March 19, 2001
On March 2, 2001, our six-year-old Great Dane underwent
a surgical procedure known as TPLO to repair his knee after his cruciate
ligament ruptured. Unfortunately things have not gone smoothly for poor
Jabber. This radiograph reveals the current state of Jabber's leg
over 12 screws and 7 rods are holding things together.
All was well,
and then it was not...
Last week I wrote about Jabber's second surgery, which initially appeared
successful. However, five days post-op it was apparent that something
had gone very wrong. The doctor phoned to tell me radiographs revealed
that the bone was not holding up and Jabber's tibial plateau was starting
to deteriorate. That left us with few options. Amputation was considered,
but quickly rejected because Jabber's other hind leg is not sound enough
to support him. It seemed that unless the integrity of the limb could
be restored, Jabber would have to be put down. I knew it to be true,
but I could not bear the thought. After hanging up the phone, I wept.
The Third Operation
Jabber's surgeon, Dr. Paul Shealy, was once again working at his practice
in Savannah rather than his Charleston clinic. Jabber would have to
wait several days before Dr.Shealy would return, evaluate his leg and
operate. Dr. Shealy told me he was baffled by the unexpected turn of
events. He considered various surgical approaches to preserve what was
left of the tibial plateau, yet he knew he had to remain flexible enough
to respond creatively to whatever he might find when he reopened Jabber's
leg sometimes what is seen on an x-ray only tells part of the
it was finally time to operate, Jabber was anesthetized and his leg
was laid open. Dr. Shealy's observations persuaded him that Jabber's
bones might be softer than "normal" bones and the tibial plateau
section was unable to take the stress of the tibial rotation. What to
do? Shealy's solution was simple yet innovative. He decided to un-rotate
the tibial plateau. He lined the bones back up the way they were before
surgery. He replaced/repositioned the two internal plates from the previous
operation and then he added an external fixator to support and protect
the leg while it heals three pins through the femur and four
through the tibia, all attached to an outside brace. (See the radiograph
image at the top of the page.) Jabber's surgery lasted five hours. Afterwards,
Dr. Shealy told us that Jabber is just too nice a dog to lose. He felt
it was more important to save Jabber's life than to slavishly preserve
the TPLO correction. We could not agree more.
considered, Jabber is doing pretty well. He is uncomfortable, but not
suffering. The armature on his leg is large and cumbersome. Some of
the rods are visible; the rest are hidden under layers of bandages.
Through it all, Jabber has been amazingly stoic. Looking at his leg,
I know it must hurt like the dickens yet he is gentle as a lamb, almost
placid. He is eating well and the rest of his body functions are normal.
He gets really excited when I walk into the room. I've driven to Charleston
to visit him almost every day since the last surgery. The drive is not
too bad, just an hour and 45 minutes each way. Dr. Shealy is optimistic
about Jabber's chances for recovery and that's very encouraging. The
external fixator will be in place for at least four weeks and Jabber
will have to live at the clinic for a long time.
is unclear why Jabber's bones were too soft to accommodate the procedure.
There may be multiple factors such as advancing age, Jabber's hypothyroidism,
previous steroid medication Dr. Shealy isn't sure. He took several
samples of bone tissue for biopsy. Hopefully the results will help to
identify the nature of the problem, but we may never know. As for the
future, Dr. Shealy is hoping that scar tissue from all the surgeries
will eventually help to "strengthen" Jabber's knee joint and
give him some additional stability.
Please keep your fingers crossed that this latest surgery will hold.
I am not sure there are any other options for us if it fails.
Go to next installment...
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