I give you the state of Dominic's elbow. The right elbow on the bottom is how his elbow should look, but when you compare them side by side you can see that the left elbow is missing a little something that the right elbow has. Things have flowed a little something like this:
Sunday night I heard a more thorough explanation of Dominic's x-rays. Dominic has elbow dysplasia. It's a very broad term that generally encompasses abnormalities of the elbow joint. I got two solid recommendations for orthopedic specialists to talk to and not the best outlook for Dom. Basically he was going to have to be a couch potato for the rest of his life. No hiking, limited walks, and a lot of the work on the unstable surfaces. This was a little crushing. The vet also prepped me for the price tag that was likely to come along with the necessary surgery to get Dominic comfortable again. It was a lot to digest and she recommended that I have a glass of wine that night.
Monday I set about setting up a consult appointment for Dom. I have decided to go to the Veterinary Surgical Center of Portland for Dominic's surgery. They're relatively close to my house, they came highly recommended and conveniently enough, Heffner and Bess have both been seen by vets there. Heffner for his iliopsoas strain and Bess for her spay and gastropexy. Dominic's consult was set for Thursday morning.
As the week progressed, I kept Dom on the meloxicam and tramadol and restricted activities and he got a lot better. On Sunday he could only stand up for about 5 min. before he didn't want to be weight bearing. By Monday night, there was no limping. He has continued to act like isn't feeling any discomfort and I have been slowly decreasing the amount of tramadol that I have him on. I'm hoping this is a good sign, which you'll understand more in my description of the consult.
On Thursday we went in to see the surgeon. He showed me the areas of concern and diagnosed Dom with an ununited anconeal process. Something most commonly seen in young german shepherd dogs. There is also some abnormal growth/arthritis in his medial coronoid process that the surgeon thinks may be what's causing Dom the discomfort. The plan is to go in and arthroscopically clean the arthritis and abnormality out of the joint and hope that the gunk in the medial cornoid process is what was causing him the discomfort and with it gone, that he'll do much better.
The surgery is set for December 26th. There are three likely outcomes of the surgery. The first is the worst case scenario. In this case the surgery wouldn't do anything for Dom. He'd still be intermittently lam post op, the arthritis would come back quickly and at a more advanced rate. It would be pain and exercise management for him from there until a quality of life decision was made. Option number two is that the surgery doesn't do much for him. He's not lame post op, the arthritis comes back a bit later and a slower rate and we monitor for pain and manage accordingly with exercise restrictions from there on out. Option number three is the one that we really want. In this scenario, removing the abnormal growth is the "fix." In this scenario Dominic is in better shape post op than he was pre op. The arthritis will eventually come back, but much further down the road and at a slower rate. We would medicate for pain as needed, but I'm not totally sure what his exercise restrictions would be.
The surgeon found it promising that Dom has not been lame until the weekend that I took him to the emergency clinic. Normally dogs in Dom's position are at least painful enough to be limping most of the time. We don't know what triggered it, but Dom was only lame starting two Friday nights ago.
We are also going to do an injection into the joint of plasma rich platelets two weeks post op to aid in healing. I did discuss medication options with the surgeon for further down the road as well as supplements and utilizing other modalities to aid in healing. So I feel that we are ready for this surgery. Thankfully Dom hasn't been climbing the walls and I have been doing some modified training with him at this point. It's just pretty limited or modified in the position that I have him in, which is mostly in a down. We've emphasized reintroducing the ramp. My house is thankfully one story, but there is a rather large step down into the garage in order for him to get outside to potty. So this week I do actually have a couple of training videos that are centered around getting him comfortable with the ramp so that he's good to use it when he will actually need it.
Day 27
Day 27 of the #100DaysofDogTraining: We are no longer going to be doing consecutive days, but we'll keep chugging along with this as long as we are able. As I've mentioned, Dom is pretty restricted on his activity level and we've needed to stop doing most of what we were previously working on. He does have a surgery on the affected elbow coming up likely next week. While my house is thankfully only one level, there is one fairly large step into the garage in order to get out into the yard for him to potty. I know from experience that this one step is incredibly daunting when you are not fully able. I do thankfully have a ramp, it's just been probably close to two years since I've had Dominic walk on it. Many things have changed in that time and I would rather make sure that he's comfortable with the ramp NOW while he's more functional than wait until it's go time and becomes terrifying for him. Thankfully I did so as he was hesitant initially to walk on the ramp. I'm starting him out by just walking him on it while it's flat on the ground. Super simple. We'll increase the difficulty in future sessions.
Day 28
Day 28 of the #100DaysofDogTraining: Today we elevated the ramp. This one step down into the garage in order to get outside is the one step that I will have to be really careful about with Dom. Conveniently right now, that means that's as high as we need to get him comfortable with. I started him out in the garage walking UP the ramp. He is less intimidated by going up something than going down, as you can see in the video. He has less hesitation going up, but definitely is more hesitant going down. He's doing really well and we'll keep working on this.
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