# Riddle's TTA recovery thread



## Savage Destiny

I've decided to try and keep a journal, here and on other dog forums, about Riddle's recovery after her TTA. I'll try and update daily with progress, pictures, routines, etc. After the initial few weeks, updates will probably be more spaced out as she gets more stable and things aren't changing daily. I'm hoping that, if I can keep up with it, the journal can be a help to other dog owners going through the same issues.

For those not in the know, today (6/19/12) Riddle is having a Tibial Tuberosity Advancement (TTA) surgery performed to correct a ruptured Anterior Cruciate Ligament (ACL) in her left knee. Riddle had the TTA procedure performed on her right knee about 3 years ago, and so far that one has held up perfectly. Riddle is a six-year-old Pit Bull, kept at a nice skinny weight. 

Info on the TTA surgery:
TTA SURGERY
TTA Surgery Information

The second link is actually from the website of the clinic doing the procedure. She will also get physical therapy at the same place!

She's out of surgery now, and did fantastic. She had also torn the meniscus in the same knee, so that was repaired as well. They know her well there, so she's been getting spoiled, sleeping in people's laps, etc. She does not get to come home until tomorrow morning, so I'll be keeping you all updated tomorrow!

Edited to add a pic from last week!


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## Savage Destiny

Riddle is home! Very tired. She pooped, peed, and then collapsed into sleep. So far her leg isn't too swollen or bruised, but we'll see how the day progresses. I'll post some epics of her and her inscision later when she wakes up. She does have some diarrhea, so she'll be getting rice and yogurt for dinner.

She came home with Clavamox, Tramadol, and Metacam. Clavamox is an antibiotic that she gets twice a day with food. Metacam is an anti-inflammatory she gets in the morning, and Tramadol for pain every eight hours. We are also icing her leg every four hours to prevent swelling. If lots of bruising presents, we'll do hot compresses too.


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## GoingPostal

Hope the recovery goes smoothly! Jersey is finally recovered enough from her TPLO to be mostly back to normal, it was hard on us to have her confined for so long.


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## Savage Destiny

Riddle says thanks for the well wishes! 

She's been very good about snuggling on the couch next to me all day. Couch camping isn't my favourite thing ever, but it's the best way to keep an eye on her, so that's our routine for the next few days.  

WARNING: GRAPHIC INCISION PICS BELOW

Just figured I'd post that for the faint of heart. 

Mega sad post-surgery face:









The "I do not like ice packs" face:









Leg and incision at 12 pm:









At 4 pm:









At 8 pm:









She's bruised up quite a bit, but not as much as the last time around! There was a tiny bit of fluid leaking at the 8 pm check, but such a small amount I'm not worried right now. We'll be doing a midnight ice pack, Tramadol dose, and check as well. I don't need sleep, right?


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## thegoodstuff

Savage Destiny said:


> The "I do not like ice packs" face:


Thats a Fentanyl face if ever I saw one :biggrin1:

Very impressive incision. Looks like 24 staples. I wish I had known that number before Nicky decided to remove his himself. I wanted to account for all of them (no staple horderves) 

Second one, then you are an old hand at it. Theres definitely no way she can sneak through airport security now. 

As you know, its tougher on the human than the dog. Does she have to use steps to get outside? 

She must be thinking "oh goody, no lampshade this time."










"You're joking, right? I dont really have to wear this freakin thing for the next 3 weeks, do I?"


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## Herzo

Good luck Miss Riddle I hope it all goes well, the recovery I mean.


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## MollyWoppy

Thanks savagedestiny, this is a great informative thread which I hope I never have to refer too. 
Poor Riddle, she's one sore girl right now.
Nice tidy incision though, it looks like they did a good job. Looks like my husbands knee after the last of his surgeries. Amazing the way the bruising expands hour after hour.
Hope time goes by very quickly and she's soon up and trotting about.


