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Lynnette

TPLO Surgery For Dogs That Have A Torn ACL

Last month, on a warm sunny day, Jim & I had just returned home from a trip to Canada.

We picked up our dog at the pet sitters, then we all played at home in the backyard together. Tenor was soooo happy to see us. It had been a week -- about the longest he'd been away from us.

Suddenly, he got this urge to just start running... HARD!

Tenor was running laps from corner to corner -- the entire perimeter of our fence line. When all of a sudden, as he was running and turning the corner, he yelped and fell down. His knee gave out. That was the start of Tenor's 3-legged mobility.

 

Our Dog Tore His ACL

We immediately called our vet, who said to put him on the Deramaxx pain killers we had leftover from the last time he pulled his leg muscle.  If it continued for more than a week, he wanted us to bring  Tenor in for x-rays.

It continued. The meds didn't help much. Tenor wouldn't put any weight on that back right leg at all. When we took him to the vet for x-rays, it was obvious that he'd torn his ACL.

tenor-dog-hip-and-knee-xray.jpg  tenor-dog-leg-and-knee-xray.jpg
 

Here's a great explanation: What Is An ACL?

 

The vet said Tenor had about an inch or so of free-range motion in that knee -- in a direction that he was supposed to have NONE. (More proof that the ligament was torn.)

dr-sam-beckman-dvm.jpgSo we scheduled our initial pre-op visit with the veterinary surgeon who comes highly recommended in these parts: Dr. Samuel Beckman with Affiliated Veterinary Specialists here in Nashville. (They're also the doctors associated with the after-hours emergency care center.)

darrell-waltrip-and-other-celebs-on-vet-wall.jpg  randy-travis-rascall-flatts-billy-ray-cyrus-dog-vet.jpg

 


So we took our vet's x-rays to the surgeon (Dr. Beckman), who also did a visual exam of Tenor and agreed the TPLO surgery was necessary.

By the way, while examining Tenor's x-rays (one set included his hips), Dr. Beckman said that Tenor will never have a problem with his hips -- they look REALLY good. Whew! some good news for a change!

Dr Beckman also spent a good deal of time explaining to us the parts of a dog's knee, how the knee and ACL work in dogs -- including ways that they're similar and ways that they're different from a human's ACL and a human's knee, the options for this type of injury, and what to expect in terms of the surgery and recuperation period.

a-dogs-acl-torn-ligament.jpg

 

What Does TPLO Surgery Cost?

We were given a ballpark figure ranging from $2,647 to $2,806 for the surgery & meds. (The variation was based on how much medication Tenor would ultimately need.)

In the end, we walked out with a bill of $2,541.

For the record, we had to pay 80% up front (on a credit card) before the surgery even took place. They don't take any chances with non-paid bills for high-dollar surgeries these days. Which I completely understand. (And no, we didn't have pet insurance.)

In case you're wondering, the bigger parts of the itemized TPLO surgery included:

  • bone-screws-dog-tplo.jpg Anesthesia (Tenor weighs 75 lbs) $375

  • ACL repair - TPLO on a large dog $650 (this was the cost for the labor alone)

  • ACL parts - 1 metal plate $210 and 6 screws $126

  • 2-night stay requiring 24-hour nursing care, level 3 $156

  • 2-night hospitalization standard (walks & feeding?) $50

  • X-rays (yes, this doctor required his own set of X-rays -- one set prior to surgery and another set immediatley after surgery. AND we have to go back in 6 months for a follow-up visit to make sure everything is healing properly, which is where he'll compare with the earlier sets) $196

The remaining balance included all of the many meds, bloodwork, IV's, surgical prep, operating room, bandages, e-collar etc.

dr-sam-beckman-tenor-dog.jpg  nurse-amy-bringing-tenor-with-ecollar.jpg



Tenor's surgery took place exactly one month to the day that he tore his ACL running in our backyard. (He is 7 days post-op as I write this.)

