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Older Tripawd Might Need Cruciate Repair Surgery, Help!"
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Member Since:
12 July 2016
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5 April 2022 - 10:05 pm
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Max is an 11 year old lab mix who had his front left leg amputated in 2016 due to a spindle cell sarcoma cancer in his wrist.  His cancer started when he was 2.  He has gone through many surgeries to remove tumors that kept recurring on the wrist, then we tried radiation which wasn't good nor did it help then we finally amputated.  Two years ago he had to have his thyroid removed because of cancer also.

Max was doing really well for many years considering we have a house full of stairs.  This past year has been difficult on his right front shoulder and his spine. (apparently on his hind legs too hence the tear in the ACL)  For the last month Max has been having a lot of trouble with the stairs.  We have a paw five harness that we use to help him up and down the stairs to take the weight off the front leg.  In the last two weeks he hasn't been really helping us much when going up the stairs. His front leg not seeming strong enough to lift him to the next step.  By Thursday of last week he was having trouble laying down with his back leg, by Saturday he was in th veterinary hospital because he couldn't support his weight on the hind leg and kept falling over even with us holding the harness.

The weekend Surgeons told us his ACL was torn based on their physical exam.  I had them call his surgeon who did his amputation, She doesn't recommend putting Max under anesthesia  more than once, so she wants to do the radiographs etc call us and then take him into surgery.  I have many questions:

Does anyone have a situation similar to this?

Is it possible for an ACL to heal without surgery for a tripawd?

If his front shoulder has been collapsing, how will fixing the ACL make a difference?  He can't function without even one front leg that is strong.  

Do the ACL braces work?

I would appreciate any advice you all have, I am beside myself worrying how we are going to proceed and what the best course is for Max.

Thank you,

Theresa

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5 April 2022 - 11:05 pm
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Theresa I'm so glad we chatted earlier. You explained the situation perfectly. As I mentioned, @benny55 will have some thoughts on this because she's been there too. I will get some ideas down in the Am but for now I like the plan we discussed about working with the in house vet rehab team for another opinion.

Back tomorrow (west coast time) with thoughts. Stay strong!!

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

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6 April 2022 - 9:38 am
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Hi Jerry,

We spoke with his Surgeon, and she said the brace and pain management and PT will probably not be successful for him because he is a tripawd and he has so much arthritis in his joints and back.  She feels his front leg/shoulder is collapsing so much because he has had the tear/partial tear for a while and he has been compensating for all that time.  That might be why he has been panting so much even when its freezing out.  She said it is really a choice of do the surgery and see how he does, or make the decision to put him down.  She suggested doing a full body CT for a cancer hunt, and the xray of his leg for her, then make some decisions.  She said he would have to stay with them at least a week after surgery and maybe even a few more days for PT.  So we would get him back sort of being able to walk around.  Stairs would still be an issue, though.  We would still have to support his weight a lot for walking during the 8-12 week period.

This is the hardest decision of my life so far.  The scans re $2,000 and the surgery would be approx 6,000.  Its not the money, its will he have quality of life afterwards?  And for how long with all the stress on his other legs?  I am open to any input anyone has.  They are doing the scans today and hopefully that will give us more information to make the right decisions for Max.

Theresa

Virginia







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6 April 2022 - 10:03 am
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Hi Theresa and the strong Warrior Max!  WOW!   You both have been through so much and clearly have an unbreakable bond and unbreakable  spirit!

You certainly  have valid questions about solutions for the cruciate tear, but especially  about the condition  of his front leg.  After talking with Jerry it appears you are moving forward with a Rehabi Specialist,  right?  I know you want answers asap, but you need clarity first of exactly what's going on.  The Specialist can assess the issue  with the front leg/shoulder  and help determine  solutions for that issue.  If it collapses  at the shoilder that could indicate so many different  issues with that well ised leg.  

Also they can eliminate any spine/disc issues that sometimes show up as a leg giving way or weakening. It may be that he has developed arthritis  that wasn't really that noticeable until he had mto add more "wear and tear" because of the rear leg giving way.

Even though the physical exam indicated  the cruciate  tear, unortunately an xray is the only way to confirm 100%

Guess I'm trying to say first things first.and to keep things chunked down.  Take  one step at a time.  Too many things are your plate to process without enough answers yet can be way too overwhelming. 

Now, as far has front legger Tripawds handling ACL surgery, it absolutely is doable!  No fun at first, but doable!!

