No News is No News

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!

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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.

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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.img_3578

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…

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…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!img_3648

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!img_3646

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).

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8 thoughts on “No News is No News

  1. Ugh, one step forward… Y’all will get there though! Our PT knows we are super active outdoors folks so she gave me things to focus on with Kenai that we can do while hiking: slow walking up hill at an angle to the slope, one side then the other to work the muscles as they push through off camber slopes; cavaletti-type work, but we utilize snow right now and tall grass/low scrub/shrub areas in the warmer months; swimming. The main PT stuff we do that has to be more structured is sitting pretty and backing up – though this dog will NOT back up unless he’s in a tight space. Simply telling him to back up is pointless to him no matter how I’ve tried to teach it, he still just turns around if we’re in a more open area lol. Can’t really blame him, it is the smarter not harder way to do things, and I live my own life by the smarter not harder principle haha!

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    1. I laughed out loud at “we utilize snow.” Titus did some zooming in the foot of fresh powder we got yesterday. I’m just glad to have some cushion between him and the ice! My understanding is that swimming is not great for an iliopsoas injury…really hoping we can resolve it before the water opens back up again, since T loooooves to swim.

      I’ve started some hind-end awareness stuff with him, but it’s slow going. Even Lilo, who has a good cued back-up and a backwards heel, etc., thinks hind-foot targeting is hard. Can’t blame Kenai for thinking the backup game is dumb! Lol

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  2. Not awful, but not fun. Do you do the iliopsoas stretches where you hold the leg up (like they are lifting their leg) for 30 seconds, then hold the leg straight back for another 30? I just did Mac’s stretches because he seems to be stiff again.

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    1. He doesn’t tolerate being stretched by a person yet, unfortunately. We have a paws-up with a lure to stretch the psoas and juuuuust started one with a peanut that should help once he learns it. I’m hoping the new place will help us figure out more ways to get him stretching.

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  3. We hit a set back with Thule’s recovery also. So was doing SO well at our last check in early Jan. We were told to use the rest of the month to build up some more condition and then come Feb she would be good to go back to regular activity. But then a week or so ago I noticed her not using her right leg to push herself up from laying down and taking some tender steps. Then she did an easy, 45 min hike and was lame later that day. She couldn’t even do our regular 10 min around the block to pee without favoring her leg later in the day. The surgeon talked to me on the phone and thinks it’s just weakness since we took a few weeks off of conditioning due to weather. I hope that is it, but I don’t think it is. She is back on an anti-inflam and restricted activity. She is doing better, but I still see the stiffness later in the day. I hope she just tweaked something chasing Reef around the living room and another week of rest will put her back on track. She was doing so well before though, it’s hard to take such a big step back.
    As long as everything get’s healed up and strong, what’s another few weeks?

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  4. Paws crossed here too. I sure hope that you can get that psoas to relax and stretch out… so that your crazy boy can start running and leaping again (your description of what he does in just a couple of rooms of the house made me laugh – it’s so much like our black dog!).

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