Otter's Journey....

Beanwood

Administrator
So it's time to spill the beans. It saves some confused faces when you catch a photo of Otter looking...well, a bit in the wars shall we say.

First things first, can anyone remember me saying something like...." This puppy is going to be a challenge...."Or " Hmmm...Bramble was such a good puppy, don't think this one is going to be quite so easy.." Not that I am pessimistic actually far from it. But how right was I? Don't get me wrong, despite Otter's deep suspicion of the human race in general, she is simply adorable. We love her to bits. She is incredible, amazing, wonderful.

Three weeks ago, maybe a little more now, Otter had a bad accident. She trapped her leg in a a small gap between a sleeper wall, and decking. She went in one way, and came out limping. Instantly I knew something was very wrong. We booked an appointment with the vet, and with a heavy heart took her in the next day.

Otter went in for Xrays, as the main concern was some sort of break. Luckily the local Orthdog specialist had his referral centre just upstairs, so he popped down for a quick look.

Later that afternoon, another vet gave us a call. A huge preamble around her nervousness, heck we knew that. I bit my tongue politely and waited her out. She got to the point. Bad news Mrs Hart, Otter has completely ruptured her cruciate ligament. My response was complete shock. At that time Otter was not even 4 months old. What the heck. The next part of the conversation was a blur, blah blah blah....see you in two months...blah blah...growth plates.....blah blah..operate around 9 months old....TTA.... Shit. (That was me btw). We then collected Otter around 6pm. A very serious young nurse gave us advice around recovering from a GA, and a small bottle of metacam. That was it. Oh and make an appointment to see their local Orthodog specialist.

We went home, didn't talk on the way, both in shock, me with a feeling of deep sadness. Otter was a high octane, clever bundle of energy. How the heck was I supposed to keep her low key until her op, blimey that was about 6 MONTHS away. Lord knows the damage to her joint by then, it was already slipping badly.

The next few days were difficult. My normal optimistic mood was very low. I just couldn't see anything positive heading forward. I didn't even have confidence in our local Orthodog. That had me thinking. I decided to look around, and my research began. I had some fantastic help on the way, a member of the old forum inspired me with her wonderful and very fit choccie, and gave me the confidence to really dig out the very best for Otter, heck...lets go and interview a few! (Interestingly my own veterinary practice were rather bemused by my decision...)

OK time for a break....:)
 

Beanwood

Administrator
OK...glasses filled....where was I?

Research. Yes. I looked at a few, asked for recommendations, and settled on a short list. Top of the list was Andy Moores, based at AndersonMoores down in Winchester. A bit of a journey, around 90 mins or so, so not toooo bad. An appointment was booked for a consultation, the earliest date was 29th July @11am. That was yesterday.

Monday (yesterday) we set off bright and early for our 11am appointment. Otter nice and comfy in the back. She settled well and dozed through most of the journey. It was hot when we arrived in Winchester so we headed through to a rather nice reception and waiting area. The receptionist were friendly and very professional. The waiting area was set out with rather nice comfy seating "units" well spaced out, and actually a rather good idea. It was straightforward to find a comfy and quiet area. It was a refreshing change not to have an busy area full of TV's advertising their pet health plans and rows and rows of food and toys. The ambience here was quite the opposite, calm, safe and quiet.

After a short time the consultant Andy appeared, friendly and direct. A handshake, brief introductions and quickly ushered into his office. A quick hello, appraising glance at Otter, and we were then off outside so he could see Otter walking and mooching around. I liked him instantly, and pretty sure @Mr Beanwood felt the same way. Unfortunately Otter regarded him and his equally nice associate as the spawn of the devil. Embarrassingly any conversation was interspersed with her barking rudely, or trying to gnaw at his startling bright socks. He commented that it was the first time he had worn them, and maybe the last.

There followed an overview of the original Xrays, and a terrifying discussion on what the problem might be based on his initial observations. You see, Otter was moving quite well, and not typical of a ruptured CCL, however, an "almost 4 month old" pup tearing a ligament is rare, almost unheard of. Thoughts naturally at this juncture turned to other possible diagnosis. One that was mentioned, was OCD ( OCD stands for osteochondritis dissecans, a painful joint disease that affects shoulders, elbows, and knees.) That made me feel sick, really, really sick.

