Day 10 Post-Op - Progress & Privilege

Koda's little stunt on Tuesday (Day 8) appears to not have done any damage to his leg bone. He is moving along just fine.


He walks with a big limp, only because he is taking full-sized strides with that Bionic Leg now and placing a good amount of weight on it. But as you can see in the video, when he wants to hustle, it's back to the Three-Legged Hop-a-Long.

I decided to trust Koda with a bit more square footage. I've been feeling sorry for him and I had the feeling he just felt disconnected because he couldn't see me or what was going on around him. So I configured the baby gates to add the dining area adjacent to Camp Koda. Now getting out to the backyard for potty would be easier, he could see out back, see past the kitchen to the front door windows, as well as watch me in the kitchen. He seemed content to just sit and look around.

Of course, I watched him for a bit to make sure he didn't try any funny business. He didn't. I'm so impressed with how well he's accepted this new freedom.

Eventually, I found him just laying on the area rugs - watching, and sometimes just there with his eyes closed. Later, I checked on him and he had gone back to his bed, napping.

Speaking of napping - in the hope of good behavior, I stopped putting on the Cone of Shame at night since Monday. He didn't seem to be licking his stitches, so I wanted to reward him for it.

Another reason I wanted to open up his space was to include his regular feeding set-up in the area. He's been getting more finicky about eating. Feeding time has not been in the usual place and I'm always holding the bowl under his mouth, instead of him standing at his feeder. It could be these little things that make him feel uneasy - because it's just not normal. Nothing about his life has been normal for almost 2 weeks.

Bingo! Once I let him feed himself from his bowl—in it's usual spot—he finished without me coaxing him. Yay!

His stitches are really healing quite remarkably. With the fur growing back in and covering the cut, it's even harder to see the incision. He still doesn't like to be touched there very much, even gently. But petting him anywhere else on that leg seems to be fine with him.

In the picture below, you can see a close-up of his stitches. The skin is really knitting together well - no puckering, redness or oozing at all. You can barely see the blue suture string used to close up the incision. He gets the stitches out in 5 days.

Day 8 Post-Op - Bad Koda!

This is Koda after being scolded... after he tried to jump up on the rock terrace... Very bad dog! After peeing, he took two steps and tried to leap up with me holding onto the other end of a 6-foot leash. He didn't make it up and landed on his back legs. Ouch! He sat down for a few minutes - probably because it hurt. I don't know what possessed him to try a daredevil stunt like that.

Luckily, he was happy to get up and limp back into the house. He wasn't any more lame than he had been during his recovery. But I was worried that maybe he did some internal damage to the bone - which is still setting and healing. I called the vet, and they asked if Koda was walking on it (yes) and if he was still taking the anti-inflammatory meds (yes). They said he probably didn't do any damage, but if he started to NOT walk on it, or if it looked swollen, to bring him in for Xrays. They also offered to prescribe some sedatives, because as dogs begin to feel better, they get squirrely.
I just might get some of those for him...


On a more pleasant note, Koda got his first "Get Well" card - from my nephew, Azi. That was so sweet of my sister to send a card! She's really thoughtful like that.

The front shows a cat offering a bone to a dog laying on a sofa
and says, "Since you can't dig up your own..."

On the inside, Azi drew a bone and a hunk of cheese and wrote, "Bone for You... cheese for you... Love From Azariah... Loves for you... I Love You... Yes, you doggie Koda."

So sweet!!! This just made my day!

Other than the heart-stopping drama Koda put me through this morning, the rest of the day was uneventful. Koda really loves hanging outside, dozing in the sun. So I secured a 10-foot steel cable to a tree and his leash and let him relax on the deck. He can't go further than the deck and toward the sliding door to the house, and I can keep a watchful eye on him from the kitchen. I suppose the ever-changing breeze—with scents from afar—keep him from being too bored.

Day 7 Post-Op - Watch Koda Walk!

