Stumbling follow-up

Blu went to the vet this afternoon following her stumbling episode in the backyard.

The veterinarian checked Blu for signs of a stroke and did not find any indications she had one. My vet was very honest and said from the description and how quickly Blu recovered, that she probably suffered a seizure. My heart just sank. For an older dog, seizures most often have a cause such as a brain tumor or something to that effect, unlike a younger dog who begins to have seizures younger and are not caused by something like a tumor but due to neurological mis firings (meaning less dangerous).

I asked to have a full panel blood work done on Blu which she was not too pleased about and showed it by pulling away her leg while the needle was in so she had to be poked twice to get blood.

I also had the vet look at the two lumps on Blu’s chest that I have been worried about. One has been on her chest since 6/25/05 and had a needle aspiration done on it but it showed nothing but blood. She said from the way it was sitting on her skin that she felt it was a lipoma, just as my prior vet did in 2005. The second lump was more questionable since it seems more attached to the muscles. My vet did a needle aspiration on it today and pulled out nothing but fat cells indicating a pretty good probability that this lump was also a lipoma. Lipoma was a relief since I was very worried about the lumps being close to her lymph nodes and was very concerned about lymphoma. When I voiced my concern of lymphoma, my vet rechecked the placed of the lymph nodes in comparison to the lipomas. It appears not to be close together.

So today I have to do a couple of things. I have to watch to see if the lipomas grow and might have to remove one if it gets big because it is located near her armpit and could affect her mobility. I also have to be patient and wait for the blood work to get back to make sure her blood is good to go and she is not fighting something I don’t know about. Once I get the blood work back, I have to watch Blu for any further signs of seizures. If she continues to have some, I might have to do more of a work-up on her in the future or put her on some medication to give her some relief from having too many seizures.

What it comes down to is the realization that I must face in having an older dog and the fact that health declines with age and I can’t fix her.

Stumbling

This morning I woke up and took Blu outside to go to the bathroom. Since it was a beautiful 70 degrees, I sat on the chair in the backyard and talked on the phone while Blu milled about the backyard, eating grass. Occasionally I would tell Blu to stop eating grass and she would run to another part of the yard while I continued my conversation and she would ultimately begin to eat grass. At one point, she was out of my sight, I am sure eating grass, when I say her galloping into view.

Mid gallop, she stumbled a bit and fell down. She looked like a drunk dog. My immediate reaction was she was having a seizure, as my other dog has seizures and it is all my mental processes could do to decipher the situation. Before I could stand up, she was up and walking again, only to take about another 5 or 6 steps and again she began to stumble. At this point, I was close to her. It appeared she lost all her motor skills. Her paws did not extend forward and she was landing on her front hocks to walk. I put her on her side and she began to do her pre-vomit body movements. She vomited grass. She sat up and just looked around.

What was different about her and my other dog who suffers seizures is many. Blu did not get lock jaw, her muscles were not tense, and she did not seem to out of it. She really just seemed like a drunk dog.

Blu sat there for a moment and I began to wonder if she was going to get up. I thought better standing next to her making her not want to move and being content. I went through panic moments of picking her up and throwing her in the car and taking her to the veterinarian, to seeing if she was okay after she vomited. I stepped back a few steps and said “come on Blu” and she popped up and ran around like nothing was wrong. She galloped into the house when I could tell she needed to go number two. I called her back out and told her to do number two and she went to the corner of the yard to satisfy my request. She came back in the house and has been fine ever since.

I did call the veterinarian and made an appointment for later today to get some blood work done on her. I want to ensure she did not get into any chemicals. I also have concerns about two lumps on her chest. One lump she has hand but the other lump was only noticed after she lost weight. I want to make sure these are not anything to worry about.

I hope she doesn’t have any neurological problems and want to make sure she did not ingest something maybe in the yard.

Happy Days

After receiving more and more comments I wanted to give an update. I appreciate so much the various comments and wonderful support I have received so I feel I should provide an update so others know their choices. So here is Blu’s update.

I decided the surgery option was not the best option for Blu. Blu’s treatment was an active treatment of acupuncture for pain relief, chiropractic treatment for spine adjustments since her spine went out of whack due to her hobbling and limbing. Blu did get some atrophy in her injured leg, so we did lots of swimming to build the muscle up and then she was allowed to play with my other dog in very short spurts (starting at one minute) and then they got to play longer and longer. Blu also began a treatment of glucosamine in the form of “Sea Jerky” and multi-vitamins.

