Radiograph of Jabber's leg

Three Surgeries in Two Weeks

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.

Earlier Installments...

Week #1: See Jabber and learn all about TPLO.

Week #2: Jabber's first surgery. How it went and what's ahead. Also, meet Merlin. He misses Jabber.

Week #3: The first surgery failed. What went wrong and what was done in the second surgery. Visit Jabber at the hospital.

View last week's
slide show

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 story. When 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.

A Waiting Game
All things 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.

It 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.

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