Dog Breed Info Center(R) DBIC

Bruno's ACL and Mast Cell Tumor Ordeal: Corrective TPLO Right Knee—2 to 6 weeks

Anterior Cruciate Ligament (ACL) rupture/tear in dogs
Mast (Mastocytoma) cell tumor in dogs

Day 8

Bruno the Boxer eating out of a dog Bowl in a kitchen with his back right leg in the air.

Bruno is feeling much better. Although he still walks with a big limp, he is using his leg. He was having trouble leaning over to eat this food. He didn't want to put all of his weight on his leg and it was hard for him to bend that far over for that long on three legs. We were holding his food dish up for him to help him eat. I bought him an elevated food dish and it does the trick. Bruno can now eat his food more comfortably

Bruno the Boxer laying on a dog bed inside of an X-Pen with a water bowl in front of him

I also bought a second x-pen and attached them together, overlapping half of it to make his pen just a little bit larger. Bruno likes to lie on his bed, but he also likes to sometimes just lie on the floor. He was trying to lie on the floor in the smaller pen and his legs were touching the sides of the pen. This pen is not only large enough for him to lie on either the bed or the floor at his own free will, but I can now safely place a water bowl inside the pen in a spot where he is less likely to spill or trip on it. I originally put the bowl on top of a rubber mat to catch the water that his big tongue splashes around when he drinks, but he still managed to get water not only on the mat but also all over the wood floor. I had to lay a towel down under the mat to soak up any flying water.

Bruno the Boxer laying next to a dog bed inside of an X-Pen with a water bowl next to him

Bruno wears his hoodie to keep him from licking his stitches when I am not in the same room watching him, but I take it off when I am with him. If he licks I tell him no and he stops.

I am counting down the days when he can join Spencer and me for our daily walks.

Two Weeks

Bruno the Boxer standing in the back of a van on a dog bed

Bruno had all of his stitches removed. No more hoodie! Spencer got to come along for the ride. I put a divider in the van keeping Bruno in the back and Spencer in the middle. The two of them cannot be together without complete supervision or some type of barrier until Bruno's bone is healed. That would run the risk of an all-out doggie rumble, which could be the doom of Bruno's TPLO recovery. Sorry, Spencer, you cannot play with your big brother for a while.

At two weeks into the recovery Bruno still has a limp and he holds his leg up a lot of the time, but he is using it. When he first gets up in the morning he is a little stiff and needs to loosen up, but once he gets going on his way to go to the bathroom he does pretty well.

A couple of times he did not finish his breakfast, which is very unlike him. He also threw up a couple of times and his stools go back and forth between normal and loose. I am hoping it is a side effect of his medicine. The Previcox can cause stomach upset.

Day 16

I noticed white mucus coming from Bruno's nose for the last two days. At first I was not sure if that was really what it was. Bruno had just eaten his dinner and he also had food on his face. He promptly licked it all off with his big tongue before I was able to inspect him further. The next day before his dinner I saw it again and this time I was sure that is what it was. Between the loss of appetite, upset stomach, runny poops and now this, it was time for Bruno to go to this favorite place, the vet. After being cooped up for the past two weeks Bruno was really happy to get out. He is on antibiotics for the next week.

Bruno's discharge papers read: Bruno arrived over concerns for a white nasal discharge and a decreased appetite. He recently had TPLO surgery and removal of mast cell tumors.

On physical exam, Bruno was bright and alert. His heart rate was normal, as was his rectal temperature. He did not have any nasal discharge at the time of the exam, although he did sneeze a few times. His lungs ausculted clearly and he was breathing comfortably.

At this time, it is not clear what is causing Bruno's nasal discharge, but congestion can lead to loss of appetite if he is having difficulty smelling his food. For now, we are going to try a course of antibiotics for possible upper respiratory tract infection. Please administer the Clavamox as directed. You should continue to administer the Benadryl and Pepcid as you have been previously. We would recommend decreasing his Previcox to every other day at this time to reduce its impact on his stomach upset.

Please have Bruno rechecked if the nasal discharge continues to worsen (especially pus or blood), if he continues to have poor appetite, if his vomiting or diarrhea persists and especially if there is blood.

If Bruno is otherwise doing well, please keep your scheduled follow-up appointments. We wish Bruno the best, he is a very sweet boy! Please do not hesitate to call with any questions or concerns.

Three Weeks

Bruno the Boxer laying on a pillow chewing a dog bone

At three weeks Bruno is feeling very good. He's acting frisky and playful. He wants to pounce on Spencer. He is not sneezing and there is no more nose discharge. His stools are normal and he has been keeping his food down. His appetite is back full force. He uses his leg most of the time, only holding it up when he first gets up from lying down or if he is standing in one place. When he walks he uses his leg, but with a limp unless he is excited then he seems to forget to limp. I try not to give him the sedatives, but when he is tossing his bone around his x-pen, pouncing on it and trying to play with Spencer on the other side he leaves me no choice. He has been chewing on a lot of bully sticks. In two weeks he goes back to the vet for an x-ray to see if his bone is healed.

Bruno still spends most of his time in his x-pen, but I will let him out to lie on a bed next to me to chew a bone or take a nap. I will also sit outside with him so he can catch some sun. He is never off-leash outside and he does not have free roam of the house. When he is not in his pen it is as if he is a toddler who just learned to walk with constant supervision. He does not go upstairs and he does not jump up on furniture. When Bruno is not in his x-pen his kid brother Spencer the Pitbull walks into his pen and lies down on the bed at his own free will. I keep telling Spencer he is lucky he does not have to be in that pen. I am not sure he believes me. To him the pen is the place to be.

