Another pupdate....

We just had our consultation for that second opinion and we'll be taking our girl in for another surgery tomorrow 🙁 This surgeon says that this type of avulsion fracture cannot generally heal on its own, particularly in a tripawd where weight bearing is a necessity. The portion of the tibia that's broken off is where the quadriceps muscles attach and those are what extend the knee and allow weight bearing. So while this procedure is a common one in young puppies who this type of fracture is most likely seen with, Bryce will need to be on strict rest for the next 8 weeks. The doctor will place some pins and tension wire to secure that section of bone and then he'll splint the leg extended so the quadriceps muscles don't continue to pull at it. That splint will be on for the first two weeks and for the first four weeks, we'll be using the Help Em Up exclusively so she cannot put any weight on that leg at all. No significant weight bearing is critical to get this to heal properly and to get her back to her typical activity level. 

We've got another long road ahead of us now that our recovery clock has been set back to zero. We've got a rugged baby play pen style thing we're going to rig up to give her minimal space to move around, but that is open on the top so we can pick her up out of it while she has the splint on for those first two weeks. 

This surgeon said that if *he* had seen the radiograph taken at the three week mark, when we took her in after she stopped using the leg initially post op, he likely would have splinted it then or at least given us a strict rest regimen to follow to get it to heal on its own before that portion of bone was pulled away. We're quite frustrated with our original surgeon who perhaps could have done the TPLO procedure differently to account for this type of post op complication given her tripawd status, and with our primary care vet as well who saw those xrays at three weeks, where there's clearly a fracture, and didn't say there was a potential problem!

This is the xray taken at the 3 week mark when we took her in after she randomly stopped using the leg. I had forgotten to give her gabapentin that morning, so thought maybe that had something to do with it. The vet even asked my husband (who took her in) if she was a bit of a diva (she can be) because it may be that she's just acting a bit diva about a slight increase in pain.....in retrospect feels A LOT like a brush off of an actual issue!

I'm still trying to stay focused on the current situation and getting her through the recovery which will likely be much tougher this time around. That said, it's very difficult not to feel like we've been let down by the folks who we had entrusted to care for our pet [read: child]. Not to mention that we paid quite a bit for the TPLO procedure and now will be paying an even higher cost for a second procedure.  Very thankful that we have pet insurance but still is frustrating. 

Well that felt a bit more like a rant than an actual pupdate, but I guess I needed to get that out of my system!

Pupdate! 

Things have been going pretty smoothly during these last 4 weeks. Bryce has gotten her brace/bandage off and we've gotten our 4 week post op xrays done too. They show the first surgery, the TPLO, is all healed up (yay!) and the second surgery, the avulsion fracture repair, is healing up nicely. We spent those first two weeks with her in the splint, wheelbarrowing her around when going outside and all other times she was confined to her "room" as we call the pen setup we have. The second two weeks saw the bandage off but still the same no weight-bearing and wheelbarrowing around.

Now that we're seeing a good level of healing happening, she's allowed to weight-bear but we still need to use the help em up to support her when going outside. No actual walks or running, jumping, stairs etc. and still on the diet of "strict rest" spending all her time in her "room" though she is able to come to work with me at the office two days a week (where I have a mini "room" pen set up under my desk).

She is such a trooper and is doing well off all the post op meds--we still have some sedation meds available if we need to use them but so far her sleepy hound dog mode is doing a good job of keeping her mellow enough. We can tell that she's getting anxious to be done with all this recovery and rest and not getting to zoom around, but we're so thankful that she's such a creature of habit and that our working/life circumstances allow us to not have to leave her alone for long stretches of time! We're going to be in this mode for the next four weeks until her 8 week xrays which will HOPEFULLY show the second surgery is fully healed and we can start with some rehab to get back to her normal level of activity. 

I had some pictures of the recent xrays and of our girl when she first got her brace off, but my rural internet is not playing nice and they won't upload properly. 

Anyway, I wanted to touch base and say that we're doing as well as can be expected and are hoping for the next four weeks to go quickly and smoothly and are looking forward to the end of this recovery which is starting to feel very close now!