[107barney]

Daisy had a consult with the surgeon today. The surgeon said that Daisy is not a candidate for surgery. He felt that it was in Daisy's best interest to rest the leg and follow her progress in a few weeks. He stated that the arthritis in her joint has been there since about a year of age, due to wear and tear on her joint, muscles, and ligament thanks to poor breeding producing severe Grade IV medial patellar luxations. It was his feeling that the time for Daisy's surgery was 13 years ago, when she was a puppy, but some surgeons vary on their opinions and it's a judgment call. He did say that he would have predicted a worse functionality at 13 with her knees, so she has done very well. He also feels that a prior injury in 2010 may have been a partial tear to the CCL, exacerbating the problems in her joint.

A surgical repair would set her back functionally, and we could potentially lose her in surgery due to impaired liver and kidney functions.

The good news in all of this was that Daisy is getting around very well and I was able to stop her tramadol pain medication. She's not able to take metacam or other nonsteroidal anti-inflammatory medication because of her liver disease and also that she is on aspirin (could lead to bleeding ulcers and GI distress). The surgeon said that Daisy looks great for a 13 year old poorly bred dog with atopy and allergies and agreed with her internist that she has clearly outlived her prognoses.

I worry that the day will come when her ligament fully tears, but he said we have to cross that bridge when we come to it. I don't know how surgery would benefit her in the future if it is too high risk for her now. I guess I have to hope for the best. For now, rest and warm compresses to the joint, and I am considering use of the cold K-Laser with the rehabilitation vet since he said that would help to penetrate the deep tissues in the joint and for a dog like her with longstanding progressive arthritis it may help. Other PT or water treadmill are not indicated, which is good, because Daisy would hate it. He recommended using omega 3s, and I told him that Daisy is already on a therapeutic dose of omega 3s as recommended by Dr. Remillard - sadly, she can only tolerate fish oils a few times a week and I now sneak her a little sardine from time to time.

All in all, I'm disappointed that Daisy can't just "be fixed" but I feel reassured that the answers I have gotten today and his opinion are correct in light of her entire medical history. Unless surgery was clearly going to improve her prognosis and outcome I find that he is correct that risking her life is not worth it.

Thanks to all who kept Daisy in their thoughts.