The Day Of The Surgery

(On the way to Surgery in the car)

Today is the day Titan would be having the surgery to fix his knee.  We were nervous but we kept everything as normal and as positive as we could for our big guy.  We woke up early and went for a nice morning stroll.  I let him sniff everything and we took our time saying hi to the neighbours going to work.  Titan really does love being social.  We had a beautiful sunrise all pink and orange.  I took this as a sign of good luck.  By the time we got back we had to head out.

The drive to Caven Hill Veterinary Service is almost an hour.  So we had lots of cuddles in the car ride.  When we arrived at the vet office Titan walked right in with his tail wagging ready to greet everyone.  It was time.  We signed some forms, one saying we agreed on the price and put down some emergency numbers.  We gave them half of the payment at this time.  We also had to sign a form about whether or not we wanted an ECG monitor during the surgery and microchipping done.  We already have Titan microchipped and the ECG was an extra $100 dollars, so we opted out.  He would have blood work, xrays, and tests done that were included in the price already and we had just checked his heart the last time we were here at this vet.  So once all the paperwork was in order they came around the desk and the lady held her hand out for the leash.  It was very hard for me to hand that leash over and know he wouldn't be coming right home with us.  Titan was even leaning on me a little, like he knew.  I gave him pats and told him to be a good, brave, boy.  We brought a towel from home with us and handed that to the lady as well (even though she didn't seem too pleased to take it).  I just wanted him to have something that smelled familiar so I insisted.  Once she had the leash off they went and I watched him walk back behind the doors.  And with that we left to head home and wait for a phone call to update us.

We tried to keep busy but it was hard waiting to hear something, anything, about how it was going.  Finally at 4pm I called in to get an update.  The lady who answered knew who I was talking about the moment I said Titan's name.  "Oh the big huge Great Dane! Oh yes I will get the vet tech".  I smiled after hearing the excitement in her voice, I knew he would make friends there.  The vet tech came on the line next and told us that he was just now out of surgery.  It went very well and he did great.  There was no complications while under sedation.  I thanked her and let out a huge sigh of relief.  First part was over.  Next was getting through the night and hoping he wouldn't be in too much pain.  Thankfully that was a good part about him staying, they can manage and monitor his pain and meds easier.  

And so we head to bed, not really able to sleep, but excited about being able to bring our boy home tomorrow and start the healing process together.  

Getting Ready

(Titan the day before his Surgery on his couch)

We have spent this weekend getting things ready for Titan's return home from surgery and for his recovery process.  One of the requirements for a good recovery is that Titan doesn't do stairs.  At least not for the first 4-6 weeks.  Well, that was an issue as the only way in and out of our house (both front and back) is with a set of 5 stairs.  We are very lucky to have such good friends who are always willing to help, and this time was no exception.  Peter and Kate were able to come out on Saturday and help build a ramp in the backyard for Titan.  I can't thank them enough for this amazing act of kindness on such short notice.  It will take some getting used to as Titan is a very "particular" dog but he has gone up and down it now with encouragement and praise.  We just had to make sure the ramp wasn't too steep (which is why there is one little step at the top) and that the ramp had good grip for his feet (which is why it has outdoor carpet on it).  Knowing he's willing to use the ramp got rid of a lot of stress.

(There was even some tail wags)

The next thing we had to worry about was where Titan would sleep.  Normally he climbs up onto his favorite spot, the couch.  But this is a big step up, and with him not able to do stairs we had to rethink this as well.  We already know that he will be staying on the carpet area in the living room, so we researched dog bed ideas and found out the best option (and a much cheaper option for a dog his size) was a baby mattress from Wal-Mart.  For $70 Titan had a new, comfortable, easy to clean, lightweight, all natural cotton bed.  I had read that sometimes the incision from the surgery can leak, and there could be accidents the first few weeks if the dog is unable to get up in time to use the bathroom, so we also invested in a waterproof and easy to clean mattress cover.  They also had some great little blankets to make the bed extra comfy at just $5 each.  So, we brought it all in and let Titan check out his new stuff.

All together we spent about $300 on the ramp and bed stuff.  

We also had to get our finances in order.  The vet told us that because this surgery is so expensive the specialist usually likes to get half of the payment when the dog is dropped off.  After being told they don't except American Express (our emergency card) we needed a little money help.  A huge thank you to my amazing sister Julie who came out to help me with this.  I don't know how I can ever repay these awesome people who support us and help us at times like these.  Knowing we have such wonderful family and friend support makes getting through this surgery and recovery process less stressful and much easier on everyone.  And Titan just loves his Aunts and Uncle visiting too.  