Blu currently has no restrictions in her movement, the muscle has regained its mass, and she is allowed to play with my other dog for an unlimited amount of time. Being she is nine and a half and my other dog is ten and a half, they both suffer from stiffness just from being old. Blu currently suffers from hip pain associated with hard play, but has not showed any signs of knee pain. My acupuncture and chiropractic veterinarian check Blu’s knee for stability every time I go in for a visit and neither one can tell any difference between the two knee joints.

I am very happy with the choice I made not to put Blu through surgery. Blu does not have any secondary issues I might have to worry about because of surgery and she did not have to go through the agony of it either. She is just as active now as she was before she was injured. I know I have spent equal to or more money than the surgery cost itself, but I feel the outcome was a much more desired success. I do have to worry about the possibility of arthritis in the knee, but I would have to worry about that anyway just because of her age.

The bottom line is, as this blog has tapped into on many occasions, there is no conclusive research to show that osteosarcoma is directly or indirectly linked to a TPLO surgery, but there is conclusive research that shows osteosarcoma cannot exist at the potential site of the metal plates used in the TPLO surgery if the TPLO never occurred. And with this kind of research, I just could not see myself putting my dog at risk of cancer knowing this.

And if your dog had a TPLO surgery, I wish the best that your dog does not develop osteosarcoma and your dog walks, runs and jumps like mine does everyday, Pain Free!!!

I am very happy with the choice also of not putting my senior dog through such a horrible experience. She has had such a happy go lucky life and I think surgery would have taken some of that zeal away. The injury was hard on her, there is no denying that, but the surgery would have taken something away from her spirit. I think injuries are always harder on older animals, and Blu was no different. But, I also know, looking hindsight, holistic care was absolutely the best choice for her.

Adjustments

Blu had her chiropractic appointment two days ago. I am happy to report that Blu was able to get adjusted on her right hip that was so tender, but she had a bit of trouble on her shoulders. Sounds like she had been playing hard on her front legs. Blu was tender around her right knee where she was diagnosed with her CCL, but not as tender as the veterinarian would have expected. The veterinarian looked at Blu walking around and told me that Blu seemed to be cured of her knee injury.

I talked to the veterinarian a bit between the wide stance Blu has when I think she is having hip pain, versus the leg being partially back when she is having knee pain. She said this seemed to make sense and then told me the stance most breeders have their dogs stand in for photos is the same stance that show dogs stand in, which is the front legs together, but the back legs in a motion like the back end is walking, one leg far ahead of the other which is impossible for a dog to stand in with hip problems. Apparently this is why the stance is a standard.

The veterinarian and I relooked at Blu’s x-rays and she agreed that Blu does have a bit of hip dysplasia in the right hip only, and it is very slight. She seemed to think that Blu is completely healed from her knee injury, but is suffering from some hip pain. I asked her about Blu’s muscles in her right hind leg and asked if the muscles being smaller on that side would affect anything. She admitted that Blu does have a bit of atrophy probably related to the injury and she needs to undergo some physical therapy to regain her muscle mass on her right hind leg.

I explained to the veterinarian that I have realized this dilemma, as Blu needs more exertion on her leg, but letting her do some activity, like running with her canine friend Koa is too much exertion. She recommended a veterinarian to me that does physical therapy. Unfortunately, this was the same veterinarian that diagnosed Blu initially. I explained that I was not too happy about returning there with Blu because of his recommendation. She simply smiled and without ever having said anything to her about Blu’s prior recommendation she said “he is very pro surgery.” That is the understatement of the year.

The thing is that I can either return to the previous veterinarian and purchase underwater treadmill sessions and stand my ground on no surgery, or find another location for rehabilitation. Oh, but one problem, there is only one other place for such therapy, which is the University which is very difficult to be seen at. The chiropractic veterinarian said there is an underwater treadmill there, but it is usually only for the animals who have received treatment there, which Blu has not. She said she could call over to see if there is any possibility, but most likely there would not be a chance. I told her not to bother.

