"Where happy Butterflies work:
Obedience, Rally Obedience & Therapy Dogs"

Andy's Journal: Patella Injury & Recovery

Sept. 3, 2005: Andy went over the side of the ex-pen at my father's house while I was unloading the car for the long weekend stay. He damaged his left patella in the process, probably upon landing. I suspect surgery is a given, as he isn't putting weight on the foot. Holiday weekend, and in this area, no one is open.

Sept. 7: Andy has a referral to an orthopedic surgeon in Portland, OR - Dr. Tim Munjar at Veterinary Surgical Center of Portland (formerly: Veterinary Referral Center of Portland. Our vet was going to refer us to a local specialist, but I'd already done my homework and found, via many glowing references from agility and obedience enthusiasts on the NWDogActivities list, Dr. Munjar. So we're going to see him. The earliest appointment we can obtain is Sept. 23.

Sept. 23: As I suspected, surgery is required to put Andy back to 'normal' function. The surgery described to me is "Medial Patella Luxation Reconstruction" - or more specifically: Tibial tubercle transposition and wedge trochleoplasty. Andy has been prescribed a very small dose of Metacam daily to help with inflammation. Surgery is scheduled for October 6. I can pick Andy up on the following day, after meeting with Dr. Munjar about the surgical procedure and getting Andy's discharge instructions. It really seems like it is going to be a long wait for 2 weeks, but then I remember we have been waiting 3 weeks to see Dr. Munjar for the initial consultation.

In the weeks since his accident, Andy has been staying in my bedroom with his mother for company and lots of toys. He misses not training and lets me know about his displeasure when I work the other obedience dogs.

I've gone to the Goodwill store, and found some almost-new, really large bathroom mats for the bedroom and some washable area rugs with good rubber on the back. These are covering the floor in the bedroom, as there is no wall-to-wall carpeting and stability for the little guy is very important.

Andy's set-up:

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October 6: I get up at 3:00 am to be ready to leave for Portland with Andy by 4:15. Of course I'm very nervous for Andy, hope the surgery goes well, and am searching for a latte' stand that is open - but none I know along the drive open until 5:30! It is a long drive to get that first coffee drink....We arrive at Dr. Munjar's office at 8:15 - 4 hours after we started the trip. I've packed a little bag for Andy: 3 of his toys with squeakers - 2 teddy bears and a frog, and some of the food he is used to eating. He is wearing his harness, as I can control the speed he walks better. I leave all that with Andy for his overnight stay, and drive back home, to get in half-day of work. Dr. Munjar calls about 3:30 to let me know the surgery went well, and was as anticipated, and that Andy is doing well. That is a big relief.

October 7: Up early again, 5:00 am. My appointment to retrieve Andy is at noon, and I arrive a little early. The x-rays are shown to me (they even had one of his hips, and they look great!), showing the pin and wire in his knee and that the patella is now securely in place. Andy has his leg vet-wrapped in bright red, for stability for the next 2 weeks until his appointment to remove the bandage, sutures and to evaluate his progress. Until then, he is allowed only leash walks: no romping, no running, jumping or stairs. And certainly no interactions with the other dogs. For Andy's well-being, he is staying in my bedroom. Since he scaled an ex-pen, I can't pen him, so when I'm not able to watch him, he is crated with his bears and frog. Andy has an anti-inflammatory, antibiotic, and pain medication - the pain meds are to be used only if he needs it. His bandaged leg has to be plastic-covered when he is taken out to potty on-lead. For the next 8 weeks, all his outings will be controlled and on-lead, as he's not allowed to be his normal rambuctious self. We arrive home around 6:30 pm. He is using the leg a bit for balance, just putting the toes down.

Leash walks defined at this stage: sniffy-type potty walks, just a few minutes in duration. So that's no real 'going for a walk' type walking. It's just moving from this patch of grass to that bush, then to a post, and back inside to his crate.

Post-surgical Andy with his new-found friends:

and at home:

October 8: Andy accompanies me to a rally obedience seminar. I locate my chair next to the door of the room the dogs are in, and Andy is just on the other side. I've brought his pain meds with us, and he needs one around noon. He's good at the seminar; we went outside about every 2 hours for a short walk and potty. Now home, he's back in the bedroom as I type this paragraph, crated with his bears, and it's almost time for dinner and his antibiotics.