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## Savage Destiny

thegoodstuff said:


> Thats a Fentanyl face if ever I saw one :biggrin1:
> 
> Very impressive incision. Looks like 24 staples. I wish I had known that number before Nicky decided to remove his himself. I wanted to account for all of them (no staple horderves)
> 
> Second one, then you are an old hand at it. Theres definitely no way she can sneak through airport security now.
> 
> As you know, its tougher on the human than the dog. Does she have to use steps to get outside?
> 
> She must be thinking "oh goody, no lampshade this time"


Actually, we didn't do the Fentanyl patch. Last time it made her REALLY anxious, and we ended up ripping it off. So we didn't do it this time. We do have stairs going outside, but thankfully she's light enough to carry!

She has a Comfy Cone for when she can't be supervised, but she's good about leaving the staples alone.


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## magicre

that is some beautiful sutures....wait. staples? 

at any rate, beautiful work.....

i hope he recovers quickly....


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## Savage Destiny

Riddle is still doing well today. She is a bit more antsy though, so we may break out her stroller for an outing tomorrow.

She felt good enough to stretch out on the floor though:









And then she had a good roll! She was naughty at the end and tried to lick her staples though.
SavageDestiny - YouTube

More incision update pics too!

8 am:









12 pm:









You can see that the leg swelled up pretty good around the hock. We did check in with the vet, and he says not to worry about it, but to start twice daily hot compresses just on the hock area. We're also massaging from her toes up to help encourage blood flow.

I thought I took 4 pm pics, but apparently I was delirious and didn't, lol. I was napping and Riddle's daddy did the 8 pm check and ice pack, so we don't have those either. Sorry!


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## thegoodstuff

Savage Destiny said:


> Actually, we didn't do the Fentanyl patch. Last time it made her REALLY anxious, and we ended up ripping it off. So we didn't do it this time. We do have stairs going outside, but thankfully she's light enough to carry!
> 
> She has a Comfy Cone for when she can't be supervised, but she's good about leaving the staples alone.


What are you using for pain management?

I bought an air mattress. I was gonna live in the unfinished first floor basement for 6 weeks but I decided it was just too depressing. So, 13 stairs inside and 12 outside, with no sight of my feet.


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## Savage Destiny

We didn't get much of an outing today.  I set up the stroller and we went out, but halfway to the park it starting POURING. We had to turn back, since I didn't want Riddle's staples getting wet. The plastic cover zipped up kept her dry, but she can't see much or sniff anything with it closed, so it was a bust. It rained the rest of the day too! We'll try again tomorrow, after I get off work. I'm nervous going back! Her daddy will be with her this weekend, but I really want another ME there, haha.

I started trying to put notes with the time for her incision pics, since yesterday I got SUPER confused as to which was which! So that's why those are there now. 

8 am









12 pm









4 pm









8 pm









We had some fluid leakage earlier in the day, but the hot compresses seemed to clear it up. They've also helped the bruising and swelling go down quite a bit. We decided to do the hot compresses every 4 hours, just like the ice, so we do 5 minutes ice, 5 minutes hot, 5 minutes ice. That's what the PT said to do when we were doing both.

So far this seems better than the last time around! 

We're using Tramadol for pain. In truth though, we're using even less than prescribed in an effort to get her to STOP walking on the leg. She did this last time too. She's not allowed to walk except for going outside to potty, but she uses the leg like it ain't no thang, and that's bad. The surgery assistant thinks that she doesn't understand that pain means STOP, and I have to agree with her. Riddle has always been that way, which isn't great since she's so klutzy.


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## magicre

looks like she is doing great.....


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## NewYorkDogue

Wow-- I just saw this thread (too consumed with my own pup's surgery, I guess!). Anyway, I am impressed with your thorough presentation and "journaling" of Riddle's surgery and recovery. I learned a lot just reading through the links.

The stapling is impressive, as well. When will they be removed? Also, how long will she be on restrictive activity? At least you have been through this- or something similar- with her before, so you know the ropes, so to speak...

I am faced with 6-8 weeks of restricted (i.e. leashed walks only) activity with Mateo, which will not be fun. However, he also will be going through some good physical therapy beginning at the 3 weeks mark or so, which will involve some type of swimming activity- he will enjoy that, for sure. 

