Stitches Out (again) & First Walk

It's now been 16 days since the hardware removal surgery. Koda had his check-up visit with the surgeon and the stitches removed yesterday.

Watch that left leg move!

Dr. Munjar said his leg felt good, and the area which was painful when probed before (where the bone plate was) no longer seemed to be causing Koda pain. All good news.

Just from my own observation, Koda has been in a pretty good spirits the last 2 weeks. I think he really does feel better without the bone plate implant. He is walking more "solidly" too. He still has a slight pivot - which is from quadricep muscle atrophy in that left leg. But the new regimen of walking will serve to strengthen his muscles and get him back into shape for all the things that a middle-aged dog likes to do.

No stitches here!

Dr. Munjar said to go for 10 minute walks 3x's a day through the weekend. Today we managed 2 walks. On the first walk, 14 houses - NO SIT STOPS!!! I was nearly holding my breath as he walked past one house after another, turned around and made it back home without any stops! His second walk was 19 house lengths, but he did have to stop and sit at house 9 and 11. I'm not sure if it was his leg or him being out-of-shape. So I guess more walks will give us a better idea of his leg condition.

Next week, we are supposed to increase to 15 minute walks 3x's a day. These walks are kind of the "proof is in the pudding" tests. If he is able to ramp up his walking, we'll know he is on the way to a full recovery. If he still has to sit down, it will be heartbreak again, as we would have to pinpoint what is wrong.

11 Days after 2nd Surgery

Post Op #2, Week 1 update: Koda is doing really well! He's walking (dare I say it) better than he was 7 weeks after his TPLO surgery. When walking, he "plants" the left leg more solidly, and it doesn't seem to splay-out as much. This second recovery phase has definitely been a bit easier than the recovery phase after his first surgery. While his leg is still fragile because of the 6 holes in his leg bone, it's not like the tibial head and tibia bone are severed. That part of the leg is healing nicely. This recovery period is for the 6 holes to fill in to solidify his tibia and for the incision to heal, which is "just" a clean soft tissue cut.

Koda refused ice treatments on his leg. And after 3 days, didn't appear to be in any pain, so I stopped his pain killers. Well, that and because he refused to eat them anymore.

Yeah, giving him meds became a big production with lots of foaming and spitting drama...

Because Koda had so many meds to take - anywhere from 1-3 times a day, I had to get creative. His anti-inflammatory meds and glucosamine chrondointin supplements (for strong bones) were liver-flavored (I gather dogs like this), so I could crush these into his raw meat "stew" meals. He wasn't drinking enough water, so I started adding a lot of water to his meals to keep him hydrated, making more of a stew.

But I couldn't mix the antibiotics and pain killers in his food because they were bitter, and once they got wet, the bitterness permeated and he refused to eat his food. I think I wasted a couple doses discovering this, as he left his bowl after one taste.

Medication Tricks:
Because dogs go mostly by smell, I added some wild fish kibble to each of his pill bottles, so that the meds would take on the smell of the kibble. Then we'd play the Kibble Treat Game, where I rapidly toss kibble for him to catch in his mouth and then sneak in a pill in the rapid succession. Because he was so excited about getting treats, he'd just swallow quickly.

Going with this "smell masking" idea, I'd entice him into his kennel with the promise of kibble and then mix a few of his meds in a handful of kibble and bits of chicken jerky. Usually he was so excited to eat the kibble that he's just wolf down the pills too. But then he discovered the icky taste of the pain killers because he used his tongue to lick up the kibble/pills. Foiled.

Other times, I'd prepare 6-7 cheese "treats", with pills in two of them and do the same rapid cheese treat dispersal: cheese, cheese, pill in cheese, cheese... and so on. Because he was so excited to eat the cheese, he'd just swallow and anticipate the next treat. But this method only lasted a few times. He got wise to the cheese treats. I think the moisture of the cheese caused the pain pills to leach out their bitter taste. *sigh*

After all these methods stopped working, I was forced to give Koda his meds "the hard way" - which entailed P holding him still, while I pried open his mouth, dropped the pills in the back of his throat, closed his muzzle and stroked his throat until he swallowed. Koda was NOT happy.

Shaved leg and stitches 8 days after hardware removal.

Shaved leg and stitches 11 days after hardware removal, his fur is growing back amazingly fast. In four days, Koda will have his stitches removed and a check-up with Dr. Munjar. I think at this 2-week mark, he may be allowed to go up and down stairs again. Koda has really, really missed the upstairs bedroom. When we go up the stairs during the day, he waits by the baby gates with this forlorn look on his face. I think he will be much happier once he can sleep upstairs again.

Second Surgery - Metal Bone Plate Removed

After a two weeks of anti-inflammatory (Rimadyl) and muscle relaxers (Methocarbamol) without any improvement, it was decided that the metal bone plate in Koda's leg should be removed. Eleven weeks after his first surgery, he underwent his SECOND surgery - to help him recover from the first one. *sigh*

I was able to drop him off for surgery and pick him up the in the same day. At 4:30pm when I came to get him, the techs brought him out and he started thrashing and flailing - still groggy from the anesthesia and confused about his gigantic appendage.

Exhausted and disoriented, he laid down on the lobby floor while the techs called the surgeon RIGHT THEN to see if it would be okay to cut off the bandage (it was supposed to stay on until the next morning).

Cleared to removed the massive cocoon of a bandage.

Lots of layers of cotton to compress his leg and prevent swelling.

Dr. Munjar had cut Koda open the same incision from the first surgery. He said it's cleaner this way and because blood vessels have not yet formed through that scar tissue it's actually better to cut there. If he made a second incision, the strip of skin between the old and new incisions would be cut-off from blood supply and become a sort of "dead zone." Interesting.

The first night home was extremely difficult. When I got him home, he just kept crying and whimpering on and on and on. He was anxious, swaggering like a drunk and agitated. He kept pacing. We have to keep him quiet and NO STAIRS for 2-3 weeks because his leg is even more fragile now that the bone plate was removed, leaving 6 big holes in the bone! They said he could easily BREAK his leg!!!! If that isn't stress, I'm no sure what is! If he breaks it, it will be another surgery and another 8 week recovery!

We tried confining him to his kennel to get him to stay still. He kept crying. It was so heart breaking! Finally, P ended up sleeping on the sofa back in make-shift Camp Koda.

The next 2 weeks will be tough because Koda is not allowed up the stairs. We may cautiously try to "wheel barrow" him up with his backside in a sling. But if he struggles and falls, it would be really bad. So not sure it's worth the risk, even though Koda desperately wants to go upstairs. He keeps standing in front of the staircase, looking up longingly.

Koda will now spend his days, doped-up on antibiotics (Simplicef), anti-inflammatory (Rimadyl), pain killers (Tramadol) and anti-diarrhea/tummy anti-inflammatory (Metronidazole - he'd had a 24-hour bout of liquid diarrhea over Memorial Day weekend, oh joy). If he didn't calm down after his first night home, I would have to give him a sedative on top of the rest of his meds. Thankfully, he appears to be more relaxed today.

It's going to be a tough next 2 weeks. For some reason, I kept thinking the recovery after this second surgery was going to be a breeze. I was wrong. It's still going to be a long haul as we baby step towards full recovery.