Bruno the Boxer looking at a bag of sweet potato dog treats

When I would come back in from walking Bruno outside to go to the bathroom I had started getting a sweet potato chip treat and giving him one for going into the pen and sitting down. Bruno has apparently caught onto this exciting routine because now when I bring him back in and unsnap his leash he heads straight for the kitchen and stands there staring at his treat bag! When I get one out of the bag he heads to his x-pen and eagerly sits down on his bed waiting for his reward. Going into the pen is now associated with food. :)

Bruno the Boxer standing on a dog bed with a bully stick on the bed

Bruno inside his x-pen eating a sweet potato chip

Four Weeks

At 4 weeks I cut back on Bruno's sedatives and started taking him for short walks to drain his energy and work on building up his muscle. Technically he was not supposed to start until the 5th week, but I made the call based on how well he has been walking. Bruno heels very nicely on a leash so I don't have to worry about him getting injured from pulling or making any sudden twists or turns. The vet's office told me they tell people to hold them back a little more than the dog actually needs to be held back because most owners let their dogs be more active than their instructions state. I have been following their instructions very closely with the exception of starting his muscle building a week early. I feel I not only have to worry about his leg but also his mind, less drugs, more natural calming in a controlled manor. I would not recommend the same approach for someone who does not have very good leash control over their dog.

Six Weeks

Bruno the Boxer looking at a Basset Hound on the other side of the vets office

Bruno had his first appointment with an oncologist for his cancer. The good news is he checked out well and does not need radiation or chemotherapy. His chest x-ray came back good. He has an appointment in a month for another check-up.

The appointment was a bit rough on his knee, though. His operated on knee is very sore from all of the excitement. As usual I had asked the vet tech to please ask him to heel when he went back for the x-ray. I gave her a brief demonstration of how I say the word “back” and give him a short, quick, gentle tug on the lead as a heel command. As she walked away with him she took him by the collar instead of walking with slack on the leash and lifted his weight from the ground as she walked. She held him tightly with a lot of tension. Thinking about it now I realize that if you lift the weight from the front of him you are putting all of his weight on his back legs, hence being even harder on his bad knee. When Bruno returned from his x-ray she was holding him tightly beside her by the collar and Bruno coughed up a little white foam as she let go. She told me that he needed a sling for his leg for walking and how excited he was. I had explained that he didn't need a sling. Bruno will walk and listen if you ask him to. I showed her again how he will walk beside me and go in and out the door with no tension on the leash. He will stop at the doorway on the way out if you ask him to with only a voice command, again no tension. I also explained that if you walk with tension with a dog they will naturally give you tension back. I tried to make it brief because the point of the visit was not his knee or how to communicate with a dog, but the cancer. My dream is that one day more people will understand natural dog behavior (especially those at the vet's office) and know how to communicate with a dog in a way the dog can understand. If only I could have gone back with him for the x-ray I could have told him to heel and to lie down nicely. I can only imagine how excited he was by the time he got back to the x-ray room with tension on his collar. Any vet office to him already represents excitement and many faces to lick. Bruno is one of those types of dogs that will have manners if you ask him to, but if you don't ask him to and he is in an excited place he will do as he sees fit. He didn't used to be like that when he was younger, but he has spent a lot of time in the care of many different vets, including overnight visits and he has learned that some humans will not ask him for manners. Bruno is trained, but if the humans are not trained he knows it.

Bruno's oncology report reads as follows:

Age: 5 years old, Gender: male neutered, Weight: 91.1lbs

Bruno presented for a consultation following the surgical excision of 2 mast cell tumors having been removed at the time of TPLO surgery. There was no evidence of recurrence in either site. Based on the presence of clean surgical boarders and the low mitotic index in both tumors, there is no indication for adjuvant therapy at this time. Be aware that Boxers are prone to mast cell tumors so we will have him on a "mast cell tumor watch". We will recheck him in 1 month. We look forward to following Bruno and thank you for bringing him to our facility!

Because of Hurricane Sandy, Bruno's TPLO check-up was postponed until next week.

Six and a Half Weeks

Bruno the Boxer looking at the other dogs in a veterinarians office

Bruno had his TPLO check-up. The surgeon said everything looked good. Bruno's walks are to be increased to 10 to 15 minutes a day, 4 times a day.

Bruno has been nicknamed Wiggle-Butt by a lot of people. He assumes that everyone around him is there just to see him.

When the vet tech came to get him for his knee x-ray I asked her to please ask him to heel on the leash. She asked if he would pull. I told her he will if you let him, but if you ask him not to he will do that too. He will heel on the leash. I showed her very briefly how I give him the command and explained he will walk with a loose leash. I told Bruno “back” and he took a step back and looked up at me for my next command. The vet tech laughed and said "He actually backed up for you." I passed her the leash and she was a pro. She asked him to heel with a quick, gentle tug and release of the leash. Bruno looked at her and knew what to do. The tech was relaxed and the leash was loose. Bruno happily trotted beside her. When they returned I was happy to see he was still heeling next to her with a loose leash.

x-ray of Bruno's right leg with screws and plates inside

Bruno's right knee x-ray showing the screws and plates inside of his leg

A second x-ray of Bruno's right leg with screws and plates inside from a different angle

Bruno's right knee x-ray showing the screws and plates inside of his leg