My adopted front legger Frankie (a wild and crazy strong willed Blue Tick Hound) has had cruciate repair on both back legs!  And then a third surgery to remove a dilapidated worn out repair.  The first time he jad surgery was with whwt they call a "fishing line" surgery.  It was far less expensive than the TPL surgery he had later, but not quite as "strong" Additionally he was right at the high end of weight limit  (70 lbs) where that type of repair  could be effective.  So when he had his second one, I opted for the procedure  where they actually  use pins, and aI thing even plates (?).  

Frankie did require Rehabilitation  therapy afterwards off and on for several weeks.  It was very helpful. 

I won't  get too much I to the recovery, what to expect, tips to navigate through it, etc until you have some feedback on that front  leg.  Oh, I will add that his front leg was arthritic during all of his surgeries,  but didn't  interfere  with his recovery or his mobility  at all (knocking on wood).

As far as conservative  approach, your Rehab Specialist  can best support you in that. Again, was told by Frankie's Vet and Rehab Specialist, it "can" be done.  Depends on the degree of the tear, etc, etc.  And not an expert, but it seems that braces can help in some cases, and not so much in others.  Fitted properly by his Rehab, it sounds like it would be worth a try.

Do NOT beat yourself  up over what can and cannot be done, okay?  Finances  are HUGE hurdle for many and we can only do what we can do. You have already done more for your sweet Max than many would be able to do.

I know I've thrown back more questions than answers, but I thinkmifnyou can identify  the issue with the collapsing  shoulder, then you can proceed with a plan for the rear leg.  In the mean, talk with your Bet or the Rehab avout starting a conse6 approach anyway.  It will involve  rest, some antiinflmmatory  and some pain meds.  At least you'll be getting a head start.  And involve temorarily carrying  him up and down stairs if at all possible!  Otherwise, continue  lift with the sling as best you can.

Yes, do stay strong, get your clarity, continue your research and stay co here!!  YOU ARE NOT ALONE!   We are here bynyour side to help you navigate through solutions, okay?

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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6 April 2022 - 12:46 pm
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Theresa I'm so glad a plan has been made. It's perfectly reasonable. You done good! Your surgeon sounds terrific. Sounds like she provide a balance of realistic expectations, and some hope.

As always, Sally's insight is so, so helpful. Thank you friend!

Let us know what they say after the scans are done. I think at that point you'll have a better idea of the real options. I don't want to overwhelm you with more info at this point OK?

Thinking of you and sending lots of sp_hearticon2sp_hearticon2sp_hearticon2

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

Virginia







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6 April 2022 - 2:56 pm
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Oops, As you can see, I was responding  to your first post and didnt see your second update til just now.  

Some pain meds may help right now for his arthritis  and the tear while you're  waiting for the scans, etc.The panting  would definitely  indicate pain so you might want to double check avout getting him on some meds for comfort.   Did the Vet seem to indicate the front leg would get better depending  on your course of action?

Yes, see what the xrays say as that will help how to proceed.  I can provide more insight into recovery, recovery aides, etc, later.  Your asking questions that center all around Max 's well being and quality.   Such a well loved lucky boy to have you as his person 😁

We'll look forward to your feedback when you've had a chance to catch  your breath.

Extra hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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6 April 2022 - 5:47 pm
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Hi Sally and Jerry,

Its so nice to hear from you again!  You helped us make the decision to amputate Max's leg back in 2016. 

I still need him to be evaluated by a Rehab Specialist, I was dealing with his surgeon today.  She just called and said his CT scan looked pretty good.  Nothing major to note, no cancerous looking tumors, a small infection where he had a tooth pulled, Said the left thyroid looked good, and no growth where they removed the other one.  His liver has 4 tiny cysts that she said she is not concerned about, she did say his liver is a little enlarged though.  He has been on meds of all kinds since he was 2, so I'm not sure if that's why or not.  She said his front leg has arthritis in the elbow pretty bad, but the shoulder looked fine.  She said his back left leg looked good, and the right showed the cruciate tear and some arthritis.

She said she did take some x-rays also, but I didn't question her much about them.  I should have, I was just finished crying my eyes out about thinking of if we had to put him down, while he's a happy guys still.

She said her recommendation is to move forward with surgery, she doesn't feel that the conservative method is a good idea, she said we will probably be back in a few months in the same place. (Remember she is the surgeon)

I just sent her a few emails with more questions.  She will be in tomorrow for me to get more answers.  I also asked who the Rehab specialist is and can he/she take a look at Max and all his records and give me their opinion.  