Riddle's procedure looks much more intense; I am sure she will handle the recovery period beautifully. 

BTW, my dog is also on Tramadol, mostly on an "as needed basis" for the first week. I, too, wondered about it "masking" the pain more than it should. Difficult to tell, though. He will power through his limp, as though it is no big deal...


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## Savage Destiny

Just one pic today! I was bad and forgot to tell Riddle's dad to take pics! The leg looks MUCH better, the swelling and bruising have pretty much vanished. We're pretty excited! 

8 pm









NYD, the staples will be in for 2 weeks, so she'll get them out on July 3. Riddle is on restricted activity for 12 weeks, and in her case that means literally no walking except to go out and potty. As the weeks progress, we'll get exercise routines, but other than those activities she's not to move around at all. It's a bit of a nightmare. She'll be doing underwater treadmill once the staples come out, and she's done that before so she's an old hand. She starts getting 5, then 10, then 15 minute walks progressing to jogging at some point, but I can't remember what week that starts in. Also things like weaving through cones, walking over broomsticks on books, and range of motion exercises, but those aren't for a bit yet. Our first (well, for this round) PT session is on Tuesday, so I'll post what routines she gets. 

I'd start stocking up on puzzle toys for Mateo! They really help keep the boredom at bay. We also feed her ground meat and bone frozen into Kongs for her meal once a day, which keeps her occupied too. The more I can keep her mind open, the better! I also found last time that doing her daily walks in places like Home Depot or PetSmart was better than walking around the neighborhood. Way more to sniff, more to see, just more stimulation in general. Kept her happier!


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## NewYorkDogue

I was thinking of some puzzle toys for Mateo, but when I looked at them, they all seemed to be too small for Mateo's short, wide muzzle. Even a puzzle rep whom I spoke to on the phone sort of agreed..hwell: I suppose I can make up my own "find it" game with treats hidden around the apt. I have a friend with a Newf that does this on rainy days.

I agree about the mental stimulation being key. I have started taking him to different parts of the neighborhood that I had been avoiding (i.e. Broadway, the theater district, usually because it's more crowded.) However, mostly what he loves is the social aspect of meeting/interacting with people anyway, so he's fine with it. 

It's true- he's more extroverted than I am. 

By the way, her healing looks really good-- and I am also looking forward to some underwater treadmill action with Mateo!


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## Herzo

Looking good.


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## Savage Destiny

We finally took the stroller out! It was really warm and sunny after work, so even though I was exhausted, we went for a walk/ride. There's a park about 5 minutes away from us, so it's easy to get to and nice for her to sniff around in from the stroller.

Just a stroller pic today, since her leg looks pretty much identical to yesterday.










We did have a bit of a scare though. When I went to do her 8 pm ice pack and hot compress, and I realized that her hock was icy cold. Her thigh and foot were warm, but the hock itself wasn't. So we went to the emergency vet, who checked her out for us. Temp was normal, the area had a good pulse, and she wasn't in any pain, so he thinks she's just fine. He said that sometimes narcotics like Tramadol can slow circulation, especially coupled with the fact that she's not moving around. So we're cutting the Tramadol back to every 12 hours instead of every 8, and stopping the ice packs.

I knew things were going too good, haha! 

NYD, you could teach Mateo to use his paws instead of his muzzle for a lot of puzzle toys. Riddle just naturally paws at things instead of nosing them, so she paws and claws and whacks at all her puzzle toys. She does just fine with them! I haven't found one yet she can't figure out how to do with her paws.


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## Savage Destiny

Well, last night/this morning was a bid of a nightmare. We ended up back at the emergency vet a little after midnight. The leg had warmed up fine and was doing just peachy, but around 11 pm she had some diarrhea, with a couple drops of blood. I didn't think too much of it, but at 12 am she had more diarrhea, with much more blood. So we took her back in, and by 1 am she was having liquid diarrhea and pooping pure blood outside the vet's office. 

They're not really sure what happened. It could have been the medication, it could have been stress, it could be completely unrelated. She has been on Tramadol, Metacam, and Clavamox before with no issues, but we just don't know. So we are stopping the Metacam for now. 

