Pistol - Home from Vet/Surgeon

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Pistol - Home from Vet/Surgeon

Postby my2cotons » Fri Jun 01, 2012 4:50 pm

Well, we are home and I still have no idea what we are going to do. He tried to do the drawer test on him. He said he got some movement, but because he was so tense, he couldn't give me a 100% diagnosis, but he is of the opinion it is at least a partial tear. Then of course he told me everything you all said he would tell me. CM is a waste of time - a brace is a waste of time and money. If it is torn, it will not heal and he will never have full use of the leg if we don't fix it. He is recommending sedating him in order to get a clear diagnosis with the intention of just going right on in to surgery if it is torn. He did say that, of course, if its not torn, then the CM is definitely the prescribed treatment, but if it is torn, it should be fixed. He wants to do the one where they put the artificial ligament. So I don't know. I still think I would like to try the A-TraC Brace by Wound Wear. I guess this weekend we will just continue keeping him restricted - see how he is the first of the week and then decide something.

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Re: Pistol - Home from Vet/Surgeon

Postby Moemer » Fri Jun 01, 2012 5:12 pm

I'm sorry to hear that!! :( Can you sedate for a better assessment, and then think it over/research more? At least then you'll know what you're dealing with. I can't remember, is an xray helpful for CL tears?
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Re: Pistol - Home from Vet/Surgeon

Postby SherriA » Fri Jun 01, 2012 5:21 pm

From what I understand, you lose nothing by giving CM and the brace a try. If, as the vet suggests, it won't heal then you can decide to do surgery at that point. If the vet isn't even sure, I wouldn't rush into surgery. What does he plan to do under sedation to make a diagnosis? An Xray can't show a ligament tear; you need an MRI for that and even an MRI can only tell you whether or not it's torn, not the degree of the tear.
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Re: Pistol - Home from Vet/Surgeon

Postby mraleigh01 » Fri Jun 01, 2012 5:43 pm

Sheri, they do the drawer test under sedation if they can't get a result while the dog is awake.

Darn, I was hoping you would have a definite answer by now.

I COMPLETELY understand not wanting to put a dog under. I am never thrilled with the prospect. However, it would definitely reveal what the problem is---whether you need to spend $2-3k for a repair, or $300 for a brace (which would be great!). I'd hate to see you spend the money on a brace when surgery is needed, and you have to pay for both. Plus the downtime.

For what it's worth, my dog had the artificial ligament. It's like fishing line. It loosens at about eight weeks post op, and the scar tissue takes over stabilizing the joint. We're very happy with the results.

Praying you don't need the surgery, though!

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Re: Pistol - Home from Vet/Surgeon

Postby mraleigh01 » Fri Jun 01, 2012 5:54 pm

PS. Did the vet say he would go through with surgery if it's a partial tear, or will it have to be a full tear?

I don't envy your decision.

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Re: Pistol - Home from Vet/Surgeon

Postby JudyL » Fri Jun 01, 2012 5:56 pm

I wonder if they'd do an x-ray at the same time he was sedated for the manual manipulation? Did he even mention doing an x-ray? While the x-ray wouldn't show the ligaments, as Sherri said, I believe that it would show whether or not the tibia is displaced too far forward in relation to the femur, which would indicate either a partial or full tear. If you are thinking about the brace, don't you need an x-ray to order the appropriate size anyway?

I'm sorry you didn't get a definitive answer. :(

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Re: Pistol - Home from Vet/Surgeon

Postby Jen » Fri Jun 01, 2012 6:07 pm

That's just flat out BS that conservative management is a waste of time and money. You're probably not going to make it worse and you might avoid the expense and risk of surgery. And I only say probably because I am far from an expert.

I was just reviewing my posts on ODO about Bella's acl to remember what we did with her. She had x-rays and the drawer test while sedated and the vet said likely a tear. We rested her and did swim therapy and chiro for six months. She wasn't on total crate rest for the whole six months, but if I recall she was on quiet leash walks only (a TALL order with a reactive dog!) that whole time. I also got much better at my shaping skills during that time, and she learned most of her current tricks during her rest time. :D Clicker training is a Godsend during crate rest periods!

I'd listen to Claire and the CM list for good advice. I'm not expert enough to say I'd forgo surgery for sure were I in your situation, but three hundred dollars and a couple of months isn't a lot to gamble, imo. And I'm about the cheapest person here! lol You can always sell the brace for at least a portion of your money back too.

