Daisy in Action!

Jet's cousin Vanessa came to stay with us last week, and she took some videos of Daisy in the rehab tank! Daisy looks much happier than she did when we first started taking her. The first video is her running on the tready, the second is of her swimming!

Antibiotics

The antibiotics worked! And it was almost instant - it only took 3 doses (1 day) to notice an obvious improvement in her weight bearing. So it looks like we have a low grade infection. The plan now is to see if it recurs, and if so, we will need to keep plate removal as an option.

The normal post-op appointment and xray is normally done at the 8 week mark. But because we x-rayed at 7 weeks, we are going to do the post-op appointment x-ray at 12 weeks to make sure the bone has healed fully. This is so that if plate removal is necessary, the bone is more than strong enough to hold together without the reinforcement. As the bone fuses back together in the healing phase, it creates a calcification which actually makes the break site stronger than normal. Daisy is going to have an uber leg!

Daisy running on the underwater tready! We had to coax her a little with treats...

During her rehab appointment this week, we had her going for 20 minutes non-stop, but we alternated between walking and running. This was the first time she had run in the tank, and we were hoping to make her tired as she has been gaining stamina over the course of her rehab appointments and has been hyperactive when she gets home. We kept her feet on the ground this time and increased her "action" time by 4 minutes which doesn't sound like much, but because there were no rest breaks, it really made her work.

Swimming Daisy! You can tell by the look on her face that she really didn't like it.

We tried her with swimming at her last appointment and she just doesn't have the right build to be a good swimmer! She has a dense, heavy body, and spindly legs and without our help holding her up in her little life jacket, she was threatening to sink.

Doing the post swimming therapeutic exercises. They created an obstacle course with big cushions and an ottoman to make her leg work harder and to practice balance and weight shifting just with her back legs.

The girls have been going out with Arin our dog walker, and have been playing tricks on her! It's so hot now that they play the "grass hopping" game to try and keep off the pavement and save their little paws from burning. I suggested that they just hang out at home and not go out in the summer, but Arin said that they wait by the front door and get so excited about going out that she will continue to take them until they tell her they don't want to go! But in addition to grass hopping, they have been finding wet lawns along the way to lay down on and have both objected to getting up. I don't know who is laughing more - Daisy, Charlotte or Arin! I get the funniest written messages about their escapades when I get home. They make me laugh out loud!

Week 6

We just had Daisy's 6-week rehab appointment and as luck would have it, her surgeon walked past as we were trying to coax her with food to keep walking on the treadmill. He came in when he realized it was us, and asked about Daisy's progress. We had the same rehab therapist as we did the first week, and we all agreed, that she should be progressing better than she is. At week 6, although the bone isn't completely healed yet, there shouldn't be the limping that she is presenting with. The puzzling part is that her range of motion is great; it's her weight bearing that is lagging.

In the tank having a breather between tready sessions.

So her surgeon did a bit of manipulation and prodding and poking around the wound and the plate and agreed that she seems a little sore at the distal end of the plate. This could be from a low grade infection (some dogs get this) which can be fixed with antibiotics. So we got a prescription of antibiotics and they took some x-rays to make sure everything was in order, and we need to report back at the end of this week. If she stops hurting and starts using her leg, we will know it's an infection. If the antibiotics make no difference, it may just be that she needs more time to heal. Either way, plate removal is looking more and more like an option.

But even though she is still limping around, she is back to herself again! Trying to instigate trouble and steal food off the counter.

We let them wrestle if there is no running or chasing involved...

can't steal all their fun!

Meanwhile, Charlotte had a haircut as we thought it was time to free her from her woolly coat! She had a #7 blade haircut and looks absolutely adorable. She didn't like it to begin with and was acting all introverted and sad. And to make matters worse, Daisy had no idea who she was when we got back into the car and it took her a while of butt sniffing to realize it was her sister!

Pinky's new haircut!

Rehab Session #2

Jet, Charlotte and I took Daisy to her second rehab session this past Monday. I felt bad for Charlotte having to stay at home all the time, so we took her too. I tried to take the weenie to a dog expo on Saturday on a little excursion, but although Daisy was crated with a kong as a distraction, she screamed like she was being murdered! Charlotte and I sat outside for 10 minutes to see if the noise would stop, but it didn't and when I let Charlotte go, she just ran to the door as if to say "let me in to my sister"! So I did. They were reunited. And they were quiet. And I went to the pet expo alone!

So during Daisy's second appointment, we discovered a few things. Although her range of motion had improved by 5 degrees, she was still not weight bearing as she should be at the 4 week mark. This is a concern to us both, so we are going to be extra vigilant over this next week and take her in to see the vet next week after her next rehab consultation.

