Java's surgery update-NEW plan (long)
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  1. #1
    javasmom is offline Senior Member
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    DefaultJava's surgery update-NEW plan (long)

    Ok, so I am still fighting with the insurance company over the pre-authorization claim that I put in for Java's surgeries. I have been instructed to call Fabrice the supervisor back todayat 12:30. He was going to review the case and files and see what could be done. I am not holding my breath....

    Now...I have cancelled Java's surgery which was scheduled for Monday. I have been becoming more and more uneasy as the week wore on and her surgery date approached. It finally just got to me on the drive home last night. I am not 100% confident and comfortable with the ortho vet at my regular vet's office. I am not comfortable with the exam he did or the diagnosis that he came up with after the exam. My regular vet examined Java and said she tore her CCL in her right rear leg. Ok. He also examined the left rear leg and did not comment on it, just on the right leg. He referred us to the ortho vet that is part of their practice. He told us that the ortho doc would sedate Java to be able to exam her more fully (Java is very tense and uncomfortable at the vets..she does not relax at all).
    Our appt. with the ortho vet was this past Monday. He examined Java while she cowered in a corner of the room, then we had to hold her down while he looked at her. She was terrified. He DID NOT sedate her to do the drawer test accurately. He did not do x-rays either, which I am told are not always done. He then announced that she needed 2 TPLO surgeries. We kind of looked at him and said "What?" He said both knees were torn...something that never crossed our mind before that point. Java has NEVER limped on her left rear leg, only her right and it was very obvious. Limping, toe touching, lifting her foot off the floor. I have never seen any of those symptoms in her left leg. Ever. She has never appeared to favor it. Now, I know I am not a vet or an ortho vet, but I do know my dog and I would have noticed had she had a problem with her left leg too.
    The vet immediately scheduled surgery for Monday, went over a couple of things with us then left, leaving us there in shock.
    After thinking about it over and over for the past few days, I just finally voiced to Brian (my BF) that I was not 100% comfortable with Java having the surgery. I had my doubts that it was the best thing for her. He said he had been thinking the same thing and had come to the same conclusion. Now, please, keep in mind that this has nothing to do with the money. NOTHING. Keep reading....

    We have now scheduled Java for an appointment with the surgeon that operated on and successfully fixed Moka's broken leg, Dr. Massat. We were both extremely impressed with him and trust his opinion fully. Moka has full use of her leg with no noticeable after effects-no limping, lameness or even soreness. He is also highly regarded in this area as well as in NY. If he says that Java needs the surgeries, then we will be 100% confident in that diagnosis and treatment plan. I am pretty sure she needs teh TPLO surgery on her right leg, not so sure about her left leg though. If the insurance company will not pay for the surgery(or surgeries) then we will pay for it out of pocket, no regrets. I want what is best for my Chicky-Doo, but I also want to be sure that what I am doing is the absolute BEST thing for her first. I don't want to have doubts about whether or not I did the right thing. I will pay the $7000+ to have her fixed without question, as long as it is the best thing for Java. And I feel that going to see Dr. Massat is the best thing. I just wasn't totally comfortable or confident with Java having the surgery based on the other ortho vet's assessment of her.
    Just so you know...Java is on joint supplements, 4x a day and does not *seem* to be in any pain. Her appt. with Dr. Massat is for this Tuesday at 9:45 am. I am really looking forward to what he has to say. His surgical tech is calling us today with details about exactly what the doc will do to Java on Tuesday.
    So now we wait for Tuesday and see what Dr. Massat has to say.
    What do you guys think? Does this make sense?

    Thanks,
    Gina

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  3. #2
    AngusFangus is offline Senior Member
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    I think it makes perfect sense.

    With something as invasive and serious as this, if you have the luxury of a little time (which you do), a second opinion is always a good idea. The way she was "examined" the first time would not inspired a lot of confidence from me, either. But when things like this are happening, I know how easy it is to just stand there and sort of go into shock. But after you had time to think about it, you knew exactly what to do.

    I think Dr. Massat sounds like a great person from which to seek advice.

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    kelli's Avatar
    kelli is offline Senior Member
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    There's nothing wrong with getting a second opinion.. but just so you know koda never really limped either.. though i never really gave her the chance since she was on strict no exercise no jumping restrictions.. and the reason she may not be showing signs on her other leg is because it's the better of the two legs so she walks on it because it's less painful than her other..

    Labs are ridiculously tough to gauge pain with.. they won't show any signs of it unless it's unbearable to them.. koda never limped a week after surgery.. i guarantee you she was still in pain but she showed no signs of it.. i'm telling you, you can't tell by limping or no limping, favouring or no favouring .. and odds are, in a dog that young with one torn ligament, she probably does have two.. or at least one that will go shortly if not now.. she was born that way .. nothing you can do about that.