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Re: Pistol - Home from Vet/Surgeon

Postby my2cotons » Fri Jun 01, 2012 7:46 pm

Thanks all for input. Sherri, he is planning on doing the drawer test under sedation. Judy, that is a good idea, to ask for the xray if I have them sedate him to do the drawer test. I told him I needed an xray for the brace - but he was so dead set against the brace, I don't even think he heard me. He says even a partial tear needs surgery - which I think is extreme. I think my biggest problem is I didn't care for the guy. He was very young and cocky - just one of those "know-it-all" kind of guys. He wasn't really disrespectful to me, but just wanted me to know he knew way more than I do - which I'm sure he does. I told him I had being doing a lot of research and he said that there a lot of people on the internet who don't know what they are talking about. Shish! I have a headache. Also a backache. Pistol was such a mess over there. He wouldn't sit still so I ended up standing and holding him while we waited - 30 minutes in the waiting room and 15 in the exam room before the vet came in. Then carried him from and back to the car because it was quite a ways for him to walk. Plus carrying him up and down the steps outside here at home all the time andpicking him up to put him on the sofa, etc, etc. After a week of family + dealing with him and worrying about him - I am exhausted.

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Re: Pistol - Home from Vet/Surgeon

Postby mraleigh01 » Sat Jun 02, 2012 4:39 am

Gah! That's lousy about the vet. I'll take an older vet, who has seen it all, over a young buck out to prove something any day.

So you are going to get the sedation for the drawer test?

I do know my vet wouldn't operate when it was a partial tear. However, we all knew it was going to blow at some point, like her other knee did. :thumbdown:

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Re: Pistol - Home from Vet/Surgeon

Postby Claire » Sat Jun 02, 2012 4:52 am

Just saw your post on CM group and here, Kathy.
The vet gave you exactly the party-line I expected from a surgical vet. Trained to do surgeries, not CM. If you don't like him, do not use him! There's a lot to be said for bedside manner as well as expertise.

Get an x-ray, get a brace, and give CM a good shot. You can see from the Yahoo Group how many success stories there are. If we with larger dogs can have good results, you with Pistol should also. Some vets won't even perform ACL surgeries on small dogs because CM works so well for them.

If you want to find a vet who will help you with a brace, look on the WoundWear website and put in your zip code. That's how I found one to help me with Rudi's. She didn't even sell me the brace because I already had it, but she worked diligently with me and even gave me a couple free visits because I traveled so far each time to see her. I'm just wondering if that brace is the best for a small dog. It IS rather cumbersome to wrap the Neoprene brace and secure with the Velcro straps. I'm trying to envision you managing that on a tiny leg. I suggest you look further on the CM site for all the different types of braces available and ask the group about it. Although I do see a response to you from someone else with a small dog..... I would PM her and ask for details of how she managed with it.

You've had your hands full around the house! I hope when you get things back to normal (whatever that is for all of us these days), you can feel comfortable about how to proceed with Pistol.

BTW, if that vet is dead-set against CM, and if you still want him to do an X-ray, be SURE to read on the WoundWear site exactly how much they need to see on that Xray. Rudi's barely covered the proper amount of leg because it was taken before I knew I wanted to use a brace.

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Re: Pistol - Home from Vet/Surgeon

Postby whiteboxerboy » Sat Jun 02, 2012 7:02 am

well, i'm sorry your visit with the vet didn't go better on all fronts.

i'm no help with ACL problems but i did have a thought. it may be crazy & ridiculous but here it is: if you are going to find a different vet have you considered coming to dallas? there are 2 different specialty hospitals and i've never ever heard one negative report from anyone about the vet's at either of them. i realize the road trip may be stressful for Pistol but if he's going to have to be sedated for the x-ray & manipulation anyway at least he'd probably sleep on the way home. i don't know how long the drive is from your house to dallas, maybe it's too far? ugh, then there's the follow up visits, too, i guess. i dunno, maybe a bad idea but i had to throw it out there.

i want you to have a good vet that you like and are comfortable with. you could stay with us overnight if you needed to. :smile:

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Re: Pistol - Home from Vet/Surgeon

Postby my2cotons » Sat Jun 02, 2012 8:32 am

Darn! Does this ever happen to you all. I typed a reply here, fairly lengthy - then before I posted I went over to mraleigh's profile to get her first name. I just feel weird addressing someone by their screen-name. :) Anyway, I came back over here and "poof" my reply was gone. Gah!

Anyway, ty you all for words of encouragement and suggestions. mraleigh, it is interesting to me that your vet wouldn't do surgery on a parial tear considering this guy is so anxious to do it, saying even a partial tear needs to be fixed.

