https://www.acvs.org/small-animal/patellar-luxations


https://www.acvs.org/small-animal/cr...gament-disease

:eek::eek::eek: I hadn't thought about complications. I'm used to thinking of morbidity in terms of death. More questions to ask tomorrow. There is a youtube video of this surgery being performed, but I can't bring myself to watch it--yet.


Well, I watched the beginning where it looks like they're cutting open a salmon, but when they cut deeper and brought out the needles, I had to skip ahead to where they bring out the bone chisel, watched about 5 seconds, and then had to turn it off.

I don't know if the CCL can show up on x-rays as it's soft tissue so unless it had a bit of avulsed bone attached to it, it probably wouldn't. Maybe you could Google what tests are necessary to show it or whether a physical examination alone will show it.

LadyJane's links above describe the diagnostic techniques. You're right, CCL damage does not show up on x-rays. CCL damage is determined during the palpation, which the vet did, but I'll double-check tomorrow to make sure the vet was feeling for the right things.

I fainted three times during my nursing career....and all three had to do with bone....first was a nose job and when the chisel came out and they started chipping that hump off the top of that nose, I was gone. The second was when they were putting a pin thru a leg and attaching traction...when the Black and Decker drill came out and they started drilling a hole thru the leg to run the rod out the other side, I was gone! Third time, in ICU when they cracked a chest to massage the heart....cut thru the sternum....OMG!.....I was gone. When I had my heel spur removed from my left heel, the surgeon said they were going to do a block....inject anesthesia into....I said stop....I cant stand needles and I cant take bone chips flying off my foot....put me under or I am out of here! I can not stand anything to do with cutting/chipping/broken bones....I didnt watch your surgery video either! Wishing your baby a uneventful operative procedure and a speedy recovery!

My Jezebel had lp and tore her CCL. Three days later I had her at a board certified ortho vet. They did not have to sedate her to get an x-ray, and she is a live wire.

No, the x-ray did not show the CCL tear. That's where the experience of the board certified surgeon came into play. He strongly suspected a CCL tear because of the way that he could manipulate the joint. The x-ray showed that the bones in the leg were not lined up the way that they should be. Instead of the tibia and fibula being directly under the femur, they were shifted over.

When she had surgery 6 days later, the pictures from the arthroscope showed little strands of the CCL, like a frayed rope, floating free in the sinovial fluid.

Since your pup's surgery is almost a month away, you need to be very careful with her. With an unstable knee, you need to avoid anything that could possibly cause damage to the meniscus or tear ligaments.

Thanks for the info! Did Jezebel make a full recovery? I put a phone call in to the vet, and I will be speaking directly with the surgeon on Friday. I was reassured that he has plenty of experience doing luxating patella surgery, but I will ask about CCL tears and x-rays. The surgeon is also a professor with the U of Illinois Veterinary College and works part time at the U of I Vet Hospital, as well as mentoring U of I vet students in his private practice. I'm very confident in his abilities, but will clear up the remaining questions. In the meantime, I'm trying to discourage Bella from jumping up and down and off the bed and furniture.

No doubt a good vet will evaluate any hind-limping dog for CCL and drawer sign, stability of the joint and her leg circumference compared to the contralateral leg and so forth and felt she likely didn't have a tear in the CCL, don't you imagine?

I was on your shoes 12 years ago when my young dog needed this surgery. I opted to go with a boarded surgeon who does so many of these surgeries. She's never had a problem with that leg in all these years and I truly believe that it's because she had a great surgeon. I know it costs more this way, but if you can, go for a diplomat of the ACVS who has lots of experiences with toy dog repairs. Best wishes!

Indeed. By the way, the vet who examined Bella yesterday is also a mentor for U of I vet students (I'm quite the internet stalker ;)), so I'm sure she did a thorough examination. But I'm going to ask the surgeon about CCL on Friday anyway, because even if Bella hasn't torn anything yet, it could still happen before the surgery. In the meantime, I'm trying to keep Bella as calm as possible until then.

Oh no.........just seeing this about Bella. I also took Macy to U of I but to the teaching hospital. They sedated Macy to get a good X ray because she would tense up when they tried to move her knee cap around. She was diagnosed with Stage 2 in one leg and Stage 1 in the other. Strangely, she holds up the knee with Stage 1 when we go for a walk and the Stage 2 knee doesn't bother her at all when walking.

I asked for a Board Certified ortho doctor and was directed to Dr. Tisha Harper who is a clinical assistant professor at U of I. She didn't recommend surgery at this time but I have to take Macy back in August to be looked at again.

I think the lines get blurred on the vets that have their own practice and still teach at U of I and the ones that are strictly U of I vets. I think they told me surgery was around $3000 if she has to have surgery at U of I.

Will be thinking of little Bella when she has her surgery. The doctor also told me the recovery time is the worst part because they have to been in crate confinement for 4 - 6 weeks.

Hi, the information that I had about x-rays requiring sedation came from the U of I Vet Hospital website:

"Because in most cases we will use reversible sedation to get diagnostic quality X-rays, we ask that your pet be fasted for the appointment."

Orthopedic Surgery FAQs | University of Illinois Veterinary Teaching Hospital

I wish you the best with little Macy! I'll keep everyone posted on Bella's surgery.

Yes, due to the surgery last April and two months of restricted activity she made a full recovery. I'm so glad I had it done because with the instability of the knee -- due to the LP and the torn CCL -- I know she would have worn down her meniscus by now and it would be bone-on-bone lame.

That is the kind of sedation they used on Macy and I was in Champaign for 8 hours killing time waiting while they ran her through tests. As I understand it the sedation is kind of twilight and they can give medication to wake them up immediately if they are experiencing difficulty. There isn't any way Macy would have let them take an X ray without sedation.