Although we are nervous about the surgery tomorrow, we plan to spend tonight all together (Titan, Dad, Mom, and Ares) in the living room enjoying what I'm sure will be the last "normal" night for a while, with lots of hugs and cuddles.

Information Day

As someone who likes to know exactly what is going to happen, what to expect, and how to best be prepared, I am always researching and reading up on current situations.  This TPLO surgery is no different.  When we found out about it the other day, the first thing I did was start reading up on it.  What it is and how does it help:

"The TPLO (Tibial Plateau Leveling Osteotomy) surgery has become one of the most popular orthopedic surgeries performed on dogs who have torn their cranial cruciate ligament, also commonly referred to as the dog acl.  Developed by Dr. Barclay Slocum, the TPLO surgery it first was considered a radical procedure for addressing canine ACL injuries. Now in existence for over 20 years, the surgery has proven itself, time and time again, to be an extremely effective long term solution for addressing cruciate ligament injury in dogs.  The philosophy behind the TPLO surgery is to completely change the dynamics of the dog’s knee so that the torn ligament becomes irrelevant to the stability of the knee itself.  Let’s quickly review the basics. When your dog stands, if you look from the side, you can see that your dogs knee is bent, at a slight degree of flexion. Because of this bending, the ACL inside the knee joint is always load-bearing, meaning it always has tension on it. This constant tension on the dogs ACL, therefore makes this ligament the most susceptible to injury. In fact, injury to this ligament is hands-down the most common orthopedic injury in dogs.  When a dog tears its ACL, every time the dogs goes to stand or put weight on the leg, the femur slides/rubs on the back of the tibia. This rubbing causes pain and inflammation, which is very uncomfortable. This is why most dogs with a torn ACL will not even put any weight on the leg, or if they do, they will just toe touch the leg to the ground.  The true beauty of the surgery is that it completely alters the dynamics of the knee. Once the bone is cut and rotated the tibial plateau, where the femur and the tibia communicate, no longer can slide backwards. The knee is immediately stabilized. By doing so, this eliminates the need for the ACL ligament entirely and returns stability to the joint immediately. Once the knee is stabilized, the dogs will begin to use the limb again. In fact in most cases the dogs are weight bearing with-in a few days after surgery if not the very next day." - Top Dog Health

I called the vet to go over everything we would need to know for Monday.  Titan would have to be there for 9am and he would be there for the day.  That I expected.  What I was not prepared for is Titan having to stay the night and well into the next day.  Till 6pm on the Tuesday to be exact.  On the one hand I'm happy that he will be monitored right after for any irregularities with the surgery and they will be able to give him what he needs to stay calm and out of pain.  On the other hand I just want to bring my baby home.  It's going to be hard knowing he isn't just downstairs on his couch (yes he has his own couch, he is very spoiled) and ready for a cuddle at any point.  The house will not be the same without him here.

I'm also worried about a dog his size going under sedation.  I've read and heard about dogs going into cardiac arrest because it's too much for the heart to handle. The vet assured us that this is a very common surgery and he would be monitored closely.  He also checked his heart and lungs and they are strong and will handle this well.

Next information we needed to know would be the cost.  We will have to pay for the surgery, bloodwork, xrays, sedation, overnight stay, the equipment going into Titan's leg (of course our big boy will need the extra large metal plates), a cone for recovery, and medication for afterwards.  All together we are looking at $4364.00.  Ouch.  We knew getting a big dog would mean big vet bills, we just didn't expect them so soon as Titan is only 4 years old.  I again stress the importance of pet insurance for these big guys.

Lastly I have started to research all about recovery.  This is going to be a long process especially for a dog who loves his walks and digging up the yard outside.  I never thought I would say it, but, I can't wait until Titan will be able to go and dig up some big holes again. I was told that the main recovery will be 4-6 weeks.  Strict rest.  No stairs, no walking unless he is to use the bathroom, no play, just rest.  We are going to try and use good old fashioned monitoring as thankfully me and my husband work opposite shifts.  We will have to find lots of ways to keep Titan busy with treats and games he can do laying down.  As a last resort I have read that some vets will give you sedatives if needed.  Titan will be confined to his living room area.  We have opted to not use a crate (even though some vets recommend this to keep the movement limited) because Titan doesn't like walking on hardwood floors and always stays on the area rug, at least one foot always touching.  It will be easy to make sure he stays in this area with that techinque and when we need to get him to other places we will put down runners for him.  We will be getting him an actual mattress as a bed so he won't have to step up onto his couch.  After the initial 6 weeks, we have a check up at the vet to see if he can move around a bit more.   This full healing process will take possibly up to a year I have read, but if you want everything to heal right and don't want to damage things any further it is a must.

