My name isXXXXX and I will do my best to help you with your questions about Valentino. I'm so sorry he's having trouble, but glad you are looking for the information you need to help him.
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There are a lot of different ways to repair torn cruciates, so you do have some options.
I am wondering how hard recovery will be with both legs being operated on.
We tend to make our recommendation as to whether or not to do one or both legs based on the individual dog and his unique circumstances. There are advantages and disadvantages to both.
So this is somewhat common to do both legs at the same time?
What are the advantages of doing them together? And what are the advantages of doing them separately/
The advantages of doing them together are primarily focused on Valentino only having to undergo one surgery and one recovery procedure. That means you can expect him to spend approximately 6-12 weeks recovering ONE time, as opposed to twice.
Additionally, when there are confirmed problems in both legs, you run a very high risk of causing further injury to the unoperated-on leg during recovery from the first surgery. This is because it is already not stable and is having to do the work of two legs.
Because of these two reasons, most surgeons prefer to do both legs at once, if that is at all possible.
It is also less of an expense to do both at one time as opposed to separately.
Doing the surgeries separately is a better option when one leg is severely affected and the status of the other is uncertain. This is sometimes a better option for smaller, younger dogs when the doctor isn't convinced both legs will actually need surgery.
In a sense, if both of Valentino's legs are seriously affected, doing one leg at a time wouldn't provide any advantage because it still wouldn't leave him with one good leg: he'd have one recovering leg and one injured leg. Two recovering legs is usually a better option.
While he is recovering, you should plan on being able to provide some support and assistance for him to stand and walk by slinging his rear legs from a towel around his belly.
The only person equipped to answer specific questions like how long you should expect it to take for Valentino to recover is the surgeon you're working with. In general, ACL repairs take between 6-12 weeks to recover. Some are more complicated than others. The most important thing you have control over BEFORE surgery to shorten that recovery time is make sure Valentino isn't overweight.
During the recovery period you'll be less likely to have complications if you follow your surgeon's instructions precisely in regards XXXXX XXXXX like exercise restriction, physical therapy, using ice, and things like that. Treatment with a therapy laser will also speed healing, if that's available.
In regards XXXXX XXXXX questions about pain, the whole reason to do this is to restore Valentino's knees to a non-painful, stable state.
There is some pain involved with surgery and recovery to be certain, but the goal is to rebuild things so Valentino's knees hurt less and work better.
They'll never be as good as healthy knees, but he'll do the best he can with them.
I was having problems with the chat feature earlier and am worried you cannot see my replies or respond yourself. My computer indicates you are typing. Can you see what I am saying?
4 Weeks ago the doctor said he was about 3-5 pounds overweight, he has been eating mush less in the last 4 weeks so I would imagine he has lost some weight. We have tried the sling option but he immediately throws his back area up and almost topples over... any suggestions
Good. I can see your response.
I'm glad you've tried the sling. If it's being done properly, you can end up bearing ALL of the weight of his rear end from the towel, and he can walk along "wheelbarrow" style.
How long before he will be weight bearing and can go on his own, he is very ocd about going in his own area and tends to hold if he is not comfortable which I would imagine is not healthy
If he is throwing his back up and toppling over, if I am understanding correctly, you need to lift more so you are holding him up and he cannot topple over. Rest assured I understand this is not an easy task with a large dog. When we have really big dogs we use two people to assist them in this manner. One on each side of the dog holding onto one end of the towel.
Unfortunately, I cannot tell you how long it will take before he is weight bearing. Neither can your surgeon. It's impossible to predict the future as there are too many factors out of our control. In a best case scenario, he may bear weight immediately upon waking up. In a worst case scenario, things could go disastrously and fail catastrophically and he would never bear weight again. Neither of those scenarios is terribly common. If he's like most dogs, he'll start to bear a little weight within a few days and will not require the assistance with a towel after a couple of weeks.
Please rest assured that no matter how OCD he is about going to the bathroom, his physical reality may change those habits. If he has to go, he will go.
So should I not be concerned if he is holding large amounts of time?
Dealing with Valentino's needs to eliminate will certainly affect his recovery. Complications with urination and/or defecation can result. They are not terribly common, but if they do occur, they can be dealt with. It wouldn't be accurate to say you shouldn't be concerned if he doesn't go to the bathroom for a long time. The fact remains that worry over such issues is something that can be dealt with if they occur.
Does that make sense the way I've explained it?
You may go through a bit of a rough time for a few days or even weeks, but no permanent damage to his urinary system will result as long as he is receiving appropriate nursing care.
Valentino will be able to decide how important his going-to-the-bathroom OCD issues are to him. He may find it challenging enough dealing with his recovery that he no longer cares to find just the right spot.
If he appears to still obsess over finding just the right spot, then you can relax and rest assured that his recovery is not taking too much of a toll on him.
BotXXXXX XXXXXne is that nothing during this surgery will prevent him from being able to go to the bathroom. A tremendously ill or injured dog (no matter how OCD to start with) with urinate or defecate in its bed if it is unable to get up.
But that's an entirely different situation than we're talking about. Perhaps you can relate if you can consider situations where you were ill and didn't care who saw you vomit, urinate, or defecate. It's coming out when it has to, no matter what.
The surgery that I am describing is that the least invasive surgery for this type of injury?
Hmm. Again I find myself struggling with exactly the right words to answer the particular way you've worded your question...
No, it is not the least invasive surgery for this type of injury. It is one of many methods. There are some that are less invasive, but I wouldn't call them good methods. How invasive a surgical repair for an ACL tear is not really part of the criteria I would look at when choosing a treatment plan. It's irrelevant.
Once a decision is made that to pursue a surgical solution for an unstable knee, the best way to proceed is with the plan that will have the greatest chance for a successful outcome and quick recovery in that individual surgeon's hands on that unique patient.
Those are the important criteria.
A more experienced surgeon is going to be better able to make a decision like that.
There are a lot of different ways to fix unstable knees, and you do have choices.
Your comfort level with the surgeon and his ability to communicate with you will be critical.
Does that make sense?
I don't know if you can answer this, but if all things were equal what would your preferred surgery be?
My preferred surgery would be the one that is most likely to result produce the best possible outcome for my dog with the resources at hand (budget, surgeon, recovery limitations, etc.)
Whichever surgery would meet that criteria would be my preference.
That's why we have different tools in the toolbox.
And that's why you need to have a vet that you trust. You have to trust that he is well-trained and experienced and is making his recommendations for what to do for Valentino based on what he thinks is most likely to produce the best result.
For some dogs and situations my preferred surgery would be an extra-capsular repair like the one you are describing. For others my preferred surgery would be a TPLO.
Ok thank you for your help
You bet. Again, I didn't want to dodge your questions or give you easy answers. I wanted to give you truthful, accurate, and complete answers, even though they're harder to deal with. I hope you understand.
Is there anything else I can help you with?
No I think that should do.
If you think of anything else later, even after you've left the chat, you can always post more to this thread and I'll be notified via email. I want to be as helpful as I can.
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