I'll be waiting for your updates on Bella and if Macy has to have this surgery I might be picking your brain when her time comes.

OMG just reading this I was near gone, lol don't blame u for fainting lol

sending prayers

I absolutely love love love those pics of Bella! So pretty! That surgeon sounds pretty well qualified even if not board certified, but I also know nursing instructors that I wouldn't let treat someone I mildly disliked, so you are right to fully research him before the surgery date,. Good luck and praying that Bella has a quick and uneventful recovery.

dog
 

I am glad you took Bella to the vet and know what you are dealing with. Now I will pray for you to have guidance for a top surgeon. Please be sure the vet you hand your baby to knows what he is doing and is not using your precious Yorkie . He is not board certified, does he really know how to do this surgery on a little dog? Better be sure.

I was truly laughing out loud as I read this. Hilarious.

Good luck to you and little Bella.

Professor at the U of I veterinary college. 33 years of experience. Very good reputation as a vet and as a community leader as well. Do I trust him? Yes. Certainly more than a board-certified surgeon with only 7 years of experience, which is one of my other options. His specialty is cats, dogs, and ferrets. He performed adrenal surgery on a ferret for the local animal shelter for free, so he can definitely work with small animals. I will get info on the number of times he's performed MPL surgery tomorrow.

Thanks! Bella is very photogenic, even when she's not smiling, LOL! My father was a medical doctor, so I know the ins and outs of board certification, what it means and what it doesn't mean. For me, experience performing the surgery is much more important than board certification. I'll be speaking with the surgeon tomorrow, and if there is any doubt, I'll get a referral, but he looks like the best in the area so far.

OK...I'll bite: What's wrong with being board certified with 7 years of experience?

I guess I am very confused. Operating on soft tissue on a ferret is so different from doing ortho surgery. I know what board certified means as well .. and I am very surprised that you seem to have a low opinion of surgeons who strive to have this distinction. I agree with you that some vets are proficient even if they are not boarded; but to eliminate a boarded surgeon just because he/she is boarded seems odd to me. I think you did say he will examine her first? I hope so and that a torn CCL is ruled out prior to the surgery.

I like a vet with experience in terms of #s of cases. The vet that did my dog does several of these surgeries weekly.... Over 400/year. If the 33 years of experience was spent on ferrets, that would not lead me to believe there was a great proficiency in MPL correction.

Not enough years of experience, if I have an alternative with 30 years of experience. And actually, for the board-certified vet, that's only the number of years since vet school.

I spoke with Bella's surgeon this morning. He was very friendly and forth-coming. The MPL surgery is NOT routine, but he has done many procedures. The surgery takes about an hour on average. Since the surgery lasts so long, blood testing prior to the surgery is mandatory, to make sure she has no liver issues that could complicate the anesthesia. He checked her blood results from her spay 6 months ago and said that they were perfectly normal, and he doesn't expect them to be different, but they have to recheck just to be sure. In rare instances, cases of luxating patella can reverse themselves, so if I notice drastic improvement in Bella, I should let him know so she can be rechecked, and the surgery possibly cancelled. He will absolutely give her another extensive physical examination before the surgery to double-check the severity of the luxating patella prior to surgery. He will not do an x-ray unless he suspects arthritis, or she shows muscular atrophy or other symptoms of potential complications. Luxating patella involves soft tissues that do not show up well on x-ray. Bella will be kept at the vet overnight after the surgery for observation. She will have to be crated for at least a couple of days after surgery, and re-evaluated. Dogs that recover quickly from the surgery do not have to be crated as long, and that is determined on a case by case basis. Since Bella has luxating patella in only one leg, she has a good prognosis. The success rate is at least 90% for cases such as hers. We spoke for a good 15 minutes. If I can remember any more details, I will post them.

I don't have a low opinion of board-certified surgeons at all. I am more concerned about experience and the number of surgeries performed, as well as success and reputation. Yes, he will examine her before the surgery and rule out a torn CCL. I will be there for the examination.

The ferret story was just an anecdote for someone who questioned his experience with small, delicate animals--OF COURSE he has performed many MPL surgeries on Yorkies. I am beginning to get annoyed with people questioning my choices--those people are NOT in my situation, and they do not have access to all of the information that I have. I will not respond to any more such posts. If anyone has questions about the surgery itself, or suggestions of additional things to ask the surgeon, or additional things to look out for during recovery, fine, but at this point, there is NO WAY that I will reveal the name of my surgeon or vet clinic so they are not further questioned as to to credentials or dragged through the gutter. Thanks for your cooperation.

Your decision is YOUR decision. I did not question it. I was just a bit taken aback by your comments regarding board certified surgeons. I just did not want people to come along and assume board certified are not a good choice. They are specialists and do the same type surgeries day in and day out....so in my book, I could not compare one with 7 and one with 30 who is not working in a specialty. I think it is highly likely that the one with 7 years has done more of these surgeries than the other. With that being said, I did not say you made the wrong choice OR that the vet you are using is not good. I merely feel it is important to make a comparison if not for you, then for others who happen along to read about these surgeries.
I hope all goes well for your girl.

I want to reiterate that I don't have a problem with board-certified surgeons at all. I would never discourage anyone from using a board-certified surgeon unless I knew for a fact that a particular surgeon was no good. In this case, I simply have an experienced surgeon with an excellent reputation who just happens to not be board-certified. Thanks for your well-wishes for Bella!

I realize that you clarified it. I was merely saying why I commented on it to begin with. Your first post made it sound (at least to me) that you had no respect for boarded surgeons. To me 7 years as a boarded surgeon sounds ok because that is all they do each day...whatever the specialty is.