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FRUMY
Trad climber
SHERMAN OAKS,CA
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May 10, 2010 - 11:45pm PT
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FRUMY
Trad climber
SHERMAN OAKS,CA
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May 14, 2010 - 02:42am PT
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Edge
Trad climber
New Durham, NH
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May 14, 2010 - 09:17am PT
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Lets Go!!!
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Chiloe
Trad climber
Lee, NH
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Topic Author's Reply - May 14, 2010 - 10:18am PT
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Dogs love to ride, don't they?
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rectorsquid
climber
Lake Tahoe
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May 14, 2010 - 12:39pm PT
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Skipper, in the back, gets car sick and seldom sticks his head out the window. He also never chases balls or squirrels.
Piper, on the other hand, is actually a dog and does all of the expected dog stuff. Yeah Piper.
Dave
[edit to add this better photo of Skipper]
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Aya K
Trad climber
New York
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May 14, 2010 - 01:21pm PT
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Chiloe - sorry I missed it earlier, but re: TPLO or TTAs for CCLs in dogs - the deal is basically that if you do them early, they'll help slow down the progression of osteoarthritis considerably, so young active dogs benefit greatly from them. However, they're not NECESSARILY going to help your dog return to function any better, in other words, if you do nothing, and just treat the pain, eventually the joint capsule will tighten up, sort of taking the place of the function of the CCL (preventing the tibia from sliding forward, exactly like in a person), and they'll be more or less good to go again (in the average dog. Different for like working dogs, who need to be absolutely 100%). However, the osteoarthritis will definitely progress much more quickly if you do nothing.
There are also various other intra- and extracapsular repairs that can be done (for example, replacing the busted CCL with what is essentially fishing line); they're more likely to actually help the dog when you do them than a TPLO or TTA is, however, a TPLO or TTA that works is likely to help MORE (in the short term) (if that made sense the way I explained it...)
In the long term, whether you do TPLO, TTA, intra/extracapsular repair or nothing, the outcome is the same - they get arthritis. Intra/extracapsular techniques tend to break down in a couple of years so the progression of OA tends to be similar to doing nothing (but sometimes they work really well for years and years), and like I already said, TPLO and TTA will just retard the progression of the OA.
There are loads of varying opinions on this; if you talk to an orthopedic surgeon they'll always tell you to do surgery, whereas other doctors may tell you to do nothing.
For what it's worth, I'll tell you what I did (since I get the feeling that our dogs are kind of similar in age and size). Stella, who is 14 now, ruptured her CCL last November. I decided to do NOTHING because she's 14, and honestly I feel that it's more than likely that she will be dead before the subsequent osteoarthritis catches up with the joint. She was 3 legged lame for a couple of weeks after it ruptured (she did it jumping out of the back of the truck), and then over the next month or so gradually regained use of the leg. She had pretty severe atrophy of the muscles for a while.
However, it's now however many months later it is (6 or so) and she is back pretty much 100% (because she was old and a little creaky to begin with). She runs around, picks fights with Rocky (our 6 year old dog), and loves her antiinflammatory meds so much that she is jumping in the back of the truck again. Her muscles have also filled back in. I'll take some video of her next time I'm upstate (two more weeks of vet school left this semester!! WOOO!!!) because you would never believe that she's 14 or that she has no CCL in that leg.
Obviously I'm not suggesting that this be your course of action - I don't know your dog and you need to talk to his doctor about it! But I just wanted to caution you that surgery is not necessarily always the only or best option, especially in an older dog.
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atchafalaya
climber
Babylon
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May 14, 2010 - 01:28pm PT
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The TPLO surgery is a huge waste of money, and bad for your dog. Don't do it, stick with the fishing line method. The only reason vets push for it is to charge you more.
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Chiloe
Trad climber
Lee, NH
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Topic Author's Reply - May 14, 2010 - 01:37pm PT
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Thanks, Aya, your information is much more detailed but our vets too told us "on one
hand ... but on the other hand" so we ended up deciding against surgery. Jack gets
around fine on all fours today, not so agile as he useta be but he's 12 now, which the
chart at our vets says = 77.
Livin' a decent life, though. (That's something I love about all these climber-dog photos.)
Here he is last week on a mountainside 3 miles from the road.
BTW, I think you've made a great career choice.
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bluering
Trad climber
Santa Clara, Ca.
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May 14, 2010 - 04:15pm PT
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That's Jack sayin', "Gimme your sammich!"
funny video, Edge...
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Chiloe
Trad climber
Lee, NH
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Topic Author's Reply - May 14, 2010 - 04:20pm PT
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That's Jack sayin', "Gimme your sammich!"
What I like about that picture is he's not looking at the sammich.
