Closer it gets, fraction of an inch by fraction of an inch

The incision keeps getting closer and closer to being sealed. Just a tiny bit of red left at the top. Adrien is enjoying time laying around in the xpen, especially if someone is there with her, but she will take time alone if I am working and she doesn't have to wear her collar.

Narrowing the gap

Well, the gap is closing more and more each day. Here is another shot from this morning and it is closing up more at the top. Hopefully in another week, but incision will be completely sealed over.

Getting some closure

The incision looks pretty good at the bottom but still has a gap to close on the top. It makes sense as she has to bend her knee and that part gets stretched while the rest of the skin is more static. The red part is a scab something of that nature. It is holding up well and perhaps a bit of time and some more neosporin and we will be all sealed and can leave off the collars altogether.

Enjoying a little time donut fre

After her checkup, I let Adrien into the xpen without her donut collar to have some water and she went and laid down, so she is getting a little time sans donut.

A good checkup

Adrien's leg and incision have been looking pretty good to me. We had a follow-up 1 week post-op today and I gave her the tranq in the morning and she was snoring away while I was on my morning conf. call and then I went to get her up and take her and she "shook it off." She stood the whole car ride to ATA and then stood the whole time we were waiting. They took her back and came out to say things looked really good, keep with it. Come back in 2 weeks for a first xray. That is about 1 week ahead of when I thought they would start xrays, so that is great. I asked about icing, neosporin and tranq. Icing should continue another week, neosporin another 5 days, and only tranq as needed, but they provided them. I will have to see how it goes with her in the crate all day with no tranq. I can work another day from home and see how that goes. They also want the inflatable collar on her to prevent licking of the incision until I go back. I will stick with the practice of having it on in the crate but leaving it off when I am supervising her when she is with me in the xpen or if she stays asleep in the xpen while I go to the table and work where I can watch her. So, next big milestone is May 7th. Xrays are a drop off in the morning and pickup in the afternoon affair like the surgery, so will have to head there right after Ben dropoff.

Routine

Nothing major to report from yesterday. We have gotten into a routine where I let Adrien out (and remove her donut collar) in the morning to relieve herself and then we go to the Xpen for her to drink/eat/get pills/lick me. Then I get her laying down and I ice her leg and ankle and put on neosporin. I hang out with her in the Xpen for 30min - 1.5 hours (or more) and then I take her back to get her donut on and into the crate. With the tranquilizer and if I leave the room, she settles down. She must be bored, she spends all day laying around and then comes in the Xpen and lays around. We do it again in the early afternoon (I have been in here in the Xpen since a little before 3 and it is almost 5) when she gets her pain killers and I ice/neosporin and she relaxes with no donut and then back in the crate, rinse and repeat at night before bed. I try to change the comforter and launder it from the crate at least once a day (rotating with 2 comforters though I have a third I should get in the rotation). We go back to ATA on Wed. and find out what the next phase is. The meds they gave me for her are only 1 week, but I go back, so there may be more coming. Based on not taking xrays until week 4 and probably not starting rehab until week 8, she is going to be living in her crate for a long time. I need to get someone to come in and watch her while I am gone for vacation,but I need to wait and see where we are on the timeline to see how much work that is. It is possible she could go to the shelter, but the stairs are the issue there. Very bad idea for her to do stairs anytime soon unless she is in rehab and then I think she can.

It is nice to have a laptop to sit in here and work. I was thinking about bringing out the TV to sit it out here so I can hang with her while she rests. She is pretty good about resting when someone is with her (well, very good), but she is very social and gets up when you open/close a door to see if someone is coming to be with her.

Who knew I was going to be a nurse instead of a foster. The leg looks a bit better though still more swollen then I would like. I don't really see much drainage at all which is a really great sign. I see a bit in a spot or 2 when she has been outside and then comes into the Xpen and stands there eatin/drinking, but only sometimes. I hope they give her a good report on Wed. She won't lay down in the car, so I need to tranquilize her but then it will be tough to get her in and out. If she stands the whole ride there, the leg will look much worse. Not sure there is much I can do at this point. Hopefully the incision will be healed by the following Wed and the stitches can come out. It would be great to not have the meds/neosporin/icing routine.

