Luxating Patella Surgery for Daisy -- RECOVERY DAY 1!
Hi All,
Have been lurking here for a long time now and usually don't have the opportunity to sit and post... I learn so much just from reading everyone else's experiences I usually don't have too many questions... hopefully I can get some help here and apologize in advance for the long post...
We recently brought our 1.5yr old Shiba girl (Daisy) to an Orthopedic consult with the same doctor who successfully operated on our 10 yr old Pomeranian for Luxating Patella (this past September). I noticed she has been a bit limpy on her left rear leg when shes just walking around at home, however, once she's outside walking, running, or playing, she seems to not be bothered. She also is a bit bow-legged in the rear. She has never shown any pain to us (no Shiba screams or sensitivity to touching/manipulating the leg) but I wanted to have her checked out for peace of mind at least. I have been giving her joint supplements since she's been about 9 months and she eats a combo of Honest Kitchen and Orijen foods. (Don't know if what she eats really matters when it comes to these types of problems, but just wanted to throw it out there...)
The doctor's diagnosis was that her left knee was very easy to pop out of place (Grade 3) and that the right side is borderline (Grade 1). He said she has probably learned how to deal with the discomfort but recommended surgery ASAP to avoid any further damage to both legs.
This is a doctor we trust and have had great experiences with for our Pom, who i mentioned underwent the same surgery on both rear legs as well in Sept. His recovery has super hard on us all, however, he is no Shiba and is super mellow and laid back and therefore, sped up the recovery. We all know the general crazy behavior of Shibas, Daisy is no different, she is a giant ball of puppy energy. My biggest concern is how to deal with her recovery... Anyone who has had to go through any major surgeries with their Shibas (or other Nihon Kens), pls give me some advice?
-Did you have to keep him/her medicated/sedated the entire recovery to minimize the energy/movement? I really hate the idea of this... I honestly don't know if I can stomach seeing her drugged up for atleast a month... but given her typical energy/fitness level, the doctor suggested this might be necessary to keep her calm and give the legs time to heal. Are there any other ideas about how to work through her recovery without resorting to sedatives? Between my boyfriend and I, we are trying coordinate taking time off work so either of us can be with her during the day and she isn't left alone for longer than an hr at a time.
-Do Shibas really calm down significantly after the age of 2? We discussed perhaps waiting until then so it will be easier on us all, but the doctor said the longer we wait, the more the legs become damaged. And like people, don't believe getting to a certain age is necessarily a guarantee for "calming down"...
-Are there any psychological impacts (to the dog) that come w/ a major surgery that anyone has experienced? Again, I feel like the experience w/ my Pom going through the same surgery isn't really a good gauge since he's honestly a model citizen of a dog... you could do just about anything to him and he's still super happy go lucky. He recovered beautifully but he is alot older and much more easy going...
Thanks everyone for taking the time to read this and I hope I can get some advice. Have included a picture of the Daigi Monster and Nos (my Pom) for everyone... (hopefully I did it right...)
Have been lurking here for a long time now and usually don't have the opportunity to sit and post... I learn so much just from reading everyone else's experiences I usually don't have too many questions... hopefully I can get some help here and apologize in advance for the long post...
We recently brought our 1.5yr old Shiba girl (Daisy) to an Orthopedic consult with the same doctor who successfully operated on our 10 yr old Pomeranian for Luxating Patella (this past September). I noticed she has been a bit limpy on her left rear leg when shes just walking around at home, however, once she's outside walking, running, or playing, she seems to not be bothered. She also is a bit bow-legged in the rear. She has never shown any pain to us (no Shiba screams or sensitivity to touching/manipulating the leg) but I wanted to have her checked out for peace of mind at least. I have been giving her joint supplements since she's been about 9 months and she eats a combo of Honest Kitchen and Orijen foods. (Don't know if what she eats really matters when it comes to these types of problems, but just wanted to throw it out there...)
The doctor's diagnosis was that her left knee was very easy to pop out of place (Grade 3) and that the right side is borderline (Grade 1). He said she has probably learned how to deal with the discomfort but recommended surgery ASAP to avoid any further damage to both legs.