By the way, we consulted with 3 separate veterinarians prior to scheduling the surgery, regarding whether or not there were other options instead of the TPLO surgery to repair Tenor's knee. But, because he's such a large dog, each recommended the surgery.  And each told us the going rate was between $2,500 and $3,000 for TPLO surgery. (Other reports support this figure.)

What if you cannot afford the surgery for your dog?

 

TPLO Surgery For Dogs With Torn ACLs

Here are some of the interesting things I learned about a dog's ACL and TPLO surgery:


Dr. Beckman said that TPLO surgeries are incredibly common in most full-breed Labradors, though a mixed-breed Labrador generally doesn't have as high chances of inheriting the weak ACL as full-breed Labs do. Tenor was the exception to this rule. (He's part Labrador Retriever, part Great Pyrenees.)

 

dr-sam-beckman-tenor-dog-with-ecollar.jpg Dr. Beckman does roughly 100 TPLO surgeries on dogs each year. He did 2 others on the same day he did Tenor's.

 

When a dog tears his ACL, basically you can either do nothing or have the surgery. There's not a lot of middle ground with things you can try along the way. Of course, you'll have your dog owners who swear by natural medicine and holistic care, including vitamins, natural foods, and supplements -- which may work for some. But for the most part, the larger the dog, the more the TPLO surgery is pretty much the only way to go.

 

I was told (by all 3 veterinarians we met with) that it's not as imperative as you might think to rush a dog into surgery right after you notice the limp from a torn ACL. It won't "heal wrong" or anything. And dogs (including Tenor) can function quite well on 3 legs in the meantime. The biggest difference is... the longer you wait to have the surgery, the more pronounced the arthritis will likely be as your dog ages. Arthritis in dogs who've had torn ACLs is pretty much inevitable. It's just the degree to which that arthritis sets in that differs in dogs -- and it's based on a whole host of other factors (including diet, activity level, overall health, etc.)

 

Dr. Beckman said the bad news is... when a dog tears his ACL in one leg, 30% of dogs will tear the ACL in the other leg at some later date, as well. (I've actually read this stat could be as high as 50%.)

Greater than 90% of dogs enjoy a seemingly pain-free and limp-free quality of life.  It is important to understand that the knee cannot be returned to a 100% return to function.  In addition 30-40% dogs that rupture one knee, will have the opposite knee rupture, often times within the next 12-18 months. Source

 

I asked about the "fishing line surgery" that I'd seen on the Internet (in the video below). All 3 veterinarians agreed that type of surgery works better on smaller dogs; larger dogs are just likely to tear that as well. Or, our surgeon added, if a dog is older and/or less active, and money is an issue, then that might be a viable option. (Tenor is a 2-year-old puppy with lots of energy.)

 

 

Basically, for TPLO surgery on a dog, they separate the bones, remove the ruptured ligament, and screw the bones together with a metal plate that enable the knee to bend properly. In veterinary medicine throughout the years, the size and shape of that metal plate has changed a bit in order to accommodate what they've learned about the way dogs use their knees and how their range of motion is slightly different than humans. Plus, they use a smaller metal plate for small dogs and a larger plate for large dogs.

 

dog-sitting-2-days-after-tplo-surgery.jpg I asked Dr. Beckman about glucosimine and condroiton supplements, and whether I should be giving them to our Tenor to build up the fluids and strength of the joints. He said that was a great question. (Why, thank you!) Basically, he said there's a ton of research that shows glucosimine and condroiton (both, the human versions and dog versions) are perfectly safe for dogs. What has not been proven however, is their degree of effectiveness with dogs. He said some of his patients seem to do well on those supplements; others show no improvements. He recommended that I talk to my regular vet about it, because a regular vet specializes in long-term care for dogs (whereas he specializes in short-term emergency care for pets).

