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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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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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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.
 

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Discussion Starter #4
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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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??
 

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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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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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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.
 

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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.
 

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I think a 2nd opinion is a good option for you. I'm glad you are doing it.

Personally I wish you would discuss traditional surgery with your vet as well. You have a pet dog. The traditional surgery is a LOT cheaper (and you have financial troubles). Your dog would do well with traditional surgery, IMO. Please don't rule it out.
 

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A second opinion, for animals and humans, is always a good idea I think! Especially since it sounds like you really like this surgeon and trust him :)

Just be sure to keep in mind, CCL tears in mature dogs are most often the result of a degenerative condition - chances are high that if she has one tear, the other leg will at some point tear as well. (This in contrast to very young dogs, where traumatic is more common.) So if the opposite leg isn't torn now, start saving is usually the advice given.

The traditional surgery is a LOT cheaper (and you have financial troubles). Your dog would do well with traditional surgery, IMO. Please don't rule it out.
This is very true, but it sounds like you've already made your mind up about TPLO - which is equally as good as lateral suture in most cases. Good luck with the vet appointment and please keep us updated on how she's doing :)
 

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I think a 2nd opinion is a good option for you. I'm glad you are doing it.

Personally I wish you would discuss traditional surgery with your vet as well. You have a pet dog. The traditional surgery is a LOT cheaper (and you have financial troubles). Your dog would do well with traditional surgery, IMO. Please don't rule it out.
I have not ruled anything out. I am leaning towards TPLO because Java is very young (13 months old) and she is a larger dog (72 lbs), as well as extremely active. I have researched CCL repair methods and I feel confident that TPLO is the way to go for my girl, however I am keeping an open mind and will see what the ortho vet has to say about it. I trust his opinion on this matter as I am no expert on it. Doing research on the internet in no way qualifies me as an expert, so on this matter I will defer to the doctor.
Finances are the least of my concerns when determining which surgery to do. I will do whatever surgery is the best option for Java to lead the healthiest, happiest and most active and normal life possible, regardless of cost.
 

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A second opinion, for animals and humans, is always a good idea I think! Especially since it sounds like you really like this surgeon and trust him :)

Just be sure to keep in mind, CCL tears in mature dogs are most often the result of a degenerative condition - chances are high that if she has one tear, the other leg will at some point tear as well. (This in contrast to very young dogs, where traumatic is more common.) So if the opposite leg isn't torn now, start saving is usually the advice given.



This is very true, but it sounds like you've already made your mind up about TPLO - which is equally as good as lateral suture in most cases. Good luck with the vet appointment and please keep us updated on how she's doing :)
I understand this, but Java is not a mature dog. She is 13 months old.
Believe me, I am anticipating the second CCL going also, if it's not already. I almost prefer for them both to be done now to be honest. I'd rather do one now, wait the 8-12 weeks and do the other. Just get it over with and move on rather than do one and wait for the other shoe to drop.
The vet did tell me that once you fix one leg there is as high as a 60% chance that the other leg will blow within 12-18 months.
So, I won't be totally surprised or upset if it turns out that both knees need to be done now. It might actually be a relief.
 

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With TPLO the chances of the other knee going are far higher than with traditional. They often change the angle of the leg so dramatically the other leg can't take the strain.

Magnum was five years old, 73lbs, blew her knee completely, had traditional repair, went on to compete in agility for two more years before I retired her due to a front foot problem/lameness. She has never blown her other knee. She runs like the wind every morning when I take the dog to play (she is 9 years old now).

Just food for thought.

Both procedures are good. I'm just thinking financially for you. If you can go with the less $$ amount, I don't know why you don't. I'm not in a position to spend money I don't have on my animals. I have to pinch every penny.

Hopefully you won't need two surgeries.
 

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With TPLO the chances of the other knee going are far higher than with traditional. They often change the angle of the leg so dramatically the other leg can't take the strain.

Magnum was five years old, 73lbs, blew her knee completely, had traditional repair, went on to compete in agility for two more years before I retired her due to a front foot problem/lameness. She has never blown her other knee. She runs like the wind every morning when I take the dog to play (she is 9 years old now).

Just food for thought.

Both procedures are good. I'm just thinking financially for you. If you can go with the less $$ amount, I don't know why you don't. I'm not in a position to spend money I don't have on my animals. I have to pinch every penny.

Hopefully you won't need two surgeries.
Thank you so much....I will definitely ask the doctor about the traditional repair as well. I wondered why the other knee was so likely to go after TPLO, what you said about changing the angle makes perfect sense to me!! Thank you so much for the information. I do want to go into this appointment with my list of questions and as much information as I can.
 
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