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Re: 2 year old lab, CCLR

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Thank you for your input. To give you a little more information...The dog had an extracapsular suture technique done and proceeded to blow the suture because she was not restricted post op. The same occured after the second procedure. Cranial drawer is only present in stifle extension but not flexion. I completely agree that a TPLO would have been the best option for this case! I explained that to the owner in the beginning. The owner understands the TPLO surgical procedure and reasoning and does not agree with the surgery itself nor does he want to put the dog through surgery again. The dog is weight-bearing and has increased in weight-bearing and strength over the last 5 weeks. The owner is pleased with the progress and I am amazed the dog has normal range of motion with the significant amount of fibrosis! Since surgery is not in this dog's future, if you have any suggestions to apply resistance to exercise without damaging the dog's progress that would great! Thanks again... I think this group is an invaluable resource!!!Sent from my BlackBerry® wireless handheldFrom: "Jeff Bowra" Date: Mon, 8 Dec 2008 14:41:02 -0800To: <VetRehab >Subject: Re: 2 year old lab, CCLR You say unstable but is it weight bearing? How long after last surgery? Has a surgeon been consulted? Dog needs a TPLO!! (Or other successful surgery by a boarded surgeon. If the tibial slope is extreme I think that TPLO is the best option) IMHO A 2 year old dog with an unstable knee is not going to have a good long term outcome for that knee. I have seen many cases like this and they are wasting their $ on the rehab. TPLO by an experienced surgeon and they will be very happy!!!! Jeff Bowra DVM On Mon, Dec 8, 2008 at 1:11 PM, Backlund <drmichellekgmail> wrote: > I have been reading the recent threads regarding walking a dog through snow > and had a related question...I have a 2 year old lab with a cruciate rupture > that had 2 surgeries to repair, came to me unstable, but owner doe not want > to put dog through another surgery...I have been working with the dog for 5 > weeks now and am looking to start exercising the dog with some resistance. > Currently I do not have an underwater treadmill and we do not have soft > fluffy snow here in Nebraska! The owner said the dog would love to go in > the lake but I am concerned about the water temperature for rehabbing! Any > other suggestions??? Thank you! > > Backlund, DVM, CCRT candidate > > -- Jeff Bowra DVM Canine Rehabilitation Practitioner Aldergrove Animal Hospital 26841 Fraser Highway Aldergrove, BC, Canada www.familypetdoc.com www.thespaw.ca

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Prolotherapy is an excellent option for this kind of case. You can create a remarkable amount of stability at little cost to the owner and the dog. Plus with poor restraint on the owners part you can still have the dog heal very rapidly. This is becoming an option of choice for many top human athletes as well.Judith M. Shoemaker, DVMAlways Helpful Veterinary Services305 Nottingham RoadNottingham, PA 19362ph fax info@... www.judithshoemaker.com

To: VetRehab From: drmichellek@...Date: Mon, 8 Dec 2008 23:07:15 +0000Subject: Re: 2 year old lab, CCLR

Thank you for your input. To give you a little more information...The dog had an extracapsular suture technique done and proceeded to blow the suture because she was not restricted post op. The same occured after the second procedure. Cranial drawer is only present in stifle extension but not flexion. I completely agree that a TPLO would have been the best option for this case! I explained that to the owner in the beginning. The owner understands the TPLO surgical procedure and reasoning and does not agree with the surgery itself nor does he want to put the dog through surgery again. The dog is weight-bearing and has increased in weight-bearing and strength over the last 5 weeks. The owner is pleased with the progress and I am amazed the dog has normal range of motion with the significant amount of fibrosis! Since surgery is not in this dog's future, if you have any suggestions to apply resistance to exercise without damaging the dog's progress that would great! Thanks again... I think this group is an invaluable resource!!!

Sent from my BlackBerry® wireless handheld

From: "Jeff Bowra" Date: Mon, 8 Dec 2008 14:41:02 -0800To: <VetRehab >Subject: Re: 2 year old lab, CCLR

You say unstable but is it weight bearing? How long after lastsurgery? Has a surgeon been consulted? Dog needs a TPLO!! (Or othersuccessful surgery by a boarded surgeon. If the tibial slope isextreme I think that TPLO is the best option) IMHO A 2 year old dogwith an unstable knee is not going to have a good long term outcomefor that knee. I have seen many cases like this and they are wastingtheir $ on the rehab. TPLO by an experienced surgeon and they will bevery happy!!!!Jeff Bowra DVMOn Mon, Dec 8, 2008 at 1:11 PM, Backlund <drmichellekgmail> wrote:> I have been reading the recent threads regarding walking a dog through snow> and had a related question...I have a 2 year old lab with a cruciate rupture> that had 2 surgeries to repair, came to me unstable, but owner doe not want> to put dog through another surgery...I have been working with the dog for 5> weeks now and am looking to start exercising the dog with some resistance.> Currently I do not have an underwater treadmill and we do not have soft> fluffy snow here in Nebraska! The owner said the dog would love to go in> the lake but I am concerned about the water temperature for rehabbing! Any> other suggestions??? Thank you!>> Backlund, DVM, CCRT candidate>> -- Jeff Bowra DVMCanine Rehabilitation PractitionerAldergrove Animal Hospital26841 Fraser HighwayAldergrove, BC, Canadawww.familypetdoc.comwww.thespaw.ca

