Friday, November 19, 2010

Tay - the light at the end of the tunnel - literally!

Tay's surgery went well.  The biceps tendon was 80% torn so it was severed in surgery today.  What is amazing to me is that he said it was very badly damaged and he had to do a lot of cleaning in there and yet she only seemed lame to a well trained eye who was really looking for it.  When her activity was restricted it was very hard to tell she was sore.  When her front leg was stretched back there was no apparent pain response.  The only pain response was when the tendon was directly palpated.  When she tried to do agility she would show lameness.  I tried to rest and rehab her twice with no success because the tendon was torn and not just strained as originally thought/hoped.

So often our dogs will be limping briefly and then the limp "goes away" and we assume that the pain is gone and therefore the injury is gone.  This is often not the case.  When our dogs are repeatedly sore after activity is a very likely there is a serious underlying injury causing it.  Soft tissue injuries can be so hard to diagnose.  Dogs are very stoic - part of their survival instinct. 

I took her to the University of Missouri Vet School for the consult and surgery - I explored other options but needed something that would have a doable rehab (no hobbles) and not cost a small fortune.  As some of you know, Tay is a special dog.  She use spinning and pacing as part of her self-calming rituals.  She is prone to worry and anxiety about things that are hard to control like strong odors.  Hobbling her would most likely cause her psychological damage.  Some of my other dogs would handle it fine but not her. The vet there was able to use ultrasound for the diagnostics (not an MRI) and digital x-rays which is much more cost effective.  He had excellent client service and genuine understanding of dogs and totally understood Tay's fears of going to the vet and was very respectful of that.

For the initial consult I had a thundershirt on Tay, had given her valium, had her stone collars on her and left her in the car until they were really ready for her to come in.  I had very high value treats with me too.  When I brought her in the volunteer came over and was really nice to her and talking to her.  Tay actually walked through the double glass doors and walked into the exam room which she rarely does at any vet's office.  In fact she has generalized double glass doors as scary. 

Tay liked the third year vet student (even in her white coat) and without any treats.  The student said "She knows I don't have my degree yet."  Tay licked her face which she does not do at the vet's office. When the surgeon came in Tay was afraid of him and he was great - no white coat, very soft in his approach and met her on her terms.  He got on the floor with her and was very gentle. She still was afraid.  I said "she knows he has his degree" and he said "I have no doubt she knows :)"  Even the second day Tay still really liked the student so that made me feel good because Tay was not too happy about being there.

The next day when I had to drop her off for surgery I thought she'd be in the waiting room for just a few minutes and they'd come and get her.  I couldn't give her any food and I didn't have any thing on her since I thought she wouldn't have to wait long.  As it turned out we had to wait 40 minutes because everyone was busy in surgery.  Fortunately the waiting room was really quiet and I did lots and lots of T-Touch on her.  It was all I had.  After about 15 minutes her breathing slowed and she laid on the bench next to me.  That is huge for her at the vet hospital. It is good to have a variety of stress relieving tools available.

Over the years with all of the different stress issues I've had with dogs I carry lots of "tools" in my toolbox because I never know what I will need.  I highly recommend learning T-Touch - it came in handy for me when I could not use anything else to help calm her down.   It took about 15 minutes before she calmed down.  Thundershirts are based on concepts from T-Touch body wraps.

Anyway all of this has given me a lot to think about.  The surgeon thinks it was a "jump down" injury and not a repetitive or turn injury and probably happened when the tendon was luxated.  Very plausible given that Tay is obsessed about jumping into chairs (thanks to Leslie Renaud's idea to give stressed dogs a place to go at trials!) and she has a "running" aframe which when she is excited can be more of a leaping aframe - usually not over the yellow but more of a leap off than a striding off.  "Running" contacts can be injurious too.  Tay's tendon was luxated in the surgery and the surgeon can't be sure whether it was luxated before it was injured or not.  However she has sporadic lameness on the other shoulder which is not typical with biceps tendons.  Usually only the dominant leg is affected with a biceps injury UNLESS they are genetically predisposed to luxating tendons.  That means the tendon rolls out of place and makes it more prone to injury.  I am contemplating having him scope the right shoulder to see if that tendon is luxated and if it is then he can "tack" it down to hold it in place.  He scoped both elbows and ultrasounded both shoulders and the right shoulder tendon looks to be in good shape and no sign of problems in the right elbow.  She is painful in both elbows so the concern is where is that pain coming from in the right leg.  I have a follow-up appointment in Missouri in January and I'm leaning towards having him check out her right leg at that time just to be sure.

In the meantime we have lots of leash walks ahead of us.


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