar went under the knife, I determined that out of the three types of surgeries that would be suggested, that the TPLO would offer Bar the most promising prognosis. Lars is a young dog with many years ahead of him, years that I would love to be able to enjoy running, wrestling and obviously, working with him.
The TPLO, AKA tibia plateau leveling osteotomy is the most major of the main surgical options as it involves cutting away a piece of the top of the tibia, rotating it to reduce the angle at which it meets the femur, and then securing the bones together by a plate and six screws, effectively removing the job of the damaged cruciate ligament. Once surgery is performed, the joint is immediately stable, thus recovery is relatively quick and in the majority of cases, full. Dogs are able to toe touch and begin gently putting weight on the surgical leg within a few days, unless your name is Lars, who was freaken weight bearing the same day!
By one month post op, Bar was going on 20 minute walks daily and I had my hands full trying to keep him calm as he was suffering from extreme cabin fever. At five weeks, I weaned him off his anti-inflammatory drug Metacam, and by seven weeks he was exhibiting a little pain, evident by his limping after walks and him favoring his right side when standing still.
Eight week x-rays showed that his leg was mending up nicely but that there was still visible surgery line showing, meaning that the bones had not totally fused where they were being held together by the plate and screws. Four weeks later, x-rays showed the exact same amount of surgery line showing, a step backwards if you will because the hope was that Bar would have fused bones by this point. I was advised to increase his activity in an attempt to stimulate bone growth, and armed with a bottle of Metacam, that is exactly what I did.
This brings us to 16 weeks, and good news! Bar’s surgical leg is almost better! Images showed a hint of surgery line, but much less of one than what could be seen a month ago, which means that we are on the right track! Over that last month, I had increased Lars’s activity a lot and he had handled it all without a hick-up, some of which maybe down to the Metacam doing its thing.
Just because the leg bones are fusing together does not mean that Bar is all better yet as he has a lot of soft tissue that needs to be strengthened. Now that the angle of the tibia meeting the femur is slightly altered, there is more pressure on his little quad muscles and tendons in and around the knee and all need to be strengthened to cope with the structural changes in his leg. Since the beginning, I have been working with Lars and his leg to help him strengthen it by performing manual flexion of the knee to loosen things up and Lars and I do a little rehab program daily consisting of puppy squats, figure eights, and some other balancing exercises aimed at making him use the leg to make it stronger.
We are now almost 18 weeks post-op and Lars continues to improve! He had his first off leash freedom today, 15 minutes of supreme worry for me, 15 minutes of overwhelming joy for the Bar! As time passes and he is able to handle increased activity with no discomfort, I will do two things: continue to wean him off the Metacam, and continue to bump up his activity level.
His recovery has been a bit of a rollercoaster for both of us, and I have learned a lot along the way that I did not learn by reading up on the procedure online but I guess when you actually have to physically live through something like this you have to realize that every dog will tell a different ‘tail’ if you will.