Post TPLO, Post External Fixature...

[Guest guest]

Hello All!

 

I have an interesting case I have been working with for the past 6 weeks...9 year old overweight Shep X that had a TPLO done in January for a right cranial cruciate ligament rupture.  He broke the TPLO screws and was sent to a teaching hospital for repair.  An external fixature was placed.  The external fixature screws broke and were replaced with larger screws!  During the external fix surgeries a bone graft was placed in the tibia and other torn ligaments in the knee were sutured(?).  The tibia has finally healed.  The surgeon and radiologist report there is no malignment of the tibia. 

 

Six weeks ago the dog came to me very painful, weight bearing at a slow walk but not at a trot, knee externally rotated and carrying the right hind limb abducted, not underneath the body.  He is no longer painful on a low dose of Zubrin and Vetsystems Whirlpool sessions.  He now stand straight over the knee but is still externally rotated at the hock, only applying weight on digits 2 and 3.  He will walk in the UWTM treadmill the same way initially and then will square up over the right hind half way through treatment.  We are also using NMES prior to UWTM sessions on the quads/hams and hock flexor/extensors.  The owner is unable to work with the dog much at home due to her work schedule. So we also do stretching here in clinic and some joint mobilizations in the right hind.  He consistently walks four-legged now and will use the right hind at a trot also.

I am wondering what else to do for this dog to try and improve the carriage over the right hind limb.  We have definitely made strides in the last six weeks, maybe I am hoping for too much improvement too fast?  In the beginning, I was thinking it would be 10-12 weeks before seeing significant improvement based on the initial exam findings and the owner is happy with the improvements thus far.  Any thoughts and suggestions on adjustments to treatment would be appreciated.

 

Thanks!!!-- Backlund, DVM, CCRTBacklund Animal ClinicCanine Rehabilitation and Wellness2616 South 158th PlazaOmaha, NE 68130Phone Fax