March 12, 2001
For the past two week's I have been telling you about a surgical
procedure called Tibial Plateau Leveling Osteotomy (TPLO).
It is a highly specialized surgery that "redesigns" the internal
structure of the canine knee. It is usually performed to address a crippling
cruciate ligament tear or a complete cruciate failure. It is most often
performed on large or giant-breed dogs because traditional cruciate
surgery often is not entirely successful for that segment of the canine
population.
Jabber's
First Surgery
Our Great Dane, Jabber, recently underwent
TPLO surgery, in Charleston, SC. Last week
I described the surgery and told you it had been successful. Initially
it was. Unfortunately, three and a half days after surgery something
went terribly wrong. Jabber was in pain. His leg was swelling and there
was a lot of bleeding under his skin. X-rays indicated that two of the
top three screws in the plate assembly, which was holding his bones
together, had backed out. This was shocking news. I had just visited
Jabber the day before. He seemed okay, although he was not very happy.
I spent some time with him and took pictures. When I got home, I put
together a short slide show to chronicle his first days of recovery.
The next morning Jabber's surgeon, Dr.
Paul Shealy, phoned me with the bad news. Jabber was going to require
another long surgery. Dr. Shealy was not sure exactly what he would
find, but he told me he was confident he could handle whatever he encountered.
Unfortunately Dr. Shealy was at his Savannah clinic, so Jabber's surgery
would have to wait until Dr. Shealy returned to Charleston the next
day. Poor Jabber!
Jabber's
Second Surgery
When Jabber's leg was reopened, Dr. Shealy discovered that the bone
had cracked along the screw line of the top three screws. That's why
the screws had backed out. How could this happen? Our best guess is
that Jabber experienced some kind of fall and landed on his leg. It
might have happened overnight in his kennel. If the split bone was not
the result of a fall, then there is probably a bone problem which may
reappear later. (Hopefully that is not the case.)
As
expected, Dr. Shealy found that the tibia head had significantly shifted
due to the trauma. He removed the plate and put the two pieces of bone
back in the "jig" and rotated the head to reset the angle.
Since there was so much damage to the original screw area, he could
not use that portion of the bone. Instead he applied a new plate facing
in the opposite direction. Dr. Shealy told me he feels he got a very
solid attachment.
He also reinforced the split with another plate to stabilize and protect
that portion of the tibial head. He's optimistic that Jabber can have
full and complete recovery. It will just be a bit slower than most.
Our Visit
I visited Jabber on Friday, two days after his second surgery. He is
staying in the 24/7 emergency clinic (the surgical center) instead of
being moved over to the physical therapy center. (Normally Dr. Shealy's
TPLO dogs are moved over to the PT center where they live for five days
while getting their scheduled therapy.) Jabber will remain there until
he's ready to come home in a week to ten days. He is being closely supervised
to make sure he does not re-injure his leg. Two people together assist
him in getting up and down for potty, etc. (He weighs 175 pounds!) The
physical therapy that usually begins at the PT center on the third day
post surgery will still take place, but the therapists will come to
Jabber and do it all right there at the emergency clinic.
Jabber
seems very comfortable and he is in good spirits. He was actually more
relaxed during my second visit than he was when I visited him for the
first time at the PT center. I brought him his favorite giant teddy
bear and fed him treats, which he eagerly devoured. All this, just two
days post-surgery! As soon as Jabber's incision stops draining he can
have his regular bed back. (Right now he is sleeping on a blanket.)
The staff is very nice to him. Sometimes as they pass his kennel they
greet him and he wags his tail. The enclosure is centrally located so
he can watch the staff as they prepare other dogs and cats for surgery.
Jabber's leg is padded and bandaged more extensively than it was after
the first surgery. Dr. Shealy is not taking any chances. So far he has
maintained a perfect record of successful TPLO surgeries and he is doing
everything possible to ensure that Jabber makes a full recovery.
Click here for slide show or
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