Some of the websites I have been using to get information from are:

https://dogs.thefuntimesguide.com/dog_tplo_recovery/

http://www.lauriebryce.com/tplo/recovery.html

http://dogkneeinjury.com/

http://www.topdoghealth.com/library/orthopedic-surgery/articles-surgery/tibial-plateau-leveling-osteotomy-tplo/

http://www.whole-dog-journal.com/issues/7_10/features/Restrictive-Activity-Canine_15657-1.html

http://edmontonveterinary.com/clients/6500/documents/TPLO_Home_Recovery_Program__final_july_13_12.pdf

We Found Out

Today (November 18th, 2016) is the day we found out our big lovable Great Dane Titan would need a TPLO surgery.

It all started a week ago when after a normal and playful day at the dog park we noticed Titan limping and keeping weight off his left hind leg.  Being a 4 year old Dane at 160 lbs we thought maybe he had just pulled or strained a muscle.  So we made a vet appointment for the following Friday and hoped that it would get better on it's own with some TLC.

The days went on with no improvements.  Although Titan was eating, drinking, acting playful, and wanting to go for his walks, he was still not putting any weight on his back leg and would limp around to get places.  My gut told me this was more then just a simple fix.

The 18th came and we were off to the vet in Peterborough, Caven Hill.  They are wonderful there.  No emergency fees and open 24/7 with a great knowledge on this giant breed as they work closely with a Great Dane rescue we adopted Titan's brother Ares from as well.    We prepared ourselves for worst case scenarios and assured Titan we loved him and it was all going to be okay.  When we got there Titan walked in with his tail wagging, eager to greet everyone and all the other dogs.  He's a very social boy and enjoys making friends.  After a short wait we were ushered into the exam room.  There we spoke with a vet who listened to all our concerns and went over everything with us.  But in the end we knew the best option was to get an xray.  Again, this vet is very good and the xray only cost $200.00.  I told the guy "If he's nervous he will just lay down and not move." and the vet smiled and said "that's okay."  So off Titan went with the vet to get his xray done.  I think I was more nervous then anything as I knew this would be stressful on my Titan.

We went into the waiting room and sat down to wait for our names to be called to come and get Titan.  After a bit only the vet came out and he seemed stressed himself.  Titan wasn't co-operating.  The vet asked us if we would approve them using a sedative to help Titan relax.  We were okay with this as we didn't want anyone more stressed then needed and had also just been told that Titan's lungs and heart all sounded great with no murmurs, so we knew he would be okay under the sedative.  So we sat in our chairs in the waiting room listening for our names to be called again.  A few dogs came and went.  Owners happy to pick up their dogs and at the same time giving us that look to say "I hope your dog is okay too."

Finally we heard our names and went back into the exam room to speak with the vet.  That's when we heard the dreadful confirmation and words.  Titan would need surgery.  My heart sank.  My mind raced.  The questions started.  The fear grew.  I reached for my husband's hand as we listened to the vet explain things to us.

The xrays showed that Titan would need TPLO surgery.

"TPLO, or tibial-plateau-leveling osteotomy, is a surgery performed on dogs to stabilize the stifle joint after ruptures of the cranial cruciate ligament (analogous to the anterior cruciate ligament [ACL] in humans, and sometimes colloquially called the same)." - Wikipedia

The xrays would have to be sent to a specialist as this was a very specific type of surgery and the vet who could perform it would have to be called in.  There would be a 4-6 week recovery time, with months of therapy after that.  We were looking at at least $3500.00 just for the surgery.  Talk about stress!  The one silver lining was that we had pet insurance.  A long time ago when Titan was just a tiny (if you can believe it) puppy a nice man with an older Dane told us the best thing we could ever do was get pet insurance.  Boy was he right! Big dogs cost way more and it was one of the best things we could have done.  And the vet's always seem relieved as well when we tell him we have it.  This time was no exception.

Once the vet went over the basic things with us about the surgery and how we would have to wait a few days for the specialist to look over the xrays and call us to set up a date for the surgery, we were sent back to the waiting room to wait for Titan to wake up from his sedative.  We were able to pay at this time for our visit.  Everything for this vet visit came to $580.00.  That is for the xrays, pain medication, sedative, reversal from the sedative, doctor's exam, and taxes.  Compared to the vet close to our house where the xrays are $500.00 alone, this wasn't too bad.

And so now we wait.  The pain medication is doing it's thing and Titan wants to play and run and rough house with his Dane brother Ares.  The hardest part right now is not letting him be a happy dog and play because he doesn't understand why and I'm not good at tough love.  I know in the long run it will be for the best so with the support of my husband we are currently on Titan watch until next Monday (November 28th, 2016) when he goes in for Surgery.