We are concerned because she said Max still hasn't eaten for them.  I want to pick him up tomorrow and bring him home.  She said we can if we want to.  But my entire family is like NO because we can't handle him the way he is right now.  The surgeon would like to operate on Friday, so she wants to know by tomorrow evening what our decision is.  Max has been in LIVS since Sunday, just being boarded, waiting for his surgeon today. 

I still have the issue of the stairs right now.  If we go ahead with surgery we did figure out a way to add a ramp below a large window on our middle level but it will require Max to stay down there for a few weeks which he is so not used to.  I can't avoid all stairs bc my house is a high ranch and all the bedrooms, kitchen etc. are on the upper level.  It is hard for my husband or my son to carry him up and down the stairs as he weighs 80m lbs.  I am afraid of them falling with him.  That would make things even worse.  My daughter and I can't carry him.  My husband travels for work and is gone very other week, my son goes to a local college and has a part time job.  When they are not around it will be very difficult for myself and my daughter who is 4'9" and weighs the same as Max.  We need him to be able to help himself a little in order for this to work.

Are there any other questions I should be asking?

What do you think of the results of the scan etc?

Thank you both for being so supportive and sharing your wisdom!  I really appreciate it.

smiley9Theresa

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6 April 2022 - 7:45 pm
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Hi Theresa, thank you for filling us in.

First, it's just incredible that Max has done so well overall until now! 2016? WOW! We need to celebrate his spirit, spunk, and longevity. GO MAX! smiley_clap

I'm going to try to give feedback based on your info. Here goes:

She just called and said his CT scan looked pretty good. 

SWEET! Dang it's great what technology can uncover. He has beaten those cancer odds! YAY!

 She said his front leg has arthritis in the elbow pretty bad, but the shoulder looked fine.  She said his back left leg looked good, and the right showed the cruciate tear and some arthritis.

My question would be, how does arthritis play into the cruciate repair? Can the hardware sustain itself in an arthritic joint? 

Elbow arthritis is painful. If he is bearing all the weight up front when he recovers, what will it do to that elbow? 

She said her recommendation is to move forward with surgery, she doesn't feel that the conservative method is a good idea, she said we will probably be back in a few months in the same place. (Remember she is the surgeon)

There is that possibility. But you have to remember her perspective: surgeons live to fix the body. They don't like to do what they think is wasting time with other treatments, when they can almost guarantee what they do will fix it faster. But that "almost guarantee" is the key phrase. Even she cannot guarantee what she does will solve the issue. 

If you read the managing soft tissues article in this forum, you'll see that rehab therapists are clear in that their methods may not work either. You might even end up spending the same amount on rehab what you would spend on surgery. But the reason to pursue rehab, if a therapist agrees there is a chance it could work, is that by doing so you are preserving a pet's quality of life and minimizing the risk and difficulties that a major soft tissue surgery recovery requires. 

I also asked who the Rehab specialist is and can he/she take a look at Max and all his records and give me their opinion.  

Their vote would be my deal breaker. I would want their take on the situation if I found myself where you are. I'm not saying it's the right way to go, but I like to cover all my bases and this is one way I would do it.

We are concerned because she said Max still hasn't eaten for them.  I want to pick him up tomorrow and bring him home.  She said we can if we want to.  But my entire family is like NO because we can't handle him the way he is right now. 

Poor Max. That's a long time not to eat. Is there any chance that a harness like the Get-a-Grip or Support Suit (with shoulder sling) could make it easier for you guys? That shoulder strap uses your body weight as leverage to assist a dog. If this wont' work, do you know if is there anyone doing veterinary medical boarding near you? We have a friend in Fort Collins who does this for dogs coming out of surgery at Colorado State.

The surgeon would like to operate on Friday, so she wants to know by tomorrow evening what our decision is.  

 If so, then I would nudge her into getting the in-house rehab team to look at Max's situation first thing tomorrow. Otherwise I would ask her when the next available day is for this procedure.

Gotta run for now. I hope this helps. Keep us posted!

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

Virginia







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6 April 2022 - 8:38 pm
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We certainly do  remember  when you and Max's family joined.  He recovered  at his own pace and in his own way and always surrounded  by a family who adores him.

Of course, not a Vet but it seems that, all things considered, the scans looked pretty good.

Okay, so that's  one box you can check off as far as nothing really bad showing up.