October 13: One week today, 7 weeks to go. Andy was off the pain meds after two days. During the week, he started putting very light weight on his leg, but not as a rule. Occasionally he will stand square on all 4,but it's still mostly for balance, a bit of toe-touching,and sometimes weight-bearing. He's doing great, but has entirely too much energy! His favorite activity is lying 'quietly' while he squeaks his bears, and chewing on a braided bully stick while we watch tv. He's on lead, on the sofa, so there's no danger of him getting up and jumping off the sofa.

October 21: Two weeks after surgery. During the past week, Andy has occasionally used his bandaged leg for balance. His bandage and stitches were removed by Dr. Munjar today. Andy's exercise is still very restricted for the next six weeks: no running, no jumping, no stairs. The knee gets iced 3-4 times daily for the next 4 days. He also receives a passive range of motion exercise 3-4 times daily. His outings for potty have been increased to 5-10 minutes each time, and no real walking with purpose - just 'sniffy' type walks (which he doesn't do very well - he's either ready to go at full speed, or stand and smell the fresh air). His next recheck with x-rays is scheduled for December 2.

October 22: Today, to my surprise, Andy used his surgical leg for walking some. A bit of walking, then a bit of 3-legging it. By the last evening outing, he used the leg the entire outing.

October 23: Andy is not using the leg so much today on his outings. He does not appear to be in pain, so no pain meds are being given.

October 26: Andy is using the leg now, putting full weight on the foot on each outing. He seems to be doing really well.

Weekend, November 5-6: I have a Rally trial to attend. I made the difficult decision to stay overnight, so I could care for Andy as needed. It meant taking ALL the dogs with me. Andy handled the trip, and potty-walk outings well. He so wanted to be working! It was very difficult to tell him to settle and be quiet in his crate, but was happy as long as he had his bear to snuggle with.

His activities are the same: controlled activities (no running, jumping or playing with other dogs), walking just enough to go potty, and return inside.

December 2: Another check up with Dr. Munjar. Andy is 8 weeks post-op. The x-rays look good and the knee is doing great. While he is not cleared for regular training (another period of slow work), he is cleared for walks. His walking routine takes 5 weeks, going from 10 minute walks to 30 minute walks - increasing each week by 5 minutes. 3 walks a day. Swimming is ok, as long as it's moderately done.

So I think what we will do is the walks for 5 weeks, and Andy will come do a novice rally course at practice, once only, and that will be the extent of his participation. I can use him as demo dog at my beginning class (he came last Tuesday and was the demo dog - had 4 exercises to show - and he was tired about 3/4 way through class, even though he was sitting nicely and waiting.)

He isn't cleared for jumping at this time - that's 3 months away.

During January-February, I worked Andy on fronts and stays, and short duration (4-6 human steps) heeling. He wasn't allowed to jump or do stairs. His endurance is increasing bit by bit every week being my beginning rally demo dog.

March 3, 2006: Final check up - the ortho surgeon gave Andy the go-ahead to return to normal training and his usual activities "let him be a dog" was the statement. His repaired leg is not as well muscled as the good leg, so now we'll begin swimming to equalize the legs. Dr. Munjar also noted there was not a buildup of scar tissue (which would impair movement), which he was very pleased with.

April, 2006: Andy has been swimming for a month now, and his jumps are straight (he was twisting the rear as he went over due to the inadequate muscling on the left) and strong.

May 2006: Since Andy received the ok to return to normal activities, swimming has improved his muscling, and he's achieved his Rally Advanced title, and one leg toward his Rally Excellent title ....as well as 2 qualifying scores in AKC and 2 qualifying scores in UKC toward his Companion Dog title.

Andy is still uncertain of slick surfaces, and will 'scramble' sometimes going over them. He shouldn't be worried as his strength is good, but I think he'll always be wary of shiny and slick surfaces.

He was the BEST patient I could have hoped for during his recovery and rehab. He did what was asked of him, and posed no problems. He took strict confinement very well, though I could tell he really, really wanted to run and jump and play.

Dr. Munjar is by far more conservative in how an animal is rehabilitated after surgery than indicated by other owners having the same or similar surgeries by other orthopedic veterinarians. It is important to follow the veterinarian's orders closely in order to have the best chance of a successful surgery and return to health.

I took Andy with me when Chrissy (she injured a leg as well...more on that later) had a consult with Dr. Munjar on May 26, 2006. He checked Andy's repaired knee, and it's very stable.

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Note: this page is not intended to be medical advice, see your primary care veterinarian and orthopedic specialist for that. This page is only a journal of Andy's recovery from surgery.