Menina's Recovery Timeline

Feb  ?    

Injured right rear leg

Feb 15  

Dr. Laviola - Chilhowee Veterinary Clinic - Xray: No broken bones, very inflamed right rear hock, anti-inflammatory and restricted activity.

Feb 25   
Dr. West  - Chilhowee Veterinary Clinic - Recheck - felt like tendon was moving on heel (tuber calsis) bone.  Referred to orthopedic specialist.

Mar 2  
Dr. Blackford - Blackford Surgical Referral - Repaired luxated superior digital flexor

Mar 3  
Restricted Activity - Walk on leash only to potty.  Absolutely no running, jumping, or stairs!

Mar 16  
Removed Cast - Start 3 Week Crate Restriction.  Walk on leash only to potty.  Absolutely no running, jumping, or stairs!

April 6  
Start 1 Month Walking and Swimming - No running or jumping.  Start walking and swimming. As long as she is not sore, continue to increase the activity. Also do range of motion exercises on the hock to help her tissue to heal in the right orientation.

May 5  
Start Month 3 Restriction - Try some running. Don't start agility yet.  Must avoid weaving and jumping until the 3-month restriction is over.

Jun 6     

One Month Re-Introduce Agility Training. Gradually return to agility activities.  Make sure you gradually re-introduce jumping and weaving.  The tissue should be adequately healed so she shouldn't  re-injure herself. Dr. Blackford has never had a re-injury for this problem, but she has never repaired this problem in an agility dog.  The scar tissue (when adequately healed) should be stronger than the normal tissue.  There have been reported cases of Shelties breaking down in the other leg. Hopefully that won't be a problem for Nina.

Jul 1  
Ready for Agility Competition - Assuming all goes according to plan.  Wish us well!

Temporary Height Card

I was able to get Jane Mohr to measure Menina for her temporary height card.  She measured 15 7/8 inches.  This puts her smack dab in the middle of the 16" jump height range.  She will have to be remeasured at 2 yrs (after December 10).

Wish List - Conmplete

• Crate cover and bumpers - to make hanging out at trials more comfortable. - Got this

• A wheeled cart to carry items from vehicle to show: crate, chair, ice chest (drinks and food), shade tent - got all this

• Backyard fence - Got this - finally - It's beautiful!

• Wire pen to allow freedom to walk about outside camper.  Got this

• Taller wire crate for Menina - She has grown so tall that she can't stand up straight in here 19" tall one. Borrowed from Smiths for house purchased slightly smaller one for car.
  
• Van or truck to carry things easier for trials. - Got this

Home Again

We arrived home yesterday after a long weekend at Harriman.  I really enjoyed the agility trial.  It was fun to watch the dogs and handlers, good to learn more about the agility sport, interesting to meet new dog folks, and helpful to get to know fellow TVKC club members.  It broke my heart to have to keep Menina in her crate the whole weekend.  I have several questions yet on her recovery.  Here is the email I sent to her surgeon today.

• Surgery: March, 2, 2010, Dr. Blackford repaired luxated superior digital flexor

• Recovery: 
  
  1. Cast removed 3/16/2010.
  2. Activity still restricted to crate and short leash for potty.  Using ace to keep her calmer.  Limited activity for 3 more weeks after cast removal.
  3. Using prescribed gentle forward and backward movement to leg for physical therapy several times daily.
  4. Appears to be healing a little every day.  Affected leg appears a little stiff when she walks - range of motion is not yet equal to left leg.  Infrequently, but sometimes, I do see her limp (just a single step) if she walks quickly outside.
  5. Per your instruction, I plan to gradually introduce leash walks after our three week crate restriction. Start 4/6/2010
  
  HERE ARE MY QUESTIONS: 
  
• Would swimming be beneficial?  If so when, how much?
  
• At what point can start a gradual I return to agility training?  Jumping? Weaving? Teeter? A-Frame?  Walk?  Tunnels?
  
• Registration for May and June competition are opening NOW.  When can I anticipate being able to compete? 
  
• Should I get you to look at her again for evaluation prior to training or competing??????  I so want to get back "normal" but I must make sure that we give her the best chance for complete recovery.  Your guidance is appreciated.

TVKC - Harriman

Today is the first day of the Tennessee Valley Kennel Club Agility Trial.  Unfortunately, we will not be competing since Menina is recovering from her surgery.  She has another three weeks of "cage rest".  I volunteered to help with the trial, so we packed up the camper and arrived last night.  It will interesting to learn more about agility, trials, and the whole traveling with the dog thing.

The Patient is resting well.

Well, surgery it was.

We visited Dr. LeeAnn Blackford this AM. Nina was diagnosed with a luxation of the superior digital flexor tendon.

• This is an uncommon injury usually seen in the Sheltie, but can occur in any breed.
  
• The superficial digital flexor tendon is the caudal-most component of the calcanean (or Achilles) tendon.
  
• Its retinaculum holds it on the caudal aspect of the tuber calcanei.
  
• When this retinaculum tears, usually due to exercise-related trauma, the tendon can luxate medially or laterally.

What does all that mean? Well, a little canine anatomy first. Take the rear right leg ... Focus of the purple tendon:

The Achilles' tendon is on the back side of the leg. It consists of two major and three minor tendons.

(1) Gastrocnemeus tendon - the main tendon that attaches to the heel (or calcaneous bone)

(2) Superficial digital flexor - second main tendon that partially attaches to the calcaneous bone and then passes over the end of the heel bone and attaches to the digits; this tendon flexes the digits.

Three minor tendons (not shown)

The detailed diagram below shows that bursa cushions the purple tendon (superior digital flexor) where it runs over the heel bone (tuber calsis). This is the bursa that has been so swollen on Nina during the last few weeks.


Now we need to review the definitions of a few terms....

retinaculum [ret″ĭ-nak´u-lum] - a structure or that retains an organ or tissue in place. In this case the retinaculum has been described as a sheath covering the tendon.

luxation - [luksā′shən] a dislocation or a displacement.


So, in plain English, Nina's Achilles tendon was dislocated off the heel bone due to a torn sheath that holds the tendon in place.

The surgery was performed to repair the torn sheath to stabilize the dislocation.


The following three diagrams show how the surgery that was performed on Menina this morning.