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If the owner isn't keen on the TPLO/TTA approach, we have had GREAT

success with the tightrope procedure. We have only done a handful of

knees and one shoulder instability with this techniquie, but we are so

far extremely impressed. Jimi Cook at Missouri has been doing the

technique for about two years, and complication rates are similar to

TPLO/TTA/Extracapsular repairs.

FYI, tightrope employs fiberwire (900 pound pullout strength), bone

tunnels and bone buttons to anchor the lateral suture in the femoral

condyle and tibial crest. Combined with arthroscopic exploration,

makes for a very minimally invasive procedure. We've done them in

dogs where TPLOs have failed, with most impressive results.

Marti Drum, DVM, PhD

Small Animal Physical Rehabilitation

Department of Small Animal Clinical Sciences

C247 Veterinary Teaching Hospital

Knoxville, TN 37996

" The most exciting phrase to hear in science,

the one that heralds the most discoveries,

is not 'Eureka!' (I found it!),

but 'That's funny...' "

-Isaac Asimov

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I have found that ofter after two sx, they are very 'gaurded' and

take much longer to weight bear and with the pre-existing unstability

this may prove to be even more of a challenge. I have many cases

where owners do not want TPLO. you may want to think about getting

this dog a brace that may help to stabilize the joint while fibrosis

occurs and giving extra support. If you read Laurie Edge info

from the Minnessotta symposium there is invaluable info on rehabing

without surgery. (have done over 12 dogs now all sizes using this

protocal and they have done very well - with owners who refuse sx)

Not sure if you have someone local who can do a custom brace, as in

my expereince custom is the only way to go!

tania

>

> Thank you for your input. To give you a little more

information...The dog had an extracapsular suture technique done and

proceeded to blow the suture because she was not restricted post op.

The same occured after the second procedure. Cranial drawer is only

present in stifle extension but not flexion. I completely agree that

a TPLO would have been the best option for this case! I explained

that to the owner in the beginning. The owner understands the TPLO

surgical procedure and reasoning and does not agree with the surgery

itself nor does he want to put the dog through surgery again. The dog

is weight-bearing and has increased in weight-bearing and strength

over the last 5 weeks. The owner is pleased with the progress and I

am amazed the dog has normal range of motion with the significant

amount of fibrosis! Since surgery is not in this dog's future, if

you have any suggestions to apply resistance to exercise without

damaging the dog's progress that would great! Thanks again... I

think this group is an invaluable resource!!!

>

> Sent from my BlackBerry® wireless handheld

>

> Re: 2 year old lab, CCLR

>

>

> You say unstable but is it weight bearing? How long after last

> surgery? Has a surgeon been consulted? Dog needs a TPLO!! (Or other

> successful surgery by a boarded surgeon. If the tibial slope is

> extreme I think that TPLO is the best option) IMHO A 2 year old dog

> with an unstable knee is not going to have a good long term outcome

> for that knee. I have seen many cases like this and they are wasting

> their $ on the rehab. TPLO by an experienced surgeon and they will

be

> very happy!!!!

> Jeff Bowra DVM

> On Mon, Dec 8, 2008 at 1:11 PM, Backlund

wrote:

> > I have been reading the recent threads regarding walking a dog

through snow

> > and had a related question...I have a 2 year old lab with a

cruciate rupture

> > that had 2 surgeries to repair, came to me unstable, but owner

doe not want

> > to put dog through another surgery...I have been working with the

dog for 5

> > weeks now and am looking to start exercising the dog with some

resistance.

> > Currently I do not have an underwater treadmill and we do not

have soft

> > fluffy snow here in Nebraska! The owner said the dog would love

to go in

> > the lake but I am concerned about the water temperature for

rehabbing! Any

> > other suggestions??? Thank you!

> >

> > Backlund, DVM, CCRT candidate

> >

> >

>

>

>

> --

> Jeff Bowra DVM

> Canine Rehabilitation Practitioner

> Aldergrove Animal Hospital

> 26841 Fraser Highway

> Aldergrove, BC, Canada

> www.familypetdoc.com

> www.thespaw.ca

>

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