He knows grab-and-run is not the right trick.
Instead, he's looking soulfully into my eyes. That is the right trick.
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Aya K
Trad climber
New York
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May 14, 2010 - 04:25pm PT
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I love school. It's way betetr than dumb old grad school ever was.
I love that all the kids are getting along!
ps atch - vets aren't recommending TPLO and TTAs to make money... they're recommending them because when they work, they result in a much more satisfactory return to function that on average lasts far longer than an intracapsular repair. If anything, especially after considering the money invested into the materials and the time invested in learning the procedures, I suspect intracapsular repairs net more profit.
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atchafalaya
climber
Babylon
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May 14, 2010 - 04:36pm PT
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"vets aren't recommending TPLO and TTAs to make money"
uhh, yea, right...
Aya, TPLo's cost approx $4500, and the fishing line procedure costs around $1500. I am unaware of any research that supports the TPLO or TTA procedure as more effective than fishing line. And in my dogs case, the recovery from the TPLO procedure was so severe that I could never recommend the TPLO to anyone faced with the choice. He never recovered from it.
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Aya K
Trad climber
New York
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May 14, 2010 - 05:32pm PT
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Atch - I fail to see the point you're trying to illustrate by quoting the prices of the procedures; I already explained that the difference in price is due to the investment that surgeons put into the procedures.
But more specifically, to perform TPLOs, there is a huge investment in materials (ie the special bone saws, sharpeners, TPLO plates and so on; there is a ton of TPLO specific stuff that needs to be bought before the first one is ever performed; the materials that end up in the knee in a TPLO or TTA cost literally thirty times what the materials the end up in the knee for a LSS do) and continuing education (you need to take a special course to be certified to perform a TPLO, and then get extensive training with surgeons experienced in the technique subsequent to that to perform it adequately, whereas plenty of general practitioners who are comfortable doing surgery are comfortable performing lateral sutures) and the actual time (this is a big difference! A TPLO on average takes FOUR TIMES as long to perform as a LSS), effort and skill involved in performing them. After all, you're cutting clear through a bone! So anyway, that's why it costs so much more.
As for return to function, osteoarthritis and all that, Lazar, et al in Vet Surgery 2005 - looked at a bunch of dogs with TPLOs and LSS (the fishing line method) and compared pre-op rads with rads 12 months post-op, found that the dogs with the worse scores for OA as graded by radiographs were 6x more likely to have had a LSS than TPLO. Long term, from a different study? Running the dogs over a force plate showed no difference in knee function. It's pretty equivocal when you look at the dog population as a whole. There is, however, a general suggestion that large, active dogs do better with a TPLO vs a LSS, where as smaller or less active dogs do just as well with a LSS. I can't find a reference for any study showing this offhand, but even in my own experience I've seen several lab-sized dogs who have had a LSS in one knee and a TPLO in the other where the LSS blew out a couple of years later. Pretty irrelevant since it's a sample size of like 3, but it is in line with the general feeling in the orthopedic community.
Like I said, there is plenty of evidence that in the long term, no matter what you do, things end up the same, and I see nothing wrong with doing a LSS (or nothing!) if it is appropriate in the dog (ie not obese, not >80lb, etc). But to say that TPLOs are performed only to make money (presumably based on your negative experience) is unfair. The choice to do a TPLO or a LSS or something else should be based on the individual dog, the owner's expectations, and the surgeon's personal experience with the procedures. There really aren't any hard and fast rules.
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Bob D'A
Trad climber
Boulder, CO
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May 16, 2010 - 03:08pm PT
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Eva, resting.
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drljefe
climber
Old Pueblo, AZ
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May 16, 2010 - 04:01pm PT
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Edge
Trad climber
New Durham, NH
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May 17, 2010 - 03:12pm PT
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Pretending to be coy; Jasper could win an Oscar for this performance.
Penny, Guardian of the garden, herder of the asparagus.
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diablo
Trad climber
sd,ca
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May 17, 2010 - 03:37pm PT
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Charlie D.
Trad climber
Western Slope, Tahoe Sierra
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May 17, 2010 - 04:52pm PT
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More old photos of Gus;
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hooblie
climber
from where the anecdotes roam
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May 22, 2010 - 12:49pm PT
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after an exhausting day of flushing out the possiblities...
a dog's just gotta get some beauty sleep. it's not pretty to watch...
but it get's the job done.
signed, ASTRA!
~~~
edit: here's a tip for any of you fellow blondes out there
in need of a little doghouse redemption.
have a merry old time chewing up some nice red lipstick,
it really sets off those floppy dog lips.
then ease back to the party in that droll, non-chalant way.
the folks point and wiggle, sound really jolly... and well,
seem to forget about that glorious roll in the dead stuff
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