I went to the office today for the first time since Wed. I think I may have stretched the interval to her pain pills a bit by the way she was acting after I gave them until they kicked in. I need to get that timing a little better.

Another day, another hmm, what would be the end of that sentence

Petco adoption day was slow today, but that is normal. I took KD and Heidi and Josey. We setup outside since the weather was so nice. We did get an application on Heidi, but they had called the shelter and asked that we bring her so they didn't have to go out to the shelter, so that wasn't a surprise.

Adrien was pretty good this morning. She didn't get her no bite collar off last night. She was laying into the corner of her crate when I saw her last before heading to bed. These collars make it hard for her to lay down normally. I hung out with her in the xpen so she could eat and drink and I pet her and got her laying down and then as time came closer for me to go to adoption day, I gave her the tranquilizer and let it slow her down. She didn't want to get in the crate, but Ben told me she was sleeping well when he got up. She wasn't overly cooperative on the ice packs. I did use a much colder pack and I got it done a couple of times today, but the leg is still plenty swollen and has a little weeping. It isn't as inflamed, but it has a long way to go to be looking okay. While at Petco today, I picked up an inflatable ring collar. It is an alternative to the ecollar and no bite. It looked like it might be less uncomfortable than the no bite. Not that the nb collar isn't working, I am just checking out an alternative.

I came home from Petco (after a stop at the grocery store) and Adrien thought I was going to come let her out of the crate. She was mistaken. I had to make dinner for the Passover Sedar and then after we finished and cleaned a little, I let her out to go in the yard and then took her in the pen to take off the no bite and to let her eat/drink and got her laying down to neosporin the leg and to ice it. I hung out there in the pen with her for about an hour to an hour and a half and she napped. I finally decided that she was tired and sleepy and I could put the inflatable collar on to see how it worked and let her go for a final potty break and in the crate. The inflatable collar didn't seem to bother her too much, but as with the other collars, she has to lay her chin on the front lip of the crate to get it up so that it matches the extra height of the collar. I need to throw in a pillow tomorrow.

Can't keep a good girl down but you can slow her for a while

Well, the tranquilizer knocked Adrien out yesterday during the middle of the day. She was behaving so I took off the No Bite collar so she could be more comfortable. When I put I put it back on later, I apparently didn't do a great job as she got it off in her crate while I was running an errand. After taking her in the pen to lay with her, put on her antibiotic and try to ice her leg, I put the collar back on and put her in the crate for the night. She wasn't happy at all, but settled down. It took her a bit to find a position where she could lay with her collar.

This morning I switched to a better cold bag instead of the ice pad in a sleeve that I was using and I can tell it is more effective since she doesn't want me to keep it on her. I spent a while petting her and letting her lay there with me with her collar off so she would settle down. Finally I had to give her the tranquilizer so it would take effect while I am off at adoption day. My buddy Randy called to let me know about the boomerang event going on at Zilker. I feel bad that I can't be there to help out. Joe Rader had sent out a request for help and I fully intended to help but then the surgery was scheduled this week and the leg has been swollen and a bit weepy and I have my adoption day and I just haven't/can't make it down there. I have to leave for the shelter to get things ready for adoption day in 30 minutes and she is curled up and sleeping there in her bed and I have mixed feelings about leaving the collar off and leaving her there but I know that the correct thing to do is to get her up, put on a collar and put her back in the crate. The tranquilizer should help her relax in the crate even though I got her up. I guess I am a softy, but I need to do what is best for her whether she likes it or not, but feel guilty because it is only what is best for her because I have to leave. If I were staying here with her, she could just lay there and sleep like she is now for the entire afternoon. Sigh.