She was given a shot of Famotidine, which helps coat the stomach. She's also on Omeprazole once a day and Endosorb three times a day to help stop the diarrhea. She also got 500 cc of subcutaneous fluids last night, since she was already getting dehydrated.  

So far she hasn't pooped at all today, and I'm not sure if that's good or bad. She's been eating and acting totally fine. Hopefully this was just a fluke. 

And now I am off to bed, since I only slept three hours last night!


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## Herzo

Wow scary, strange how things can go bad in a big hurry. Hope everything is A OK.


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## magicre

i would not be surprised if all three caused this occurrence.

hopefully, she'll do better without all of those meds...maybe you can get some herbal support for her now.....and recovery will be sooner rather than later.


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## Savage Destiny

Riddle is back on track! She's had two solid poops today.  So that's a big relief! 

Her leg and incision continue to heal:


















We had our first physical therapy session today. It was great! We did even more stuff than we did for the surgery three years ago. First up was cold laser treatment. That seemed to help her feel much better, she was walking on the leg really well when we left. Then we did electrotherapy for her muscles. Basically, it administers tiny shocks to the muscle to make it twitch, which helps retrain the muscle. It was really neat! Here's a video for anyone interested:

Riddle gets electrotherapy! - YouTube

We also got three sets of exercises to do twice daily. We do 25-30 reps of range of motion, which is moving the knee like she's walking. Then we do 25-30 leg compressions, which is putting one hand on the knee and one on the hock, holding at a 90* angle, and squeezing together. Then we do 10 reps of three-legged stands, barely lifting her right foot so she has to stand on the "bad" leg for a second. 

I'll try to get video of the exercises!


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## NewYorkDogue

The progress Riddle is making looks amazing! It sounds like you are doing everything right for your girl...

Mateo and I will have the first consultation with the physical therapist next Friday, July 6th. Looking forward to it- and very curious as well...

BTW, I also liked watching her roll around on the floor in the next video. What a sweetie.


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## Savage Destiny

Whew! Sorry about the lack of updates! Our internet has been wonky and it seems like every time I get a chance for computer time, it goes out. Sigh.

Here's her incision today:









It's looking a bit red in some spots. It's not swollen or inflamed, so I'm hoping the redness goes away. I'll be keeping a close eye on it.


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## Savage Destiny

Riddle gets staples out tomorrow! Hooray! I'm slightly concerned, because she still has fluid in the knee, a small pocket. But the wound is closed, so it can't escape. I guess we'll see what the vet says tomorrow!

She did get to go on a stroller ride last night. We went to another park, and she LOVED lying in the grass and sniffing everything.


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## Savage Destiny

Staples are OUT!










It looks GREAT! I'm so happy.  She was great for the staple removal, of course. The fluid is just a small seroma, which should reabsorb into her body over time. It could take a couple weeks, apparently, but it'll be fine. Overall I'm really happy!


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## magicre

it looks great.....it really does. i hope all of her recovery is complete and goes smoothly.


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## Herzo

Keep it going, it sure looks good.


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## Savage Destiny

Had our first- well first for this surgery- underwater treadmill session yesterday. She pouted throughout, but did great like she usually does.

We went to just icing the knee now, twice a day. Her tri-leg stands were also increased to three-four seconds of holding up the "good" leg, instead of a quick lift and drop.


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## Savage Destiny

Sorry about lack of updates, there hasn't been much to update! 

Yesterday at her PT session Riddle got cleared for 5 minute walks daily! Yay! The PT said that she is healing really fast and well, which is what I want to hear! We are going to see a doggie chiropractor though, since the PT noticed that Riddle's hips aren't aligned correctly, probably from all the limping and leg favoring over the last few months. So we're gonna try and get in with one ASAP!


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## Savage Destiny

A very good update today!

Riddle saw the chiropractor yesterday, and I'm so glad we went! Not just her hips were out, pretty much her whole body was out of alignment. I swear the chiro fixed almost every single vertebrae! It doesn't surprise me given all the ortho stuff she's had wrong over the last few years. I could tell she felt better afterwards, she crashed when we got home and slept really good. We're going back in 2 weeks for a recheck.