The next stage was getting a diagnosis. More diagnostics were needed, and owing to Otter's rather nervous nature this was going to be tricky. Eventually it was decided that I was to administer Trazadone, and we would take her away for an hour. Trazadone is an anxiolytic and the function was to take the edge of her nervousness and enable some light sedation to be administered. We left to find a coffee shop where we mused over what we had learnt so far. At this point I am terribly upset. It all seemed to make sense and point to a diagnosis of OCD. Both of us were quiet and sad, trying to absorb the information so far. Roughly an hour later we are back at AndersonMoores, and leave Otter with Andy. She seems much calmer and allows Andy to lead her quietly down the corridor. I can't look. Marcus has tears in his eyes.

We sat in the waiting area, where we are offered coffee. It seems an incredibly short wait, a quick coffee, and there is a wobbly Otter in front of us, slightly crossed eyed, but absolutely fine! :) We are sat in his office, discussing options. Andy is very clear, describing the joint, with a model, and also on a whiteboard. Otter has ruptured her cruciate ligament, we don't know at this point, if anything else is going on. Calmly, quietly and with compassion he outlines possible options. I will have a go. 1. Wait until growth plates are closed and perform a TPLO. 2. Don't wait and look at a reverse TPLO (got a bit complicated at this point) 3. Extracapsular Lateral Suture, a bit old school and may break...4. Do nothing, and treat conservatively...or 5. An interesting option. Implant into the tibial plateau and prematurely halt growth one side, allowing the other to continue to grow. This eventually results in stabilisation of the stifle. OK that was a very simplified version, the long version involves talking degrees and angles, and complicated mathematical equations, and something called a live Xray. OK sounds interesting. How many have you done. None. Otter would be a first, and one of the first ever in the UK to have this procedure.

OK, another wine break needed!!!!
 

Beanwood

Administrator
Home straight now, I promise! :)

We didn't take much time to decide. The last option is minimally invasive. The aim is for the stifle to correct itself over time. As her growth curve is unlikely to follow a linear path owing to growth spurts the improvement will be interesting to track. If it doesn't work out, well there are still options down the line. For me, some stability, even temporary is better than none at all. Waiting and doing nothing was a worry in itself. @Mr Beanwood had no doubts in his mind whatsoever. The surgery was then booked for today. I think you have probably guessed Otter has had the surgery by now. She is fine, and recovering well from the GA. We are collecting her first thing tomorrow morning :)

Back to the op itself. The angle is perfect. The meniscus intact (this this the "cushion" supporting the the joint) and the ligament itself although traumatically damaged, is still intact. There is a chance, due to her age that some regeneration may take place. He opted to leave it alone, after all, the pressure will soon be off the ligament entirely. The best news though, is there are no OCD lesions.

So the next update will be tomorrow, when we collect our dear little Otter :hug::inlove:
 

HAH

Moderator
Location
Devon, UK
Oh Kate, you poor poor creatures and man, that sounds like the right decision. I guess with Otter being so young there is limited precedent for dealing with cruciate ligament damage, so this is all exploratory to a degree. You and @Mr Beanwood are incredible and strong and doing the absolute best for Otter - she couldn’t be in better hands (you don’t need telling, but still...).

I imagine you’ll be buzzing for tomorrow but I’m hoping you get a decent nights sleep. She’ll be so thrilled to see you! Xx
 
Oh dear, Kate, what a trauma! These things happen so quickly... I’m glad Otter has come through the op well. Now comes the struggle of keeping her calm during her recovery. Sending lots of lambies to help... :thelambiesarecoming::thelambiesarecoming:
 
I can cover the 'angles' if anyone is interested :wink:
In summary the slope of the Tibial Plateau is currently (Usually) 20 degrees. By inserting a screw through the higher end of the growth plate (At the front) and thereby stopping the 'height' of the front increasing, the rear part will grow, and the slope will decrease. We're aiming for an angle of 5 degrees (So practically flat)
Anyway - that's all very interesting - but no mention of the wonderful All Day Breakfast :giggl::run:
 
Oh wow, that was a journey. And it's morning here so I was only drinking tea.

My goodness, what a rollercoaster and what an awful worry for you and your dear Otter.

It sounds as though you have the best possible result at this stage so let's hope that continues for you xx
 
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