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Angus – Bilateral TPLO (or not?)

bilateral TPLOWell here it goes. Our 8-year-old black lab mix, Angus, has always been a very high energy athletic dog. A few months ago, he turned up lame on the right side, not putting his foot down, etc. We didn’t witness the event that caused this, but it was likely running through the yard doing his normal crazy lab stuff. At any rate, an initial exam by our regular vet said he thought “it might be” a CCL tear or partial tear and recommended we try Rimadyl and rest to see if he improves. He did improve and we were relieved. Then he re-injured the same leg, and did not recover as quickly. We continued to monitor him and over time he showed signs of improvement, but we still felt we needed to get to the bottom of it and find out for sure what the injury was.

I took him about 2 weeks ago to see an ortho and he confirmed through the drawer test that it was indeed a tear. Bummer. We discussed the surgical options (TTA, TPLO) and the doctor advised against conservative management or a brace, stating that conservative management would be lucky to yield him about 50% of his activity/mobility back, and that dogs don’t like to wear the braces. Since he had been doing pretty well, we figured we had a little time to do our (my) homework on surgery and figure out the finances. Then last week Angus injured himself again (the opposite leg this time, unfortunately) and was in a lot of pain. I started him on Tramadol, which helped with the pain, but after several days, no real improvement in walking. I took him yesterday to the ortho (a different doctor than the first time) and confirmed my worst suspicions: the left is now torn too.

So now we are faced with a bilateral surgery which we can’t afford, or conservative management which I know nothing about. I’m not sure we could do a brace on both legs–that seems like it would be very cumbersome and uncomfortable for Angus. My husband is not at all on board with spending the money for the surgery (this is not Angus’ first expensive surgery). I am concerned, don’t know what to do, and don’t know how to convince my husband that surgery is the right choice. I’m not even sure myself. I have called a few different vets in town (who would have no financial gain from the advice they gave) and ALL agreed that the TPLO would be the best choice. Any advice on the good or bad side of surgery would be most helpful. Thank you so much. I have gotten a lot of great information by reading some of the stories on here.

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7 Responses to Angus – Bilateral TPLO (or not?)

  1. December 11, 2015 at 10:38 am #

    I’d do it. Your dog has years left and still runs the risk of developing arthritis, with or without the surgery. I did it for my 7 year old dog but did one leg at a time. That would be my recommendation. You’ll have to keep the dog leashed for good now. That is really the only way to protect the joints. I find it necessary to use mental stimulation through training to keep my border collie mix physically inactive. I also invest in a lot of chew toys so she can divest energy through chewing. They need some alternative to their accustomed active lifestyle. I am still not walking her yet. It has been a year since the first surgery, but only 6 months since the last. I am fortunate in that I have a payment plan arranged with my vet that works for both of us. He’s a general practitioner, not an orthopedic specialist. That was my choice since he has always been such a trusted partner in my pets’ care.

  2. December 11, 2015 at 11:28 am #

    While Jasmine had both knees bad and had surgeries shortly one after the other, at each surgery she had a relatively reliable leg to get her through. If she needed surgery on both knees at the same time, or back-to-back, TPLO (or TTO) is most likely the option we would have chosen.

    All cases of bilateral tear I know about had the TPLO done. I believe that conservative management without brace is impossible to do successfully with both legs affected. It is a gamble with only one bad knee.

    Braces could potentially work and I think it is possible to have a brace on both legs but most of my friends who only had dogs with ONE busted knee ended up having to do the surgery anyway after the knees suffered further damage. Braces can work but would have to be on at all times and even then some dogs suffered secondary problems such as with their hock etc.

    “Knees love being operated on,” Jasmine’s vet used to say. While I didn’t like that statement then, after getting Jasmine’s knees surgically fixed and knowing about dogs who’s conservative management failed, I’d have to agree with it.

    This is one of the problems that can be fixed really well and the dog can return to their full lives once they get through the post-op.

  3. December 11, 2015 at 11:58 am #

    If you look through the Dog Knee Injury Facebook page, you will find my guy’s story….look for Domino. His were back in 2013 I think?
    Domino had bilateral TPLOs (it didn’t start that way), when he tore his second CCL one week after his first surgery.
    Had I known, I ABSOLUTELY would have done them both at once. It’s cheaper, safer, and should result in 100% recovery.
    His complications were due to the fact that the second one tore before the first one was even healed, throwing too much stress on the first repair and loosening the plate. Had I known then what I know now, I could have saved us both a pile of pain, and him several surgeries.
    Domino was (I am guessing cause he’s a rescue) about 8 years old when he got the surgeries. He is back to about 90%, and I rarely see signs of pain. He still runs around, although he doesn’t jump like he used to, but he is a 10yo lab mix now, so I am happy he can move without the pain meds. He does all right, and I anticipate another year or two before the arthritis starts to get to him.
    Financially, I would have saved myself at least $3500 had I done the two surgeries at the same time. My vet said the bilateral is safer for the dog too, because they will split the weight evenly. You cannot effectively brace only one side with a bilateral tear, and dual braces are uncomfortable for the dog at best in large breeds. If there are dual tears, even partial, the likelihood is that the dog will tear the second one partway through recovery because they are keeping the weight off the surgical leg.
    I’d definitely recommend doing them at the same time. I took a loan against my truck to cover the nearly $7000 for both surgeries and all the complications. I REALLY wish we would have known his other leg was so close to tearing. 🙁

    • December 2, 2016 at 11:14 am #

      Great advice

  4. August 27, 2016 at 7:12 pm #

    So many people don’t deserve a dog, because they wont or cant do what needs to be done for the animal in situations like this. Kudos to you for doing what needed to be done. (Our pitt mastiff mix is two weeks into his second tplo and doing great! Also, you would be amazed at the difference in price among vets for this surgery. Our first quote was 3600 bucks for the first one, and found a great vet who did it for 1800. This one was a couple hundred more.

    • December 9, 2016 at 6:57 am #

      Bob,
      Could you tell me where you found your vet for 1800 and what city do you live in?

      Thank you.

      • December 9, 2016 at 8:32 am #

        Susan, We live north of Detroit. Vet is Dr. Wilson. He has a large practice in Romeo, MI. 2nd surgery was closer to 2k.

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