Tightrope Repair for CCL and Meniscus Tear – Grayson

Grayson’s Tightrope Procedure for her CCL/Meniscus Repair

Grayson’s Background:

Breed: Weimaraner

Sex: Female/Spayed

Age at surgery: 4 years old

 

Grayson’s story began about 6 months before her surgery day.  We noticed her having trouble rising from a laying down position and getting up and down off of furniture. At first we thought that maybe it was her hips. We took her to the vet to have X-rays. She was diagnosed with a partially torn CCL.

We were given three options for surgery (TPLO, Nylon repair, or Tightrope) We chose the tightrope, but it was not recommended unless the dog had a FULL CCL tear and our Grayson had a partial. We ended up taking her home with Rimadyl and Hip/Joint supplements. Over the next few months she did WONDERFUL…I actually thought that it may have healed. Then, on mother’s day she must have torn it the rest of the way because she began carrying her leg and showing signs of extreme pain. We immediately scheduled the surgery for the next week.

 

Day 1-Surgery Day:

My nerves were shot on the drive to the vet. I was so worried about our sweet Grayson. Mostly because I had to leave her overnight. I trusted the vet whole heartedly and knew she was in good hands. I just hated to be away from her and I hated that she had to go thru this invasive surgery. When we got to the clinic he did a quick exam of the knee and walked me thru what was going to happen. The tech’s took her back to do pre-surgical blood work and run an EKG on her to make sure she was ready for the anesthesia. After all her test came back normal they prepped her for surgery. I left her at the clinic around 8:30am and she was set for surgery at 10:00am.

So began the waiting game….I am not good at the waiting game. I received a text about an hour into surgery from the Surgeons wife (who is also a vet and close friend). Her text said that the surgeon had opened the knee to find a completely shredded CCL and Meniscus. She said the surgery was going to take longer then normal because of the meniscus tear.

About 2 hours later the surgeon called. He said she was doing good and was waking up. He explained to me that not only did she have a CCL tear but her meniscus was torn as well. He also informed me that she had a genetic/birth defect that prevented her knee from being aligned properly (more then likely contributing to her injury at such a young age). He had some trouble getting the knee realigned but eventually was able to get her all fixed up. He assured me she was in good hands and told me I could pick her up the next day. Thru the night she would be placed on IV antibiotics and receive  pain meds to keep her comfortable.

 

Day 2-Bringing her home

The anticipation was killing me. I don’t think I could get to her fast enough. I had not slept much because I was so anxious. When we arrived at the clinic he informed me that she had not yet bared weight on her leg. This was a bit of a shocker for me because everything I had read said with the tight rope procedure they will usually began using the leg within 24 hours. He assured me not to worry that she was not only in pain but a little nervous as well. We were given strict pill dosing instructions for her Deramaxx (anti inflammatory) and Clavamox (antibiotics). He told us not to let her go up and down steps of jump up and down off of furniture. He said that we could start short walks after a couple of days.

We carried her out to the car and placed her in the back seat. She cried out a couple of times while trying to get comfortable. She had also urinated on herself in the night and they were not able to bathe her because of her sutures. I was in shock at the site of her incision. I counted 18 sutures. I will attach pictures. It was pretty ugly.

Once we arrived home we placed her in the grass and see if she would potty. She would still not use her leg or potty. We brought her in and got her to eat and drink a little and had her lay down in her dog bed. This is where she stayed for the next 5 hours. She slept and slept…Finally that evening she woke up and ate a full bowl of food. We took her out into the grass and noticed that she was beginning to lightly use her leg. She also peed and pooped (which I was worried she would not be able to do). She took her medicine pretty easily. I bought the Greenies brand “pill pocket” treats at Pets Mart and placed her pills inside. I would recommend these because they come home with lot of meds and its VERY important that they get each dose.

 

Day 3

 

I actually let her sleep in the bed with me last night. I just kept a hand on her to make sure she didn’t try to get off the bed (but she slept soundly all night). She woke up in good spirits this morning, and is back to her normal self–minus the hurt knee/limp part. She still is only barely putting her toe down every now and then, but is fully using the leg when its time to go potty.

We let her lay in the shade in the grass while we did some minor yard work. She seemed to really enjoy herself and we thought the fresh air and change of scenery would be good for her. I noticed some bruising and swelling on the inside of her leg. I text a picture to our surgeon and he assured me that it was normal and that gravity will cause some swelling inside her leg. He told me to begin checking her temp daily and call him if it is ever above 103. I checked it and thankfully it was 101. He also assured me that she would show small improvements each day. I am happy with her progress today, but looking forward to even more improvements and time goes on.  She also ate her normal breakfast this morning and easily took her medications. She is a pretty good patient.

 

Day 4

 

When Grayson woke up this morning she did her normal routine of going outside. She seems to be using the leg a little more then yesterday but still carrying it 90% of the time. After her morning potty break she came back in and I put her into the bed with us (she slept on her dog bed next to our bed last night) for the first time she laid on her leg. I was surprised to see her do this because she has been “babying” the leg so much. I am sure her healthy leg/hip needs a break since we are on day 4 and she spends the majority of her days laying on her good side. When she got up there was a little bit of blood/fluid on the sheets, but nothing alarming and considering the size of her incision I would guess this is normal. She also has some bruising on the inside of her leg still but the swelling has gone down some since yesterday.

