another torn cruciate and arthritis

Penny appears to be still enjoying life, even though she has significant arthritis in her left knee and a torn cruciate in the right knee. After the surgeon told us she's likely to get significant arthritis in her right knee if he operates to do a traditional repair of the joint, we decided to continue to monitor her progress. He believes enough scar tissue will build in the knee to enable her to move comfortably. She bunny-hops along when she's in a hurry, but otherwise walks on all four legs.

However, Deb from Bow Rei Me thinks Penny is weaker in her right rear leg. I'll have to keep an eye on this. Perhaps we could return to some of the physio exercises we practised when she had the first knee repaired.

So, all through the hot, hot temperatures of February and March we've been taking gentle walks, and the weather has made this a sensible choice. Now that it's cool once again, I guess we'll have to be more vigilant that Penny doesn't over exert herself. But so far she seems content to amble along. We're up to half-hour walks now.

Of course, any little puddle of water - hooray for some rain at last! - is very inviting.

Penny's second cruciate tear

We returned to talk to the specialist veterinary surgeon last week to discuss Penny's torn cruciate ligament in her right knee and he believes nature is healing the problem without any necessity for surgical intervention. It's inevitable that Penny will get arthritis, sadly, but the surgery might result in worse arthritis than a natural healing.

We were so excited that we treated ourselves to a little picnic in a park near the vet hospital. Penny had been fasting, in anticipation of an operation, so we bought her some supermarket dogfood, which
we don't usually do. She loved it. And a cake and a hot drink each for the relieved humans.

We'll go back to see the surgeon in two weeks' time to discuss it again. In the meantime we're taking her on short walks where she is encouraged to step out in a steady manner and exercise the leg without any twisting or turning.

I've looked back at my own blog post from Sunday 18 July 2010 and see that we tried to manage her first cruciate tear conservatively. On Thursday 22 July 2010 we were still trying to manage the situation with rest, and I was busy researching alternatives.

On Wednesday 8 September 2010 we opted for a traditional cruciate repair and began the slow process of her recovery.

What I didn't realise at that time was that when a traditional repair of the knee is performed, the nylon suture eventually breaks down and it's the build up of scar tissue that keeps the knee stable.

I've just been looking at Vet Surgery Central's diagrams of the extracapsular repair and it helps me understand what the surgeon has told us about Penny. It says:

Heavy suture material (monofilament nylon) is passed from the lateral labella to the tibial crest and tied in order to eliminate joint instability (drawer movement).
With time, scar tissue develops around the stifle joint which helps to stabilise the joint. The build up of scar tissue will also decrease the range of movement of the joint.

As I understand it, we have unintentionally practised 'conservative management' of Penny's injury by keeping her quiet for the last two months and restricting her walks to first five, then ten, and now fifteen minutes, on level surfaces and mostly on lead. We kept her so quiet because we were afraid she had cancer throughout her body. Terrifying, but since the second CT scan we are assuming that is not the case.

I'm encouraged by reading this post about a dog called Tucker who had a traditional cruciate repair on one leg and succeeded with conservative management on the second leg.

I'm particularly interested in this part of the story:

This second time around I did things a bit differently. I still kept him confined to controlled, leash walking when he needed to use the bathroom, but I also made it a point to walk a half a block or so each time we went out. My logic here was that it was important to keep the joint somewhat strong and mobile while his body was working [to] build up scar tissue and muscle around the torn ligament. I was careful to make sure that he did not get overly excited, jump and/or run, because I was sure that any strenuous activity or quick motion would tear the ligament for sure and set us back.

The blog author mentions the transition from NSAIDs to Yucca Root. I might investigate this product. They mention treatment with glucosamine and chondroitin supplements, which we give to Penny every day, and also omega oil to help with joint lubrication and reduce inflammation. We do that every day also.

Another point is to make sure there is no weight gain, and to try for weight loss if appropriate. Well, what with being on NSAIDs, which gave her diarrhoea, and getting less food because we didn't want to upset her stomach, Penny has lost some weight over this period. (Actually, we were rather scared when her weight went down to 14.6 kg/32 lb.) I must check what her weight is lately.

