Sunday, December 30, 2012

Day 3 Post TPLO Surgery

Brinkley is doing even better today.  She only whined at us for 45 minutes this morning while we watched T.V.  That’s down from the 2 hours yesterday.  She wants on her couch so bad.  I feel like we’re teasing her by sitting on it where she can see us.  The only change I made to her meds was that I didn’t give her the Xanax this evening.  I’m not really sure it does anything or not, and I really don’t feel like giving her even more pills that she doesn’t need.  We’ll see how it goes without them.

We took Boone for a hike today and while we were gone we put the inflatable e-collar on her. We’ll when we got back it was not on her.  Not sure how she maneuvered that one, but the incision is still clean, all staples are in place and it didn’t look like it had been slurped on, so I think we’re okay.
The only thing I’m a little worried about is the amount of fluid settling in her hock/ankle.  It’s not swollen, just fluid, but it keeps getting bigger.  Nothing has come out of the incision as far as drainage, it looks like it’s all collecting in her ankle instead.  I’m going to call tomorrow and see if I should be concerned or not.  Here’s a picture of her incision this evening, you can see the fluid build-up in her ankle in the picture on the left.
 Boone didn't want to get left out either, so here he is on his hike today.
 

 
Read about how Brinkley's journey began here:
A Mastiffs Journey Through Cranial Cruciate Ligament Surgery
 
And to read about the rest of Brinkley's journey:
BrinkleyMastiff - Walking on Day 8, Post-TPLO Surgery Makin'Mischief Mastiff Collar... Plus Brinkley Day 11 TPLO Update
PassiveRange of Motion Exercises in Post TPLO Mastiff

Day 2 Post-TPLO surgery

Brinkley is still doing good, limping even less today.  She is using the leg much more than I anticipated.  It’s already getting difficult to keep her still.  She wants to go out in the backyard and play.  I did get her Xanax prescription filled and was only going to give it to her if need be, but after an hour of whining this afternoon she started getting ancy and wouldn’t lay down, so I gave her one.  She did take a nap for a few hours, but after dinner she was back at it again, so I had to move her from the x-pen to her crate to keep her off her feet.

I’m also finding it difficult to ice it like I’m supposed to.  She won’t hold still for it and starts getting upset and wanting to pace, so I have to stop each time.  I tried bribing her with a duck chew and Shawn (my husband) even tried to help by distracting her and loving on her, but it was still a no go.  We’re supposed to be icing it 2-3 x per day for 10 minutes each time and I really think we’ve only iced it for a total of 10 minutes in the last 48 hours.  Her stool is also back to normal already, so I have forgone giving her any of the stomach medication they recommended. 
The incision still looks good.  She does have quite a bit of swelling settling in her ankle.  I’m not sure if it’s fluid or just swelling, but I’m keeping a close eye on it.  She has not tried to lick it once, so we aren’t using the e-collar, which she is scared of anyway.  When we left her alone today while we went to the store we just left her in the x-pen and I put the inflatable e-collar on her.  She tolerates it much better and did fine while we were gone.  Here’s a video I took of her this morning while Shawn took her out to potty.
video
 
Read about how Brinkley's journey began here:  
 
And to read about the rest of Brinkley's journey:
Makin'Mischief Mastiff Collar... Plus Brinkley Day 11 TPLO Update
PassiveRange of Motion Exercises in Post TPLO Mastiff
 

Friday, December 28, 2012

Coming Home From the TPLO Surgery Center

Well I got Brinkley home. She is doing well. The leg and incision both look good and she’s already bearing weight on it a little. I don’t know what kind of dog food they fed her but MAN does she have some nasty gas. Might be from the anesthesia, but it is deadly.  

They gave me the basic instructions before they sent me on my way. No physical activity other than on a leash to potty only for the next two weeks. She is on the same dosages of pain killers as she was before, 150mg Rimadyl 2 x per day and 150mg of Tramadol 3 x per day. They also wanted to prescribe her Acepromazine to keep her calm, but seeing how that is not a sedative that should ever be used in Mastiffs I refused it. Instead they gave me a prescription for Xanax, which I have to go to Walgreens tomorrow and fill. I have never given a dog or heard of a dog getting Xanax, but a quick question in one of my Mastiff groups confirmed it is used commonly in dogs and is quite safe. I'm also supposed to pick up some Pepcid for her and give it to her twice a day for 5 days to help keep her stomach settled. The leg is supposed to be ice packed (directly on the incision) for 10 minutes 3-4 times per day and she is to go back then to have the staples removed and for a recheck and in two weeks. At that point they will give me further instructions for beginning physical therapy. 

Here she is when we first got her in the house, she was so happy to be home. We pottied her and then came back in and she went in her makeshift pen and laid right down. 


 
Once she got settled we had to peel off the sticky bandage covering that was over the incision. They generally take if off before they send them home, but I convinced them to leave it on for our 2 hour car ride so she didn't have to wear the e-collar in the car. I'm actually not sure if it would have fit in the car if it was on her. This is what her leg looked like after we got the super sticky bandage off of it. It looks pretty good. Her leg does have some swelling and it has settled in her ankle a little bit, but all in all I'm impressed at how good it looks at this point.