Now if you can get the Rehab Specialist  to take a look at him, that could be another box you can check off as far as their assessment and opinion.  Yoi can ask for more feedback on how to get that front leg in better condition.  Even though the Vet gave you an expla for it collapsing, you need to know how to overcome that.

Stairs can still be a hurdle.  Mr Max will just have to "enjoy" being downstairs  for awhile.  If I recall, he slept downstairs  during  amputation  recovery.because he had a family member with him.  But yeah, a ramp in some configuration  would be helpful.  It may be hard for him to adjust to at first.

There's something called a "recovery suit" found in our G ear department.  It's like a "wrap" and doesn't  require piputting legs thru any holes, etc.  It has handles and shoulder straps so you can stand straight  as you "support" the dog "walking" beside you.

If I recall, my Frankie stayed at the Vet for at least five or six days until he could get mobile enough  that I could "assist" him. Frankie hates being "helped", thus he did more on his own than he should, but it made it easier  on me.

Maybe your Vet will let you bring some warm chicken or a cheeseburger for a visit with Max?  I know their are varying opinions  on whether visiting  a dog in the hospital is beneficial  or harmful.  But often a dog will eat for his hooman and not fornthe Vet.

Okay, feedback from the Rehab can give you another box to check off tomorrow.

This IS a hard decision.  The "between a rock and a hard place" kind of decision.   While I certainly  understand  the Vet wants to get this done quickly, please don't  feel like you are being  forced to make a decision  whether to proceed by tomorrow.  

Sometimes  the decision  boils down to this:  Which decision  would you second guess the least??   If you don't  do it, will you constantly  beat yourself up with "wudda', shudda, ' if only" kind of regret and constantly second guess yourself wondering "what if".      Or will you be at peace knowing you did your research and made a decision  out of love for Max.   OR if you proceed and recovery is difficult  and  doesn't  really accomplish  what you were hoping, will you  be filled with regret and guilt?  Constantly  second guessing that decision?  Yet still at peace knowing you tried everything!

Of course, most importantly, there would be no regret or second guessing if Max can become mobile again with the successful surgery and successful  recovery👏.

Let us know what the Rehab Vet says, okay?   And you vpcan still ask about the conservative approach  just to satisfy  your quest to gather information. FWIW, I would still want clarity that the front leg is not hindering   mobility after the surgery.  

Wish you weren't  facing this. One thing for sure though, Max  has definitely shown everyone  how to master the art of being happy and joyful on three for all`these years!!  Truly a loved boy♥️

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

Virginia







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6 April 2022 - 8:43 pm
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As usual,  while I spend  what seems like hours trying to typo my response,  Jerry has her post put in before I hit submit reply.  I do like that our posts are similar  and we are on the same page about the Rehab, the front leg, etc,

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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7 April 2022 - 10:47 am
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Hi Sally and Jerry,

After speaking with the surgeon and the rehab specialist, they are in agreement to go ahead with the surgery.  Both feel his front leg collapsing is due to him shifting his weight bc of the tear which he has probably had for quite a while but it was only a partial and he has been trying to compensate. Now that its a full tear he really can't put any weight on it.  After surgery and recovery, they can do some physical therapy for the front shoulder/leg to strengthen it up.

We asked if he will be in a cast or have to wear a cone for 3 months and she said no.  If we will have to support him constantly to get up or walk in the small space.  Again she said no, he will probably lay down a lot at first.   She said by the time I get him back he will be able to stand and bear a little weight on his leg.  We are to keep him confined to one room, and no stairs.  She said we will have about a week and a half to get the house ready for him to come home.

What is your experience with recovery?  How was Frankie when you first got him home and in the few weeks after?  

We are outfitting the house with a ramp and I'm buying a baby pen gate to keep him in if we have to go out and leave him home alone for some reason.  She said it should be the size of a closet.  He will be confined to the living room, where the window is for him to go out on the ramp.  Its approximately 15 by 15 less the furniture around the walls.

What do you think?  Should we go ahead?

Thank you both for all of your input.  Once I figure out how to post some pictures or video of max I will.  Show you how great he did after amputation!  I would have never done it without the support of all of you!

Big hugs,

Theresa

On The Road


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7 April 2022 - 11:10 am
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Hi Theresa,

Thanks for the update. Sounds like the surgery is the best way to go for this situation. You've got both the rehab side and the ortho side in agreement, there's no doubt that it's a good move physically. And it sounds like you are in agreement too, and ready to go. How's the family doing with the idea?

