Tuesday, September 6, 2016

Simitri Stable in Stride: Islay's Knee Injury and Repair

by Judith Brown

Islay is a 7 year old Gordon Setter female, she is the fifth generation of my own breeding program. I have been breeding GordonSetters under the Sassenach Prefix for 35 years.

Islay is an extremely active athletic dog, she’s my competition girl.

I’ve not really done too much in the hunting field, but last year I took my hunter’s education and got my Wildlife Identification number so that Islay and I could go hunting upland birds. Islay is in top condition and able to go at a steady pace for several hours hunting.

At the beginning of this year I noticed that she wasn’t putting 100% of her weight on her left rear leg.

Nothing that just anyone would notice but enough to make me keep an eye on her. Occasionally when we came back from a run or swim, she would get out of the vehicle and not use her left rear for a few strides then it would be fine. The leg didn’t get any better or any worse, so we carried on as normal.

My vet checked her out and though maybe she had a pulled her illiopsoas muscle

We headed off to the Canine fitness centre to have massage therapy,as we had the US National Specialty coming up in Canfield Ohio that we were flying to both show and run in the hunt test. In between Islay ran in some Canadian Field Tests and picked up qualifying scores. We also compete in Barn Hunts, it was on our way home from the last one I stopped to let the dogs have a swim and a good run after competing all weekend.

When Islay came up out of the water she was on three legs and stayed that way. 

I made an appointment with my vet the next day. This appointment confirmed a tear in her cruciate ligament (ACL/CCL).

Being able to confirm the problem we straight away started to talk about surgery. 

I knew there were three options as I had heard and seen other gordon setters with torn ACL so knew what I was dealing with. I was familiar with the TPLO and TTTA surgery as well as the suture technique.

I think the TPLO and TPA surgeries are quite invasive and cause discomfort to the dog and take a long while to heal. 

Along with the joint looking more human like than canine. The suture technique seemed the easiest but I wasn’t sure how well that would hold up with Islay been such an active dog.

My vet, Dr Rob Allison, told me about the Simitri Stable in Stride, saying they had performed one at the clinic just three weeks prior. 

I went home to do some research and find out more about the procedure. I was fortunate enough to find the paper that Dr Embleton had presented to a group of veterinary practitioners. Reading about the procedure I felt is may be the solution.

I am fortunate enough to have a friend in the US who is a vet and performs TPLO’s on a regular basis, he also owns Gordon Setters and had performed the surgery on other friend's Gordons. I sent the Simitri paper off to him and asked his thoughts on the procedure. He was very positive about it, the only concern being it was relatively new so long term data was not really available. However the information on how improvements had been made since inception was readily available on the internet to read.

I felt the Simitri procedure was the least invasive, but giving the most support immediately. 

I liked how the joint had support whether the dog was sitting walking or laying down.

My vet had already told me about Dr Embleton and how he had come up with the Simitri Stable in Stride procedure and that Dr Embleton would come to my vet’s office to perform the procedure with either Dr Allison or Dr Miller assisting.

Dr Embleton had done 180 of the Simitri Stable in Stride procedures to date. 

Once I had decided on this procedure my vet went ahead and booked Dr Embleton. Dr Embleton and I had a long phone interview/chat on what was going to happen and what I was to expect and the importance of following the post surgery procedures. He answered all my questions in detail and we also had a back up plan if once the leg was open and things didn’t go as planned.

Preparation for the procedure was very thorough. 

Islay got a series of x-rays in order for Dr Embleton to get the measurements for the brace and to see if Islay was a suitable candidate. Two days before Islay’s surgery I had taken her out for a walk down by the river, it was wet and raining out and unfortunately Islay slipped and fell on the wet grass.

I knew immediately when she got up that she had blown the ACL in her other leg. 

I emailed Dr Embleton and said I was taking Islay to my vet to confirm the worst and did he want to do both legs at the same time. By the time I had got to my vet Dr Embleton had already contacted them to discuss what we were going to do, he then called me and asked my thoughts. Naturally I wanted to do both legs together so Islay would only have to have one general anesthetic, but after a long discussion and knowing that Dr Embleton was the expert with the procedure opted to do just her left leg first and then wait a month to do the next one.

Dr Embleton phoned me immediately he had finished the surgery to tell my that it had gone 100% text book. 

The recovery part was up to me. I was allowed to bring Islay home that night, normally the dogs are kept overnight after surgery, but my clinic does not have anyone there once they close. I had very strict instructions on what I could and could not do with Islay.

I had set up a large wire crate on the main floor with a memory foam mattress and blanket for Islay. The crate has room enough for her to lie down and stretch out, stand up and turn around easily. With the support of a scarf under her belly and a lead on her neck, Islay was able to walk from the clinic to my vehicle, the surgery leg was toe touching the ground as she walked. Dr Embleton requires me to video Islay once a week so he can see how she is progressing.

Islay had been progressing really well.

Within 24 hours she was weight-bearing on the leg. A little dubious on sitting and laying down easily, but as the days passed Islay got better at manoeuvring herself.

Dr Embleton was available to answer all my email questions and put my mind at rest on how thing were progressing. At 96 hours the surgery leg was pretty swollen with lots of fluid in the leg and a nice set of purple bruising. This is what to be expected and perfectly normal, but sometimes you don’t absorb all the information you have been give both verbally and the nine pages of procedure Dr Embleton had emailed me.

The only stupid question is the one you don’t ask, and thankfully I have no problems asking questions. 

Dr Embleton was very good answering them all.

In the month since the first surgery Islay has been using her leg and is already building up muscle again. 

Once the staples were out we were able to go into the river and have some water therapy and our frequent walks got longer. Islay flew with me to Ontario and took part in the Veteran Sweepstakes at the Gordon Setter National Specialty, other than her shaved leg Islay is looking good and feeling really well.

Range of motion is full and the hair is growing back. 

Islay just had her right leg operated on couple days ago.

The day after the surgery Islay was weight bearing on both legs easily. She’s a little stiff through her right hip at the moment, but we are at the 96 hour mark where the swelling is at its worse. Islay is happy and would love nothing more than to go for a good run, but she will have to wait at least another 8 weeks for that, as the bone needs to heal where the screws have been placed.

I would definitely make the same choice again, watching her speedy recovery and how she has handled everything, I know it was the right thing to do.

I’ve been posting short videos on Facebook for my friends to see how she is doing, everyone is amazed at how fast she has some back from the surgery and how stable her legs are.

Some of my friends have done the TPLO on their dogs and tell me its sometimes a week before there is any weight bearing on the surgical leg. It just warms my heart to know that Islay will still be a competition dog both in the field and show ring. Next year we will finish off our American Grand Championship and the last leg of her Junior Hunter title and by next hunting season she will be the bird machine as always.

Related articles:
What's New in Surgical Treatment of Cruciate Injuries in Dogs? Interview with Dr. Neil Embleton, Co-Inventor of Simitri Stable in Stride 
Veterinary Highlights: Simitri Stable in Stride Stifle Stabilization System  

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