Caring for a Three Legged Dog or Cat
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My dog, Jack, tore his CCL on his only back leg two weeks ago while we were out of the house, and we came home to him not being able to walk. It took a couple of weeks to diagnose, but now we have now met with the orthopedic surgeon in Salt Lake City and have planned surgery for this Tuesday (two days from now).
I am torn between TPLO and extracapsular repair for Jack. He is a 10-year-old, 55-pound heeler mix. When I first met with the surgeon, there was no doubt in his mind that he would do TPLO. When I asked if extracapsular was an option, he said that at Jack's size, both methods are options, and that it's up to me. He said if it were his dog, he would do TPLO because it results in a more stable joint, but both methods would work.
I am so torn because I know that TPLO will make a stronger knee for Jack, and I hear many stories from people where it was successful. However, it goes against everything I feel to have the surgeon cut the bone in Jack's only back leg and screw it back together. If it all works out, I will be happy I chose TPLO. But the worst-case-scenarios keep creeping into my mind, and I wonder if it's just not worth the risk if there is another option. If it's true that extracapsular will also work, it seems like a better option to me, with less pain and fewer risks. I just don't know how the three-leggedness factors into the options, both in terms of how he will heal, knowing that it will be impossible to keep him 100% off of the repaired leg, and the long-term success rate (well, long-term, knowing that Jack is 10).
The vet told me not to lose sleep over it, because both methods would be fine, but I'm finding the decision to be quite agonizing 
Any insight from people will similar experiences would be great!
Ohh I'm so sorry you're dealing with every Tripawd pawrent's worst nightmare. My heart goes out to you! How did Jack lose his leg in the first place?
Imagining the worst case scenario is something humans are really good at! But it sounds like you've really done your homework and you have a great medical team on your side. This makes a tremendous difference. Also, with Jack being a medium sized dog, the recovery shouldn't be too bad either.
We've had others who have dealt with this situation before so I hope they'll chime in. If you want some reassurance, here's what our expert vet Wookie had to say about acl surgeries and Tripawds in this post:
2. Have the knee surgically repaired. I suppose this would be the option I would lean towards. Yes, it would definitely be a more difficult recovery and more potential for complications due to the fact that he is a tripod, but I think it is doable. Personally, I would not recommend a TPLO for fear of implant failure due to early weight-bearing, but you could probably talk to 10 different surgeons and get 10 different opinions. I like the Tightrope procedure, it's much newer so a lot of surgeons aren't doing it, but there are no cuts in the bones and no plates and screws that could fail, like there is with the TPLO. I have had patients walk on the leg the day after surgery without even a limp!
Be sure to check out these post about three-legged Chuy who went through multiple leg surgeries after his amputation.
When a Tripawd Needs Another Leg Surgery
Swim Your Tripawd to Better Health
Let us know how things are going. We're glad you joined us. Your future posts won't require moderation.
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
Thanks, Jerry. Jack lost his leg when he was about 1 1/2. He was in foster care after his original owners gave him up, he ran away, and was hit by a car. Someone took him to the shelter and his foster mom found him there. She had his leg operated on (metal pin down through the femur), but everything got very infected and didn't go very well. This is the point when we were lucky enough to meet him! The surgery ended up being unsuccessful and we ended up amputating about 3 months later. That's when we found out how lucky dogs are to have a spare. I only wish we were in that situation now...
I know that some surgeons swear by the TPLO as the best way to fix a knee but I also decided against the TPLO procedure for Tazzie and had a board-certified surgeon fix both of her knees with the lateral suture technique and she did great! She had her surgeries prior to needing amputation so my story is a little different but both of her knees held up well the entire 14 months that she was a tripawd. I did take her for treadmill rehab both times due to her size (she weighed about 190 pounds at the time) and also did some physical therapy.
Most dogs do well with a TPLO but I have seen some complications including draining tracts, severe infections, broken plates, and even OSA at the implant site. Complication rates for the TPLO depend on the surgeon but are listed at 5-20% (most not severe). It is possible for lateral sutures to fail but that is also unlikely especially in a 55# dog. I do know several surgeons in our area that perform the tightrope procedure and they really like it! Some dogs do benefit from a TPLO depending on the angle of the joint and the need for quick return to function (hunting dogs, etc).
I would love for Wookie to comment on how she selects a dog for TPLO procedure vs other techniques.
Pam
Thank you, Pam. You mentioned that there are several surgeons in your area that perform the tightrope procedure- where is that? I am not sure if it is one of the options with the surgeon we are working with.
Thanks!
This isn't exactly related to this conundrum, but: Jackson had all of his medical problems away from our home and his vet (which are in CT, on the shoreline), but rather in the middle of New Hampshire. Turns out, an ACL surgery is about $1000 less in NH. Amputation was about $800 less. At those rates, we still would have saved money staying in a hotel the night Jackson recovered - that is, if my parents didn't still live there.
If you find a good vet that is further from home than you would like, it may be a drive, but it may be cheaper!
Good luck with your decision. Keep us posted! Oooooh, I hope the procedure goes well and that recovery is good!
ACL tear in right hind leg 12/5/12 and scheduled ACL repair surgery 12/21/12. Pre-op xrays revealed osteosarcoma. Amputation 12/28/12. Chemo (carboplatin) started Jan 10, 2013 and ended on April 5, for a total of 5 doses. He handled carbo like a champ! No side effects. We started metronomic therapy at his third chemo and have been also doing some holistic treatments. He's a lively, playful 10 year old huskie-boarder collie and a very proud member of the Winter Warriors! Our love. Our funny little guy!
I am in the Seattle area and we are very lucky to have many skilled surgeons within a 30 to 50 mile radius of our clinic.
Pam
We decided to go with the TPLO, based on our vet and surgeon's concerns about the lateral suture holding up to Jack's hopping action on his only back leg. The surgery was Tuesday and went smoothly. It's been a rough couple of days so far but we're looking forward to the future. Thanks for everyone's input and well wishes, we'll keep you posted.
Glad to hear things went well, we have our paws crossed that things continue that way!
If you are ever interested in submitting a guest blog post about this experience, we would love to publish it. I know that lots of folks would find it helpful as well as comforting if they were ever in this scary situation. PM me for details if and when you decide (no rush of course, I realize you have your hands full!).
Keep us posted and give Jack a smooch from all of us at Tripawds!
Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet
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