February 1, 2023

Today Whiskey had her TPLO Surgery at Mount Laurel Animal Hospital. She was in the best hands with our our good friend, Amanda, who is the Nursing Supervisor for Specialty Surgery.

Pre-Surgery

Porter’s Poo Palace that we use for camping has been sanitized (twice) and brought indoors to be transformed into The Fish Fortress for Wish the Fish’s recovery from TPLO surgery. A secluded, confined area for Whiskey is imperative for her safety and proper recovery from her surgery. This area included a low, flat bed, a feeder, non-skid whelping mat that covered the entire floor, and lighting courtesy of a rechargeable camp light. Luckily we had all of this on-hand!

Checking out her recovery digs:

Lounging with Mom after we administered the pre-surgery medications to help her relax:

Arrival

We arrived a bit early to Mount Laurel Animal Hospital…but Whiskey didn’t mind because she was watching all of the farm animals from the car, then took a short potty break before entering the hospital.

Check-In

Amanda checked Whiskey in and fully explained the procedure and what to expect.

X-Rays

Radiographs were taken and confirmed that Whiskey has a complete tear in her cranial cruciate ligament. Effusion is present in the left knee where the suspected partial tear is located.

Dr. Morris called me once the radiographs were taken to let me know Whiskey is doing well and was about to get her epidural in preparation for surgery.

Surgery

Whiskey was sedated and anesthesia was administered.

Once the incision was made, Dr. Morris could see that luckily Whiskey’s joint is normal and her meniscus is intact. Whiskey’s X-rays are displayed on the screen so that there are live views of her measurements as Dr. Morris reconfigures the angle and makes a curved cut in the top of Whiskey’s tibia bone

Whiskey’s heart rate, oxygen level, blood pressure, CO₂ levels, breathing rate and body temperature were all monitored throughout the surgery.

The TPLO was performed without complication. Whiskey received an injection of a long-lasting numbing medication along her incision during closure to aid in post-operative comfort.

Post-Surgery X-Rays

Whiskey’s incision was closed and post surgery X-rays were taken before moving her to the recovery room.

Possible Complications

Although we are optimistic that Whiskey will not have any complications, we need to be aware that it is a possibility. The risk of these potential (and hopefully unlikely) complications far outweighs the benefits of repairing Whiskey’s knees so that she can return to her normal Pointer shenanigans and be provided with the opportunity for the best achievable quality of life. Potential complications associated with this procedure include infection, dehiscence, need for implant removal, implant failure, implant migration, persistent lameness, patellar luxation, progression or arthritis, pivot shift, fracture, future meniscal injury, and need for additional intervention.

Recovery

Whiskey recovered smoothly from anesthesia. The breathing tube was taken out and a warming blanket was placed over Whiskey while she recovers with her IV fluids. Dr. Morris called to review the surgery. After a few hours of recovery, Dr. Morris called us again and let us know that she was comfortable at this point to release Whiskey to come home since she was doing so well.

Whiskey hung out with the best nurse any patient could ever ask for…our friend, Amanda! Whiskey took a trip to the kitchen and ate a snack, which she was able to keep down!

Pick-Up

Amanda met with me and reviewed all of the post-surgery instructions. Success of the surgery depends heavily upon the adherence to the post-operative instructions for the next 8-12 weeks. Too much activity too soon, or failure to closely follow the given instructions could disrupt and potentially fail the repair, which would require a re-operation. Whiskey is expected to increasingly put weight on the operated leg over the next 2 weeks so that she is at least touching the toe to the ground by the time of suture removal. By 6 weeks post-op, Whiskey is expected to be comfortably weight bearing on the leg. Full recovery can take up to three months.

• Incision Care:
  • Monitor the incision daily for excess draining, redness, swelling or discharge: Bruising can be expected at the incision site and it should progress thru the healing phase as if changes colors. Any bruising that spreads in surface area should be documented with photographs if able and the hospital should be contacted.
  • Cold pack the incision area 2-3 times daily for 5 minutes for the first 3 days following surgery.
  • Incision does not need to be covered. It should simply be kept clean and dry.
  • No swimming or be bath for the first 2 weeks following surgery to allow the incision to heal.
  • Seroma formation is common with knee surgery. A seroma can present as swelling around the ankle, the joint below the incision. This is where edema from the surgical site will settle over the first 10 days post-op. It will feel like a fluidy sac. A warm compress can be applied to the area for 5 minutes 2 to 3 times a day and gently massage the area. If the site is painful or red, the hospital should be contacted.
• E-Collar:
  • An E-Collar is imperative at all times when not directly supervised. If the incision is accessed, there will be increased risk of complications such as infection or dehiscence.
  • Many patients are able to reach around inflatable donut collars or soft cones. As a result, use of a hard plastic cone is recommended
• Exercise Restrictions:
  • Restrict activity to short (< 5 minutes) leash walks only to go out to the bathroom for the next 14 days.
    Whiskey must always be on a leash when outside.
  • No running, jumping, stair climbing or playing with other dogs. If you need to use stairs and your pet is too
    large to carry up and down – make sure Whiskey is on a leash and walk up and down the stairs very slowly.
  • Whiskey should be crated or kenneled in a small room without furniture when not directly supervised. Using a crate
    is a security for Whiskey to heal appropriately. If Whiskey is hyperexcitable when you are home, use the crate to
    create safe periods of rest.
  • Use yoga mats, bath rugs or carpet runners to cover slick floors in the kitchen or hallways to prevent slipping. Major
    areas of concern are around doors where Whiskey will be coming in and out as well as around food and water
    dishes. If needed, use a towel or sling to support your dog during walking around these areas of your home.
• Medications:
  • Carprofen (Rimadyl)
    • This medication is a non-steroidal anti-inflammatory medication used for pain control. Adverse effects include
      anorexia, vomiting, diarrhea, and dark tarry stool. Please stop this medication and call if you note these. Do not administer this medication with other NSAIDs (Aspirin, Meloxicam, Previcox, Deramaxx, etc.) or steroids
      (Prednisone, Temaril-P. or injectable/topical steroids).
  • Gabapentin
    • This medication is used to target neuropathic pain. Adverse effects include sedation, anorexia, constipation and occasional anxiety/tremors/neurologic sions.
  • Trazodone
    • This medication is used as needed to keep Whiskey calm. Adverse effects include excessive sedation, anorexia, constipation, and occasional anxiety/tremors/neurologic signs
  • Codeine
    • This medication is a opioid derived medication used for pain control. Adverse effects include sedation, anorexia
      constipation
• Bag of Goodies
  • medications
  • a pill cutter to help us with the dose amounts
  • cold pack
  • food that is easy on the belly in case her stomach is upset
  • folder with post-surgery instructions

Shortly after the post-surgery discussion, Whiskey walked out of the hospital with Amanda!

Arrival Home

Besides setting up a safe confined recovery pen, we also had these two items to assist us to lift and/or support Whiskey if needed:

Once we were home, Whiskey quickly settled in to her Fish Fortress.

Whiskey’s same-day release was possible because of the outstanding skill and medical expertise of the Mount Laurel Surgical Team. We are so grateful for the compassionate attention and professional care displayed from each and every person involved in Whiskey’s surgery.

Follow-Up Care

A recheck examination will be scheduled at the 2-3 week post-surgery mark. At this visit, Whiskey’s incisional healing will be assessed.