New Bandage

So this morning, I woke up to discover Heidi had removed her bandage some time during the night.  Not a huge deal since technically her stitches can come out any time now, but I was planning on waiting a day or two longer just to be on the safe side (the range was 10-14 days and today is day 11).  Heidi was licking and chewing it constantly this morning, so I have made a makeshift bandage for now.  I went out last night and bought 2 X 2 gauze pads and some bandage tape.  Her bandage was starting to come off then, so I anticipated the need for a new one.

makeshift bandage materials

Finished product!

Basically, I just laid out 3 of the gauze pads on the inside of the packaging since it was sterile.  (I didn't want it to touch any "dirty" surfaces.)  Then I put long strips of tape along the edges of the gauze that would also be able to adhere to her leg.  And VOILA!  Easy peasy!  We'll see how long it stays on.

I also took a picture of her incision while the bandage was off for all of you curious to see:

It's probably about 5-6 inches long and looks great if you ask me.  No redness at incision site just minimal redness where the tape irritated her skin.  There's still a tiny bit of swelling under the knee as you can see, but it's gone down a lot since a few days ago.  I was so paranoid the incision would get infected and I wouldn't realize because it was covered, but it looks like we're in the clear!  Now if I can just keep her from licking this bandage off for a couple more days!

Guilty face: "Mom, I'm not licking my knee, I swear!"

Merry Christmas!!!

It's Christmas day and we're officially 9 days post-op, woo!  We can take Heidi's stitches out anywhere from 10-14 days post-op, but I'll probably wait until Tuesday or Wednesday just to be on the safe side.  We have still had easy sailing the past few days.  My only small concern is a little bit of swelling on her knee.  It's a round squishy swollen area very similar to all the swelling that had moved down to her ankle (which is now gone!).  So hopefully her body will slowly absorb the fluid or whatever is in there and we'll be good.

Heidi has been off her pain medicine now for 5ish days and she's not quite as calm as she was before.  We doubled the amount of trazodone (the calming drug) once we stopped the pain meds but it doesn't keep her as quiet as I'd like.  This is one of the experimental drug studies we're in.  It definitely calms her some, but she's still moving around more than I'd like.  She's also probably tired of being restricted to our living room... I'm sure I'd get a little stir crazy cooped up for this long.

Unfortunately, Heidi is not able to travel in her condition, so we spent Christmas here, just the 3 of us.  It was weird not being with extended family today, but we had a very enjoyable Christmas.  Last night we had dinner and presents with my parents since they're close by and went to the Christmas Eve service at their church (one of my absolute favorite things about Christmas!)  Then this morning, Alex, Heidi and I had our little Christmas present time.  Heidi was excited about the bones and gingerbread girl Santa got her!  We also made a delicious Christmas dinner, but I won't go into that since this blog is supposed to be about Heidi!  We really missed our families this year, but enjoyed our first Christmas as Mr and Mrs!

love the gingerbread girl Santa brought me!

Tomorrow Alex goes back to work so I'll be on my own carrying Heidi out to use the bathroom.  The good news is I practiced tonight and I actually can pick her up and carry her down and back up the stairs.  Go me!  I'm stronger than I thought- she weighs 70 lbs!  I don't have to go back to work until Wednesday.    When the time comes to take out her stitches, I'll take a picture to post so you can see how big the incision is and what it looks like.  I actually haven't even seen it.  The vet put a bandage on it and somehow it's managed to stay on.  They said to leave it on as long as possible to protect the incision and keep her from messing with it.  It has worked wonders and we haven't had to use the e-collar since the first day so I'm sure Heidi is thankful as well.  Well, that's all for now... Merry Christmas to all, and to all a good night!

Got my Christmas bandana on!

Day 5

So I don't have much to report today but like I said before, that is good news.  Yesterday was Heidi's last day of pain/anti-inflammatory meds so I'm interested to see how she does.  Alex said she's been more crazy than usual.  I can already tell our biggest challenge is going to be keeping her quiet for 8 weeks.  One thing to mention, the swelling in her ankle has gone down a lot.  I figured it would take longer, but I'm not complaining!  Since I don't have much else to share today, I'll leave you with a few cute pics I've taken.

Swelling of leg and loss of muscle mass in her thigh.  Will have to build that back up after the recovery period.  This was taken a couple of days ago so the swelling is even better now!

How we pass the time

Day 2

Last night Heidi slept in her kennel with an e-collar on as I mentioned before.  She hates it and woke us up several times whining in the middle of the night.  She was thrilled to get out of that thing this morning when we got up.  Today we got Heidi set up in the living room again, but this time right next to the couches so she could be next to us and we wouldn't have to sit on the floor all day.  That has worked out wonderfully so far.  Not much has happened today but that's a good thing.  I have noticed that the swelling has moved down her leg as the doctor said it would and she now has a jiggly cankle (pictured below!)

