Bella's MPL (luxating patella) surgery

[ladyjane]

Originally Posted by OwnedByJezebel

Wow there sure is a big difference in recovery when fixing LP only and fixing LP + torn CCL. My Jez (had both LP and CCL tear fixed) wasn't allowed to run for 8 weeks and was far more restricted.

Muscle wasting happens so quickly, doesn't it? I found it scary during that time because I knew when she was relying more on the good leg and putting more stress it that the risk was higher that she would injure that one, too.

I too am shocked at the time period. I had one pup with LP only surgery and his crate rest period was 8 weeks. He had TPLO surgery prior to that...and then the knee failed. Maybe that was part of it? I really don't know.

Yep, the muscle wasting is fast, but I have found that they recover quickly once they regain full use.

[pstinard]

Originally Posted by OwnedByJezebel

Wow there sure is a big difference in recovery when fixing LP only and fixing LP + torn CCL. My Jez (had both LP and CCL tear fixed) wasn't allowed to run for 8 weeks and was far more restricted.

Muscle wasting happens so quickly, doesn't it? I found it scary during that time because I knew when she was relying more on the good leg and putting more stress it that the risk was higher that she would injure that one, too.

Yes, it is a little scary, because she has mild LP in her good leg, and I'm hoping that she doesn't injure it while she is rehabilitating her operated leg. So far, so good. I found an excellent article on rehabilitation following MPL surgery, and so far, Bella is right on schedule:

http://topdoghealth.com/faq/document...LE-Booklet.pdf

The recovery for MPL surgery alone must be quicker than the recovery for MPL + CCL.

I'm taking Bella out for figure 8 walking after I get home from work.

[pstinard]

Originally Posted by ladyjane

I too am shocked at the time period. I had one pup with LP only surgery and his crate rest period was 8 weeks. He had TPLO surgery prior to that...and then the knee failed. Maybe that was part of it? I really don't know.

Yep, the muscle wasting is fast, but I have found that they recover quickly once they regain full use.

I think that MPL-surgery-only has a faster recovery time, at least according to what I've read. I'm grateful that Bella hasn't had any CCL problems (knock on wood).

[OwnedByJezebel]

I'm not doubting that the LP repair has an easier time healing, it's a much simpler surgery. What surprises me is how Bella is allowed to do certain things that are not allowed with LP replair + TPLO.

Statements like this make me cringe: "She will use her leg when she's walking or running slowly, but she still picks it up when she is running more quickly." That is so risky. She should not be allowed to run at all, no access to stairs, and confined and restricted.

According to page 7 of your rehab document:

**** WARNING****
During all times outside of therapy STRICT CONFINEMENT is MANDATORY.
It is extremely important to follow this protocol as closely as possible to ensure proper recovery. Any form of rambunctious activity is PROHIBITED during this critical recovery period.

I'm not telling you what to do, she's not my dog, and I'm glad she is doing so well. It just brings back the feelings of how paranoid I was post-op that I would fail to properly control Jezebel and then find that she had jumped on the sofa or would run, even for a short distance, and then mess things up and have to go back into surgery.

[pstinard]

Originally Posted by OwnedByJezebel

I'm not doubting that the LP repair has an easier time healing, it's a much simpler surgery. What surprises me is how Bella is allowed to do certain things that are not allowed with LP replair + TPLO.

Statements like this make me cringe: "She will use her leg when she's walking or running slowly, but she still picks it up when she is running more quickly." That is so risky. She should not be allowed to run at all, no access to stairs, and confined and restricted.

According to page 7 of your rehab document:

**** WARNING****
During all times outside of therapy STRICT CONFINEMENT is MANDATORY.
It is extremely important to follow this protocol as closely as possible to ensure proper recovery. Any form of rambunctious activity is PROHIBITED during this critical recovery period.

I'm not telling you what to do, she's not my dog, and I'm glad she is doing so well. It just brings back the feelings of how paranoid I was post-op that I would fail to properly control Jezebel and then find that she had jumped on the sofa or would run, even for a short distance, and then mess things up and have to go back into surgery.

Now you're going to make me paranoid too! Somewhere in the document I linked, it says that the dog can be out of the crate if she is under supervision. Bella does have supervision during the day by Walter, who really is a good daddy despite the unfortunate couch-jumping incident to which someone replied, "Note to self, attach one end of leash to Walter and the other end of leash to Bella." Bella is crated at night in her carrier (which sits on the nightstand) to keep her from doing crazy stunts like running around the house and jumping on and off the bed. I don't allow her to run outdoors, and her indoor runs are very short distances on carpet, usually from one room to another. Her trots to the food bowl are generally well-controlled, using all four legs. I'm especially careful to keep her from running on the kitchen floor, which is vinyl, and where she could slip and injure herself. I've been known to walk on my hands and knees with her when I need to get her frozen peas out of the refrigerator. Bella had no access to stairs for the first two weeks. After her stitches were out, I asked the vet about stairs, and he said that stairs were fine so long as she is not flying up and down them and skipping steps, and she isn't--she takes them one at a time. And she gets better and better at steps every day. I think that each dog is different, and the rehab document that I linked to is trying to present the most cautious approach.