No, it is not from an auto accident, it's a no bite collar

I called the vet today because I was concerned about how the incision looked yesterday and that she was already putting weight on the leg and that she was doing the "wake up" shake which I thought might be from wearing the cone head. The vet asked me to bring her in and I loaded her up in the car and we went right over to ATA. He looked at it (she stood up most of the car ride, wouldn't lay down) and said she is being overactive and the incision doesn't look good. I said I was doing what I could to keep her laying down, but can't force her down in her crate and am only letting her walk outside on leash in the yard to quickly go relieve herself though she takes a minute or so to find a spot. The only options at this point are to give her tranquilizers (which they provided) and they also suggested replacing the cone if it was really bothering her. They called Petsmart to see if they had those inflatable donut collars and they didn't have anything other than what I had bought at Petsmart last night (cone head). They checked their resource list and sent me to another vet that carries no-bite collars. So, now instead of being from France (conehead, get it?), she looks like she has whiplash.

So, now the routine is add in topical antibiotic twice a day, ice the incision 3 times a day as it is swelling from leg usage, and 1 sedative in the morning to lay her low. She is down and snoring right now, so the sedative kicked in (she took it around noon). Will have to see how long she stays down.

Not a great second day

Things seemed good, she was even putting a bit of weight on the leg when going out to pee, but now it seems the incision is opening a little and it is freaking me out. There is a bit of blood, not much. She was shedding her E collar yesterday and I tried a couple of times today, but I couldn't keep it on her. With the bit of blood (not sure it was weeping or blood, but am leaning towards blood), I went out to buy some new E collars and I got one that is just the right size and put it on her and duct taped it so that there wasn't a flap for her to attack. She is still attacking it anyway and is very unhappy, but the leg is not looking great and I have a call into the surgical supervisor to see what she advises. I don't think it is life threatening at all, but I am still very worried. I think I will have to take her back to have it looked at in the morning. It is supposed to pour here tonight and I think that will upset her too. I would like to go cleanup the leg and put a cooling pad on it, but I am afraid to let her out of her crate. I wish I had some tranqs to make her lay down. She is sitting up in the crate complaining and it isn't helping my mood.

Not a bad first night

Well, Ben helped me take Adrien out to try to go to the bathroom last night. She had a little bit of water last night and no problems but didn't want to eat. We took her out with him holding the leash and encouraging her and me holding up her midsection to back with a towel sling under her. She didn't go, but she enjoyed sniffing outside. Her hind section was still not awake from the epidural. We put her in her crate (which she doesn't like, so it took some prodding and lifting of the rear) and I put on her cone. We moved the crate by the backdoor for proximity She really didn't like that, but I turned out the lights and took my laptop in the bedroom and worked in there. She whined and made a bit of noise, but went to sleep after a bit of complaining.

I got up this morning and went to let her out and she had shed the cone, but the stitches don't look any the worse for the wear. I put her immediately on the leash and she made it the few steps to the backdoor and sat down. It took me a minute to get the towel sling under her to help her over the door step. She doesn't seem to enjoy the towel sling, but there has to be absolutely no jumping, so she is going to have to get used to it for a while. Once we got over the threshold, I let her off the sling and we walked a few steps into the yard and then perhaps another 15 feet and she went a little. I turned her around and helped her back in and right into the XPen by where I will be working for the next few days. I sat with her and pet her and she seemed calm. I looked over at the incision and it looks pretty good even though she didn't have her cone. I don't really see any weeping (which is okay either way) and I don't see any major swelling or any edema which they told me would be normal. I went and got her dose of pills and tried to shove it down her mouth and that didn't work so well. It took me multiple passes to get the pills down and I had to check the blanket to ensure I got them all. For the last pieces, I got some spray cheese and she licked them right up. That is the strategy from hence forth. She is taking 75mg Ultram x 3 per day, 170mg Previcox x 1 per day, 500mg Cephaloxin x 2 per day. I offered her some water and food and she wasn't interested so I left them in the pen. I sat with her and put on an ice pack to her incision for a few minutes and she let me rub her stomach and laid on her side and seemed content. I closed her back in and moved the 8 feet over here and she is lying on her side and hanging out. As long as I don't see her licking, she can have the cone off while I am here.

