Can someone send some GOOD luck our way!?!?

Well, the inevitable has happened.  The lump on Heidi's knee returned and we just brought her home from the vet school after having her THIRD surgery.  Mind you, my poor girl is not even 3 years old yet!  As the vet suspected, the irritation being caused by the wire from her MMP surgery was not a one time fluke.  We went to the lake for Memorial Day and Heidi went for a swim (her first time actually swimming willingly!) and the knot reappeared.  I called the vet school on Tuesday and they got her in today, Friday.  It was a fairly simple procedure- basically they removed the wire and the pin from the MMP surgery, but left the porous titanium wedge in place as there was no sign it was infected.  The pin and wire aren't actually needed now that her leg has healed, however it is usually not necessary to go back in and remove them because they typically don't cause problems.  Of course, that's not the case for our girl.  They took a tissue sample for culture and also cultured the wire and the pin.  We should know by Tuesday or Wednesday whether or not there's an infection brewing in there and she may need antibiotics.  We are hoping and praying that if it is an infection it's just in the tissue and not in the bone/wedge.  The vet said usually if an implant is infected, the bone sort of separates from the implant which can be seen in an X-ray or during surgery.  Hers did not have any type of space as far as they can tell, so that's a point on the positive side.  We do NOT want to have to remove the wedge so hopefully all of you Heidi fans can send any spare luck our way. 

Heidi is doing great since surgery.  They actually let me pick her up today, which was surprising because I was initially told she'd have to stay overnight.  I was thrilled to say the least (until I had to swipe the plastic, ouch!).  Right now, she is sleeping on her bed beside me.  They said she may limp because her leg would probably be a little painful, but in typical Heidi fashion, she is exceeding the expectations and she isn't limping at all!  I have Tramadol and Rimadyl to give her for a few days to help with pain and inflammation, but so far she's doing really really well.  Just groggy and a little nervous/paranoid acting. 

As always, I'll keep you updated if anything changes and will let you know the results of the cultures.  In the mean time please, please, please cross your fingers for good news next week!

Say it ain't so...

Well, it has been a long time since I've updated the blog, but we've had some changes since my last post.  In early January we let Heidi play out in a yard leash-free for the first time since surgery.  She probably overdid it a little, and the next day we noticed a little swollen lump on her incision line (her knee that was done in July- the MMP surgery).  It was kind of hard, kind of squishy- weird I know.  After a few days of rest, the swelling went down and we went along our business.  A few more times we let Heidi have some off leash activity and each time, this little knot would appear the next day.  More recently, I've noticed this knot is always there.  It swells with excessive activity, but never goes completely away.  Finally, maybe the end of February we took her to our local vet to get it checked out.  They did not think it was anything too serious, but were afraid to do anything to it since they had not performed the surgery, and recommended we see the doctor who did the surgery.  So after much deliberation, Alex and I made the appointment.  Last Thursday night I came home from clinical and the knot/lump had burst (no idea how or why).  It was bleeding slightly, but that was about it- no pus or yucky discharge.  Luckily, our vet appointment was set for the following Monday (yesterday) so over the weekend I kept it covered with gauze and tape and flushed it daily with sterile saline.

Fast-forward to yesterday, the day of the appointment at the vet school.  I took off work and to Raleigh we went.  We had X-rays and obtained a culture of the wound.  The vets think the knot was probably caused by the tiny wire that held the implant in place.  (If you look back at one of my previous posts, probably around July of 2012, there are X-rays of the procedure she had and you can see what wire I'm talking about).  Apparently some dogs are super sensitive and the tiny ends of the wire can irritate the tissue in that area.  This irritated, inflamed area then probably developed an infection- we will know more about that when the culture comes back (by Friday).  They started her on a broad spectrum antibiotic, Clindamycin 300 mg every 12 hours, and once they find out if it is a bacterial infection and what type, they will prescribe her something more specific.  In the mean time I am cleaning her wound with a chlorohexidine solution they gave me, applying triple antibiotic ointment, and covering it with a gauze bandage.  I chose to go this route for now, until the culture comes back.  They really encouraged me to do the surgery to remove the wire, but I wanted to see what "bug" was in her, causing this mess before making that decision.  There is a small chance it could just be an inflammatory response with no infection, but they seem to think this is unlikely.  Our greatest risk here is that the actual implant (wedge shaped foam-like piece between 2 pieces of her bone) or her bone could become infected.  That is a very serious problem and would likely require removal of all of the hardware in her leg, which would leave her at a high risk for injury.  That would require another 8 weeks of total confinement to allow the empty space to fill with bone and would be very very tough on both Heidi and us.  So we of course are trying to avoid that at all cost, but I also just want to make sure there is an infection in the first place before jumping to more surgery. 