We had a different rehabilitation consultant this week and she suggested that maybe Daisy is not weight bearing because she has an underlying infection caused by the plate. She said that the plate could be removed if necessary, by a very simple, fast, painless and relatively non-invasive procedure. She also pointed out, that Daisy actually had 2 surgeries: the TPLO and the patella surgery at the same time. So we should maybe give her a bit of extra leeway with regard to the speed of her recovery. As parents though, we are concerned.

As I write, the girls are curled up asleep together which is bliss for me. When they are both awake, all they want to do is play! I feel like an ogre when I have to enforce the rules and make them stop. I'm sure they call me Shrek when I am out of earshot. Jet, on the other hand, is the Alpha with the calm, assertive energy, so not only do they chill out, he only has to say one word and they do what he says!!

Physical Therapy & Emails to the Vet!

Since the last post on the Princesses, Daisy has had her stitches out and has made it through her first physical therapy session. She is doing great. Her parents are a little strung out though...

Our veterinary surgeon is so fabulous that he lets us email him with questions as we need to, so I make full use of this service and email him our concerns, prescription requests, surgical questions and anything else we are worried about!

So when Daisy finished her first prescription for her pain medication, we didn't refill it immediately because we just assumed that they had given us enough to keep her comfortable until the pain had subsided. But as the days passed, we both noticed that she was uncomfortable, but as we had her physical therapy treatment within the next few days we waited to see if we were right in our assessment, or whether we were just being hypochondriac, paranoid parents!

Her rehab consultant was great and gave us more pain meds and sedatives as after her therapy, she said that she may be sore and definitely tired. She took measurements to check the muscle tone and range of motion in both her back legs, she explained thoroughly to us what she was doing and why rehabilitation after surgery was so important. We went into the consultation only half sold on the idea, and thinking that we could do it ourselves, but after her appointment, we realized how important it was and how much more they can do for her than we could do.

We really didn't know what to expect, so when she dressed Daisy in a doggy life jacket I knew we were in for a treat. Well, treat for us, not so treat-like for Daisy! She put her in a perspex tank that she filled with warm water to just past her belly, then turned on the underwater treadmill! It was amazing to watch, but Daisy went into "OMG I'm having a bath" mode and froze until she realized that she had to move her legs so she didn't hit her butt on the back of the tank. The life jacket has a handle which came in very handy when repositioning her on the treadmill as we reached in from above!

Once Daisy got used to it, she seemed to tolerate it and ended up doing two 5 minute sessions in the tank which completely exhausted her. But the great thing about exercising her leg in water, is that it provides more concentrated exercise, less pain and faster results. It also allows Daisy to build up her muscles and leg function so that when she gets the 8-week-all-clear she can return to normal activity without any stiffness or complication from inactivity. Fabulous!

The day after? Daisy did not use her leg at all and Jet was really worried that she wasn't recovering as she should be. But after an email to the vet, he explained that they are just like us - they get sore after a good workout too and if we were still worried at her next appointment to let him know when we arrived and he would take a look at our princess. How nice is that? I think that we have unrealistic expectations of how tough Daisy is and when you combine that with how serious this surgery actually was, we shouldn't be worried yet that she is still limping. It's only been 4 weeks today.

I forgot to take photos of her in the tank, but we have another appointment this Monday, so I will take one then. Sorry about that. You'll all have to make do with these goofy photos of the girls instead.

The Princesses Tila & Duncan

It's been 7 days since surgery and she is getting active! She bowls us over on the way out of jail and tries to jump on the couch, run off to the bedroom to squish under the bed, plough through the dog door, play with Charlotte or simply do something she is not allowed to do. And as a 60 lb pooch, she can be quite forceful. Lucky I am going to the gym!

Her swelling is going down quickly and the bruising has completely gone. Her sutures are being removed next Friday and her rehab session is booked for the following week. Her poopy problem has almost ceased, but we reduced her sedative to half a tablet which may have helped with that. Arin and I did some physio with her today by putting a heat pack on the swelling, then doing some massage to help drain the last of the fluid build-up.

To help Daisy feel like she is still part of the family, Jet lifts her onto the couch so she can chill with us for a while. When it's just me and the girls, I open the crate door and set up myself a little mat beside her so I don't have to lift her up. My fear is that she will get excited and jump off the sofa and I won't be able to restrain her! The key to her recovery is controlled movement so I've started looking for a treadmill as part of her post surgery physiotherapy. We figure we have to go through this again in a few months so it's a good investment.