 

Tenor's stitches are self-dissolving, so there are no stitches to remove. But Dr. Beckman still likes to check the dog's progress at 2-3 weeks post-op. Then again at the 6-month mark to make sure things have healed properly internally (thus, another set of x-rays).

 

He said it is rare that a dog will also tear the cartilage in the knee at the same time he tears the ACL (1 in 100), but our dog tore the cartilage in his knee at the same time. That just meant that Dr. Beckman had to remove that broken piece of cartilage while he was in there doing the surgery.

 

conehead-dog-tenor-in-jeep.jpg  dog-with-ecollar-in-jeep.jpg

 

Stay tuned... tomorrow I'll post photos and details of Tenor's recovery from TPLO surgery!




  • canadianeh93
    I have a 34 month old female Akita (Malibu) who is, as I type, in her second TPLO surgery. She had her first one July of 2008 when she was just over 1 and she recovered amazingly. She slipped in August of 2009 and has been doing the "toe touch" since. We did rest her time and time again to the point where she would be good and then she would turn the wrong way while chasing the Pom (Boone) and we would be back at square one. We opted to have the surgery done now so she is healed by summer and ready to go. At the rate that she is going, with no exercise, she is not as healthy as she could or should be. She tips the scales right now at 120lbs and could definitely stand to loose a good 10 to 15 of them.


    It is a very expensive surgery to have. We are from Alberta, Canada and the first surgery that she had was in Calgary which cost us $4000.00 +. I did some research and I am sitting in Great Falls Montana where her surgery will cost me half that. $2100.00 I call her my "Million Dollar Dog". She is worth every penny of it and I can't wait to see her run like she should be able to. I hope she recovers from this one as flawlessly as she did the last one.
  • Amanda
    Lilly our black lab 3 1/2 now had TPLO May 2009 and we did everything to keep her well...she had some infection but that cleared up and we were doing so well. One day when I wasn't around my husband decided it would be a good idea to see how she would do running. She limped some afterwards on her "good" let but seemed okay after a few days. She has played with our other family dog several times and always seems to limp afterwards. Now tonight she is limping and toe touching with the "good" leg...I am so worried we are in for surgery 2 coming soon. At this rate she will be at full tilt when she turns 5... and that stinks but if we don't do it we are not giving her the best life. We will have to wait until we pay off this first surgery in order to do the next one so for now I am holding her off on Deramaxx and Glucosamine and Adequane shots every month. Okay, so thanks for letting me tell you all about this...I have been so stressed that this would happen since the day she had hers surgery in May :(
  • Charlie's Mom

    Charlie, my 9 y/o beagle tore his ACL in his right hind leg

    the weekend prior to Christmas - must have

    been a hole in the kind of muddy field when at Blackie's

    Pasture. He was diagnosed at the Pet Emergency Center in San Rafael and given some pain medication and anti-imflammatory meds.

    It was not easy to locate a surgeon to perform his TTI

    surgery during the holiday week We were really lucky

    to find Dr. Anderson at the Animal Surgery and Emergency Center in Los Angeles.

    He is now 2 weeks and 3 days post op. Staples

    are out and he is doing great!

    He does want to be more active, but seems to understand. Does not try to jump on sofa or bed.

    Just taking anti-inflammatory meds now.

    He'll have post op xrays with sedation early Feb.

    Emergency room cost - about $300.

    Surgery cost - about $4400. Have insurance !!.

  • Johnson Biggs

    Cider my 6 year old 120lb yellow lab just had tplo surgery on wend and she is recovering really well. Dr. Juan Marti in Chesapeake, Va did the surgery and could not have been any nicer and helpful during the process. Being that our dog is a little over wieght our local vet put Cider on Slentrol for fast wieght loss, has anyone had any experince with this med? Also any advice for post op care?