 
But then we had to put on the e-collar so we didn't lick it. Not to happy with the e-collar. Is that not the saddest face in the world? 
 
She is being pretty whiny at this point. Hopefully she'll get over that pretty quick. She's had a bit to drink and we're going to have some raw hamburger and a chicken leg quarter in a little bit. I'm going to ice it now.
 
Read about how Brinkley's journey began here:
A Mastiff's Journey Through Cranial Cruciate Ligament Surgery
 
And to read about the rest of Brinkley's journey:
Day 7 Post TPLO Surgery
Makin'Mischief Mastiff Collar... Plus Brinkley Day 11 TPLO Update
PassiveRange of Motion Exercises in Post TPLO Mastiff

Preparing the House for a Mastiff After TPLO Surgery

In preparation for Brinkley coming home this evening I spent the night last night cleaning the house up and getting everything post surgery ready.  I bought two 3x5 rugs yesterday to go on the linoleum in front of the sliding door so she doesn’t slip when we go outside. I put up an x-pen in the living room so she can be around us when we are home, but she will still need to be crated when we aren’t home.  I'm forseeing sleeping in the floor with her the first few nights, but we'll see how it goes. 
When I pick her up they are supposed to give me a harness that goes under her abdomen so I can help her walk and an e-collar, but I’m hoping we won’t have to use either of those much.  I hate those giant plastic e-collars, and I’m sure that’s what they have ready for her.  I purchased one of the donut type inflatable ones that should fit her in case we need to use it instead. 
Here is the setup I have ready for her.  I hope the drive home goes well.  We’re expecting some snow and it will be rush hour St. Louis traffic I’m driving back through, so it will probably be a long ride home.


 
To read the beginning of Brinkley's CCL story start here: A Mastiff's Journey Through Craial Cruciat Liagment Surgery
 
And to read about the rest of Brinkley's journey:
Makin'Mischief Mastiff Collar... Plus Brinkley Day 11 TPLO Update
PassiveRange of Motion Exercises in Post TPLO Mastiff

Wednesday, December 26, 2012

A Mastiffs Journey through Cranial Cruciate Ligament Surgery

In the Beginning...

Well in less than 24 hours Brinkley will get dropped off for her TPLO surgery.  I have deliberated back and forth, back and forth on whether to do the TPLO surgery or the Tightrope surgery on her and I have decided that I think the TPLO will yield the best results for the long term for her.  This was not an easy decision for me, so I hope by documenting her surgery and recovery I can maybe help someone else out down the road to make their decision a little easier. 
Flashback to where this all started…. Brinkley is a 175lb female English Mastiff who just turned 2 years old in October.  She is very high energy for a Mastiff and that is one of the reason’s I think her ligament tore. She first tweaked her knee a few months ago.  Nothing severe, just a little limp for one or two steps when she first got up after she played too hard or ran or walked too far.  In an effort to help her heal up we put her on house arrest and restricted any roughhousing indefinitely.  It seemed to be going well and the last month or so she seemed to be doing fine…. Then her knee went out completely on December 12th.  We got home from work, both dogs went out in the backyard and 3 minutes later I heard a yelp. I ran outside to see what was wrong and she was not using it at all and was barely even toe tapping it.  She was in obvious distress, so we brought her in and crated her so she couldn’t move it to much and I gave her a Deramaxx I had left over from Boone’s neuter.  The next morning I was off to the emergency unit at the University of Missouri to confirm my suspicions, a torn Cranial Cruciate Ligament.  They gave me Tramadol and Rimadyl to get her through until she could have surgery, but the earliest open appointment they had was January 23rd.  Although they are one of the top orthopedic surgery vet groups in the Midwest, I was worried that in compensating for the injured leg she would blow the other knee out if we waited 2 months, so I called around and was able to get an appointment at Midwest Veterinary Referral Center in St. Louis a specialist group that only focuses on surgery, oncology and other specialized canine treatments.  They got her in the three days later and we scheduled a surgery appointment for December 27th…. tomorrow.
Now, back to the present…. Brinkley gets dropped off in the morning.  Since the tear I have dropped around 10lbs off of her (she is as skinny as I ever would want her to get now) in an effort to take some stress off the leg during recovery.  She was prescribed 150mg of Rimadyl 2 x per day and 150mg of Tramadol 3 x per day. For the first week and a half I gave it to her, but have since weaned her off as she really doesn’t seem to need it.  I have had her on Glucosamine/Chondroitin as well as Fish Oil supplements since she was a puppy also, something the vet was pleased to hear and said she should be on for the rest of her life to lubricate the joint. She limps much less now that when she initially tore it, making me wonder if it is only a partial tear.  Only the pre-op x-ray will tell though.
I weighed the pro’s and con’s of the surgery options and I’ll share with you how I decided on the surgery I did. There are four surgical options for dogs with CCL injuries; traditional Extracapsular Ligament Surgery (sometimes referred to as the fishing line surgery), Tibial Tuberosity Advancement (TTA) surgery, Tibial Plateau Leveling Osteomy (TPLO) and the Tightrope surgery. With a dog like Brinkley the only real options for surgery are the TPLO or the Tightrope.  The Extracapsular and the TTA surgery were out of the question.  That left me to choose between the TPLO and the Tightrope surgery. Below are the things I considered while trying to come to my decision.
TPLO Pro’s – (1) longest term option, once it’s done it never has to be done again, (2) veterinarian doing the surgery uses a new type of TPLO plate that screws into the bone, making less room for ‘wiggle’ while the bone heals (3) metal plate can be removed once the leg is 100% healed (http://www.tploanswers.com/Pages/default.aspx)
TPLO Con’s – (1) some people think the metal plate used to hold the bone together while it heals can cause cancer later in the dogs life, (2) the bone itself is cut and repositioned, making it a more intensive surgery and (3) a more intensive recovery time (4) if the surgery fails there is nothing else that can really be done.
Tightrope Pro’s – (1) no bone cutting, less intensive surgery resulting in (2) a less intensive recovery time and (3) if the surgery fails you can always go back and do the TPLO surgery at a later time.
Tightrope Con’s – (1) tape they use to ‘replace’ the ligament can give out overtime and the surgery will need to be repeated possibly resulting in (2) arthritis in the meantime, (3) the tape they use is also a wonderful place for bacteria to harbor and grow once the surgery is done, sometime making it necessary to remove the tape yielding the surgery as a failure, (4) the holes that are drilled through the bone that the tape runs through can wallow out over time making the surgery less effective and arthritis to proliferate faster.
As I said above, I decided on the TPLO surgery after reading MANY hours worth of personal stories about both procedures (success and failures) and by considering the recommendations and personal experiences of many other Mastiff owners who have gone through similar circumstances. I will have to say that I do LOVE the vet that I have chosen to do the surgery.  Orthopedic surgeries are her specialty and she not only attended the University and interned under Dr. Jimmy Cook (the inventor of the Tightrope surgery), she is also accredited by the American College of Veterinary Surgeons. I hope we made the right choice. 

