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-   Sick & Injured / Emergencies Talk (https://www.yorkietalk.com/forums/sick-injured-emergencies-talk/)
-   -   Bella going to the vet today for back leg lameness :-( (https://www.yorkietalk.com/forums/sick-injured-emergencies-talk/273284-bella-going-vet-today-back-leg-lameness.html)

ladyjane 02-24-2014 07:07 PM
Quote:
Originally Posted by pstinard (Post 4397091)
Good point about the torn CCL. Can an x-ray pick that up? I read that good quality diagnostic leg x-rays require sedation. In fact, I just read another article saying the same thing, but maybe that's old information. I will make inquiries tomorrow.
https://www.acvs.org/small-animal/patellar-luxations


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

pstinard 02-24-2014 07:14 PM
Quote:
Originally Posted by yorkietalkjilly (Post 4397096)
Well, I was more interested in his morbidity associated with this procedure - the cases of failure of the procedure or complications from the groove being chiseled too deeply/shallow or a tendon being accidentally nicked, associated nerve/vascular damage or something along those lines that rather than any mortality rates.

Okay, got the date and you can bet we'll be praying and watching for your posting that she is awake and in recovery.
: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.

yorkietalkjilly 02-24-2014 07:15 PM
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.

pstinard 02-24-2014 07:28 PM
Quote:
Originally Posted by yorkietalkjilly (Post 4397101)
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.

Yorkiemom1 02-24-2014 08:42 PM
Quote:
Originally Posted by pstinard (Post 4397100)
: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.

surgical correction of medial patella luxation in dogs.flv - YouTube

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 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!

OwnedByJezebel 02-25-2014 08:33 AM
Quote:
Originally Posted by pstinard (Post 4397091)
Good point about the torn CCL. Can an x-ray pick that up? I read that good quality diagnostic leg x-rays require sedation. In fact, I just read another article saying the same thing, but maybe that's old information. I will make inquiries tomorrow.
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.

pstinard 02-25-2014 09:20 AM
Quote:
Originally Posted by OwnedByJezebel (Post 4397305)
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.

yorkietalkjilly 02-25-2014 09:39 AM
Quote:
Originally Posted by pstinard (Post 4397318)
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?

107barney 02-25-2014 10:09 AM
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!

pstinard 02-25-2014 10:12 AM
Quote:
Originally Posted by yorkietalkjilly (Post 4397326)
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?
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.

richards6402 02-25-2014 10:34 AM
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.

pstinard 02-25-2014 11:20 AM
Quote:
Originally Posted by richards6402 (Post 4397353)
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.

OwnedByJezebel 02-25-2014 11:30 AM
Quote:
Originally Posted by pstinard (Post 4397318)
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.
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.

richards6402 02-25-2014 12:31 PM
Quote:
Originally Posted by pstinard (Post 4397372)
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.
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.

bailie 02-25-2014 02:38 PM
Quote:
Originally Posted by Yorkiemom1 (Post 4397118)
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!
OMG just reading this I was near gone, lol don't blame u for fainting lol


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