  • Kristina Kerzel

    My 1 year 11 month Chocolate Lab named Ginger had TPLO surgery on Aug 5, 2009. She went thru surgery well and they say it takes about 12 weeks before she could return to normal activity without leash. Went to her 12 week checkup to be told she needs 4 more weeks of crate and leash walks. On top of that she has iliopsoas strains which now needs laser therapy on them. Went to her 16 week checkup today and said her leg is 95 percent healed but was told they think her right leg now has an acl partial tear because it is sensitive to touch and swollen. I do not see where she is favoring it at all. They suggest lasor therapy for 1 month and see if it heals her knee along with the iliopsoas strains . If knee is not better the reccomend tplo surgery for that knee. One more month of leash and lasar. I am wondering when this jorney will end. My poor baby wants to play and run so bad. She gained 11 pounds thru her recovery. She was 86 pounds and went up to 97. Feeding her Eukanuba adult weight control suggested amount on bag. Today she weighed 84 pounds. Lost weight with almost no activity. Don't want her to loss no more so increased it by 1/2 cup.

  • Jason

    For those of you that are confused about what to do. If your dog has snapped one ACL and you are not careful with them; then there is a high chance they will snap the other as well. I paid 2750.00. I got 3 opinions and all were very accurate. We just got TPLO surgery done on my American Bulldog/American Rott. She is 3 Years old and very active. She is 98lbs and I have to say this was the best thing ever. She is 3 weeks into recovery and things are looking better and better each passing day. Before she used to tip toe on her back legs and shifted all her body weight on the front two legs. She would waddle like a duck! Now she is walking with the right posture her legs are spread at equal distance and appears she is on her way to being a normal dog again. I love my dog and think this is the best thing for her. Most people think a leg will heal on it’s own. Let me clarify that statement; They don’t. No matter how much rest the dog has the ligament needs to be repaired or replaced if they are ever going to get to live normal lives again. The purpose of keeping the dog relaxed is so the pain becomes tolerable to the dog. What I didn’t see on this site was the mention of how severe the arthritis will get as the dog gets older. TPLO worked for me and my friend Tela. I would recommend you do it too! If you live in Houston Brookdale Animal Hospital is great. If you have a small dog less the 50 pounds there are alternatives that don’t cost half as much. I think the cost if between 4 and 8 hundred dollars. Hope this helps anyone. jlozano@xvand.com if you have any questions. I would be more than glad to share my experience with you.

  • Brandi

    Jason,

    My 130lb rott just had the surgery on monday, and today we went to go the bathroom, and he took off after a deer, he didn't cry or anything, but now I'm so worried. He never does that, so I wasn't worried. Did your dog ever run right after surgery?

  • Gayle

    Jason,

    My chow chow, Sassy (6 yrs old) her TPLO surgery in June. She is completely healed now. I was very strict on the lease thing for 2 months. Our daughter works for the clinic that did the surgery and she was adament about the leash. The repairs after they damage their new hardware is quite extreme. The lease is much easier than a costly repair. Sassy now is allowed to run free and she seems to know her own limitations. She chased a rabbit at the park last Sunday and she did not run with quite the same vigor but the thrill is in the chase anyway -- she never catches them. Synovi G3 soft chews help with the arthritis. She has had an ulnar ostiotomy when she was 6 mos old and has been taking the G3 to help with arthritis with that. Doctor says it will help after this too so she is still taking it.

  • sheri

    Hi Jason,

    Make sure your dog is on a leash and goes to the bathroom and comes right back in. My dog tried to run after lizards but i had her on a leash so she did not get that far. Good luck i know this surgery is rough and has a long recovery.

  • Hi Brandi,



    For what it's worth, my dog (featured in this article) broke out into a full run several WEEKS after surgery and it scared me to death! But it had absolutely no affect on him - he healed perfectly fine, and quickly -- despite that one running instance.



    I'm not sure what running just a few DAYS after surgery would do though... I'd watch him closely, that's for sure. I would also touch base with the doctor who performed the surgery, and ask for their advice (or reassurance) too.

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