This is a doctor we trust and have had great experiences with for our Pom, who i mentioned underwent the same surgery on both rear legs as well in Sept. His recovery has super hard on us all, however, he is no Shiba and is super mellow and laid back and therefore, sped up the recovery. We all know the general crazy behavior of Shibas, Daisy is no different, she is a giant ball of puppy energy. My biggest concern is how to deal with her recovery... Anyone who has had to go through any major surgeries with their Shibas (or other Nihon Kens), pls give me some advice?
-Did you have to keep him/her medicated/sedated the entire recovery to minimize the energy/movement? I really hate the idea of this... I honestly don't know if I can stomach seeing her drugged up for atleast a month... but given her typical energy/fitness level, the doctor suggested this might be necessary to keep her calm and give the legs time to heal. Are there any other ideas about how to work through her recovery without resorting to sedatives? Between my boyfriend and I, we are trying coordinate taking time off work so either of us can be with her during the day and she isn't left alone for longer than an hr at a time.
-Do Shibas really calm down significantly after the age of 2? We discussed perhaps waiting until then so it will be easier on us all, but the doctor said the longer we wait, the more the legs become damaged. And like people, don't believe getting to a certain age is necessarily a guarantee for "calming down"...
-Are there any psychological impacts (to the dog) that come w/ a major surgery that anyone has experienced? Again, I feel like the experience w/ my Pom going through the same surgery isn't really a good gauge since he's honestly a model citizen of a dog... you could do just about anything to him and he's still super happy go lucky. He recovered beautifully but he is alot older and much more easy going...
Thanks everyone for taking the time to read this and I hope I can get some advice. Have included a picture of the Daigi Monster and Nos (my Pom) for everyone... (hopefully I did it right...)
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Comments
Lucy, my now 26 month old Shiba had surgery to correct a grade 3 LP in her left rear leg last year. I don't recall exactly when it occurred, but I think it was around September. She also had a grade 1 in her right knee. From all of the research I've done (both internet and talking to vets), it seems grade 1 is not a surgical condition. Grade 3 is most definitely a surgical condition of high importance. The longer you let it go, the more damage is done to the joint which has two significant implications. First, it makes the repair significantly more complicated and less likely to be permanent (there is at least a 10% repeat rate on LP repairs). Second, it significantly increases the chances for early onset of serious arthritis in the joint. I would not delay in getting it fixed. Shibas are tough little dogs and don't like to show pain. Your vet's suggestion that she has learned to compensate makes perfect sense to me, so you may not be fully aware of the extent to which it bothers her.
I do know of one instance where a vet has recommended fixing both knees at the same time, but that was due to financial reasons. My understanding is that if both knees require repair, the surgeries should be done at least 4 weeks apart. Using the operated on leg is crucial for rehabilitation. If both knees are operated on at the same time, it will significantly delay the process and make your life much much much more difficult during the recovery.
To answer your questions:
-Did you have to keep him/her medicated/sedated the entire recovery to minimize the energy/movement? I really hate the idea of this... I honestly don't know if I can stomach seeing her drugged up for atleast a month... but given her typical energy/fitness level, the doctor suggested this might be necessary to keep her calm and give the legs time to heal. Are there any other ideas about how to work through her recovery without resorting to sedatives? Between my boyfriend and I, we are trying coordinate taking time off work so either of us can be with her during the day and she isn't left alone for longer than an hr at a time.
---No, I did not medicate Lucy after her surgery other than pain meds. She had an oral pain reliever/anti-inflammatory that she took for about 10 days and she had a pain patch that gave her timed release pain medication for 7 days. She also continued to get the oral pain meds as needed for another few weeks, but that was very rare. I kept her exercise down, she was leashed to me at all times or in her crate when I couldn't keep a direct eye on her. I didn't find it hard at all to keep her calm for the first 3 weeks. After that I had to be very careful about her jumping up and down from the couch. She also started sleeping in her crate again (rather than in bed) to avoid her jumping down in the middle of the night. After 8 weeks she returned to bed.
-Do Shibas really calm down significantly after the age of 2? We discussed perhaps waiting until then so it will be easier on us all, but the doctor said the longer we wait, the more the legs become damaged. And like people, don't believe getting to a certain age is necessarily a guarantee for "calming down"...
---I think you nailed it. There is no guarantee that she will calm down at age 2. Even if she does, 6 months is a long time to go with a grade 3 LP. A LOT of damage can be done in that time, so I would advise against waiting.
