Not a Torn ACL?

A week or so ago I wrote about Yellow Dog and a probable torn ACL. Yesterday, My husband and I loaded both dogs in the truck; Tobias spent the day at my in-laws' house, and Yellow Dog made the trip to Ventura to VetSurg, a clinic specializing in orthopedic surgery.

Potty stop on the way there.

With all of the COVID-19 restrictions, it was a very long day. Our appointment looked a lot like a back alley drug deal. Everything was done by phone or out in the rear parking lot with technicians slipping in and out the back door. Someone would call and ask what our vehicle looked like, and next thing you knew, a package was quickly brought out and delivered. Most of the time the "package" was hobbling on three legs, but some times it was in a crate. Cats.

When we arrived, we conducted the check in by phone. When the doctor was ready, Yellow Dog was taken into the clinic while we waited outside. After examining her, Dr. Campbell came outside to discuss some possible diagnoses as well as some tests that he could run to help more specifically pinpoint the cause of her lameness . With an ACL surgery on the table, none of us wanted to guess at her injury.

Yellow Dog's doctor.

Before actually doing any diagnostic work, Dr. Campbell talked about what an ACL surgery would require. While money is always an issue in this kind of surgery - Dr. Campbell acknowledged that right away, the after-care and success rate were even more important to us. He completely understood our concerns and shared them himself. We have a young, high energy dog that would find it difficult to be crated for a month straight and then limited to short walks for another month. And then, she would need yet another month to slowly increase her activity level. In all, it would be six to eight months or more before she returned to "normal." 

We spent a lot of time waiting in the parking lot.

Once we knew what some of the options were - Platelet-rich plasma (PRP)  injections or surgery, we agreed to a full set of Tibial Plateau Leveling Osteotomy (TPLO) radiographs. If she needed surgery, these are the same images Dr. Campbell would need to perform the surgery. In this way, they served double duty; once for diagnosing the extent of the injury and twice as a guide for performing the surgery. Since those images require pretty heavy sedation, we took a walk and found a place to eat lunch. That in itself was rather odd as it was the first time we've been to a restaurant since February. We were the only customers.

The ramp is our new normal.

Once Dr. Campbell had a chance to review the X-rays, he gave us a call. To his surprise, nothing about the radiographs confirmed an ACL tear. On top of that, her lameness - a 1-2 out of 4, didn't convince him of one either. As he continued the examination, particularly once she was sedated, he discovered a fair amount of fluid in her ankle. While she reacted a bit on her stifle, he suspected it was actually because of a mild sprain lower down.

In his estimation, a sprain was the most likely cause of her lameness, not a torn ACL. He definitely wanted her in a splint, but he also thought it would be a good decision to take a sample of the fluid at the ankle and send it to a lab for analysis. We agreed. Since we were there, it made sense to run whatever diagnostics we could, especially since that particular one wasn't too highly priced. We should get the results in about 5 days. If it is indeed a sprain, the fluid will show signs confirming it. If not, well, we'll cross that bridge if we get there. 

For now, the doctor felt comfortable calling it a sprain. Yellow Dog will need to wear a splint for the next three weeks. At ten days, it will need to be changed. A week later it will need to be changed again, and at the three week mark, we'll pull the splint and send Dr. Campbell a video of Yellow Dog moving. She can go for two, 10-15 minute walks a day, but other than that, she needs to stay pretty quiet.

In all of our conversations about what if this and what if that, we never even considered the possibility that it could be such a simple injury. The cost of an ACL surgery was an issue, but more important was Yellow Dog's quality of life. We were just so worried that the doctor would be able to do the surgery only to tell us that she would need to be on a leash or in a crate for the rest of her life to protect the work done on her knee. That, I was just not willing to do. So when it turned out to be a probable sprain, we were both at a loss. I still don't think we believe it quite yet.

She is not a fan. Not a fan AT. ALL.

Thankfully, with just a few weeks of rest, she should be okay. Now we just need to keep that cone on and the splint protected. By the way, that little Medipaw - the protective boot over the splint, is the cutest thing ever.