ness Posted February 12, 2013 Share Posted February 12, 2013 (edited) Last year I posted a thread about Kenz's on-going lameness saga and how things never really resolved. For anybody who didn't read the original thread Kenz had MPL surgery on her LH in May last year and despite that had on-going lameness issues post-surgery. Well she ended up back at the specialist again this morning because enough is enough and its gone from bad to worse in the last few weeks. You can bet my state of shock when I was told she had a luxating patella in her RH after I had been categorically told time and time again that her RH was no issue and so having forked out significant sums of money for a consult with a neurospecialist plus plenty of physio and chiro visits to try and improve the situation. Her LH isn't great either even post-surgery. She still enough muscle wastage to suggest that leg is the one that is bothering her the most. What a serious nightmare this has turned into. My young girl is physical mess and I am emotionally (and financially) spent over the situation. My gut feeling all along was that the RH also had a luxating patella but none of the "specialists" were convinced and guess what I was right. She is booked in to see a second specialist tomorrow but I am honestly not sure what that will achieve for the moment. I just desperately want my non-lame dog back . Edited January 22, 2014 by ness Link to comment Share on other sites More sharing options...
sheena Posted February 12, 2013 Share Posted February 12, 2013 Ness. I can understand your frustrations & sadness with this. Link to comment Share on other sites More sharing options...
Kavik Posted February 12, 2013 Share Posted February 12, 2013 Sorry you are having such a rough time of it Link to comment Share on other sites More sharing options...
ness Posted February 18, 2013 Author Share Posted February 18, 2013 (edited) So the second specialist effectively confirmed the first specialists opinion - yes she does have a grade 2 MPL in her RH and her surgery LH is still luxating a bit. (possibly a grade 1). However they also both agree the current level of luxation is not likely to be what is causing her current lameness issues. She has significant muscle wastage in her LH (so the repaired leg). The first specialist has confirmed that during her original surgery he used a nylon suture and crimp - as best I can google in a similar manner to how it might be used in a cruciate repair. What he told me is he placed an antirotational nylon suture to help support the soft tissue repair. The chiro vet has suggested that its an internal suture bothering her (and up until this past weekend I was told there was nothing in there that wasn't dissolvable) so this makes sense. The specialist who did the repair has also said though he doesn't think that is what is causing the lameness and is loathed to go in and remove it unless we are going ahead with a revision surgery on that leg. Has anybody had a traditional cruciate repair and had troubles with the suture causing enough discomfort to result in lameness? Edited February 18, 2013 by ness Link to comment Share on other sites More sharing options...
Panzer Attack Posted February 18, 2013 Share Posted February 18, 2013 Omg ness!!! What a nightmare! No advice, just support and you know where I am if you need to rant xx Link to comment Share on other sites More sharing options...
JulesP Posted February 18, 2013 Share Posted February 18, 2013 My border collie Fern snapped a ligament which caused the patella to slip out of joint. She was operated on, had the required crate rest, then the onlead stuff etc etc. The operation failed. The vet thought that the repair had snapped and gave me such a low % for a second op to work that I chose not to do it. Fern was never 3 legs off the ground lame constantly. The lameness came and went, as in leg off the ground. If I gave her a bit of a massage that usually seemed to fix it. Eventually scar tissue formed around the knee and whilst she didn't look sound it didn't cause her any issues. This happened when she was about 3yo and she passed at 15yo. She got some arthritis in her back but don't know if she would have got that anyway. I did retire her from dog sports as I didn't like her jumping. Next time Kenzie looks really lame, pick the leg up and gently bend it. See if that helps to slip the knee back in. Link to comment Share on other sites More sharing options...
ness Posted February 18, 2013 Author Share Posted February 18, 2013 (edited) Yeah have tried that but its impacting on her life 24/7. She can't do anything that she likes. She sits at the bottom of the stair case at home and whinges. She is lame on a short walk around the block to the point where she shuts down in pain. As I said the chiro thinks its not the patella so much as the suture rubbing which is not something that will disappear unless they go in and remove it but the specialist isn't to keen on that suggestion. Hence my question as to whether anybody else knew anything specifically about the use of a Nylon and crimp in repair (most commonly used to repair a cruciate rupture). Edited February 18, 2013 by ness Link to comment Share on other sites More sharing options...
OSoSwift Posted February 18, 2013 Share Posted February 18, 2013 I do know of cruciate repairs that have had to have the suture material removed as it was causing issues Link to comment Share on other sites More sharing options...
*kirty* Posted February 18, 2013 Share Posted February 18, 2013 Very rarely an animal will have an allergic reaction to suture as well (have seen it in a cat) so perhaps there is inflammation around the suture? Link to comment Share on other sites More sharing options...
ness Posted February 22, 2013 Author Share Posted February 22, 2013 Well Kenz is really going from bad to worse. She doesn't want walks at all. Doesn't want to swim at the beach just stands on the shore after a few throws of her toy into the water. Tonight we literally got 200m up the road before she started having issues with her LH and then shut down. She stands at the bottom of the stairs and whinges cos she wants up but can't seem to walk up herself. I don't know who to trust or where to go anymore. And still not in a position to just throw $450 at x-rays because thats what one specialist suggested but the second specialist doesn't feel that will show anything anyway. frustrating to see my girl so shut down over whatever it is thats bothering her. Link to comment Share on other sites More sharing options...