Here is a video of Brinkley Pre-TPLO.  You can see why she most likely isn't a good candidate for the Tightrope surgery.  Even injured she still is as rambunctious as ever.

video
 
Read about the rest of Brinkley's journey here:
Makin'Mischief Mastiff Collar... Plus Brinkley Day 11 TPLO Update
PassiveRange of Motion Exercises in Post TPLO Mastiff

Wednesday, December 12, 2012

Feeding Your Mastiff Puppy

UPDATE: January 2016 - This post is several years old.  I have been feeding a raw diet for nearly 5 years now and it is in my opinion the best thing I could ever do for my dogs. If you are looking for advice or opinions on a specific brand of food please follow the protocol I set forth in the blog post Choosing a Top Quality Dry Food or visit dogfoodadvisor.com to find out the specific rating of a food. I have fed raw so long I can't comment on any one food other than what is outlined in my articles and at dogfoodadvisor.com

When it comes to feeing your puppy, try to feed them 3 to 4 times a day until your pup reaches 3-4 months of age, and then advance them to twice a day. Your puppy will indicate to you how much you should be feeding them. You can start with the guide below, but if your puppy eats the recommended amount of feed within a reasonable time, 20 minutes or so, then increase the feeding 1-cup at a time.
4-8 weeks of age         3-4 cups per day spread between 3-4 meals
8-12 weeks                  4-6 cups per day spread between 3-4 meals
12-16 weeks                6-8 cups per day spread between 3-4 meals
4 to 6 months             8-10 cups per day spread between 2-3 meals
6-18 months               8-12 cups per day spread between 2-3 meals
It is also important to remember how prone to bloat Mastiffs are.  I don’t feel comfortable feeding more than about 3 ½ cups in one sitting to help keep the risk to a minimum.  Also be sure to keep you puppy or dog from guzzling water after a meal.  A drink is fine, but don’t let them drain the dish, you don’t want all that dehydrated kibble expanding too quickly in their gut.
Make sure you puppy has access to fresh clean water at all times.  Water should NEVER be withheld to aid in potty training.  The only time my dogs or puppies do not have access to water is when they are crated, and for very young puppies this should be for short amounts of time only.
When choosing a food for your puppy, make sure to feed a quality kibble with no by-products or added chemicals.  It is also good to go ahead and start your puppy on adult food, not puppy food (your vet may argue with this, but they aren’t giant breed specialists, remember these aren’t large breed dogs, they are giant breed dogs).  Most puppy foods have protein levels that are too high for giant breeds that grow so rapidly.  You want your protein level to be right around 25% and absolutely no higher than 28%.  It is also important to keep  your calcium/phosphorus ratio right at 1:1.  Doing these things is a huge step in preventing conditions like HOD (Hypertrophic Osteodystrophy) or Panosteitis.  These are both painful conditions and can be crippling for life if not treated with a balanced diet.
Remember, the size of your Mastiff is genetic, not nutritional. You cannot hurt your puppy by keeping him lean and fit, but overfeeding a Mastiff puppy can ruin them orthopedically for life, causing a lot of pain and numerous vet bills over the life of your Mastiff.