This is the scene from my vantage point at the kitchen table - Koda sitting and standing, popping his head in between the gaps in the furniture barricade. He is increasingly antsy, pacing around inside Camp Koda. He can't understand why he doesn't have the run of the house like he used to - before this thing with his leg. I'm not sure how much square footage to give him, as he is growing frustrated by being penned up in such a small enclosure.


Watch Koda walking! Today he is getting around even better, more like a bad limp. He is really using his Bionic Leg to walk now.

The stitches look more healed every day. His fur is growing back and covering the cut and sutures. So happy that the worst part is over.

I went out for a quick run in the neighborhood, so I put on his cone (it seems to make him less agile) and added a few boxes and such to reinforce the more vulnerable parts of the barricade. Koda pushed a few pillows, so I know he is testing the walls to see where he can possibly get out. I think within the next couple of days I will use the baby gates to give him access to the hallway to my office, where I've had to return in order to get some work done.

Just in case—in the off chance that Koda clears the living room barricade—I put up some baby gates in front of the stairs. If he got out, at least he couldn't hurt himself going up and down the stairs (like the maniac he is on stairs). I suppose I'll be putting these up in the next few weeks, when he gets full access to the first floor.

He was a good boy. When I returned from my run, he was just sleeping on the floor in his corral. Yay!

Day 6 Post-Op - Well Enough to Jump

At 4:47am, Koda woke us up with the sound of his dog tags clanking against his cone. Since he didn't go potty before we all went to bed, he needed out in the middle of the night. This was unusual because he is usually one to sleep very soundly through the night. I guess there are always exceptions.

Today, Sunday, was the first day we would be leaving Koda completely unsupervised for a couple hours while we were at church. We put the cone on and fortified the Camp Koda blockade to ensure he would not try to escape.

When we returned, all was well. No drama. No evidence of attempts to escape. He was just sleepy and a bit sullen because he had the cone on.

His stitches are healing up nicely. The skin is smooth and closing up, while his fur is starting to grow back. He has a little bit of fuzz - which feels like suede. Outside, he is now "striding" with his Bionic Leg and actually using it to walk! He does so very gingerly, not putting very much weight on it, but indeed using it to walk. The bruising is almost entirely gone, with barely any trace of redness or purple patches. Just as Dr. Munjar, said, the bruising would be very ugly and get worse, and then *poof* disappear. Looks good!

We did have some drama later in the evening. My husband was getting ready to take him out to the backyard. Koda was amped. He turned his back on Koda while putting on his shoes and the excited dog jumped over the bench! And his bad leg didn't quite clear the bench and hit it! Ouch. Ugh. Need to watch this dog very carefully now. He's obviously feeling good enough to jump over things! After that little stunt, we reinforced that exit with a baby gate covered with a towel so he can't see though it (and thus it appears more solid). So the barricade is about 8 inches higher now.

While physical improvements are welcomed, the recent fussiness about taking his meds and eating is not. It's taking more effort to get him to eat. He seems disinterested in his food and I have to practically spoon feed him. Not really sure what that's about. It could be that he feels he is so inactive that he's not hungry. Koda is not like most dogs, who will eat any chance they get. He self-regulates.

Here you can see that the swelling in his leg and ankle are gone. His leg is back to normal proportions. He's gotten his regal and nonchalant expression back on his face, as well.

I also started manual physical therapy with Koda today - passive range of motion for his knee. He let me handle his leg and gently flex and stretch his leg to work his knee a bit. We just do it 10-15 times per session, 2-3 times a day.

Day 5 Post-Op - Standing On Four Legs

Saturday morning, I left my husband in charge of Koda Care for the morning. (I have a standing weekend long run with a girl friend.) I left detailed instructions for hubby and hoped for good news when I returned a few hours later.

Standing on all FOUR legs now!

Apparently, Koda was feeling quite frisky, playful and mischievous. I found out that the two "cheesy treats" - filled with Codeine and the antibiotic - were flat out rejected. Koda spit them out and refused to eat the cheese chunks. I wonder if he wised-up to our deceptive ploy. And I also found out he didn't want any of his breakfast - hopping away from the offered bowl, towards the corners of his corralled area. This is the first time he refused both treats and his food, since the surgery. He also refused to do any potty.