Panzer Attack Posted February 22, 2013 Share Posted February 22, 2013 Oh Hun Link to comment Share on other sites More sharing options...
Janba Posted February 22, 2013 Share Posted February 22, 2013 I'm so sorry Link to comment Share on other sites More sharing options...
*kirty* Posted February 22, 2013 Share Posted February 22, 2013 (edited) I'm so sorry to hear this. Poor little puppy. If you feel that you can't trust the first specialist anymore, perhaps go back to the second. I've known lots of dogs that have had the De Angelis method of cruciate repair (with the suture) and none have had problems with the suture rubbing. Do you know exactly what procedure she had done? ETA: I see you said it was the CCL procedure. Have you seen this page? Warning: there are some gory photos if you scroll down but the first page is just writing. http://www.jorvet.com/wp-content/uploads/2011/12/CCL_Lateral_Suture_Brochure.pdf Another page: http://cal.vet.upenn.edu/projects/saortho/chapter_81/81mast.htm Edited February 22, 2013 by *kirty* Link to comment Share on other sites More sharing options...
Kirislin Posted February 22, 2013 Share Posted February 22, 2013 This probably sounds far fetched but do you know if they ever use infra red cameras to show up where the inflammation is? Link to comment Share on other sites More sharing options...
ness Posted February 22, 2013 Author Share Posted February 22, 2013 No she didn't have a cruciate repair she has a soft tissue only medial luxating patella repair. The specialist tightened up the loose soft tissue with some dissolvable sutures but also placed a non-dissolvable nylon to try and support the soft tissue repair while it was healing. This was placed as an antirotational suture. My understanding of the antirotational suture is its suppose to prevent excessive tibial twisting inwards. I think it is placed around the lateral fabelle. Link to comment Share on other sites More sharing options...
*kirty* Posted February 22, 2013 Share Posted February 22, 2013 (edited) I found this page too. Not sure if it helps, but it says that with the more severe luxating patella problems, more than just soft tissue surgery may be needed. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1571132/ "Soft tissue procedures include medial desmotomy, lateral imbrication, antirotational sutures, and release of medial musculature. These procedures can be used in the immature patient to modify abnormal forces on growing bones and in mature patients to supplement bony procedures. By themselves, they are seldom sufficient to correct patellar luxation. Antirotational sutures are similar to the extracapsular sutures used for repair of the cranial cruciate ligament. They can be passed behind the lateral fabella and then through the distal part of the straight patellar tendon. Alternatively, the suture can be passed in figure-8 fashion around the patella after being anchored behind the lateral faballa." ETA: One of the links I posted mentioned something about soft tissue being caught up in the suture becoming necrotic. Does the joint ever get hot or look swollen? Edited February 22, 2013 by *kirty* Link to comment Share on other sites More sharing options...
ness Posted February 22, 2013 Author Share Posted February 22, 2013 There is probably no doubt now that not enough was done in surgery but the residual grade 1 luxation I have been told by both specialists isn't likely to be the cause of her problems now. Her vet has said similar. Although again not sure who I believe after everything we have been through. I still wonder about the suture/crimp causing irritation but to have that taken out she may as well have the surgery done to repair the patella again. If she has a revision surgery they will move the tibial tuberosity. I have been told it only has an 85% success rate and it may not change the situation if there is something else going on that is causing the lameness. . Link to comment Share on other sites More sharing options...
JulesP Posted February 23, 2013 Share Posted February 23, 2013 This probably sounds far fetched but do you know if they ever use infra red cameras to show up where the inflammation is? Not far fetched at all. There is such a device. The horsey one is called a bioscan. It scans the body finds ouchies and you can then use it to treat the ouchy. Does work on dogs too. I know a Victorian agent but not a SA one. Link to comment Share on other sites More sharing options...
ness Posted March 4, 2013 Author Share Posted March 4, 2013 (edited) Well Kenz has ended up back on pain meds (carprofen and tramadol to have as necessary) for the last 5 days and I was told I would know how good she was going to get after 4 days. Well she is definitely much better then she has been in ages. Coping with much more exercise and having absolutely no issues with the stairs. Her chiro vet still thinks it provides evidence that the internal suture needs to be removed. I am not really sure what to think but I do agree she can't live on pain meds indefinitely but there is obviously still something going on. Not really sure what to think at the moment. Edited March 4, 2013 by ness Link to comment Share on other sites More sharing options...
bianca.a Posted March 4, 2013 Share Posted March 4, 2013 Oh Ness you two need some much needed good luck and bloody soon ((((hugs)))) Link to comment Share on other sites More sharing options...
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