I was originally going to call this post “Setback,” but luckily for you all I waited to write it until I was feeling a little bit less dramatic!
As those of you who have been here a while know, Titus was originally diagnosed with an iliopsoas strain after coming up mildly lame on the easiest hike he’d done in weeks. This was waaaaaay back on the last day of July. The surgeon who saw him in August was very clear that we couldn’t rule out a CCL tear, but the signs and symptoms at the time all pointed towards the ‘psoas. So that’s what we worked on rehabbing through mid-October, when he came up acutely lame after several weeks of nice improvement.
The second-opinion surgeon — actually my first choice, but the scheduling in August hadn’t worked out and I liked the one we saw then very much as well — diagnosed the partial CCL tear at that time. She agreed that the original X-rays from August weren’t indicative of the tear having existed at that time, which was reassuring. We still can’t totally rule out the possibility that it had been present but too recent to cause the telltale changes in the joint. But that’s kind of six of one, half a dozen of the other, and it was nice to have two opinions saying that the course of action to that point had been reasonable.
So we did the TPLO on November 1st and hoped that in addition to mitigating what did turn out to be a partial CCL tear (but intact meniscus, hurrah), it would help resolve the muscle injury.
But an offload of that right hind leg has persisted throughout the post-op rehab. I spent a couple of weeks chatting with our team about it at Titus’s PT appointments and trying to believe that it was, as suggested, simply muscle weakness and fatigue that needed strengthening. Until I finally didn’t at 12 weeks post-op when a slight hitch appeared in his gait. So off we went back to our surgeon for a recheck…
…and guess what. The knee is in great shape! Which was not a surprise to me but still felt like good news. A tiny part of my brain kept remembering that things just happen to this dog and wouldn’t it be just his luck to trash his meniscus, too? Surgeon concurred with the rehab team that the symptoms pointed away from that, that it was unlikely given the partial tear, and that he would likely be significantly more lame.
The bad but also unsurprising news was that he was — is — quite tight in his iliopsoas and also in his quadriceps. So much for simply needing strengthening and so much for the TPLO fixing the muscle issue. I guess that was a bit of magical thinking in the first place, but man, it would have been nice!
So Titus has been busted back down to walking the rail trail for a while instead of hiking, even though I don’t actually think that easy hiking we’ve done is necessarily bad for those muscles — and I’m really struggling to minimize the stuff that I think is, because this dog, untethered and unsedated, leaps and capers and sprints and does hard cutting turns just hanging around one or two rooms of the house. We’ve upped the frequency of his cold laser treatments now that our local vet offers it, too. The surgeon is also a CCRP and is going to touch base with the rehab team about stretches, etc., to target those muscles. She also agreed to give us a referral to a rehabilitation clinic a couple of hours away that I’ve heard really great things about. We can’t go frequently, but I’m really hopeful that they can help us devise an at-home program and then we can do monthly check-ins or something. I guess we’ll see.
So that’s where we are right now. Not where I’d hoped we’d be while closing in on 14 weeks post-op, but I feel like we’re looking at the right problem again and collecting the right tools to address it. Paws crossed!
And hey, Lilo and I hiked a 4,000-footer again finally! Check back on Friday for that story (and on Wednesday for Lilo’s turn to the Dark Side at a friends’ recent overnight).