-Are there any psychological impacts (to the dog) that come w/ a major surgery that anyone has experienced? Again, I feel like the experience w/ my Pom going through the same surgery isn't really a good gauge since he's honestly a model citizen of a dog... you could do just about anything to him and he's still super happy go lucky. He recovered beautifully but he is alot older and much more easy going...
---This is tough to answer. Lucy is an excellent patient, and has never minded the vet. I haven't noticed her change her opinion of the vet since. As for her attitude toward me or other dogs? I haven't noticed anything either except that she is less grumpy when other dogs try to play with her. I think she used to be in pain during play so she would be defensive and grumpy when other dogs got too rambunctious with her. Now she just takes it in stride. So in that sense, I'd say it was a positive effect. But, every dog is different so YMMV.
JessicaRabbit, another forum member, has had a knee surgery done on her pit Pigglet. Piggy's surgery was for a torn cruciate though, not an LP. I bring this up because Lucy's surgeon told me she might still have bad days for up to 6 months post surgery. After about 9 weeks, other than her hair not being completely grown back you would never have known that she had surgery. Piggy seems to still have a limp in cold weather, so her recovery has been a bit slower than Lucy's.
Also, I would highly suggest you plan and budget to go through a rehab program with Daisy. I did this with Lucy and I firmly believe her speedy recover was due in no small part to that. A typical rehab program begins when the stitches or staples are removed at around 2 weeks, and can last anywhere from 5-7 weeks depending on her progress. The first 3 weeks will require 2 visits per week and the remaining time will be 1 visit per week. Each visit runs around $60-$70 dollars depending on the place (some will also have package deals to make it a bit cheaper). Lucy was progressing so quickly that she only had 1 visit per week for 6 weeks. The program consisted of using the underwater treadmill, standing on an exercise ball, walking over and under polls, and a number of home exercises including walking sideways on a hill, walking backwards, bolstered sit-to-stand exercises, walking in a kiddie pool, and walking over polls. I performed the home exercises twice daily for the duration of her recovery, in addition to walking with her on leash. Also, the safe exercise she'll get from rehab will help to drain her energy and keep her from running around and doing exercise that isn't safe for her recovery.
Anyway, sorry for the long post. I have a ton more information if you're interested. Feel free ask any question or let me know and I can whisper you my email address.
Good luck and please keep us updated on her progress.
Whoops, Dave beat me to it!
We have done 3 LP surgeries on Ahi, our female Shikoku. Shikoku are a bit different than Shiba [higher pain threshold, rougher in play] so I can't really compare our situation to your 100% - Dave's situation is probably more on target for you. Also, Ahi is kinda crazy.
Anyway, here are my answers to your questions...
-Did you have to keep him/her medicated/sedated the entire recovery to minimize the energy/movement? I really hate the idea of this... I honestly don't know if I can stomach seeing her drugged up for at least a month... but given her typical energy/fitness level, the doctor suggested this might be necessary to keep her calm and give the legs time to heal. Are there any other ideas about how to work through her recovery without resorting to sedatives? Between my boyfriend and I, we are trying coordinate taking time off work so either of us can be with her during the day and she isn't left alone for longer than an hr at a time.
> Yes, Ahi was drugged for the first 2 recoveries. At the third recovery she had become immune to the effects on the calming drugs [Ace]. I honestly feel that, if drugs are need to keep the pup calm after surgery, as much as I HATE giving a dog [or person] drugs, it is necessary. The 1 month out of their life is not gonna kill them and will make for a cleaner recovery.
-Do Shibas really calm down significantly after the age of 2? We discussed perhaps waiting until then so it will be easier on us all, but the doctor said the longer we wait, the more the legs become damaged. And like people, don't believe getting to a certain age is necessarily a guarantee for "calming down"...
> Ours did, pretty significantly. I'm sure it varies tho.
-Are there any psychological impacts (to the dog) that come w/ a major surgery that anyone has experienced? Again, I feel like the experience w/ my Pom going through the same surgery isn't really a good gauge since he's honestly a model citizen of a dog... you could do just about anything to him and he's still super happy go lucky. He recovered beautifully but he is a lot older and much more easy going...
> If you keep them happy, challenge them mentally, and love them during the recovery time I think you can vastly minimize, if not completely avoid, any psychological impacts.
I hope that helps.