Claire, Pistol is a small dog, but not really tiny like, say a Maltese. Coton's are a larger and sturdier version. They are the size of a Bichon. He is overweight at 18 lbs. Should probably be closer to 16. But you may be right about this brace not being right for him. There is another one called the MuttKnee Brace I may look at further: http://muttkneebrace.com/

Lynn you are so sweet to offer me to come down there and stay with you. Actually, my family is in Dallas so if I did that I would have a place to stay. Dallas is 4 1/2 hrs from us. However, we are only an hour from Stillwater where the OSU Vet Hospital is. If I didn't use this guy, I would probably go over there.

This morning when we went out Pistol was walking on all 4's. Once in a while he would try to trot and he would lift the leg then, but when I pulled him back he would put it back down and walk on it. However it seems he is usually better in the mornings, so not getting my hopes up too much.

He has seen 3 vets the last week, so I think we'll just give him a break from them for a few days and see how he is doing before we make any decisions. I sure wish we had gotten a clear diagnosis out of 1 of the 3 vets though. Now that the kids/grandkids are gone, I can settle down and concentrate on doing everything right with CM and get a better feel for how we are doing. Thanks again so much - you guys help keep me sane. I know this is not life-threatening and there are worse things we could be dealing with but it still is nerve-racking.

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Re: Pistol - Home from Vet/Surgeon

Postby connie » Sat Jun 02, 2012 9:02 am

I don't have direct experience of this, Kathy, but I want to cast a vote for CM also. Surgery is always an option if CM doesn't work, of course.

As for the vet: it's hard to go against the recommendation of someone who we feel does know more than we do. But we know our dogs. When I started feeding Sander a raw diet and treating his cancer with nutritional support, more than one vet told me I was crazy. And they told me in very specific terms. The only reason I didn't cave, I think, was that I had literally nothing to lose: Sander had inoperable cancer, so the vets could just STFU, I felt. And boy, am I glad I did not let them dictate my course. They couldn't imagine that we would get the result we did -- but that doesn't mean we did the impossible, just that the vets were very limited in their approaches. It's not uncommon.

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Re: Pistol - Home from Vet/Surgeon

Postby my2cotons » Sat Jun 02, 2012 12:57 pm

I really think I want to try the brace - or a brace of some kind. They were saying on the Yahoo CM board that the filament that is used for this surgery is only temporary - that after 8 wks or so, it stretches out and at that point it is the scar tissue that is holding the joint. That is exactly what the brace does. It holds the joint in place until scar tissue forms and hardens. The surgeon yesterday was not honest with me. I told him I had heard that the filament sometimes stretches or breaks. He said, "yes sometimes, but that is the exception". He gave me no indication that it is expected at some point to to stretch or break and no indication that it is eventually the scar tissue that forms and hold the joint stable. In fact when I talked about CM and how it gives time for the scar tissue to hold the joint - he was like "well you don't want to be dependent on scar tissue when you could just fix the ligament and if you let the scar tissue form, he will have arthritis and never have full use of the leg". Am I interpreting this right? I mean I just think the guy is dishonest. :(

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Re: Pistol - Home from Vet/Surgeon

Postby mraleigh01 » Sat Jun 02, 2012 3:31 pm

OOps. Sorry! My name is Mary.

Yeesh, I don't know what to think at this point. True, my surgeon didn't operate when it was a partial tear. He said not all partials become full tears, so do CM and see where it goes. We could get lucky.
However, within weeks it was a full tear and she was in surgery within a few days.

When she had her first surgery, she got in the yard at five weeks post op and chased a fox. She loosened her line. Not a problem, it just set us back a few weeks in recovery. I *think* they are kind of designed to loosen or break after a certain amount of time (I'm no expert). Not sure why your vet thought that was the exception.

Me? I'd do the sedation to at least find out if there is a partial, a full, or even a tear at all. If it's a parital, go with CM, no brace, and let the chips fall where they may. Full? I would not hesitate to do the surgery. I'd rather the scar tissue grow in a controlled manner, with the fishing line, then anything I can do with CM. But that's me.

To be honest, I was glad the darn thing was a full tear and there wasn't a choice. Surgery. Otherwise, I would have obsessed over making a decision.
I was more fearful it was going to be cancer, or something that could not be treated. So surgery and a fix? I'll take it. There are bigger things my dogs can have that strike fear in me...........so something curable is a relief to me.

