History
Magen Shaughnessy
Name Species Breed
Marley Dog Bichon X
Age 7 years
Sex Male Neutered Referral Pet Doctors Manurewa -
Pet Doctors Manurewa
Marley a 6 year old, male-neutered, Bichon X has presented to ARC surgical service for a 2-week revisit following a Left TPLO and lateral patella imbrication surgery
CURRENT HISTORY:
Marley is doing well at home and has begun bearing consistent weight on the limb. He is being activity restricted. The incision is healing well and Marley has not been licking or scratching at it. The owner wonders if she can discontinue the medications at this point.
CURRENT MEDICATIONS:
1. Carprofen
Physical Exam
Magen Shaughnessy
Limited exam, temperament is a caution
General appearance: Bright, alert and responsive. Mucous membranes/CRT: Pink, <2 seconds Eyes/Ears/Nose: Ear canals no longer inflamed. Oral cavity: not examined (NE)
Heart: NE
Respiratory: normal rate and effort
Peripheral lymph nodes: NE
Abdominal palpation: NE
Urogenital: external exam normal
Integument: Left stifle incision appears healed Musculoskeletal:
Right grade II/IV unchanged
Left stifle: Stable on CTT, comfortable on pROM and palpation of implants. Patella remains in place.
Neurological: Normal mentation, no ataxia, or spinal pain noted Rectal exam: Not performed
Assessments
Magen Shaughnessy
2 week post-op Left TPLO + MPL correction
Incision healed
Revisit
Magen Shaughnessy
RECHECK INFORMATION:
Marley's incision is healed and an Ecollar is no longer needed. However, the bone is still continuing to heal. Marley will need to continue activity restriction recommendations until bone healing is confirmed radiographically in 6-8 weeks.
HOME CARE:
Diet: Normal Diet.
Exercise: Rehabilitation may now begin. The patient's activity is gradually increased at this time to build muscle, increase mobility in the joint and strengthen bone healing. The activities outlined below should progress only if your pet remains comfortable. Increasing the duration and not intensity of the activity is desired. Please adhere to the following recommendations during this phase of your dog's recovery.
• At this time leash walks are advised. Your dog should walk on a short leash in the heel position. Be sure to walk slowly to allow your dog to place weight on the operated foot with every step. Start with 5-minute leash walks twice daily. You can add 5 minutes every 7 days as long as your pet remains comfortable. Please STOP at two, 15 minute leash walks per day.
• Gradually increase the length of each walk but you may not advance past twice daily 15-minute walks until radiographs confirm bone healing. Once recheck radiographs confirm bone healing you may continue with the next phase of rehabilitation as previously outlined.
Hydrotherapy: Underwater Treadmill Rehabilitation can be instituted now that the incision is healed. Some of the benefits of Underwater Treadmill Rehabilitation (which is similar to wading in shallow water) include the fact that water buoyancy reduces the stress on the limb, water provides resistance throughout the range of motion, and warm water assists in pain reduction. The water height in an Underwater Treadmill can be regulated to accommodate different sized animals and can be adjusted for maximum weight bearing benefit. However, swimming is not recommended at this time. Please make an appointment with ARC Hydrotherapy.
Please monitor Marley for continued improved use of the limb. Some lameness at this stage is normal but if it suddenly worsens or fails to improve, please contact us. Please call the attending doctor if any questions or problems arise.
MEDICATION SUMMARY:
No additional medication is required at this time. You may discontinue the use of pain medications if you feel that Marley is comfortable at home.
FOLLOW UP:
Marley will need a follow-up in 6-8 weeks for a recheck examination and radiographs to assess bone healing. Do not feed Marley the morning prior to this appointment as sedation may be needed. Please schedule an appointment with Reception for Marley at your earliest convenience. There will be an additional cost for sedation and recheck radiographs.
Thank you for bringing Marley into the ARC Surgical Service today. Please don't hesitate to contact the clinic with any questions or concerns by calling 281-5815 or emailing magen.shaughnessy@arcvets.co.nz with non-urgent inquiries.
Kind regards,
Dr. Magen Shaughnessy DVM, DACVS-SA Veterinary Surgical Specialist