So now I have to either deal with Mr. “I want to cut your dog open and take your money even though veterinarian medicine can’t justify such treatment” so Blu can get some therapy, or I need to find a swimming hole for Blu to swim in at least three times a week. The chiropractic veterinarian also suggested throwing Blu in a jacuzzi, if I had one. Hmmm…maybe I need a jacuzzi!

Blu weighed in at 59.4 pounds, so she is still losing. The veterinarian said that Blu’s “atrophy” can also be an illusion because Blu has lost a bit of weight recently. There goes any plot to justify a jacuzzi to my partner! Anyway, the veterinarian said Blu looked really healthy at this weight and she did not need to lose any more. I told her I would like to see Blu lose one more pound, and she said it wouldn’t be too much.

So I am off to research canine rehabilitation, find a swimming hole, look at jacuzzi’s and will continue with Blu’s traction exercises and doing range of motion with her atrophied (or illusion) leg.

Extension of treatments

Blu has another chiropractic appointment today.  Blu has been lukewarm to the traction stretches, so it will be interesting to see how the appointment goes today.  I am hoping that maybe the right hip will get adjusted and that it being out of alignment has been a cause of some discomfort.  Meaning I am optimistic of some hip relief.

The acupuncture appointment is elongated for a variety of reasons.  The first being that time in between treatment gets longer as Blu is able to get relief longer and longer.  Initially the treatment was every week, then we went to every week and a half, then to two weeks, etc.  So the time period between her next treatment is close to three weeks.

The problem with me as an owner is I know when she is hitting new time periods that she normally would have gotten a new treatment.  So maybe the first day she does well, but occasionally on the second day she might be stiff getting up.  But then I watch her and realize that her stiffness is dramatically shorter than when she received no treatment at all.  Sometimes I notice no difference at all, such as when Blu’s treatment went from one and half weeks to two.  Of course, I want all the periods to be like this, but I know they can’t be.

Unfortunately with the holiday schedule and my work schedule, Blu has to endure an extra week between acupuncture treatments, and she is showing signs of the extension.  She is a bit stiff when she gets up from her naps.  Again it has been hard to disguish if the discomfort is from the knee or the hip since she seems to work out the stiffness is a very short time period.

So all I can hope is that she gets some chiropractic relief on her hip and she can hold out for a bit longer for her acupuncture appointment.  In the meantime, she is being a trooper, not increasing her sleep time or her down time, being active as ever, and being an expert on calming down the ever worrying owner.

Hopefull Owner

I must admit, as an owner who wants the best for my animal, sometimes my will for her to get better clouds my judgment. I begin to reason things out and become overconfident. How?

I told myself that Blu has done extremely well in her 2 1/2 month of conservative treatment. And she is showing some incredibly good signs after beginning acupuncture. In fact, I have only seen improvements with no set backs. She hasn’t done any yelping in pain, does less and less muscle spasming with use, is become confident in herself to do things that are not good for her (she still is very troubling with how much she wants to jump), has done extremely well on her diet. When she goes in the backyard by herself, she is running a little bit with no signs of spasming or pain. I have really tried to minimize this, but I know deep in my heart that I will have to slowly let her do things in order for her to regain her muscles back in her right hind leg. I have not let the dogs run together waiting for the time when I felt Blu could handle it.

I had reasoned with myself today that I would allow the dogs to run together for a few minutes in the backyard. Oh my, did they have fun. They ran and played, found the big pile of leaves and threw them in the air. I couldn’t see them, just the leaves. They had the biggest smiles on their faces running around. I brought them back in and watched Blu’s hind leg, it spasmed a bit, but nothing compared the spasming I have seen before. I thought to myself, not too bad, maybe we are progressing to short runs together in the backyard.

Two hours later, Blu came out of her kennel to visit me in the living room and she was limping. I became very disappointed in myself. I gave her an anti-inflammatory and did some stretches with her knee. She let me do the stretches with no problem and really showed minimal signs of discomfort. She did some licking in the area once I let go, which is usually a signal of some discomfort, but nothing abnormal. What I didn’t expect was the discomfort she felt in the hip. I did some movement here and she did not want me to continue. From this, I can only assume it was her hip causing her to be stiff and uncomfortable.

I had Blu stand-up and watched her a bit. When Blu’s knee was bothering her, she extended it back, putting more weight on the other knee. When Blu’s hip was bother her, she extended it out, opening up her stance at the hip. Today, she had an open stance, with a very wide extension.