I would start your dog on a good joint supplement if Pistol isn't on one already.

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Re: Pistol - Home from Vet/Surgeon

Postby Claire » Sat Jun 02, 2012 4:15 pm

Partial tears do NOT need surgery. If this vet is telling you partials need to be fixed via surgery, I would run from him.
And surgery on a small dog is not necessary either. This comes from an ortho vet, not me. She doesn't operate on dogs under 30-35 lbs to repair ACL injuries and that's double Pistol's weight.

If Pistol is putting weight on all 4's..... I would highly doubt he has a full tear.

If he's jumping up to greet you and putting weight on that leg, get him an anti-jump harness to use during the period of CM.
Take him out alone so the other dogs don't start to play with him. I know this will be difficult on YOU to see him restricted and restrained, but it is better for HIM. Play with him in other ways one/one so he feels special, not punished. Check the Yahoo info list for games to play during recovery.
When the grandkids come over, make the visit a time for E&T on dog health and enlist their aid in keeping Pistol quiet and playing with him on the floor in his xpen, etc. You need the help from the whole family. You can do it!

Chin up! Email me whenever you need a pep talk. LOL

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Re: Pistol - Home from Vet/Surgeon

Postby my2cotons » Sat Jun 02, 2012 5:53 pm

Claire, thanks! I think I am finally 100% convinced that Pistol does not need surgery and that this guy is totally dishonest. His right leg is the injured leg so he has been lifting it to pee. This afternoon, he actually lifted the left leg and supported himself with the right. I was so surprised. But then the next time we went out he started to lift the left and changed his mind. He is definitely still limping heavily and I noticed he held his leg up a lot while he was eating this evening. But still I think it may be improving a little.
I didn't know there was such a thing as a no-jump harness. I looked them up. What's funny, is that they look so much like the knee braces I've looked at except without the brace itself. If I do get a brace, I don't think I could use the no-jump harness because that would just be too much stuff wrapped around his back legs. Would the brace do anything to discourage jumping up? Thanks for the offer of pep talks. I will probably need lots of them before this is over. :)

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Re: Pistol - Home from Vet/Surgeon

Postby mraleigh01 » Sat Jun 02, 2012 6:05 pm

I hope you're on to something, and better days ahead. I keep forgetting your dog is smaller than my "horses". :smile:

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Re: Pistol - Home from Vet/Surgeon

Postby Claire » Sun Jun 03, 2012 5:48 am

Would the brace do anything to discourage jumping up?
The WoundWear brace that I used wouldn't. How well I remember the day I had Rudi in an x-pen around a sofa and he leaped up onto the sofa and OVER it in order to get to us in the kitchen when he heard the refrig. door open. No damage done to his knee, but oh...my heart!
The brace supports the knee, so if anything the dog feels MORE confident using it.

If you keep Pistol separate, confined in some area, and always on a short leash at potty time, with no stairs or furniture to get on (phew!), then you may not need to use a brace and might prefer a no-jump, since that seems to be his failing point.

He actually seems to be improving. Don't let up on keeping him quiet even if you think he's better. True stability takes a long time to form.

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Re: Pistol - Home from Vet/Surgeon

Postby my2cotons » Sun Jun 03, 2012 10:35 am

Yea, that's a lot of "ifs" isn't it. I really just feel that the brace would give us an extra layer of protection for when the "oops" moments happen. But some say it doesn't allow proper movement of the joint or whatever or it puts pressure on the back, hip, etc. or the scar tissue won't buildup as fast. Well, it won't build up if I let my guard down for 2 seconds. Like the other evening, we came in from the back yard. I let go of his leash and turned to shut the door,turned around and he was on the back of DH's chair looking out the window behind his chair - one of his favorite spots. I was interested that you had an x-pen around a sofa. What we are doing right now is, we have an x-pen wrapped around DH's chair and one around the sofa where I sit. When I'm sitting, he can sit with me, with his leash wrapped around my arm. When I get up, I put him on the floor and close the pen. Same with DH's chair. There is no other furniture in the house that he can get on. We have the front/living room blocked off. But what had happened was DH had gotten up and not closed the pen around his chair. So, basically, instead of putting him in a pen, we have put ourselves in pens. lol Anyway, I haven't ruled out the brace yet. I just kind of dread the measuring and then trying to get him rigged up when it gets here. Since you have experience, can you come over and help me? :)
So it just dawned on me - if I wasn't going to get a brace, I could do the no-jump harness to prevent him jumping on the furniture? hmmmmm

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Re: Pistol - Home from Vet/Surgeon

Postby UpwardDog » Sun Jun 03, 2012 12:10 pm

Good luck Kathy. I don't know anything about this issue but I hope conservative management can do the trick.
I would work on training not to jump up on furniture and on people since you'll need those skills regardless of whether he has surgery or not. You can teach him to sit infront of you and have you pick him up and teach him to greet without jumping up.

