King Charles Cavalier - TPLO surgery?
July 3, 2018 1:23 PM Subscribe
My dog is about 8 years old and started limping on her hind leg about 2 months ago. At first the vet thought it was arthritis in her knee, but after a period of time she was re diagnosed as having a torn cranial cruciate ligament.
The vet is suggesting that she get TPLO surgery, which is very expensive (probably about 4k) and has a pretty lengthy recovery time. She is pretty sedentary dog, and doesn't really over do things. She limps when she gets up in the morning and in the evenings,and with the pain mediation anti-inflammatory she is currently on, seems pretty ok and happy. What I want to avoid is having a painful, expensive surgery on her that makes it worse, or doesn't significantly improve her life. I'm curious if others have had experiences either way - gotten the surgery? Did it actually improve the dog's life? Didn't get the surgery? Did the dog do ok, recover? I feel like my vet always goes immediately to expensive treatments / tests, and although I do value their opinion, I would love to hear other perspectives.
The vet is suggesting that she get TPLO surgery, which is very expensive (probably about 4k) and has a pretty lengthy recovery time. She is pretty sedentary dog, and doesn't really over do things. She limps when she gets up in the morning and in the evenings,and with the pain mediation anti-inflammatory she is currently on, seems pretty ok and happy. What I want to avoid is having a painful, expensive surgery on her that makes it worse, or doesn't significantly improve her life. I'm curious if others have had experiences either way - gotten the surgery? Did it actually improve the dog's life? Didn't get the surgery? Did the dog do ok, recover? I feel like my vet always goes immediately to expensive treatments / tests, and although I do value their opinion, I would love to hear other perspectives.
I would get a second opinion. A couple of years ago my havanese (then about 2) was limping and diagnosed with a luxating patella (obviously a different injury) and the vet immediately recommended surgery. He seemed okay though and we put it off and I’m glad we did—he’s fine now after a period of limping more in the morning, and others I’ve told about it were really surprised that vet went straight for surgery.
posted by rustcellar at 2:28 PM on July 3, 2018 [1 favorite]
posted by rustcellar at 2:28 PM on July 3, 2018 [1 favorite]
My guy got TPLO - 5k$ and 4month recovery but it was worth it. 100% recovery. He was 3 though, don't know if I would've done it at 8. Vet said the joint will form enough scar tissue naturally for them to get around with a minor limp.
posted by mannequito at 3:34 PM on July 3, 2018 [1 favorite]
posted by mannequito at 3:34 PM on July 3, 2018 [1 favorite]
Our 9-year-old shih tzu mix tore his CCL about 8 months ago. We decided not to get the surgery, because the recovery time for with and w/o surgery was basically the same, and it was just too much when there was a risk that he could tear it again, or tear the other leg within a year or two.
Everything I read about non-surgical recovery said to restrict his activity for eight months, and not to be fooled when the dog appears to be well after a few months. He was doing so well after five months that we let him come with us to a family dinner with kids and other dogs and guess what? All the advice was right - he started limping again after that visit. So don't be fooled - take it slow! We restricted his walks again and he started walking normally again in a couple of weeks.
So now the eight month anniversary is coming up and he is doing fine, doesn't limp at all, even when he has been laying down for awhile. I don't regret the decision. He might have some arthritis in that joint as he ages, but that was likely even with the surgery.
posted by hiker U. at 6:51 PM on July 3, 2018 [2 favorites]
Everything I read about non-surgical recovery said to restrict his activity for eight months, and not to be fooled when the dog appears to be well after a few months. He was doing so well after five months that we let him come with us to a family dinner with kids and other dogs and guess what? All the advice was right - he started limping again after that visit. So don't be fooled - take it slow! We restricted his walks again and he started walking normally again in a couple of weeks.
So now the eight month anniversary is coming up and he is doing fine, doesn't limp at all, even when he has been laying down for awhile. I don't regret the decision. He might have some arthritis in that joint as he ages, but that was likely even with the surgery.
posted by hiker U. at 6:51 PM on July 3, 2018 [2 favorites]
I wouldn't. It doesn't seem to be impacting her quality of life.