I really need to be more conscientious about physical therapy though. I've been doing a pretty good job, but she hasn't been getting the recommended outdoor walks on cold or rainy days. I do walk her inside the house, but it's not the same, because there's only so many laps I can take around the kitchen/living room/dining room before I get bored and stop . Today is a beautiful day though, and I'm looking forward to taking her on a walk and doing some figure eights. It's almost been 5 weeks since surgery...

[107barney]

It's been a while but I did not strictly crate rest Daisy who was two when she had her MPL repair (it was a grade IV). She was kept in a small area of my kitchen and allowed to walk on leash to potty. She didn't run or jump or use stairs for several weeks to allow the soft tissues to heal appropriately.

[OneShinyface]

This thread has been SO helpful! Thank you, OP for posting your journey.

My Diva who is 5.5 years old will have surgery for LP on May 6. She's been hobbling along on 3 legs for the past 2 months and the past couple of weeks, she won't even sit normally so as to avoid any pressure on her leg.

I'm so worried because she's my baby, but her quality of life is not the same. She's always been very active and very feisty. I'm praying for a smooth surgery and recovery. I can't wait for her to get back to chasing the bunnies in our backyard.

[pstinard]

Originally Posted by OneShinyface

This thread has been SO helpful! Thank you, OP for posting your journey.

My Diva who is 5.5 years old will have surgery for LP on May 6. She's been hobbling along on 3 legs for the past 2 months and the past couple of weeks, she won't even sit normally so as to avoid any pressure on her leg.

I'm so worried because she's my baby, but her quality of life is not the same. She's always been very active and very feisty. I'm praying for a smooth surgery and recovery. I can't wait for her to get back to chasing the bunnies in our backyard.

Recovery is a long road. I hope Diva does well with her surgery! Keep us posted!

[pstinard]

Just a brief follow up and progress report. Bella continues to use her operated leg, but not 100% of the time. She does not appear to be in any pain at all--it's just that sometimes she trots with all legs on the ground, and sometimes she trots with three legs on the ground. Her initial rapid progress seems to have slowed down somewhat. I just made an appointment for her to see the vet for a follow up, just to be sure she is healing as she should. The appointment is for 8:30 AM Thursday morning. I'll give another update then.

[pstinard]

Just got back from consulting with the surgeon. The good news is that Bella's knee is healing very well, her patella is staying in position, and her CCL ligament is firmly attached. She is expected to make a full recovery. The bad news is that the pin that was used to attach the CCL to its current location is slowly beginning to back out of the underlying bone. The surgeon says that this happens in about 20% of the cases. It is of no danger to the CCL or to Bella's recovery, since the point of CCL attachment has fully healed. However, if it continues to back out of the underlying bone, it could pierce the skin and stick out, which would require it to be removed. I could have the pin removed now, which would require invasive surgery, or I could wait and see if it stabilizes or pops out on its own. If it stabilizes, everything is good as it is. If it pops out on its own, it would have to be pulled out, but would require less invasive surgery, and perhaps not even full anesthesia. I am to continue monitoring (feeling) the position of the pin from time to time, and if it continues to come out further, I am to take her back for further consultation. I was about to pass out, but the surgeon made me man up and feel the pin so I know what to look for. The surgeon assured me that Bella is in no pain, and that in fact, I'm probably feeling more pain than she is! I am inclined to go ahead and leave the pin in for as long as possible, so the joint continues to heal. Overall, the surgeon was quite pleased with Bella's progress.

[Cherie6446]

I had bunion surgery several years ago and because I have osteoporosis the pin in my foot backed out. The doc just did a small cut and pulled out the pin. I had a couple of stitches. Maybe the same can be done for Bella.

[pstinard]

Originally Posted by Cherie6446

I had bunion surgery several years ago and because I have osteoporosis the pin in my foot backed out. The doc just did a small cut and pulled out the pin. I had a couple of stitches. Maybe the same can be done for Bella.

Yes, that is exactly the kind of thing the vet was talking about. She would have to be put under full anesthesia to have the pin removed now, since it would require a small incision. If it pops out on its own, he would just pull it out the rest of the way, with *probably* no incision required. I'm hoping that someone who had this happen to their Yorkie will chime in. If not, our dear Bella will be the pioneer.

[Cherie6446]

I don't understand why they can't give her a local to numb the area and remove the pin.

[pstinard]

Originally Posted by Cherie6446

I don't understand why they can't give her a local to numb the area and remove the pin.

They can't give her a local to make an incision to remove the pin because she would be struggling the whole time. She's not a well-behaved patient like I am, LOL! And the pin is sticking out just a little. There's no telling in advance how much manipulating they would have to do in order to get the pin out now, and not putting her under would be cruel. They *might* be able to give her a local if the pin pops through the skin where they can access it directly without having to make an incision.

[ladyjane]

There is nothing invasive at all about the surgery to remove the pins. I have had a couple that needed them removed and I was able to take them home the same day. Not a big deal at all. They usually have to be kept quiet for a week or two after.