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Dave -- Thanks sooooo much for all the detail on Lucy and taking the time to write back. If possible, could you pls whisper me your email address? I'd love to communicate with you more about this offline. I could also try whispering you mine, however, I'm not quite sure if I'll get it right the first time, thanks!
lindsayt -- Thanks as well for your response! I definitely feel much better hearing from everyone and will do my best to keep everyone posted on Daisy's progress!
Brad -- Thanks as well for sharing your experience w/ Ahi ... she and Loa are my fave Shikokus
Also, I had a friend whose foster dalmatian that had to have ACL surgeries on both legs, and they did them 6 weeks apart. I'm not sure how close in procedure ACL and LP surgeries are or what the actual reason was, but they were quite adamant about the length between surgeries. Maybe it wouldn't hurt to get a second opinion?
And on that note, imho, it is not a good idea to do do both knees at the same time. While you may be reducing the amount of time the dog is put under by doing both knees at the same time, you are mos def raising the risk of complication and therefore the risk of more surgery.
I hope that help - tho I think it may of complicated your situation - sorry.
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Thanks for your both your thoughts! I'm definitely agreeing with everyone's recommendation to do only 1 leg at at time... hopefully, like Tsuki, we can just monitor the Grade 1 side leg for now and concentrate on the recovery of her left leg first and foremost... I've been swamped at work (bad economy = less headcount and more on your plate everyday) so I am hoping to have her scheduled for surgery in early Feb... Will keep everyone posted on her status! Thanks again!! You guys rock!!
My Tsuki, like B's Nemo, has grade 1 and she does not require surgery. She'll be two years old in June, so I'm not sure if it will get any worse as she ages, but we keep her at a healthy weight and provide her with daily joint supplements. I do not know much about LP and the grades of it, but most of the dogs (esp. shibas) that I've known to have grade 1 do not usually require surgery.
I want to thank everyone for sharing their experiences.. It is so hard to know what to expect with the surgery and recovery.
Snf
Just wanted to thank everyone again for their help and input and let you guys know that Daisy is going in for her surgery this morning... We have only opted to do the Grade 3 knee and we are anxiously waiting for this day to be over and cannot wait to pick her up and bring her back home. Will keep you guys updated on her progress!
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Once we got her home, she calmed down significantly but the Fentanyl Patch was definitely making her whine and a bit loopy... I ended up staying up with her till 3AM because she was pretty restless and would doze in and out, then Ken slept on the floor next to her in the pen we made until 5AM, then she woke us up again at 7AM, but I think she was just super hungry. Since we got her home, she's had 3 tiny bouts of diarrhea (that comes with no warning!) but today, it seems to have subsided and she seems constipated (as expected from all the meds during surgery). The strange thing was that her last poo before we brought her in was normal and firm, and they told me she had diarrhea pre-op while she was waiting to go into surgery... I don't know how that happened, but we were told not to give her any of the Metacam post-op until she has normal poop. She is not on any antibiotics either since they said she did not require them due to her surgery being very "clean". She's able to support herself pretty well on 3 legs, she has yet to put any weight on the operated side when she's looking for her perfect spot to pee (which has only been once so far post-op).
I'm making sure to syringe her some water every 2-3 hours since she isn't drinking directly from the water bowl we left in the pen, but her appetite is pretty good. I've been giving her boiled chicken, boiled carrots, and boiled yams and today she even went for a bit of the Orijen herself that we left for her... Last night was def tough, today is a lot better and hopefully it improves as we go on. I also have been giving her some of the Ace sedative the doc prescribed, but half dosage so it's not too much, it seems to be just right to keep her alert but calm.
Dave -- When I spoke to the doctor about my concerns w/ her bow-legging and how it would affect her if she was basically mis-matched post-op (corrected on one side but not the other), they said it shouldn't be an issue with her sense of balance or her gait as she's learning to re-walk. I guess we will need to wait and see once she's actually using her leg again if this is true or not.
Does anyone have any suggestions about what to do to keep her mentally stimulated while she is cooped up on her pen? I've been mainly sitting in the pen with her w/ my laptop while I'm working so she has some company, but I'm sure as she's improving each day and more "normal", her boredom will increase, so any suggestions will be greatly appreciated!!
And now... onto some spammage of her little shaved drumstick... she seems to be shedding alot too post-op... is this related to the stress of the procedure? She wasn't shedding before we brought her in but there's fur everywhere!
about the stimulation - what about a kong or other interactive toys (like the hide-a-bird or tug-a-jug things)?