I thought his behavior might have to do with me not doing the honors, as dogs like routines. So I made up another couple of cheesy treats, (I had to dump the other doses of meds, now soggy) and offered them to Koda. He spit them out. So we had to do things the "hard way."

Giving Meds the Hard Way:
In obedience class, the instructor taught us how to give medication in the event that a sick or older dog was not eating. You basically open his mouth, drop the pills into the back of his throat, hold his muzzle shut with one hand and stroke his throat with downward gestures until he swallows. Pills down!

Half and hour later, he was crying, so I took him outside. He did two gigantic poops and a long pee. That might explain why he didn't want to eat any food or treats! And as you can see, he is able to squat—using his Bionic Leg—to do his business.

He is starting to use his leg to walk now, instead of just three legs. He steps with it and gingerly puts just a tiny bit of weight on it. But when he is standing, he prefers to stand on just three legs. But when he does place the fourth leg, he is no longer just "toe touching" but placing his pads down.

Also, the Bionic Leg is markedly less red and bruised-looking. The swelling is going down too, but there is still a golf-ball sized amount of fluid around his ankle. But overall, the leg is looking better and better.

Enjoying another sunny day on the deck.

Day 4 Post-Op - Touchdown!

Koda is practically back to his normal self. He is really getting tired of being corralled. More and more, we are seeing him poke his head over the lower pieces of furniture, whining and wimpering. It's only a matter of time before he tries to test his boundaries and climb over a bench or an ottoman. And he has that calculating, mischeivous look in his eyes now, too. At least this all means he's feeling better!

Out in the yard, he is putting his Bionic Leg down now. Not really stepping with it, but setting it down for balance. He is still hopping along (really well) on three legs, but places the 4th foot down when he is just standing. We have touchdown!

Yes, not quite a full paw plant on the ground, but "toe-touching" - as they call it. He's putting a couple of his toes down.

The stitches are closing up nicely and some of the ugly red blotches are fading. His ankle is still purple with a bit of fluid making it puffy. But I can tell the fluid is decreasing and the bruised extremity is starting to resemble his ankle more.

Every day he seems to be in better spirits. I'm happy to see him relaxing and acting more like his pre-surgery doggie self. Silly dog! (He wants me to rub his tummy.)

Day 3 Post-Op - Tails are Wagging

This morning we woke up to a happy, alert, tail-wagging Koda. He was in a near-normal good mood and eager to go outside for some fresh air. I don't think you truly appreciate a dog's predictable, easy-going and happy-go-lucky disposition until they lose it.

We spent some time in the afternoon, laying together on the deck, soaking up the abundant sunshine that has come to grace Portland this early spring. Koda was very happy, sniffing the air with his eyes closed. He made no attempt to run amuck. It's almost as if he knows his physical limitations right now. He was content to just lay on the deck. Other than the inconvenience of getting around on three legs, I think he's pretty comfortable.

Koda is "toe touching" with his injured leg, now. Actually, I should stop referring to it as his "injured leg" because it's fixed and in the recovery phase. So I shall call it his Bionic Leg now - since it has a metal reinforcement and screws in it. Koda isn't stepping down completely on it, just touching for balance.

A look at his stitches about 72 hours after the operation. It still looks a bit Frankenstein, but the stitches are laying a little flatter. The blotches of red and purple bruising all over his leg continue. It's especially dark purple around his ankle.

You can see how much fluid is pooling around his ankle joint. It's squishy and he doesn't like me to touch it. You can also see a small "x" where there are a couple stitches. Mr. Munjar explained that they also drilled a hole in this lower part of his leg in order to stabilize it on a rig during the surgery. This is necessary because once he cut the top portion of that tibia, the lower portion needs to stay in proper alignment.

Koda blissfully dozing in the sunshine.

Day 2 Post-Op - The New Routine

Koda was pretty tired. He slept until 11:am. I was glad he stayed calm enough to sleep for so long. He did get up a few times in the middle of the night, clumsily bumping into furniture in the dark with his big cone on. But in the morning, he managed to greet me with an ever-so-slight tail wag, which is a good sign. He's still a bit out-of-it.