Some of my thoughts on recovery (Sally can fill you in with firsthand experience):

Check out our Remining Leg Surgery articles for ideas on how it went for folks

As for the ramp...has he ever used one before? Don't be disappointed if he won't use it. We see that happen a lot. Most dogs are averse to ramps because of their poor depth perception (the distance from ramp to floor is scary when you can't tell how far it is). If he's never used one before, have a Plan B in mind. How far is the window to the ground outside? Can some pet stairs be used in stead? Here are some ideas:

How to Help Your Tripawd on Stairs

Remember, Safety First with DIY Ramps for Cats and Dogs

Three Tripawd Tips for Pet Steps and Ramp Training Success

Unfortunately I can't say "Yes you should do this" or "No, don't." Only you and your family can answer that one as a unit, since you will all be participating in his recovery and therapy to some degree or another. Have a group talk and see if everyone is in agreement. 

We would love to see photos. This is how adding images to the Forums works.

  • Upload pics to a photo sharing site like imgur.com or your own Tripawds blog (https://tripawd...../supporter). Pictures and video have to be hosted (live) somewhere other than in the forums.
  • Once the photo is uploaded somewhere, right click and copy the Image URL or just copy the image if you’re on a phone
  • Return to your Tripawds Forum post and paste the image URL (or the image itself) in your post. It should automatically appear. 

If you’d like help figuring out the process let me know.

Keep us posted!

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

Virginia







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7 April 2022 - 11:48 am
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Okay, another box to check off.  You have done such an extraordinary  job of taking this process step by step and talking with all the professionals  involved..

Getting the front leg issue addressed and clarified with  an explanation made sense.  Having that "extra" time for it to heal while the back leg is healing aounds like the answer you were looking for to move forward.

Her assessment of mobility (or lack thereof at first) when he does come home aounds in line with what to expect.  ALWAYS keep in mind every recovery is different, every dog is different.  Max is a "mature young" pup and will recover at his own pace.  for a rich of balance, etc.  

The fact that the Vet will keep him for a week and a half or more is quite positive..  At that point  he should (emphasis on dhould) be able to to some toe tapping.   Keeping in mind you want the front leg time to heal, dont be surprised if you still need to do some assistance.  The extra confinement  at home will help tremendously.  

You asked about Frankie.  I can't  stress enough that Fankie HATES me helping him in anyway. He is soooo strong willed and a "donor his wau" kind of dog.   After the week at the Vet I had a harness in him to assist.  He would howl and protest and take off as fast as he could knowing he would pull me down if I didn't  let go.  He basically  walked /ran with two legs (on the same side).  I did have a ramp he was used to using and he would kind of ise the railings for balance while doing things his way!

Guess the best "advice" is take it day by day,step by step.  Get the surgery.   Check in while he's "vacationing " at the Vet.  Sou ds like you have his recovery area set up going  really well.  Good job!  You'll follow Max's lead at his pace.The toe tapping turns I to balance, turns into weight bearing, turns into full use of the back leg more and more.  It may seem like a slow process, but once the weight bearing starts, the recovery pace seems to pick up fairly quickly.  

I'm sure you'll come ho e with pain management and antii I inflammatory.....all of which will help with comfort and healing.

Thanks for taking the time to give sich a thorough  update.  It will help others when faced with this process.

We'll all be cheering for Max!!  He is sooooo lucky to jave such a loving  family!♥️. We love him too♥️

Hugs

Sally and Alumni Happy Hannah and Merry Myrtle and Frankie too!

Happy Hannah had a glorious additional bonus time of over one yr & two months after amp for osteo! She made me laugh everyday! Joined April's Angels after send off meal of steak, ice cream, M&Ms & deer poop!

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7 April 2022 - 2:11 pm
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HI Jerry,

the window is only 4 feet off the ground.  The ramp would be like 20 feet long with a slow slope.  Do you think that would be good? Plus it has railings!  I'm using a place called 101 mobility.  

let me know.

Thanks,

Theresa

On The Road


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7 April 2022 - 6:08 pm
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Hmm...four feet isn't that bad, but I recommend seeing if 101 mobility can come up with a way to make sidewalls for it, like how our friend Brian made one for his dog. He's the guy who actually told us about the visual cliff and its effect on dogs' depth perception. He's no longer trying to market that product, unfortunately. But the visual cliff is real, and sure explains why so many ramps get returned to Petco! 

Tripawds Founders Jim and Rene
tripawds.com | tripawds.org | bemoredog.net | triday.pet

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