I have to wonder if the conservative treatment, less activity, and possible muscle atrophy has played a factor on the hip being tender.

What it all comes down to, Blu severely needs to be on some kind of controlled regime of increased exercise to gain her muscle back in her knee, hind leg and hip. I have pretty much reached a plateau with the arrangement I have. Letting Blu in the backyard to be by herself is not enough for her use her muscles in a way to exert them enough, while letting her run in the backyard with my other dog is beyond what she can handle.

So I will monitor Blu for the next few days to ensure her hip is okay, then we will begin an exercise regime to help her progress.

Hip Acupuncture

I took Blu in today for some acupuncture on her hip the chiropractic veterinarian was not able to adjust. I asked the veterinarian for some diagrams of the hip and we looked on the structure of the hip and where Blu was showing signs of some minor hip dysplasia to see if this would be the cause of her hip being so tender. My gut instinct is that we just don’t know. My goal with getting some hip acupuncture is maybe with some pain reduction in the same hip as the knee with the CCL problem, that maybe Blu will actually put all her weight down on her right hind leg. Meaning, maybe the knee feels great and her hip hurts.

The acupuncture veterinarian remarked she was surprised the hip that was tender was on the same side as the knee with the problem, as she expected there to be tightness in the opposite hip due to Blu counterbalancing to minimize knee pain. This makes me wonder if Blu’s weight bearing has something more to do with her hip rather than her knee. Shoot, for all I know, with the conservative treatment, Blu’s knee could feel great.

And the more I think of this, the more I realize that Blu’s muscles in the right hind leg have been “shivering” less when she uses them. Blu has not had any signs of pain in quite some time in the knee area. Maybe her hip is bothering her more than her knee.

Anyway, Blu received acupuncture in her knee and her hip just to see what we can do.

Chiropractic Appointment

Blu had her first chiropractic appointment yesterday. I had no idea what to expect at this appointment as I am used to human chiropractic appointments being about twisting and CPR-like compressions on the spine. This didn’t seem feasible on canines because of their body structure, so I was very interested in how it would go.

Since this was the first time with this new veterinarian, the ordinary exchange of information took place. The veterinarian asked if Blu was well behaved. I found this interesting. Let’s see, no when she is around new people because she is an attention hog and wants everyone to know that they are her play toys. It was clarified, “Does Blu bite?” My gosh, no! But she is a big baby when it comes to pain! My thoughts were, oh my, Blu is going to get hurt being adjusted.

She started at Blu’s neck and worked down her spine. I thought the veterinarian was just feeling Blu’s spine when the vet told me Blu was very out in her neck and the veterinarian had adjusted her. Blu was very good, but seemed puzzled, as I think she could feel something but wasn’t sure how to react, so she just gazed at each one of us in the room. When the veterinarian got to Blu’s hips, Blu didn’t want to be adjusted and resisted the veterinarian. The veterinarian said that Blu is indicating she is tender on her right hip.

We laid her down on her left side and she looked at Blu’s right side. The veterinarian started at Blu’s front paw and worked up to the elbow. Then she began at the right hind legs paws and worked her way up. She stopped at the knee, and showed me the cranial tibial thrust and drawer test, telling me that Blu’s knee is pretty tight. She then worked up to the hip, but again Blu would not let vet adjust her.

Blu was flipped over and again the process was repeated on the left side, again showed me the cranial tibial thrust and drawer test. The veterinarian looked right at me and said “I can’t tell the difference between the two knees, they are both tight.” Blu allowed her to adjust the hip on the left side. I piped in and said that Blu’s x-rays showed the slightest bit of hip dysplasia on the right hip only. She asked me to bring in the x-rays next time, as she wants to look at them.

I was then shown two exercises to do at home (traction). One is where Blu is held by her front legs by one person and then is slightly pulled on by another person by holding her back legs. This elongates the spine and relieves pressure on it. The second is hold Blu’s front legs by one person and then the other hold’s Blu’s head behind her ears and pulling ever so slightly, to elongate the neck to relieve pressure. Both are done while the dog is standing. Unfortunately, there is no exercise for the hips. I was told to return in two weeks to see if we can then adjust the hips at that time.

The chiropractic veterinarian was surprised when during the exam she asked how old Blu was and I said nine. She stopped and looked at me. I said that most people can’t believe it. She said she was going to guess six. I said that I tried my best to take care of her and her health.