My poor girl has been through it, but she is a trooper.  Just to add my two cents, if I could do this all over again with her second knee, I would've done the TTO procedure like we did with the first knee.  Knowing what I know now, I think if you do get in a situation where the implant is infected, it is MUCH easier to remove the hardware and much less traumatic to the poor pup who endures the procedure with the TTO. Yeah, the MMP was a few hundred dollars cheaper and she was under anesthesia for a shorter amount of time, but the possible complications seem less extreme with the TTO.  Just thought I'd put that out there in case anyone is toying with a decision between those two surgical procedures.  As always, I will keep you guys updated as often as I can.  Should know more by Friday.  In the mean time, keep us in your thoughts!

Been a while...

Well, it has been way too long since a post, but I was just watching Heidi walk around today and thought I should give an update.  She is doing great and I think still improving.  It's been about 3 and a half months since her last surgery.  Last time I posted, I was still a little concerned about the fact that she still did not bear as much weight on her left leg (the one we did the MMP surgery on in July).  The hubs and I were kind of wishing we had just stuck with the TTO like we did for her first knee.  I was convinced the MMP just did not give her the stability she got with the TTO, (which may be the case but it's hard to know).  However, little by little I feel like she is putting more weight on the left leg.  It's like it just took her a while to really trust that leg.  We've also ramped up her activity a good bit over the last month or so.  She now gets to play off leash for short periods of time, although she has not played off leash with other dogs.  I think we're ready to try one on one time with another dog, so hopefully we'll get a chance to let her do that in the next couple of weeks.  Well I'll keep you guys updated!  I hope you've enjoyed reading about Heidi's journey through 2 CCL tears. 

6 weeks post-op

Well today we are 6 weeks post-op!  Sorry I missed our 5 week check-in... I just started school this week and was distracted by all the preparations of being a student again, but that's a story for another day.  Today we actually begin going on 20 minute walks.  Heidi has thoroughly enjoyed her 10 minute walks and will love our even longer ones I'm sure.  As far as her limp goes, it's only barely noticeable, yay!  She still does not evenly distribute her weight between her two back legs while standing still, but slowly she seems to be balancing it out more and more.  I think these rehab walks are helping with that because there was such a difference in muscle mass between the two legs and now we're beginning to build that back up in her left.  Surely strengthening the operative leg makes it feel more stable and trustworthy (for lack of better word).

So needless to say, Heidi is doing great.  I can't wait for her to be able to be "normal" again!  But we'll take it slow and ease her into more and more activity.  I cannot remember if I told you guys, but dogs who have cruciate ligament tears are more prone to meniscus tears.  The meniscus is a  cartilaginous cushion (if you will) within the knee joint.  The chance of a meniscus tear is not as great as the chance of tearing the second ACL after the first tear though... I think the doctors quoted us a 10-15% chance of meniscal tear post ACL surgery.  Much better odds than the 60+ percent we were warned of a second cruciate tear after the first.  So we're hoping we're in the majority and don't have to worry about any more tears!

Oh one other thing.  I did notice earlier this week Heidi had a loop of suture coming out of her incision site.  I was afraid that was happening because she kept licking her knee and it looked weird... almost the way an ingrown hair looks.  These sutures aren't the outer sutures that I removed after 14 days, but rather the internal sutures probably used to stitch up the muscle and other tissue under the skin.  These are supposed to dissolve on their own, but I know from experience working with vets, sometimes it takes a while.  So they appear to be working their way out.  I cut what I could because I was not able to pull them out.  They must be connected to other pieces, but I wanted to let you know this happened, so if it were to happen to you, you don't freak out!  I think it's normal (I did not consult a vet, but I've seen this before) so I'm not worried. 