Nice scar

Post Surgery

You know that old slam, "if my dog was as ugly as you are .....". I picked up Adrien after surgery and the vet tech who prepped her for surgery shaved the left leg and then realized she was having surgery on her right leg. Her whole backside is shaved, but she isn't going to be walking backwards or forwards for a bit. The post op instructions are strict crate confinement. I had her in the bedroom in the XL crate, but I didn't want to always be back there, so moved it out to the family room. I have her laying down on a comforter in the really closed in XPen and it isn't much more room than the XL crate and she seems to be happier there. Not sure what I am going to do tonight, but I assume crate and try not to listen to her whining. She hasn't had any water yet. I gave her a small amount in a bowl to see if she would drink it and keep it down (post anesthesia),but she hasn't wanted any. I forced her pills down her throat and she is just laying there with her cone on. Looks like she is sleeping. Perhaps I should rouse her so she sleeps later. I tried to take her out to pee, but she didn't want to so I didn't force it. She hasn't had any food/water since about 10 last night but the post op instructions say she may not want to eat or drink tonight. Her backside is very weak right now. They had given her an epidural and now that her right leg has been majorly surgerized, she isn't very mobile at all. I have to lift her midsection/back with a towel as a sling and she doesn't want to move the front legs. Tomorrow may be a different story.

Tomorrow is the big day

And I have to tell you, I am more than a bit nervous. I need to make a list of things to ask post op. Meds for pain, inflammation, antibiotics, hot/cold compresses, e-collar, and the list goes on. I take Adrien in the morning after I drop Ben off for school. I will be a bit later than they want, but she will be there. I am taking a half day tomorrow so that I can be ready to pick her up. I have a conference call in the morning during the dropoff and I hope that they understand that I am distracted.

Tried her tonight in the big exercise pen with her comforter on the floor while I went off to a meeting and I had Ben leave her in there for about 15 minutes to see how she would react and things look good there.

Surgery plan

Well, the blog was mentioned in the volunteer email newsletter today,so I need to put in the update on the surgery. We are opting for the TPLO. Adrien will go in on the morning of the 16th and home later that day. I think I will take the afternoon off. It works out nicely that a regularly scheduled Wed. afternoon appointment is going to every other week and that is the first off week, so I don't have any commitments if I take a half day. I don't know if Adrien will need an E-collar or not. I will check out the stash at the shelter this weekend. I need to remember to size a collar for her and bring it to the shelter to ensure the sizing of the e-collar. I also think I need an x-pen. I have a XL create that I will probably put her in while I am gone for the day, but I will try to do more working from home the first week after surgery. I guess I should get the x-pen this week so I can see how she does in it and if it will keep her contained or if I need to setup a room that she will have to stay in. I am anxious to hear what post-op info that ATA has for me and what the recovery plan is. Anyone recommend a local dog PT for rehab? I don't know if she likes to swim, but I guess I better check that out now before the surgery to see if that is a possible PT option after she is cleared for that.

Surgery on the 16th

Well, found out Wed. that Adrien has a slot for surgery on the 16th. The question is whether to go with extracapsular repair or TPLO. Dr. Lewis recommended TPLO in Adrien's case. He will do either surgery, but feels there is a good chance that the extracapsular repair will fail down the line. The TPLO is a lot more, but within the money we have raised. My concern either way is that I have read that about 50% (and I have read AT LEAST 50%) of dogs that have one CCL repair, end up having the other because of the extra stress on the opposite leg from compensating for the issue. Well, can't let potential future problems keep us from getting her better now. So, on the plus side, the extracapsular repair is significantly less invasive, but it also probably won't slow the onset of osteoarthritis she is likely to develop when she gets older. The TPLO is much more invasive but should slow the advancement of joint degeneration and osteoarthritis in her knee as she gets older.

Jennifer at ABR has had good experience with Dr. Lewis and has had dogs have both surgeries with him (different dogs) and says at this point she listens to his advice and opts for that surgery. I know there is a lot of online info about TPLO being a quick buck for surgeons, but I also know that isn't the case here as ATA is a very low cost service to rescue groups. This surgery would cost 3x more (or higher) at another vet. I guess what freaks me out a bit is the invasiveness of the surgery, but I can't let that hold me back from getting what is best for Adrien. Monica says we have the funds for the TPLO, so that is the decision I will also recommend.