Today is the really good news! We saw her surgeon for her 4 week post-op x-ray, and it was fantastic. He couldn't believe how fast she's healing and growing bone. She's about 60% weight bearing when standing, and 75-90% when walking! Plus her range of motion is smooth, there's no patellar luxation, and she's not tender.

Best of all... he thinks she might be able to be released to exercise sooner than normal! He wants to do an 8 week post-op x-ray instead of 12, and he thinks that she might be healed enough to start ramping up her exercise then! So we're keeping our fingers crossed that she continues to heal so quickly!


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## Savage Destiny

Little update. 

Riddle is doing 15 minute walks twice daily now! She's also doing 5 reps of cross leg stands twice a day... I pick up the right rear and front left leg so she stands on the "bad" leg and diagonal front leg for 3 seconds.

Her scar is tiny!









Enjoying her laser therapy yesterday:









And doing one of her walks on my mom's property.


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## MollyWoppy

Wow, I've just caught up on most of the thread. Gosh, Riddle's doing so well, I'm so happy for you. Glad you are able to exercise her at long last, and so soon as well compared to most dogs having the same surgery. I do have to add how impressed I am with you too, you're an awesome owner, truly, you are.


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## magicre

i'm sorry i haven't been commenting, but i've been here in spirit.

so glad to see riddle doing well.


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## Savage Destiny

There hasn't been much to comment on, Re! My updates are starting to get pretty spaced out, since not too much is changing week to week with her care. 

MollyWoppy, I appreciate that.  I work my butt off to take excellent care of my pets, and its nice to occasionally be classified as "awesome" and not "crazy", haha.


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## magicre

Savage Destiny said:


> There hasn't been much to comment on, Re! My updates are starting to get pretty spaced out, since not too much is changing week to week with her care.
> 
> MollyWoppy, I appreciate that.  I work my butt off to take excellent care of my pets, and its nice to occasionally be classified as "awesome" and not "crazy", haha.


ya know? i'm glad they are spaced out. because spaced out means nothing much to report other than, yay, he's doing great LOL

and i want to be one who says awesome .....i love how you take care of your dogs....you're as crazy as i am..which is, in this case, a compliment.


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## Savage Destiny

More updates! A week's worth. 

Saw the Chiro again on Monday, and that went well. The chiro said that Riddle held about 80% of her adjustment, so that's good! we go back in a month for another recheck.

Physical therapy Tuesday and Thursday were amazing. Riddle is now jogging 4 minutes out of 20 in the underwater treadmill (split up), and her regular walks have been upped to 20 minutes twice a day! We're also doing an exercise where I pick up both her right legs so she has to balance on the two left, 3 seconds and 10 repetitions. She's doing great with those!

Her physical therapist said this morning that she thinks it's very possible Riddle could be doing some low impact agility stuff by 12 weeks post surgery.

I AM SO HAPPY!


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## Rvent

she is a very pretty girl, glad she is doing well, ACL surgery of any kind is tuff on both dog and parent... I slept downstairs with Babs for weeks while she recovered from her surgery. It was a long road, unfortunately the other knee is a problem too.

KEEP UP THE GOOD WORK


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## July11

You are an Awesome mom. That scar will be invisible in no time. I'm so happy all your efforts and dedication is reaping benefits. And I love Riddle's cool collars, especially the Tuffy Tuff Pink one. 

What a beautiful, sweet girl!


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## Savage Destiny

Rvent, thankfully she's already blown the other knee and we did the surgery for that 3 years ago. So no more knees to blow!  Which I am very thankful for! 

I snapped some pics tonight after another forum was demanding more pics of her, haha. I'll share here too! 

Riddle says "WHY U TAKE PICSHURS? FEED ME MOAR!"










She's pretty sure having her picture taken is abuse, lol.

I did NOT Photoshop these ridiculous cartoon sad eyes!









Why you still taking pictures?









I am not looking at you anymore!