    So get your second opinion, but brace yourself for what could be coming.


    kelli, tucker and koda

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    javasmom is offline Senior Member
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    Quote Originally Posted by kelli View Post
    There's nothing wrong with getting a second opinion.. but just so you know koda never really limped either.. though i never really gave her the chance since she was on strict no exercise no jumping restrictions.. and the reason she may not be showing signs on her other leg is because it's the better of the two legs so she walks on it because it's less painful than her other..

    Labs are ridiculously tough to gauge pain with.. they won't show any signs of it unless it's unbearable to them.. koda never limped a week after surgery.. i guarantee you she was still in pain but she showed no signs of it.. i'm telling you, you can't tell by limping or no limping, favouring or no favouring .. and odds are, in a dog that young with one torn ligament, she probably does have two.. or at least one that will go shortly if not now.. she was born that way .. nothing you can do about that.

    So get your second opinion, but brace yourself for what could be coming.
    Thanks Kelli. In my head I have accepted the fact that we will have 2 surgeries to do. Maybe not back to back, but at some point. I do understand what you're saying about the limping and pain tolerance.
    I just didn't have complete confidence and wasn't totally comfortable with the ortho vet that we saw. Dr. Massat fixed my Moka and I am more confident in his opinions and abilities. I'm not exactly sure why, I just didn't get take to the other ortho vet. It was just a first impression, but there was something there that bugged me all week......so, because I am so unsure I am getting another opinion.
    If Dr. Massat comes back with the same diagnosis then I will 100% confident that the surgeries(both) are the right thing for Java and I will gladly pay for both and have it done.

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    Lexis Mom is offline Senior Member
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    I have to agree with Connie, if you are even a little bit unsure, see a second opinion. In this case, you are going to a vet you trust after he cared for Moka.

    I would be very hesitant with the first ortho vet's assessment, especially since she was cowering in the corner & had to be held. How could he have gotten an accurate assessment??

    My pretty girl, Lexi!

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    joflake is offline Senior Member
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    I'm glad you're getting a second opinion. The experience you describe with the ortho wouldn't give me much confidence either. Hopefully, she won't need two surgeries after all. Poor thing, if she already doesn't like the vets office, this isn't going to help much.

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    TobysTrix is offline Senior Member
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    Getting a second opinion is never a bad thing, and if you prefer the other vet, then by all means see him as well. Whatever happens, I hope things go well for you and her (and that the insurance company backs down).

    Several months ago, we took Chamois to the emergency vet (because it was late Saturday night) after she started limping, and was in so much pain she started throwing up. They diagnosed her with a partial CCL tear and suggested taking her home, putting her on complete rest, and seeing our regular vet on the Monday. By Monday morning she seemed fine and our vet did a very thorough examination including imaging the joint. Her conclusion was that if there was a tear it was minor, and we should keep her rested for a while. Basically she said it would either heal on its own with rest, or it was compromised enough that she'd blow it out completely soon and then need surgery. It's been long enough without any issues and no indication of injury on subsequent re-checks that we can only conclude that it healed itself, so we dodged the bullet on that one. But I liked it that she didn't rush us into any surgery or anything major immediately.

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    zoezoe is offline Senior Member
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    also glad you are getting a second opinion.
    actually, an xray will not really tell you that the CCL is torn. That can pretty much be determined by the drawer test. Both my regular vet and the ortho surgeon confirmed Jax's was completely torn without an xray. The xray is done before surgery to determine the slope of the knee before and after surgery and to use during the surgical process. Xrays after surgery will show how much of the bone and tissue has filled in for healing purposes.
    After doing the leg that you KNOW is definitely torn; 6-8 weeks of crate weeks could be a good conservative management approach for the other leg. Only problem is, when they are struggling with sugery from one leg; it's very easy to pull the other (that is what happened with Jax, so be VERY careful with your other dog that just had broken leg surgery....too much too soon and it can happen with him, too)!

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    Good for you about the second opinion. It's very important to be pleased with your vet.

    Good healing thoughts for sweet Java.
    ~Veronica and Nikki~
    Sweet Emma, 16th of February 1996~26th of November 2010
    Always in my heart and soul. Together forever, my love....

    Nikki 6 months


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    Quote Originally Posted by zoezoe View Post
    Only problem is, when they are struggling with sugery from one leg; it's very easy to pull the other (that is what happened with Jax, so be VERY careful with your other dog that just had broken leg surgery....too much too soon and it can happen with him, too)!
    Oh, that's very true Sandy.. i knew with Koda before her first surgery (okay, like 10 minutes before her first surgery) that her second knee was going to need surgery.. the vet mentioned that she will make it much worse because she'll need to rely on it when she's recovering from the first surgery.. it's a delicate balance.. i guess having the first surgery done is often what causes the second knee to go.


    kelli, tucker and koda

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