Anywho, I just wanted to give you a quick update!  Enjoy your weekend!

Rehab Walks in Full Swing!

Well, we reached the 4 week post-op mark on Friday and began our walks.  Needless to say, Heidi was thrilled to venture beyond the "potty area".  This week, she gets two 5 minute walks every day.  It doesn't sound like much, but it makes a world of difference for her.  Gives her a chance to briefly release some of that pent up energy.  (She has a LOT of it!)

I would like to note that her limp is continuing to get better.  It's much much less noticeable when she walks- maybe just a tiny hitch in her step- although she still doesn't put full weight on it when standing still.  I do think that has improved a little since my last post, however. 

As far as aesthetics go, her knee looks all kinds of funky.  The wedge of bone they pushed out to make room for the titanium implant looks really creepy and uncomfortable, but obviously it's working because she continues to improve each week.  I'll just have to get over the bumpy knee.  I need to try to get a picture of it... I promise, it's really weird and creepy... more so when she is walking.  Oh well, whatever works!  Her other knee looks very different.  It's still bulkier than a "normal" knee, but in a different slightly less creepy way.

At this moment, Heidi is laying with head against the base of the couch couch looking under it (probably at a toy) and whining with her tail thumping against the floor.  Sorry neighbors :-/  Obviously we haven't burned enough energy today.  We are looking forward to our 10 minute walks next week! Until then, have a great week/weekend and I'll update again soon!

A Little Past 3 weeks

All smiles

This post is going to be boring, but I want to try to post every week for those people who are following along because they find themselves in the same situation we're in.  Heidi is doing great!  Nothing new to report, really.  I will say I think the past couple of days I've actually noticed a difference in her limp!  When she walks it's really not too noticeable, but she does still bear less weight on her most recently surgerized (left) leg when she's just standing still.  It is totally possible this is a result of the reduced muscle mass in that leg and not so much that she's in pain (I'm hoping that is the case at least).  I was checking out her legs this evening as she was snuggling in my lap and it is crazy how big her calf muscle is on her right leg compared to her left.  There's also a pretty noticeable difference in her thighs/glutes, too (ps. I have no idea if dogs muscles are named the same things as humans so use your imagination).  I can't wait to build those back up!  Starting Saturday, she gets to begin her rehab walks :)  We'll start with 5 minute walks twice a day, which will be a real treat to Heidi! 

My only other concern is that she is becoming more and more wild. Obviously her leg is feeling much better because she is reverting back to her wild-woman ways.  We've started giving her Tramadol less than 12 hours apart.  We still only give it twice a day, but I give it when she eats breakfast around 8, then again around dinner time at 5:30ish.  Last time, we began giving the Tramadol three times a day as you may remember, but I'm sort of against over-medicating and this seems to do the trick.

Well, that's enough for now, see ya again in about a week!

It's been 2 weeks

Just laying in Mom's lap

Well, we're a little past 2 weeks post-op at this point, and things are still going great.  Nothing much to report, but I do want to say Heidi is still limping.  I think it's getting better but I see her every day so it's hard to tell.  It's definitely better than when she first came home, though.  So I think slowly it is getting better.  I was starting to freak out a little (as I knew I would) because she still had a pretty noticeable limp, but I looked back in my posts from last time, and found that at 2 and a half weeks post-op I reported that she still had a bit of a limp, so I think we're on track.  Made me feel a lot better at least!  Oh, I did take out her stitches this past Wednesday.  Everything looked good and her incision seems to be healing nicely.  She was a little more difficult this time, but I put Alex at her head with a spoonful of peanut butter, while I clipped and pulled out the stitches and that worked like a charm. 

Well we're halfway through the first 4 weeks which is fabulous!  Heidi is pretty antsy at times, but she's been a good girl.  Her grandparents came to visit her yesterday and she was SO thrilled!  As I've probably mentioned before, they are her favorite people.  And I guess that's all I've got!  Except for a few pictures, of course!

Family snuggle time!

Dad bought her a new bone

Playing dress-up in Mom's necklace