He hopped out to the backyard (on leash to prevent any break-aways) and urinated. He's not putting the injured leg down at all, but holding it up completely. Later in the afternoon, Koda did his first poop since the surgery. I know, I know - kinda TMI to be blogging about a dog's poop - but when you are concerned about all his bodily functions returning to normal after surgery, this is good news. And yes, for some reason, he's able to put the injured leg on the ground to help balance while he "takes care of his business." I guess a dog does what he needs to do when he really needs to.

Still not putting any weight on the injured leg. But he can move pretty fast on three legs. After the morning potty, we go inside and take a look at how the stitches are doing.

The stitches look good - no oozing, blood or seeping. It just looks kinda Frankenstein. There are more red, blotchy bruises appearing today. And the inflammation from the surgery is causing fluid to pool in his ankle. You can see how it looks bulbous and swollen now. Dr. Munjar said to gently squeeze Koda's foot and ankle to try to disperse the fluid back up into his leg tissue. But Koda would have none of that. So I'm not going to stress him out by manhandling it.

There are a lot of things to take care of at the start of each day now: potty, check the stitches, prepare his raw meat & veggie breakfast, and give him all three of his medications.

The antibiotics and Codeine are bitter, so I hide them in chunks of sharp cheddar cheese. Then give them to him as treats. Nothing like pain killers in cheddar cheese 3X's a day to make a dog feel better!

Then I just mix his anti-inflammatory (which supposively tastes like liver) and his Glucosamine and Chrondoitin suppliment in his food. I'm glad he doesn't attempt to find them and spit them out, as they are big tablets which would require a whole hunk of cheese if I had to trick him into eating them.

Next, ice packing his leg. Luckily, I've had this Thera-Med cold gel-pack for ages from my own injuries. It's soft, flexible and large, which is so much better than a bag of frozen peas. I slip it into an old t-shirt then fold it in half over his leg, like making a pita sandwich. He seems to be pretty relaxed while I ice his leg. I'm sure the lavish petting doesn't hurt either.

Winding down for the night. Koda gets his midnight painkiller-in-cheese treat, then lights out. Koda needs lots of rest.

Day 1 Post-Op - Coming Home

When I came to pick up Koda, the hospital has you do all the paper work and meet with the surgeon before they bring out your pet. They know as soon as you see your pet, you won't hear or remember a thing.

So I charged the remaining balance of the surgery, $1820.00, bringing my grand total to $3785 - OUCH! (Koda's not the only one in pain from this surgery!) Then I met with Dr. Munjar to look at Koda's post-op Xrays. He pointed out the 30 degree slope, now corrected to three degrees, explained about the bones, metal plate and screws (see my other post below for details).

We went over the recovery process, and various medications. Koda would be taking Simplicef, an antibiotic, once a day in the morning. Rimadyl, an anti-inflammatory, twice a day. And Codeine, a pain killer, three times a day. I would also have to put an ice pack on him 4 times a day and massage his leg to distribute the fluid that would start to pool in his ankle. And after the swelling and bruising went away (about 1 week), I would need to do physical therapy with his knee, moving it gently to keep the joint from stiffening up.

Of course, this is just the beginning. The next 8 weeks would be crucial for Koda's full recovery and successful outcome. As he starts to feel better, it will become harder and harder to confine him and keep him quiet and inactive. After about Week 2 post-op, Koda can start to take short 5-minute walks to start strengthening his legs. Then increase the minutes and frequency from there.

Then FINALLY, they brought Koda out! He was hopping along on his three legs, pretty with-it, considering what he'd been through. I thought it was pretty amazing that he was walking at all. But they tell me it's completely normal for them to be walking soon after they come out of anesthesia.

The the night tech left a note saying Koda stayed awake on a bed up by her desk (instead of in a kennel in the back), keeping her company and watching her all night. Charmer. They all commented that he had a lot of personality.