After the procedure was done, she said she would only recommend that I do one thing, and that it was not something very important. The veterinarian suggested that Blu lose one or two pounds. She explained that Blu is by no means overweight, but that she slim down a bit to relieve pressure on her joints. I smirked at her and said it was funny she suggested this. I explained that Blu has been losing weight and is still in the process of losing weight.

The veterinarian said I could go in and have Blu x-ray’d again on her hips to see how the injury has affected her hips, just to check if things are still okay, especially in the right hip. I said x-rays of the knees and hips are on my agenda after Blu gets a little more spread out on her acupuncture treatment on her knee.

I left the office feeling puzzled about a few things. How could Blu’s knee show the same stability on the uninjured knee? Is this an indication that Blu’s left knee is going to be a part of the 40% of other dogs that injure both knees within a short amount of time after injurying one? Or, is Blu’s right knee just getting better? Why is it whether Blu weighs 67 pounds or 60 pounds, veterinarians tell me Blu is not obese or overweight, but that she can stand to lose a couple of pounds? How much should my dog weigh?

I sometimes wonder because of Blu being a Blue Tick Coonhound, if her small skeletal structure throws off the eye on weight? My other dog weighs the same, but has paws almost twice as big as Blu, and her long bones are much thicker. Blu’s bones look dainty, like the bones that belong on a Whippet, long and thin. So most breeds having these long thin bones look like they are starving, thin and barrel chested. Blu doesn’t, she looks like a Labrador body on Whippet legs. It looks weird, and not weight proportionate. I look at Blue Tick Coonhound websites and they show pictures of dogs with big thick leg bones and with bigger paws. They look more weight proportionate. What can I say, Blu was the runt! Anyway, I guess I will just have Blu continue to lose weight until a veterinarian tells me Blu is fabulous in the weight department. Blu weighed in today at 60.9 pounds, down 0.3 pounds from last weeks acupuncture appointment.

I kept the acupuncture appointment for the following day, to see how Blu would react. Blu doesn’t seem to be sore chiropractic adjustment. I decided to keep the acupuncture appointment anyway though, so Blu can receive a treatment on her right hip, since it is obviously causing her some discomfort. If this hip is indeed tender enough, this might explain why Blu is still not putting all her weight on her right knee and leg. Through my research, I know hip and knee problems will indicate the same symptoms. So I will treat the knee and hip on the right side and see what happens.

Acupuncture Appointment Today

Blu and I made our way to another acupuncture treatment this morning. Blu is responding really well to the treatments. I have still been doing research because my main focus is whether the knee is stable. I like to go into the veterinarian armed with research fresh in my head so I can bombard her with questions that I can’t seem to grasp.

The veterinarian agreed that Blu is responding well to the treatment. I can only agree with this. Blu is putting more weight on her leg, having much less pain and stiffness, and is getting better mentally (feisty). She wants to start spreading Blu’s treatment out to maybe 10 days to see how she responds. Today’s appointment was after 8 days, so I thought this was a good idea.

Blu was not as sensitive around the knee today when she put in the needle, which is also a good sign that her swelling is decreasing and the pain factor is being reduced. I asked the veterinarian a couple of questions concerning the research I have been doing.

The first I had was concerning the arthritis factor. I explained that the CCL injury was a prime cause of arthritis according to the articles I read. My veterinarian explained that there are many factors to arthritis, such as trauma, even trauma without long term damage. She explained that arthritis is one of the areas that is very grey in its cause. She boldly said that no one knows how or why it develops in some dogs and not in others. Some canines have arthritis that have never had any trauma at all. She said no research has been done on arthritis, but just as no one knows what causes it, it is just like no one knowing why acupuncture works on some dogs while not working on others. No one knows but a lot of people speculate.

I questioned her about during the TPLO that the local veterinarian would do, he would not debride the partially torn CCL. I explained that the changes in the synovial fluid are from the CCL being partially torn, yet nothing would be done with the CCL, so how would the synovial fluid go back to normal? I explained this was of interest to me because the thickening of the synovial fluid is the so called “cause” of the arthritis in the knee. My veterinarian said she doesn’t know how this would work, but again that it is all theory, theory of orthopedic surgeons.