He put his butt by my face!


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## Rvent

Love the pics they are both cute, as for not having more knees to blow out, it is still entirely possible to blow out an already repaired knee (just saying) god forbid. seems to be a common thing for pit bulls among many other conditions:frown:


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## Savage Destiny

I know that it's always possible for the surgery to fail, but barring that she shouldn't have more issues. The TTA basically levels out the knee, so an ACL isn't even needed anymore to keep the bones from sliding around. Her right knee was done 3 years ago, and that one has been fantastic! She's been able to do just about everything she could before the surgery until the left knee blew.


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## NewYorkDogue

I have been so impressed with your girl's recovery, and how diligent you have been with taking things one step at a time... Thanks for sharing.

Mateo's surgery was so much less invasive; I have not had to go as slow as you in terms of recovery. He's almost back up to normal speed these days, and that is such a good feeling (when they progress and heal.)

She looks so good--- impressive!


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## magicre

we hear too many horror stories.

i'm just so glad that both dogs are recovering well.....


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## Savage Destiny

Well, Riddle's knee is doing great. We've got another complication in the form of her left elbow, however. She's got some arthritis in that elbow already, since (of course, it's Riddle) the bones never grew properly. We were treating that with laser therapy and underwater treadmill work before she tore her ACL, and it was doing great. We haven't had any flareups over the last few months since she's on bed rest, but on her morning walk yesterday she was limping on the left front. I asked the PT about it during our session today and she agreed that she is definitely favoring that leg. 

We're basically playing a waiting game right now. We're not sure if the elbow pain is from compensating for the surgery on the rear leg, or simply from increased exercise. Only time will tell I suppose.


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## Savage Destiny

Riddle got to SWIM today!

Only for 10 minutes. But she was sooooo excited! She paddled around like the happiest little thing ever, it really made her day. The swim replaced her evening 20 minute walk.

She did her standard post-swim roll in the car:









And then soaked up some sun.









The only downside to this is that she was CRAZED when we got home, and wanted to do zoomies all over the house for about a half hour. lol. It was hard to keep her quiet!


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## Savage Destiny

Riddle had her 8 week x-ray yesterday! Unfortunately, she's not *quite* fully healed, so she can't be a free dog yet. She can have lots more exercise though! Now we're supposed to be doing 40 minute walks twice a day with lots of jogging, or 20 minute walks with 20-30 minutes of swimming. Finding 80 extra minutes in my day is a challenge! I got up reeeeally early this morning and took Riddle and Melon out to my mom's 11-acre property about 20 minutes away for the morning walk, which I'll probably be doing every day now that's not a swimming day. The surgeon wants her on a long line, so she can move more freely and do more back and forth. That's really hard in our neighborhood with cars and such, and with Riddle not really dog friendly I don't feel a long line is safe in town. So we'll probably be going to my mom's property twice a day. Who needs sleep, right?? 

I think I'm going to pick her up a Flexi lead today though. I'd never have her on one in public, but she got tangled in her long line this morning and knocked herself over pretty hard. So I think for on the property it'll be a better bet than the long line, I do not want her messing anything up!


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## Savage Destiny

RIDDLE IS A FREE DOG! 

I haven't been posting because there hasn't been anything to update until today.  Today was Riddle's 12-week x-ray, and as expected she was released to normal activity! WOO HOO! She'll still be sore after exercise for a while- last time, she didn't completely stop limping for around 6 months. But there's nothing really she can bust, since she already tore the meniscus, so she was cleared for going as nuts as she wants. Of course I'll be limiting her so she doesn't overdo her unused muscles, but other than that she can run, jump, play... whatever. We are so happy! 

I took her swimming, because swimming is her favorite thing ever, and she went all terrier crazy on me. 

http://www.youtube.com/watch?v=y2OHPmr1Na8&feature=youtu.be


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## Brian 6

Thanks for this. Greta idea!
Hope Riddle is doing great. Will read on.


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## Herzo

Great glad she is a free girl. thanks for the update.


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## Tracy

Fantastic news. Well done you.:smile:


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