I would go straight to cartrophen. It's comparatively cheap, and it made a huge difference to the mobility of our 10 year old Boxer, who also has a torn ligament and limps. It only works in about half of all dogs but I'd try it for sure.
posted by DarlingBri at 11:21 PM on July 3, 2018 [1 favorite]
I would go straight to cartrophen. It's comparatively cheap, and it made a huge difference to the mobility of our 10 year old Boxer, who also has a torn ligament and limps. It only works in about half of all dogs but I'd try it for sure.
posted by DarlingBri at 11:21 PM on July 3, 2018 [1 favorite]
Best answer: There is no scientific evidence thus far that TPLO is any more effective or beneficial long term than a well-performed extracap procedure. TPLO is the new hotness, but it is significantly more risky, significantly more expensive, and as I say, thus far there is zero evidence that it's in any way a better procedure than a well-done extracap, especially for a small dog.
The extracap involves far less cutting of bone.
If you elect to have surgery performed, you want a vet who's performed many of them successfully with a near-zero failure rate and a near-zero complication rate. Regardless of which procedure you choose (if any), the skill of the surgeon and his/her track record is far more important than the type of surgery.
Overview here.
Conservative management is also a very viable option, especially for a small dog. Whatever you choose, be a strong advocate for pain management, we see cases all the time where the surgery was well done but the dog is off pain meds three weeks later and in significant pain. Many surgical specialists think their job is done when the skin is closed. Our patients are on pain meds for several MONTHS after an orthopedic surgery.
We perform a lot of CCL repairs and conservative management where I work, I'd be happy to answer any questions that will help you make a decision.
posted by biscotti at 6:43 AM on July 4, 2018 [2 favorites]
The extracap involves far less cutting of bone.
If you elect to have surgery performed, you want a vet who's performed many of them successfully with a near-zero failure rate and a near-zero complication rate. Regardless of which procedure you choose (if any), the skill of the surgeon and his/her track record is far more important than the type of surgery.
Overview here.
Conservative management is also a very viable option, especially for a small dog. Whatever you choose, be a strong advocate for pain management, we see cases all the time where the surgery was well done but the dog is off pain meds three weeks later and in significant pain. Many surgical specialists think their job is done when the skin is closed. Our patients are on pain meds for several MONTHS after an orthopedic surgery.
We perform a lot of CCL repairs and conservative management where I work, I'd be happy to answer any questions that will help you make a decision.
posted by biscotti at 6:43 AM on July 4, 2018 [2 favorites]
Our sheltie Roxie tore her ACL when she was around 10. The vet Prescribed 6 wks rest, no walking except in & outside to potty, and joint supplements and tramadol for pain. She said after that we could be referred for surgery, BUT that was generally for younger dogs esp those in sports. She said it was expensive, 4-5 K, and that she would likely tear the other one at some point. That was 2 yrs ago. We did not opt for surgery, Roxie has several other health conditions and it just seemed an unwise use of resources. She still has a limp, but goes on daily walks and is able to get around pretty well considering. She def. has trouble getting up esp on a wood or tile floor, carpet is a lot easier. She still takes tramadol twice a day and a half a canine joint supplement chew along with thyroid supplement and insulin, like I said, she’s a bit of a mess.
The worst part was the final 2 wks of rest, she wanted to get out of the doggie stroller and sniff like the other 2 dogs. Our vet didn’t press surgery, in fact she clearly didn’t see it as appropriate for this dog. Vet did suggest water therapy on a water treadmill could help but that clinic is far from us and $$$ so we skipped it. We do lightly massage her legs and hips most days and she seems to enjoy it.
posted by RichardHenryYarbo at 11:08 AM on July 4, 2018 [1 favorite]
The worst part was the final 2 wks of rest, she wanted to get out of the doggie stroller and sniff like the other 2 dogs. Our vet didn’t press surgery, in fact she clearly didn’t see it as appropriate for this dog. Vet did suggest water therapy on a water treadmill could help but that clinic is far from us and $$$ so we skipped it. We do lightly massage her legs and hips most days and she seems to enjoy it.
posted by RichardHenryYarbo at 11:08 AM on July 4, 2018 [1 favorite]
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Unfortunately, dogs who tear one frequently tear the other one because it has to bear all the weight while the first one heals. But dogs are resilient. Make sure to watch for signs of pain like shallow breathing, loss of appetite, restlessness or snappiness.
posted by Glinn at 2:27 PM on July 3, 2018 [2 favorites]