Today she did not seem to have much of an appetite. I added a small amount of canned food to her normal dry food and was able to get her to eat. She also is not drinking water on her own unless I bring it to her and coax her a little. She is also not interested in treats at all (which is not like her at all). I have heard from others that this is normal and is probably a combo of her not feeling well and the meds upsetting her tummy. I also checked her temp again today and it was normal. I left her today for the longest time period yet (around 4 hours) and when I came home she greeted me with a bone in her mouth. This made me so happy because they is what she typically does but has yet to do since her surgery. We got a wire dog play-pen and placed it in our living room. It covers about an 8×8 foot area. In the play pen with her we place her dog bed, water, and bones. We are making small improvements everyday and I am looking forward to seeing where we are at the 1 week mark.

10 thoughts on “Tightrope Repair for CCL and Meniscus Tear – Grayson

    1. She is on 1000mg of clavamox and 75mg deramaxx per day. We have also started her on a hip/joint supplement and changed her food to one with glucosamine.

  1. Changes in appetite could be caused by the meds and it is something you need to be serious about. It could be from the antibiotics, which wouldn’t be all that serious, but if it is from the NSAID, than it could potentially be quite dangerous.

    Please consult with your vet. You might need to discontinue the meds. I’d also recommend running a blood screen to see what is going on.

  2. Small improvements add up over time. I hope Grayson is doing better and that her appetite is back to mormal.

  3. There are many options for treating ACL injuries out there. There are studies showing that after 18 months post-op there isn’t really any difference between them.

    The main difference seems to be the post-op period and the kind and severity of potential complications.

    One factor in the decision would be tibial plateau angle. If the angle is too steep, it seems that one of the osteotomies might be the best way to go.

    With our Jasmine, for example, we chose traditional extracapsular repair. Jasmine was 5.5 year old at the time and she is a Rottweiler.

    Reasons we chose extracapsular repair was that it is minimally invasive (as far as knee surgeries go) and if things go wrong it is not a major disaster. Because of her size the vet did dual suture though.

    Downside to extracapsular repair is that the post-op period is longer and more vulnerable to mishaps. (we didn’t have any with Jasmine, thank God, but we were also extremely paranoid and careful.

    The lower price also allowed us to combine the knee surgeries (she had both knees done) combine with stem cell therapy.

    We couldn’t be happier with the results.

    The reason we didn’t like TPLO (the only “modern” surgery available up here at the time) was that we didn’t like how invasive that is.

    On the other hand, TPLO, TTA and the newest TTO have shorter post-op period and are less vulnerable to mishaps.

    If things do go wrong though, they seem to go very wrong. So while the complications are less likely, they are much more dramatic.

    Our vet didn’t like the tightrope option because he felt that the material used in this type of surgery is more likely to cut its way through the bone. I don’t know that for a fact though.

    So at the end it is a judgement call, also based on how much you believe you will be able to control you dog during the post op.

    From the three “modern” surgeries I’d personally lean towards the TTO. This one is a hybrid between the TPLO and TTA. To me it looks somewhat less invasive than the TPLO and more sturdy than the TTA. It it also seems less fail-proof than the TPLO.

    Another important criteria is how much experience and comfortable your surgeon is with each respective surgery. Trust me, that can make a lot of difference.

    One of the main things, which your surgeon may or may not stress out enough (many don’t) is the post-op period itself. it is not just about preventing mishaps, but also about appropriate physical therapy. Because whether one might thing that or not, physical therapy can make or break success of the most awesome surgery.

    1. I agree about post-op and care being the most important part of this whole process! This is the sole reason why we made the decision for tightrope on our 100 lb. Bernese Mt. Dog – less invasive than TPLO and TTA! I am very nervous for him, but because of him being as mellow as he usually, we are relying on a healthy and careful post-op.

      Thanks for this thread and info! At least I know more of what to expect in the first few days after surgery. Our sweet Cooper goes in on Monday for the procedure.

  4. Great explaination! Other things you may wish to consider is the dog itself. Is the dog an athlete? A walking companion? The size of the dog, or even the general health of the other joints are additional factors.

    For example, years ago, our Cocker Spaniel had the traditional repair. He was small. He was very much older. He was a companion walking animal that was happy running about the yard with otherwise healthy hips and elbows. At the time there were three basic options: The TPLO, traditional repair, and the non-surgical management.

    Since that time, newer methods and technoques have emerged. My Rottweiler, Rave, is an active hiking, swimming, boating and Agility dog. She is ACTIVE with a capital “A”, and a much bulkier and muscular dog. She has no joint problems. So it was an easy decision to opt for the TTO with Laser. It is minimally invasive and the dog is on it’s feet very early on.

    I am happy with the surgery and her recovery. She looks good she feels good and is up for any activity I can safely give her. She would easily do “too much” if I didn’t pay attention. Twice already she has sneeked jumping into the Jeep on me! The first time was the day we left the vet’s when her staples were removed.

    What I’m saying is much of your choice will be (of course, affordability) based on your particular dog. If I had the TTO available with the Cocker would I choose it for him? Actually, no. I believe I would choose the same traditional repair for him based on his age, size, and lifestyle.

    Best wishes for you and your Pitbull, Mary.

  5. Lucy, I agree with you. Just would like to note that Jasmine is a very active dog also and being a Rotty not exactly a small dog and the extracapsular repair (in both knees) worked for her beautifully.

    At the end one has to make a decision that makes sense to THEM and that agrees with their instinct. The ability to control the dog during the post-op is an important objective criteria when doing that though.

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