My veterinarian acupuncturist said it might be a good idea to take Blu back to be reevaluated by the diagnosing veterinarian, meaning the cranial tibial thrust and drawer test done again, to see if there are any changes. I am not against this idea, but I have seen owners write about how these diagnostic tests worsened the pain in their animals. I am not about to go backwards. Anyway, I looked at the veterinarian and said I was not about to go back to a veterinarian who is so quick to do surgery on my animal. I explained that the Blu might have some scar tissue that is stabilizing the joint and if that would be a bad thing and she said not necessarily, especially if it is stabilizing the joint.

After a moment, my veterinarian told me a story of her mother having tongue cancer and the biopsy was terribly painful for her mother. After the biopsy, the surgeon who did the biopsy, told her mother that she would need surgery. My veterinarian said, I guess if you go see a surgeon, you probably will have surgery recommended.  She stated that her mother did not have the surgery.
My veterinarian said that we are very quick to have surgery in this country. I explained my blog and the hits I was getting. She said she was not surprised. She said in conversation “the ligament healing,” which I called her on and said that statement is almost un-American. She said she doesn’t dispute that, but again no one knows about ligament healing because the veterinary practice has followed human medicine and become surgery happy.

My veterinarian said that if Blu was her dog and with the improvements she has been seeing, she would not subject Blu to the surgery. She recommended spreading out the acupuncture treatments to get a long term treatment plan that is best for Blu’s reaction to acupuncture. She said I could go ahead and have Blu seen by the chiropractic veterinarian to have Blu realigned, being that she has been off for 2 months now, and then see how Blu’s body reacts to being aligned and where she is putting her weight.

I also purchased some Sea Jerky, a wonderful product I used to give my dogs, which is an excellent source of Glucosamine/Chondroitin and MSM. The nice thing about this supplement is that my other dog, Koa, will eat this while she won’t eat the other stuff I bought. They come in strips just like a piece of jerky and with my dogs weight, they both get one piece of jerky a day. I went ahead and bought a box of 91 strips for $57.50. The box is a better bargain than purchasing a ten pack or 30 pack.  I will continue the multi-vitamin and the other Glucosamine/Chondroitin pill supplements for now.

Also, an update on Blu’s weight. She weighed in today at 61.2 pounds (which is 61 pounds and 3 ounces) down from her weight eight days ago at 62.6 pounds (which was 62 pounds and 10 ounces). So Blu lost 22.4 ounces (or 1.4 pounds) in 8 days. On October 2, Blu weighed 65.7 pounds, so she has lost 4.5 pounds in the last month. I think that I am going to get her a little thinner, but not much more. She is looking rather healthy weight wise, but she can stand to lose just a tad bit more. Again, the less weight to put on the leg is better for her in the long run, so no extra weight.

I still not have made my way to an academic university to research British or French veterinary journals, but these are definitely the loose ends I need in my quest for knowledge about this injury.

Research, review and new

My latest research questions were based on these articles:

This article discusses the option of conservative treatment and some of the risk associated with CCL injuries. The main concern is the weight difference of the animal and the treatment option. This particular article goes pretty low for the weight limits for conservative treatment. Other articles indicate that Blu’s current weight, as weighed in today at the veterinarian, of 61.2 pounds (or 61 pounds and 3 ounces for the nerds in all of us) is the upper weight that is considered on the cusp of injuries that can be cared for non-surgically – conservative treatment.

What I like best about the article is that it doesn’t go right to the surgical option for the treatment. This is rare, as most other articles clearly state that surgery is the only treatment option. In fact, this article list the conservative treatment first. What I dislike is that its list for conservative treatment is short. There is so much more to conservative treatment such as not allowing the animal to run or jump. These are important factors in successful conservative treatment.

What is important to note is that this is one of the first articles I read when researching the TPLO, but I recently re-read this after I decided to do conservative treatment. I got a lot more out of the article the second time around in a different mindset. That is the blessing of this blog, as I can review my tracks in a different mindset.

This article is about research done in 2005 about the TPLO stabilizing the knee joint. What is important about this article is that the summary uses the words “may help stabilize the cranial tibial thrust as originally proposed.” This is what I call a “no brainer statement.” The person that invented the TPLO also invented the cranial tibial thrust diagnostic. So the summary is as effective as saying I detected a draft and through my trouble shooting techniques, developed by me and my logic, I found the front door open, so I closed it. I could summarize that “closing the door may have alleviated the detected draft, as that is what doors are supposed to do.” One is just using jargon to the unsuspecting reader.

