Did I Make the Right Decision?

I know it’s been a while since there has been a new post. I really didn’t want to write about Covid or anything related to being stuck at home although there were plenty of ways to write about that and I have taken on more responsibilities as a volunteer for ESRA.

But, enough about that, here’s what’s going on and what I’m thinking about almost constantly. Before I begin, though, I want to be clear that this my experience and everyone in my world and especially the team of veterinarians have been absolutely the best. This isn’t an article on the pros or cons of any treatment plan for a knee injury.

Linus, my 11 or 12 year old Springer that I adopted from ESRA over 10 years ago tore his canine cruciate ligament (CCL) back in November. The CCL is similar to the ACL in a human and connects the tibia to the femur in the knee. It is also a very common injury in dogs. The surgeon that worked on Linus told me that she does as many TPLO surgeries as my regular vet does spay and neuter surgeries. Linus had corrective surgery at the beginning of January. He had a tibial plateau leveling osteotomy (TPLO) surgery, which changes the angle and relationship of the femur and the tibia. This is a very basic description and if you’re interested in learning more about torn CCLs and TPLO, you’ll have to trust me that there is a lot of reading available on the internet. Without the surgery he would continue to be in pain, develop arthritis an an accelerated rate and possibly tear the CCL in his other knee.

It was never a question for me whether I would take him to have this surgery. He is 11 or maybe 12 but he’s incredibly active and the surgery would slow down the development of arthritis and provide stability to his knee, which improves the rest of his life. My regular vet sent me to a major university hospital. I also spoke with a lot of people who have gone through this same injury and surgery with their dogs. It wasn’t hard to find friends or colleagues with experience with a TPLO or torn CCL because it’s such a common injury in dogs. It’s a fairly expensive surgery and cost me over $4000 for just the surgery. He happened to also have a torn meniscus in the knee. There’s probably another $1,000 in xrays, medications and follow up visits which means Linus has a pretty expensive knee. I can afford this but I also know that many cannot and my normal vet told me when he originally diagnosed the injury that roughly 50% of his patients elect not to have the surgery.

So, at the beginning of January, I took Linus to the university hospital where he was a star patient. He was perfect in the hospital and they even released him a day early because he was doing so well. He came home and was put on crate rest for the next 4 weeks and, of course, had to wear the dreaded cone of shame. He was also given some mild sedatives to keep him quiet and he did well for the first week. It was more an adjustment for me trying to figure out a routine, while working from home. He had to be on a leash at all times when out of his crate, and being January in Illinois, means I take him outside in all kinds of snow, sub-zero temperatures and wind.

He doesn’t want to be in a crate and has figured out how to escape, even going so far as to unzip the soft crate using his cone of shame. I now own quite a variety of crates and in a quantity sufficient to start my own kennel just so he can be wherever I am in the house. I learned within a day of him being home that putting him in a crate in a room where I didn’t happen to be was not going to work. Bark. Bark. Bark. Repeat.

Then, his incision became infected. He was put on antibiotics and I had to clean the incision multiple times a day, which was tricky because the incision is on the inside of his knee and I didn’t want to cause any further injury to the knee. He was in pain and wouldn’t eat. The barking in the crate continued. His medication schedule left me without a lot of sleep and a lot of stress. After another week of this, the culture came back on the infection and we needed to switch the antibiotics. The new antibiotic upset his stomach even more so I had to add Pepcid into his medication mix and hand feed him. His orthopedic surgeon wanted him to lose about 8 pounds and that came off within the first 2 weeks because Linus just wouldn’t eat. I can tell you exactly how many pills will fit in a teaspoon of peanut butter. It’s a lot actually.

I didn’t go into this with my eyes closed. My vet and friends were really clear that he would be restricted and have to be on a leash. This is just so much worse than I thought it would be and I hate seeming him like this. He’s in pain. It’s a real struggle to get him to eat. I’m exhausted from a crazy medication schedule and filled with guilt and stress. I’m seriously wondering if I made the right choice for him.

He had a checkup back at the university after 4 weeks and the results weren’t great. The plate that was inserted has shifted 4 to 6 degrees from the placement immediately after surgery. The surgeon tells me that this may correct itself if he has very strict crate rest as the bone hasn’t completely healed but if not, then she can do a second surgery to add more stability to the knee. The only way that Linus will actually rest in the crate is if he is sedated. She sends me home with large bottles of mild sedatives and pain relievers.

We are now 2 weeks away from his next follow up with the orthopedic surgeon. When we go back, he will have been in a crate for 10 weeks. Linus is still on the sedatives although he seems to have built up a tolerance to them. We use a sling that goes under his body every single time he is out of the crate. He’s in the crate 23+ hours in total each day. He doesn’t seem to be in pain but it’s so hard to tell with dogs. He doesn’t sleep as much as you would think being on the sedatives and pain killers and can actually stand in a crate and bark for 4 hours. We have a pretty good routine but the real test will be in 2 weeks when they do more xrays at the university. At that time, if his knee hasn’t fully stabilized, I imagine we will proceed with the second surgery so they can add additional sutures. He’ll come home with a new incision, more drugs, the cone of shame and more crate time. I know its terrible. We both hate it. My other Springer Lila hates it too but it has to be this way. All I have to do is think of prolonging this recovery for him and an additional $3000 surgery and back in the crate he goes after a potty break.

Here’s the real question I ponder all the time. If I had known all of this back at the beginning of January, would I have made the same decision to put Linus, Lila and myself through this surgery and recovery? I honestly can’t answer that question right now, even though I’ve spoken to so many wonderful and supportive friends that tell me it was the right choice and he will have the best quality of life for as long as he is with me. I say, ask me in a few months. Besides, I have to end this blog because it’s time for more meds.