I feel like I have been giving Charlotte a bad wrap and I want to correct that. She is the sweetest wiener dog ever and I love her without exception! Every dog is different, and when it comes to our girls, Charlotte and Daisy are the complete anthesis in every way: size, snout, color, hair etc. Even in temperament, where Daisy is compliant, Charlotte is stubborn. Where Daisy is eager to please and uber affectionate, Charlotte is ornery and is only affectionate when she feels like it. Where it took just a day to teach Daisy how to "shake" on command, it took Charlotte 18 months! But in all their differences, they compliment each other and they both make us laugh, just in different ways.

And because they are totally co-dependent and are each others playmate, they are both currently extremely bored! Here is a little pre-surgery photo...

Surgery +5

We are at day 5 post surgery and we are settling into a kind of routine. Jet and I take different shifts so that neither of us gets overwhelmed with being the carer! Jet takes the morning, I take the afternoon and evening, and Jet takes her out again when he gets home. When I am at school Arin (our dog walker) comes over and spends some quality time with them and feels as bad as we do when we have to put Daisy back in jail! We both feel like the biggest meanies in the world having to crate her for most of the time, but it's for her own benefit, so we have to be strong. She comes out of her crate and immediately looks at Charlotte like "let's play". As it is, Charlotte strolls back and forth past her crate, toy in mouth as if to say "come and get it Daisy"!

Chillin' with Dad

So yesterday when I got home from school, I took them outside to do their business, and Daisy wanted to sit down in the sunshine, so we set up a bed on the patio so it was more comfortable on her leg and the three of us chilled together for an hour. She must have liked it because she asked for the same thing again today! She leads me out to her favorite sunny spot and goes to sit down but just before she gets down completely, she pulls this face that says "I'm uncomfortable on this concrete. Can you get me a cushion?". Smartie. And of course, Charlotte loves the sun so she thinks it's great that we are all out there together.

Sunbakers...

Daisy's bruising has almost totally disappeared and the oedema is going down slowly. The wound looks clean, but just to be sure we cleaned it with a little hydrogen peroxide. She is still shaking periodically throughout the day which I can only guess is either pain or a reaction to her medication. Her spirits are up though and I think that makes a huge difference. She is getting annoyed with the sling too which is funny to watch as she tries to wiggle out of it, but can't because she is still not putting much pressure on her leg.

She still has the poop issue and although it seems to be improving, we may try a different sedative to see if that is the cause.

So for the people reading that may be going through this surgery with their own pets? As the days pass during recovery, it doesn't necessarily get easier, but as carers we get used to the routine. By the time Daisy has her second surgery, we will be well prepared!

Slow Progress...

We thought that Daisy's recovery would mostly be about pain, but we had a completely different complication that we weren't expecting. She has lost control of her bowel and leaks while she is sleeping.

Lying down for dinner...

She doesn't have the drop foot so much anymore and is trying to use her leg normally which is a relief. She is also a lot more perky, even though she is still sedated and we are getting a glimpse of the "old" Daisy that was hidden over the past couple of days. She even gazed longingly at the sofa and I am sure was contemplating how to get up! We borrowed a huge crate from her dog walker and it has made all the difference as she has space now to turn around and stretch as she needs to. And because I am such a good shopper, I found some blankets for $3 a piece so I went crazy and bought 7 so that we can cycle them through the wash and keep her crate clean.

The incision...

The bruising is starting to come out and there is a lot of oedema around her stifle joint. She was also shaking a lot yesterday so because of these concerns, we put a call into to the specialist. Because it was Sunday, the call went through to the vet tech on duty who took all our concerns and phoned the on-call vet. He called straight back and gave us the advice and reassurance that we needed.

The bruising starting to appear

For the swelling, he recommended a warm compress if she would tolerate it, and for the pain he said that we can increase her medication. The shaking could be from pain, but we were advised to keep an eye on it. And the poop issue? Apparently this sometimes happens because of anaesthesia and should stop within a few days. She was also very bloated when she got home and I am sure that the drug cocktail that she is on, doesn't help. Jet has been using a towel as a makeshift sling to help take some of the weight of her back legs and it seems to help a little.

Jet walking her with a sling to help support her back legs

We have also reduced her food as she has gone from active dog to sedentary dog. She used to get 1.5 cups twice a day and we have reduced it to 3/4 cup twice a day of the dry food and we camouflage her meds in some of those meat rolls that we chop up into squares. She is such a good girl about everything and only needs a little food incentive to go back into her crate after her mini walks.

Last night we both searched the internet about the TPLO surgery to find out more about her recovery time. Everything said that the first 2 weeks are the hardest and it should start to improve rapidly after that. But also, to keep her from putting too much pressure on her leg for the full 8 weeks to avoid lengthening the recovery time.

So while Daisy has been laid up, Charlotte has decided that it's time she learn some tricks and has been shaking paws on command! We'll see how long it lasts this time. Last time she did this it only lasted for one day. She is so funny. Obstinate, but funny!