While I was talking to the vet techs, Koda got bored (and tired of standing) so he just plopped down and made himself comfortable on the floor. Look at his little shaved turkey leg. :( He has a little fur sock on, it appears.

Here's what his leg looked like, just 26 hours after surgery. Not too bad. Neat little stitches on the inside of his leg. It wasn't that swollen yet, but Dr. Munjar warned me that the leg would start to bruise, becoming blotchy and red over the next week. He said it would be, "ugly... ugly... ugly... ugly... ugly... until about Sunday, and then *motions with hands* all gone." So I would need to prepare myself for how bad his leg would look before it begins to look better.

Ahhh, the "Cone of Shame" - Koda hates the e-collar. But since we couldn't take the chance of him licking or chewing his stitches while we slept, he had to wear the collar overnight. As you can see, he makes no effort to conceal his utter disappointment about this.

The hardest thing to take was his soft groaning this first night. We just sat there and pet him while he rested, moaning. So sad.

Koda is able to drink water with the cone on -
thanks to a long doggie tongue.

Camp Koda - this is where Koda will be spending his days and where we'll all be sleeping at night, for the next couple of weeks. We need to restrict Koda's activity to only going out to relieve himself and encourage him to rest as much as possible. Nighty-night, Koda!

TPLO explained with XRAYS

Why is my dog lame? Why does he need surgery? So what exactly is TPLO surgery? Tibial Plateau Leveling Osteotomy? I will attempt to explain my understanding—in simple language—of how this procedure helps our beloved dogs return to full function on their bad knees.

In Koda's case, the ligament (CCL) inside his left knee joint had a 20% tear (as the surgeon found out during the surgery). It wasn't completely ruptured, but it was being stressed while trying to keep the knee stable as the femur (thigh bone) slid down the steeply angled slope (30 degrees) created by the head of the tibia bone (shin bone) with every bend of the knee.

This stress and pulling of this CCL is what causes the pain when walking and running. Eventually the pull on this ligament increases the tearing, to the point of a complete tear. Or worse, a traumatic incident could just rupture it immediately. Koda was lucky that his was only a partial tear. Other dogs we saw, were so bad they could barely stand to put any weight on the bad leg.

However, Koda's right knee was fine. Though genetically, he still has a very steep 30 degree slope on this leg, there was no evidence of any CCL tearing or arthritis in the joint. A healthy knee! This is great news!

But Dr. Munjar did caution me that there was a 25-30% chance that Koda's CCL in his right knee could eventually tear because of that steep 30 degree angle. The best preventative measure we could take was to keep Koda's fitness level up, keep him at a healthy weight and discourage jumping up and down (which stresses the knees).

So the TPLO surgery is essentially the "leveling" of the contact area between the femur (top bone) and the tibia (bottom bone) - the knee joint. The goal is to reduce the angle to between 2 and 4 degrees.

What the surgeon does is pretty extreme - so make sure you have the procedure done by someone who is board certified and has a lot of experience doing this surgery. What happens is he cuts the entire top portion (tibia head) of the tibia bone, then rotates it to change the angle of slope. Then he uses 6 very long screws to secure a metal plate, fastening the rotated head back onto the tibia bone.

Koda's post-operation Xray: you can see how the tibial head has been "reseated" and secured by the metal plate. The angle has been drastically reduced, so that there is no longer any stress on the CCL.

The "claw-like" hook of residual bone on the left side will naturally dissolve into more of a nub, and filling in towards the tibial head. On the right side, the area of the tibial head that seems to be hanging over will start to fill in toward the rest of the bone, so that eventually it will be well-fused together. This process takes about 8 weeks. Which is why the 8 weeks of inactivity is so crucial - so that the bone can set properly and heal.

Here is another view of Koda's post-operated leg with the metal plate and screws. You can see how long the screw are - running all the way through the leg bone. You may feel that the length of the screws are excessive, but the length is necessary because bones are hollow, so in order for the screws to be secure, they need to be in contact with both sides of the bone - otherwise they will wobble.

For a professional explanation of TPLO surgery, read this.