CANKLE!!!

 She has been very content to sleep all day so far, just getting up to stretch or switch sides.  I notice she does lay on the operative leg some and it doesn't seem to bother her.  We're trying to limit her bathroom breaks.  She is used to going whenever she wants because she's not home alone for long periods of time usually.  But she's been great at holding it.  In an information packet the vet gave us, it said we should try to limit her bathroom breaks to 2-4 times a day to minimize use of the leg and potential injury, so we're trying to go every 6-8 hours during the day. So far so good!  She doesn't seem to be drinking much water, but I'm sure she was pumped full of fluids yesterday and Friday, so I'm not too concerned about that yet.  I'll post another update soon but here are some pictures until then!

What's Dad doing?

Pin-the-tail-on-the-Poodle butt, anyone?

sweepy

Post-op: Day 1

We arrived at the vet school bright and early Saturday morning to pick up Heidi.  I was nervous/excited and had butterflies in my stomach for sure.  We spoke with Susan and then Dr. Tuohy and Dr. Marcellin.  They went over post-op care and her medications.  She would be on meloxicam and tramadol (for pain and inflammation) for 3 days and on the trazodone throughout the entire recovery process.  Finally, after what seemed like forever, they brought Heidi in.  I fought back the tears this time... go me!  She actually looked pretty good and was already using the operative foot slightly which was great news.  Her new "do" was not quite as exciting, but it's a small price to pay.  Looking like a poodle butt with a pin-the-tail-on-the-donkey tail for a while is not the end of the world! I'll have to post a picture of that later.  It's quite amusing, but don't tell her I said that!

We loaded Heidi in the car and made the trip back home.  Alex had to carry her up the stairs because they are a big no-no during recovery.  I'm not quite sure what I'll do when he's not home because I cannot carry her up and down the stairs safely alone.  I bought a sling that goes under her abdomen and has handles so I could lift her rear legs as she walks.  I'm not sure if she'll tolerate it or not, but I will probably give that a shot.  We got her home and set up her bed in the living room. It was tough because she was so excited to be home and we were trying to get her to settle down and not over-do it.  Finally she got comfortable in her bed and slept there for the rest of the day.  I made myself a little place on the floor next to her and stayed by her side to make sure she was comfortable and feeling loved.  Before bed, I decided it would be a good idea to put the e-collar I bought her on, so she couldn't lick her surgery wound.  She's a licker and we were afraid she'd go to town on it while we were sleeping.  She is NOT a fan of the e-collar.  She woke us up 3 times I believe in the middle of the night crying in her kennel.  So we may have to find an alternative therapy for that.  Luckily we can take her stitches out in 10-14 days, so we won't have to deal with that the entire recovery period.

Oh, I should mention, she hadn't eaten since the night before her surgery and showed no interest in food the morning after while at the vet school.  Once we got her settled in, we made a little chicken and rice for her (her fave!) and she scarfed it down.  Luckily it doesn't seem she's lost her appetite!  We do have to reduce the amount of food we feed her each day for now, since the next couple of months her life will be much more sedentary than she's used to.  Her body condition is perfect now, and it's imperative she doesn't gain weight because carrying extra pounds will put extra pressure on her knee. 

Icing her knee on day 1

So I'm sure many of you are wondering about this "recovery period" I've mentioned.  It's no joke, that's for sure.  For the first 4 weeks she is to be strictly confined in a small area that does not have slippery floors or furniture she could jump onto.  We've blocked off a section of our living room.  Luckily we don't allow her on the couch so we're not too worried about her trying, but when we're not right with her, she will have to stay in her kennel.  She is only allowed outside to use the bathroom and has to be on her leash at all times.  We even keep her on her leash inside so we can grab her quickly if she were to try to go crazy.  At week 5, we can take Heidi out for 5 minute leash walks twice a day.  Week 6 increases to two 10 minute walks a day.  Week 7 she can do 20 minute leash walks twice a day, and they encourage us to take her through tall grass, sand, or shallow water to increase muscle mass in her thighs which will help stabilize the joint.  At week 8 we can increase to 30 minute leash walks twice daily until her 8-10 week re-check appointment.  If she gets the all clear and her bones are healed, she can increase her activity gradually over the next month until she reaches her normal activity level.  We still have to avoid rough play and uncontrolled activity during this time.

