RECENTLY, OSCAR HAD A MAJOR OPERATION KNOWN AS TPLO OR TIBIAL PLATEAU LEVELING OSTEOTOMY. IT IS A RELATIVELY NEW SURGERY AND ALTHOUGH RESULTS HAVE SO FAR BEEN BRILLIANT, THE LONG TERM EFFECTS ARE UNKNOWN. AS THIS SURGERY IS BECOMING MORE AND MORE THE ACCEPTED WAY TO GO WITH CRUCIATE RELATED PROBLEMS, MORE AND MORE PEOPLE WILL FIND THEIR DOGS RECEIVING THIS TREATMENT. AS TIME PROGRESSES, I WILL DETAIL THE RECOVERY OF OSCAR AND HIGHLIGHT ANY PROBLEMS THAT OCCUR IN THE HOPE IT MAY HELP SOME OF YOU TO MAKE THE RIGHT DECISION IN THE FUTURE.

THERE IS ALSO EVIDENCE, ALBEIT SO FAR SKETCHY, OF HEREDITARY EYE DISEASE IN BULLMASTIFFS, THIS IS CURRENTLY UNDER INVESTIGATION BY THE VARIOUS AGENCIES. WITH THIS IN MIND, I DECIDED TO INCLUDE SOME INFORMATION ON HEREDITARY EYE DISEASE IN DOGS. 

Tibial Plateau Leveling Osteotomy
Hereditary Eye Disease
The Hardest Decision
Bullmastiff Health Survey

OSCARS RECOVERY TO DATE

Although Oscar looked a real mess when we collected him from the surgeon, his first night was relatively comfortable. There was no sickness and Oscar settled down immediately to a cup of tea and some scrambled egg. The biggest problem was keeping him quiet, which showed how relatively comfortable he was. Toilet duties are a little fraught as it is a very slow and painstaking walk to get him outside, although he is confident to toe walk on his damaged leg, the surgeon told us that this was OK. He also has the greatest difficulty in positioning himself for the said duties and needs our support. In himself, he is bright and alert and we are already confident that if we can protect his leg from damage for these first few weeks, recovery will be slow but smooth. So far, I have been pleased with the way things have gone. We are told that the cruciate will take 4-6 weeks to heal, and the break from 6-8 weeks, after which Oscar can build up to where he was. The only crisis, so far, was on the day we brought him home, his leg swelled abominably and caused the bandages to cut into his leg. Within an hour, incredibly, this had done enough damage to cause an ulcer, which, although healed, has left a hairless patch above his foot. Bandages removed that day and never replaced. The open wound caused us some hair raising moments, trying to stop Oscar messing with it.

Within 2 weeks, Oscar is coping almost by himself, although we still support him with a towel for toilet duties. We allow him to move about to position himself, but we must still continually keep him as still as possible. We return to the vets after 4 weeks and everything appears to be normal.

After eight weeks , we return to the vet and are told that the cruciate is fine, but that there is little sign of the break healing, and another month must be allowed.. This causes us much concern, as the surgeon now regales us with tales of larger breeds having difficulty with this operation and the healing of the bone. We weren't told this at the original  consultation and I must admit to being not a little angry, and said as much. However, we decide that another month must be given of complete rest, and hopefully, we should be OK. Not so.

Two weeks after arriving home, Oscar stands up, stretches hard, and we hear a sickening crack, Oscar immediately begins to hobble badly, and the next day we are back traveling to the surgeon. He watches Oscar walk and tells us that

1) Oscar should be further down the line to recovery than he is, and

2) There is obviously something very wrong. There is no movement in the cruciate or the bone, so it wasn't his leg breaking.

After another batch of x-rays, we are temporarily relieved to hear that it was in fact one of the screws breaking. Our relief is short lived to be told that the broken screw is right next to the break in his leg and could cause other complications, such as movement at the break site. This in the long term proved to be the case.

Four weeks later, we return to be told that there is still little evidence of the break healing. Oscar has had zero exercise for months, he has not been out of the house except for toilet duties, and he is difficult to keep quiet. We are told that one last attempt to heal by rest, this time for two more months, must be made, otherwise they will need to try a bone graft. The phrase "try" a bone graft makes me think we are clutching at straws. However, Oscar is to be allowed light exercise, as muscle wastage due to inactivity is also beginning to be a worry. Further, the less he uses his left leg, puts more strain on the right, and if both go together....................

We give Oscar the two months, and with great trepidation return to the surgeon. We are ecstatic to find that this last two months have done the trick and Oscar's leg is fully healed.

CONCLUSION.

In Oscar's case, the operation for the moment appears to be a success. However, although the vets claim this is a widely used operation, it hasn't been used long enough for a real conclusion as to the long term effects in dogs. The grey area's are the possibility of the onset of arthritis, and whether this operation increases or decreases the effects of arthritis. The operation is intended to be used on medium and large breeds, but results are showing a difficulty in healing the bone in the largest breeds. It also takes real devotion and determination, and not a little physical strength to get a Bullmastiff through this, my wife deserves a medal. TPLO gives a real alternative to cruciate replacement, but where we originally believed recovery to be faster with TPLO and the fact that the dog can use his leg almost immediately, due to the metalwork, this has proved not to be the case. Recovery time is at least double that of cruciate replacement and can have its own complications, as in our problem with his bone healing. In Oscars case, so far at least, I would say that the operation has been a success, and that, despite all the setbacks, his cruciate has been saved, and this will always be stronger than one replacing it, I believe these are stapled to the bone, but only time will tell how much a success it has been. As with everybody else whose dog has undergone TPLO, we are now venturing into the unknown.

It is now nine months since the operation, and for the present, we are well satisfied. Oscar is now back on full exercise and doing pretty much what he wants to do, including jumping over ditches, walls and styles. So far there is no sign of any stiffness and Oscar is very happy and confident in it. The metalwork will be left in, as there is little point in removing it and causing more scar tissue. 

I suspect that in the future, more and more vets will turn to this operation, and some of you reading this will find yourselves in our position. If this is the case, and you would like to chat about this, or just get some in depth feedback, simply send us an email from the contacts page and we will be happy to oblige.

(to be continued)