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Re: Pistol - Home from Vet/Surgeon

Postby mraleigh01 » Sun Jun 03, 2012 12:35 pm

I"m waiting for the picture of you with the couch cushions up and you watching TV from the floor with the dog. :lol:

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Re: Pistol - Home from Vet/Surgeon

Postby my2cotons » Sun Jun 03, 2012 1:05 pm

Mary, I would have probably already done that, but my cushions don't comeoff. :) Heather, I looked up the no-jump harnesses and the reviews on them are terrible anyway, so probably won't be ordering one.

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Re: Pistol - Home from Vet/Surgeon

Postby mraleigh01 » Sun Jun 03, 2012 1:51 pm

Wouldn't you want Pistol to retain the ability to bend his knee during CM? I'd think a brace would cause the joint be too stiff. Just throwing out random thoughts

Are you going to see a diferent vet?

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Re: Pistol - Home from Vet/Surgeon

Postby mraleigh01 » Sun Jun 03, 2012 1:53 pm

LOL. When my other dog had a hip replacement, I crawled in the crat with him. My husband said it looked like the Wicked Witch's feet sticking out from under the house.

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Re: Pistol - Home from Vet/Surgeon

Postby my2cotons » Sun Jun 03, 2012 2:42 pm

Mary, I guess I have no idea right now what I am doing. I think I'm just going to coast a little bit - give him a few more days. I really don't want the joint messed with anymore. I feel like it has improved a little and any more manipulation will just disturb that. He saw 3 different vets last week. Each one of them manipulated the joint and I never got a definitive diagnosis. So I'm a little turned off of vets right now. Who knows, he might would be in better shape right now if I hadn't kept taking him to one vet after another. As far as a brace - who knows. Like someone said, it is all just a crap-shoot. Seems like there are lots of good reviews and bad reviews on all of them. I just would love to feel like the joint was being protected. It seems to me that surgery protects the joint from the inside while the scar tissue forms and a brace does the same thing except from the outside. I would probably not have him wear it 24/7 if I got one. I just read all these stories of people who were even a year or more into recovery using CM alone, without a brace and then having to start all over. If I could give him that extra layer of insurance at least part of the time, it just seems it would be worth the $300.00. If I get one, it will likely be the Wound Wear A-TraC.

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Re: Pistol - Home from Vet/Surgeon

Postby UpwardDog » Sun Jun 03, 2012 3:11 pm

You shouldn't need a harness to teach him not to jump up onto the couch or to sit and wait to be picked up or keep his feet on the floor for greeting. If you think you'd try training, I'll dig up some links.

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Re: Pistol - Home from Vet/Surgeon

Postby my2cotons » Sun Jun 03, 2012 3:29 pm

The links would be great Heather- but don't go to a lot of trouble. He actually is getting to where he stops and looks at me when he wants up on the couch, because I have told him to "wait" so many times. Same way with go up and down the steps outside. He knows now that I am going to carry him up and down. We have just had a couple of incidents where neither of us were right there handy and DH left the x-pen open around his chair and he jumped up because he heard a dog bark outside. There is a window behind DH's chair that he likes to look out when he hears something. So it was doubly bad, because he jumped onto the chair and then on up onto the back of it. But I think I have convinced DH to be more deligent about closing the gate when he gets up to go in the other room (like threatening him within an inch of his life :) Both of my guys have always been so excited when I come in from somewhere and jump up and down on their hind legs to greet me. That is what I probably need the help with more than the furniture jumping.

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Re: Pistol - Home from Vet/Surgeon

Postby LisaT_II » Sun Jun 03, 2012 6:11 pm

Some vets aren't dishonest, they are just idiots and you wonder how they got where they are.

If it's a partial tear, what you do right now is crucial. Seriously, don't let him jump on the couch, don't even give him a chance to jog. Time to get serious about healing and not injuring it further.
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Re: Pistol - Home from Vet/Surgeon

Postby QBert » Sun Jun 03, 2012 6:15 pm

anything useful I might have been able to contribute has already been offered... but I hope you're able to manage him from here out and be able to stick with a non-surgical approach.


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