Surgery Day

Alex and I woke up at 5:15am the day of Heidi's surgery to get her there by 7:15am.  We piled in the car and made the trip to Raleigh.  Once there, we met with Dr. Marcellin who would be doing the actual surgery (Dr. Roe was not there that day but he highly recommended Dr. Marcellin who has been a vet for years and years as well.)  We agreed to have Heidi participate in two studies during this whole process.  One is a study that uses the human drug, trazodone, as a calming agent during the recovery process and the other involved a topical form of the drug meloxicam, an NSAID (for inflammation) also used in humans.  They applied the meloxicam to her knee before surgery then took a tiny sample of her joint capsule during surgery (something they assured us she wouldn't miss at all!) to test and see if the meloxicam made it into the joint.  So we discussed that further, then they took Heidi back to get her ready.  I tried not to, but inevitably I cried when we had to leave her.  If you know me, this probably isn't too surprising, and as silly as it is, this was the second time I was offered a tissue when leaving my baby.  (The first was when I dropped her off at the kennel before our Honeymoon!)  I'm such a wuss!  She was scheduled to go into surgery around 2 or 3 and they said they'd call when she got out and began waking up.  Needless to say I was a nervous wreck the ENTIRE day.  Finally, around 7pm, I got the phone call I'd been patiently (or not so patiently) awaiting all day.  The surgery went perfectly, there were no complications and she was resting comfortably.  Again, the tears flowed at the good news.  Luckily I was alone so no one had to know!  We were to pick her up the following day at 8:30am.  I couldn't wait!

one of the many reasons I love her... she thinks she's a lap dog!  Excuse the mess... it was right after the wedding!

It started with a limp...

We were in the routine of taking Heidi to the dog park every day when I got off work.  She LOVES the dog park and lets you know when it's that time of day.  Its so bad we can't even say the word "dogpark" without her perking up and getting all excited.  So when she started limping after a romp in the park it was not a good thing.  After several days of her limping on and off we decided to ask the vet about it at her 1 year check-up which was only a few days away.  I figured it was a strain or something muscle related, but when the vet said the words 'cruciate ligament tear' and 'surgery', I knew this was not good.

Basically the vet told us her stifle (knee joint) was loose and she could feel the signature "drawer" movement associated with a cruciate tear.  Just a little background information for those of you who may not know.  The cranial cruciate ligament is equivalent to the ACL in humans.  Its main job is stabilizing the knee joint and when it is torn, the femur is able to slide down the tibial plateau (top of the shin bone) causing the joint to be unstable and painful.  Our vet, Dr. Fuller, told us she would most likely need surgery and it would have to be done by a specialist because she was too big to have the traditional extracapsular repair surgery they do in the office.  In that procedure they use a synthetic suture material to mimic the cruciate ligament.  Unfortunately the material used is not very strong and is not good in larger, high energy dogs.  Heidi weighs 70 pounds and is full of energy.  Dr. Fuller did x-rays to rule out any other problems and referred us to NC State University Vet School's Orthopedic department.  We were glad to go to the vet school because we know they are the best of the best.  Not to mention we're NCSU alumni and a hardcore Wolfpack family- go Pack!

Our first appointment at the vet school was December 7th; exactly a year from the day I picked her up and brought her home from the shelter.  It was an all day affair.  First a 4th year veterinary student, Susan, did a regular and ortho exam on Heidi, then we met with Dr. Tuohy (a resident) and Dr. Roe (who has been a veterinarian for 20+ years) and discussed our options.  Basically we had 3 choices: conservative management, extracapsular surgery, or Triple Tibial Osteotomy (TTO) surgery.  Conservative management would mean no surgery, just strict confinement for 8ish weeks to see if the knee would stabilize on it's own.  This would probably mean she could never run free and crazy again without putting her knee at risk.  Plus some dogs knees never become stable and it puts them at risk for developing arthritis and eventually lameness.  Extracapsular surgery is the one I mentioned earlier with the synthetic suture material and although Dr. Roe said he has done it on larger dogs than Heidi, it may not be the best choice for us because of her age and energy level.  That also would mean she'd probably have to take it easy for the rest of her life.  The TTO seemed like the best option.  During this surgery they basically reshape the tibia so it doesn't allow the slippage (is that a word?) of the femur.  My main goal for post surgery was for Heidi to be able to run and play like she used to.  She's young and deserves the best quality of life possible in my opinion, and the TTO surgery can give her that.  Also a factor in our decision was the price.  The extracapsular surgery was only a few hundred dollars less than the TTO and it seemed like a better deal all around to have the TTO.  So we booked Heidi's TTO surgery for the following Friday, December 16.

a super-cute statue at the vet school