What is important about this article is that the study is talking about dogs that received the ECR (extracapusular repair) that weighed between 22.7 kg (around 50 pounds) to 54.1 kg (around 119 pounds) versus dogs that received the TPLO that weighed 25 kg (around 55 pounds) to 63.9 kg (around 140 pounds). Again, this raises questions about the weight of my animal at 61 pounds. She rides here toward the lower range of animals who received both treatments. If only the summary of the research wasn’t so blatantly stupid.

Of course, this study epitomizes the use of statistics, which I won’t go into here, but I would like to see the other P-values of the not significant dependent variables. It would help someone like me who is worried about the variables that studies don’t mention as significant, so without mention, I can’t eliminate them as possible significant factors. Gotta love statistics, but only if the variables are known to the reader, otherwise only listing the significant dependent variables is filtering the information. A shame!

This article discusses many orthopedic problems that can occur. I, of course, am only interested in the knee right now. It should be noted that Blu’s hips were checked for hip dysplasia, as this can can have the same symptoms as a knee problem. It is important that veterinarians eliminate other areas of the body to ensure proper treatment. What I don’t like about this article is the statement that “Torn cranial cruciate ligaments should always be repaired with surgery.” The article goes on to give some good arguments why this is true. Again using arthritis, partially torn ligaments will always tear fully eventually, and surgery is great – nothing is better logic to sell the idea. The article goes on to tell why non-surgery treatment is not a good idea = severe arthritis. Funny, it doesn’t talk about complications to surgery, but only the questionable complications to non-surgery.

This article begins with an overview that states that “[T]orn ligaments retract, do not heal, and cannot be repaired completely.” Since Blu has a partial tear, I am not worried about the retracting, as retraction seems to be an option for a complete tear. But I could be completely wrong on this. As for not healing, this seems to be up for debate, thus the whole confusion within the veterinarian industry, surgery or conservative treatment.

This article is about canine arthritis. Again joints are broken down, so the knee joint is a section all its own. I find it very interesting that in an article about arthritis, the cause of arthritis is “resulting from rupture of the Cranial Cruciate Ligament.” Nothing more, apparently according to this article, causes knee arthritis. I find it very careless the article reasons arthritis to only CCL injuries when it is very careful to not suggest any treatment options for arthritis or how to treat a dog that suffers the apparent injury that leads to the knee arthritis.

The problem with reading these articles is that they invoke fear in the heart of the animal lover who is left to contemplate the surgery option. So I have to look at the advantage I have over others who might be reading these same articles:

Blu has a partial tear, shows no signs of meniscal damage, is not a large breed dog, but is a medium size dog, shows no signs of arthritic changes in her knee although she is already 9 years old, did not suffer the dramatic acute rupture symptoms described in articles (read initial blog entry about how she hurt herself), did have an acute injury but my veterinarian is suggesting a chronic rupture situation with her although this seems out of line, was slightly overweight (5 pounds or so) which the veterinarian did not consider a factor since the weight amount was small, and Blu has been responding extremely well to acupuncture treatment.

What it means is that my dog doesn’t fit into the mold of the average canine suffering from this injury. And maybe this is why I feel more free to look for options for treatment. But the more I read these articles, the more I feel lost in the decision process. I don’t want Blu to have arthritis, have an unstable knee, completely tear her CCL, or be in pain. Yet, it appears all article authors know this fact and play upon my desires to sway me into the decision of surgery without giving me the down side of surgery. There is not one article that lists the disadvantage of having the surgery, and there are many.

I want to have all the facts of the table in order to make the best decision and it appears American veterinarians have been able to only promote surgery options. Is it any wonder why veterinarians don’t want to do research to study the facts of long term results of TPLO or TTA surgeries? They don’t need to because they are not being met with dog owners who question the surgery option. It is the law of supply and demand while the average dog owner is not doing their part to ensure they demand the best option. This is what we do concerning medical issues and veterinarian issues.

So it is no wonder why my research shows 100 articles selling me surgery while one sells me conservative treatment and I am left swimming in too much information with very little fact. I am more convinced that I need to pay attention more to what Blu is telling me rather than what articles are trying to sell me without any concern about factual information.