The obstinate (but endearing) Charlotte...

Vegas, Dogs & Surgery

I haven't blogged for an eternity, even though I had planned to do one on "moving to Vegas". Although life has had it's ebbs and flows, it's been pretty non-stop since we moved into our house, and even more so since January. I started a couple of subjects at school and working out with a trainer, while Jet has been working crazy hours at the restaurant. There has been many a night when he has come home to find his family asleep!

My initial paralyzing fear of scorpions has passed with the regular inspection by a pest control professional and the girls are settling in well and have thanked us a thousand times over for installing a pet door which allows them in and our at their leisure!

One weekend in late January, Jet and I took the girls out for a walk, only to have Daisy present with an all too familiar lameness. Years ago, when I was living in Australia, our family dog had this very same thing, so immediately I recognized the symptom and felt a sinking feeling in the pit of my stomach. But before jumping to any conclusions, we decided to watch her for a few days to see whether it disappeared, and then take her to the vet if it didn't. Over those next few days, we noticed that she was favoring her back left leg so I took her into a new vet in Vegas. It's the same one our dog walker uses, so he came recommended which is always nice when you move to a new place.

My suspicion was right, but we needed to clear it up with a specialist consultation as it was the sort of problem that needed surgery. So after another consultation with her regular vet and the surgeon, my initial reaction was confirmed. Luxating patella and a possible torn anterior cruciate ligament. Unbelieveable. And all we were doing at the time she started showing symptoms was walking around our neighborhood! This is a problem that is presenting more and more because of inbreeding, and as Daisy is a pure AmStaff, it wasn't a surprise to the vets.

A luxating patella, from what I understand, is when the groove in the head of the femur is too shallow to prevent the kneecap from moving laterally. This then puts pressure on the knee joint and creates the ligament problem inside the joint itself as the ligament should be locked in place with no side to side or front to back movement. It's this ligament movement and ultimately a tear or rupture that causes the pain. Apparently some dogs can have a luxating patella and it will never be an issue for them. Daisy wasn't so lucky.

Yesterday was the big day! We had to take her in between 7am and 8am, with a nil by mouth policy in place for her from midnight the night before. She looked at me with that innocent, trusting face, and I felt just terrible. But the surgeon promised to call with an update as soon as surgery was finished, and true to his word, I got the "all clear" call at 12.30pm!

Surgery was straight-forward and successful. He went in and cleaned out the joint, then did the surgery where he corrected the angle of the joint and he created a deeper groove in the femur for the patella to sit in. The operation is called "TPLO" which stands for "Tibial Plateau Leveling Osteotomy". What they do is instead of repairing or replacing the cruciate ligament, they cut the head off the tibia and change the angle so there is no pressure on the joint and femur and tibia are alining straight (as they are supposed to). The head of the bone is reattached to the rest of the tibia using a metal plate on the inside of the leg. It's really amazing, and the surgeon was telling us that he had done this surgery on a police dog who had just returned to duty with a totally successful surgery.

After one night in the ICU (and apparently lots of love from the vet nurses), we picked up Daisy this morning and although happy to see us, she was quite heavily sedated and very, very sore. She is such a hyperactive dog that there was no way that we could keep her calm without some pharmaceutical assistance! We bought her one of those blow-up neck pillows so that she won't lick her sutures but so far, she hasn't needed it. She is totally out and sleeping peacefully in her crate.

Princess Daisy in jail!

I have been taking her out every couple of hours for potty breaks, and although she does what she is supposed to, she seems to be happy to go back into her crate and go to sleep again. We have one step at the back door, and she can't negotiate that yet which is no surprise. She gets her front legs outside then realizes that she can't bear any weight on her back legs so she just stands there until we lift her rear and place it on the same level as her front legs. She's a smartie!

My past experience was a little different, in that the surgery was the more simpler version where they recreate the action of the ligament with coated wire. This seemed to be less intrusive and had the scar in a different position. It also wears down over time, where the TPLO surgery is permanent and once the bone fuses back together with the help of the metal plate, there is no way that it will move or wear down. With the amount of pressure that Daisy puts on her legs when she is running and playing, strength and permanency is key.

We have already had one call to the surgery! She had a drop foot when we got her home. The toes on the leg that had the surgery were curling under and she was walking on the top of her foot. Apparently this is normal for the first couple of days, but if it continues, we will need to take her back in. But as far as Day 1 is going, she is fine. Using her leg as she feels comfortable, and sleeping a lot! Tomorrow is Jet's day off so we will both be here to help her which will be much better. I hope to update the blog daily with her progress... Daisy has a lot of fans!

And Charlotte? Her publicist issued a "no comment" statement as she was sunbathing at the time of this post as she hadn't yet had a chance to talk to her sister!!!