Heartbreaking News - 9 Weeks Post-Op

After Koda's 7-week check-up and x-rays, the surgeon said the bone joint looked good, almost completely fused and cleared Koda for outdoor walks of 10 minutes, 3 times a day. The first 5 days, he was doing really well - he'd trot for 6 house lengths, then 13, maxing out at 17 houses and back! He was tired at the end, but making progress.

But then he started having problems - having to stop, then sit down, every few houses on the way back. Finally, on days 9 and 10, he could only walk 4 house lengths and had to stop at every driveway on the way back and sit down. :(

I knew something was wrong.

I made an appointment with the surgeon.

Dr. Mujar had new x-rays done and felt his leg and the bone plate. The knee joint is still healing great - no tenderness, swelling, inflammation, etc. But Koda would flinch and jerk his leg when he pressed around where the lower part of the bone plate is screwed into his leg.

The surgeon said it's not the knee joint, but a "sensitivity" to the metal. Basically, his body doesn't like that metal piece in his leg and it's making his leg achy and sore, which is why he is able to walk less and less. He says this is so rare. Usually dogs with major allergies would be the likely candidates for this rejection. But no, it's Koda. Koda who isn't allergic to anything! He says this only happens to about one dog a year - of all the thousands of surgeries he does a year. Go figure.

The other unlikely reason he mentioned was if his knee had been swollen like a tennis ball after the surgery. In which case, when the swelling went down, all that extra tissue would need to go somewhere and would end up acting like shrink-wrap around the metal plate. So imagine trying to move and having something tight constricting that area. Scar tissue. But since Koda's knee was NOT swollen like that, he said that scar tissue is probably NOT the reason he is having problems walking.

He sent us home with more anti-inflammatory meds as well as a muscle relaxer (his groin muscle is now tight, probably as a side effect of straining to use the hurt leg). If he doesn't improve in a few days, then it will be surgery—AGAIN—to remove the bone plate.

At this point, the bone plate has served it's purpose, as it was screwed in to keep the tibial bone in place while it fused back together. Now that the bone is fused, there is no more need for it. But with 99.9% of the dogs, you just leave it in. After Koda is cut back open, bone plate removed, stitched back up, he'll have 2 weeks of home post-op care like he did before (ice, Codeine, anti-inflammatory & anti-infection drugs) and then the stitches come out. But this time, his activity will not be restricted, as the bone is already healed, so he can continue his walking regiment, etc. That's about the only good part about Koda having to undergo surgery - AGAIN.

Of course, another surgery is NOT what we wanted. But it looks like the only definitive way to get Koda back on track to walking and healing. As there are no other reasons why Koda's walking is getting worse. *sigh*

My heart aches for poor Koda.

7 Weeks after Surgery - The Next Steps

This week was a big week for Koda. He went on a big trip to Eugene (which included long car rides, staying at a hotel and much more walking than his usual meanderings around the house), his 7-week Post-Op check-up with the surgeon and new x-rays, and 10-minute walkies... outside - in the neighborhood! No more of this boring house arrest!


Here's Koda on his second outdoor walk. Watch his rear left leg. He made it down the street (13 houses) and back. He started off with gusto, very excited to be walking in the neighborhood, but on the way back, had to stop three times and sit down to rest on the sidewalk.
I was sad.
He was sad.
He looked at me with sad eyes, as if to say, "Wow. I can't believe how out of shape I am! Would you mind if I rested a minute?"

Here's is my poor doggie, sitting and panting on the sidewalk. The same dog who used to run 10-13 miles with me in Forest Park. If anything, this just reminds me that long lay-offs from activity require patience and time to gradually build back up. We will do what the doctor said, and diligently do the 10-minute, 15-minute, 20-minute, 25-minute walks over the next month, until Koda gets the A-Ok to start running again. And then it will be the same gradual build-up for running. Hopefully, by the end of summer, Koda and I will be out running on a shady trail!

Here is the 7-week x-ray of his knee. Dr. Munjar pointed out that Koda has straight patella tendonitis, and prescribed some anti-inflammatory meds to calm that down. He said it's nothing too serious and that the tendon is irritated because it is working hard to keep his knee cap aligned since the leg muscles are too weak at this point. The new regiment of walking will help strengthen his muscles and relieve the patella tendon.

He also pointed out the new bone growth at the top of the tibia, where there is a "valley" after he rotated the tibial head. Eventually, that "valley" will fill-out with new bone growth.

Conversely, where the tibial head was rotated and extra bone now exists, that "nub" will wear down a little and smooth out as it integrates with his tibia.

All in all, Dr. Munjar said Koda is doing slightly above average in his healing phase. He's not doing fabulous - like some young dogs. But he's also not doing poorly - where the bone is not healing steadily or there are other complications.