The morning of March 9th came and like before her first surgery, I was pretty nervous, although less so this time. Given that Maia had no issues during her first surgery and was doing so well with her recovery and rehab, I was actually looking forward to getting through this surgery so that Maia could walk again. Since she had now injured her right leg and with her left leg still recovering, the poor little girl could hardly walk, so I had been carrying her from room to room and to go outside to potty. While she seemed to quite enjoy being carried around these days, my back was not having as much fun.

We went through the same process as before, we packed up one of Maia’s beds, a toy, and some food and snacks and off we went. Maia clearly was not happy with being dropped off again and she barked and barked as we left. No matter how well she did in her last surgery, hearing her bark in a tone that was pleading for me to not leave her, was heart breaking.

Later that afternoon we received the call that Maia was about to head into surgery and as before, we logged in to watch the surgery. The surgery progressed much like the first one and no matter what, I was still nervous and worried. Towards the end of the surgery I noticed something different than the first surgery and my worry began to border on panic. One of the surgical assistants left the room and then came back with something, then left again and came back with something else. I then noticed Dr. Lirztman working on what appeared to be the outside of Maia’s right leg, given how it was positioned. Again, the web cam is more of a birds-eye view of the operating room, so you can’t really see exactly what is going on, I just knew that this was different and this did not happen during the first surgery, and the surgery was taking longer. When the surgery was finally over we waited and about an hour later we received a call stating that Maia was awake and doing well. We were told that Dr. Lirtzman was already in another surgery and he would probably call after that or we would just see him tomorrow when Maia was discharged. They also texted me another picture of Maia after she woke up.  She does not look happy!

Around 7:30PM that night we received a call from Dr. Lirtzman and clearly it was a long day for him as he just finished his last surgery.  He explained that the surgery went well and that after the TPLO Maia’s right knee seemed to be a little too unstable, so he performed a procedure to stabilize it using a lateral fabello-tibial anti-rotational suture implanted via a single, 1.5mm bone tunnel in the tibial crest of the distal tibial segment with a two-hole titanium suture button. That was a lot of medical terminology there to basically state he put a very strong suture through a tunnel he drilled in her leg bones and tied together to eliminate the unstable knee. The suture wraps around the tibial horn and provides extra stability for the knee.  That’s what the extra procedure was that I noticed and had me so worried.

The next day we arrived to go over the surgery and to pick up Maia. As before the surgery was explained in great detail and we were shown images from the arthroscopy that showed the ruptured CCL and meniscus damage, as well as videos of the arthroscopic procedures to clean up the knee. We then were shown the x-rays and had the TPLO procedure explained and were told that it went very well. We then discussed the extra procedure to stabilize the knee. Dr Lirtzman stated the knee was just too loose for his liking, so he performed the extra work. You can see in the x-ray the two hole titanium button.

After finishing up the post-surgical review we collected Maia and got her loaded into the backseat of my truck and headed back home. Maia has no more knee joints so her TPLO surgeries are over and she is officially a bionic dog.  Now I could focus on her healing and rehabilitation.

After we arrived home, and we got Maia out of the truck, which was no easy task in itself,  and Maia slept away the rest of the day and night. She was clearly worn out but happy to be home and I was happy to have my puppy home.

Over the next week Maia struggled to get around without me carrying her as her left leg was still weak and not healed from surgery and her right leg was definitely more sore than her left leg was. She did not like me doing the passive range of motion exercises, no matter how gentle I was, and would occasionally growl and moan at me, letting me know she didn’t like it. Ice was definitely her friend. I had hoped that like her left leg, Maia would begin putting weight on her right leg within 4 days. This however was not be this time around and Maia did not start any weight bearing until her seventh day. I was actually starting to get worried given how quickly she was weight bearing on her left leg, but on the 7th day, she started hobbling around and in a couple more days she was limping but weight bearing. Whew.

I decided that this time around I would take her rehabilitation even slower. As I mentioned before, the TPLO home rehabilitation hand book we were given was clearly written with a younger dog in mind. so for the most part, her early rehabilitation consisted of just a few laps around the inside of the house, on the rugs, and no other exercises. Basically, I just wanted her to keep moving and we would concentrate on more intense exercises as she healed up. We continued to ice her down often during her first 7 days until the swelling and bruising had subsided. Her right leg actually appeared to be less bruised and swollen than her left leg was after surgery, but was clearly more painful, perhaps from the added procedure to stabilize the knee. So, given all that, I was in no way going to rush her rehab and the ice clearly made her feel good so we continued icing her down for a few extra days.

Given that Maia now had two back legs that were sore and weak, I bought her a set of Ruffwear mesh boots that have a vibram rubber sole. They really grip well on slippery surfaces and allowed Maia to stand on tile without her back legs slipping out on her and the mesh helps keeps her feet cool. I use them when we have visitors or take her anyplace that might have a tile surface, like the doctors office or to get her a “pawdicure” on her nails. I also used them in her first few weeks of rehab as even though she would walk, she tended to not fully lift her right leg up and thus was dragging it on the carpet/rugs and that actually caused a bit of her back paw to get roughed up. These ensured her paws were nice and protected and gave her added traction.

At the 10 day mark we took Maia back to have her sutures and staples removed.  Upon arrival at the doctors office, the poor little girl was shaking like a leaf, probably thinking we were going to drop her off again and she was going to wake up in pain with another shaved leg. As the Tech took Maia back to have her staples removed, I noticed that as they went through the door to the back and before the door closed behind them, Maia’s muzzle suddenly appeared in the door trying to open it back up, the little girl was trying to make a break for it!

They brought Maia back out a short while later and stated she was healing up well and all her staples sutures were removed. The doctor also evaluated her walking and thought everything looked good. So far, so good!

As we moved further into her recovery period, Maia was clearly becoming bored with being fenced in and although I was usually just a few feet from her, she would complain, incessantly, wanting attention – especially after dinner when she had energy. Since there wasn’t much we could do,  I found some puzzles for dogs on Amazon that Maia really enjoyed playing with. Basically you hide treats in the puzzle and she has to figure out how to get them out using her nose only – no paws. This at least provided her some activity to exercise her mind and she really looked forward to her after dinner puzzles. We would also sit out in the back yard during the afternoons and she thoroughly enjoyed being outside, watching the birds and sniffing the air.

As the weeks continued to pass I was gradually increasing her exercise workload and also utilizing plenty of moist heat and gentle massage to ensure good flow into her knees. I also continued her passive range of motion exercises given that I was taking her rehab much slower. I also didn’t hesitate to ice either of her legs down if she appeared to be sore after exercise. Things were moving along great, but of course, there had to be a snag. There had to be another scare…