So, here's hoping she won't need an operation.

Penny's not worrying about it all, she's just enjoying the quiet life.

Great news!

Today, after more than six weeks of anxiety, we received the welcome news that the second CT scan of Penny's body showed no changes in the 'spots' that had shown in the first CT scan four weeks ago, so the specialist vet has classified them as benign.

Hooray!

So now we need to keep resting Penny and give her a while to get over the anaesthetic from the last scan, and then it will be time to decide what to do about her torn cruciate ligament.

In the meantime, we are restricting walks to a gentle stroll in the evenings. We try to limit it to ten minutes, but if Penny seems happy we let it go a bit longer. Tonight we explored a new dog park near us. It was so tiny that in normal times we would have thought it unsatisfactory, but at the moment it suits us fine.

One way that Penny has been keeping herself occupied is in hunting for rats in the straw-bale vegie garden.

Sometimes when hunting rats you have to brush through quite a few spider webs, but that doesn't stop Penny staying on the job.

a worrying time and grass eating

Bette Davis is supposed to have said, 'Old age ain't for sissies.' Or, as I've heard it often said here in Australia, old age ain't for wimps!

I agree, in terms of my own life, not that I yet consider myself old... But I'm sure not young.

And in terms of of dog ownership, a beloved dog getting older can be stressful. It's been about six weeks since I blogged, and the hiatus has been mainly because Penny's been plagued by one problem after another and I kept waiting for her to be back to her usual energetic self.

Well, perhaps that will happen, but if I keep waiting it might be another six weeks, so I thought I'd write about what's been going on.

To sum it all up, she had an x-ray to check what was the cause of her ongoing limp, and to our surprise and that of our vet, it turned out her right leg has a completely torn cruciate ligament. We'd both thought it would be her lower spine that was the problem. The x-ray didn't specifically show the tear, but the specialist felt sure it was the problem.

To a certain extent, a torn cruciate ligament is an easier problem to deal with, given that she had cruciate surgery in September 2010 and made a good recovery.

But the x-ray showed some 'spots' in her body and so we arranged for a CT scan, which showed some issues in her liver, upper spine and her lung. The surgeon says they might be just part of the ageing process and we could keep an eye on them. But he won't do the cruciate surgery until he feels he's checked that out. So we'll have another CT scan in a week's time. That's three weeks after the original one. He's looking to see if any of them have changed in that short time.

It's been hot weather, so it's not too hard to convince Penny that she should rest and take life easy. We started her on pain relief - anti-inflammatories - but after a while her bowels seemed upset, so we've taken her off the tablets and put her on a bland diet.

We're obsessing about her poos. I'm sure anyone who has a dog understands this obsession. Her  gut is settling, we think. But yesterday she - as usual - grabbed something from the front garden and it must have been bad, or maybe it had something on it that bit her, and she rushed around eating grass for what seemed like ages.

Her appetite is good and she poos regularly, so we're just watching and waiting. But this afternoon, she vomited up this:

What a mystery. How could a bunch of grass sit in her digestive system and come back up, when all the other food is passing through normally?

It's not the first time she's used grass to self-medicate. She has always done that. But usually it comes out the other end. I just checked my past blog entries for ones that focus on grass-eating and there are ten! Sometimes she's pooed out the grass, sometimes she's vomited it up, and sometimes she even ate grass after vomiting something revolting she'd snatched as we walked.

In the midst of all this stress, it's kind of amusing to re-read my old post about how silly I was to buy pet grass. That pot of grass has turned out to be wonderful, given that it's hot and dry here in Melbourne and most of the grass in our garden is dying off. (I let weedy grass grow in the garden for Penny's sake.) The one little pot has multiplied into a big bunch of luscious leaves. You can see it in the background of this photo of our back patio, which has been spread with mulch to encourage her to wee and poo there, seeing she can't get down the back steps. (She refuses to toilet anywhere but the back yard, though, so we have to take her the long way around the house. Sigh...)

dogs' vision compared to ours

Browsing the Dog Trick Academy, I came across a link to an interesting article about how dogs see.

I've often noticed than when something is thrown for Penny to fetch, she waits for a moment before setting off. (And how wonderful it is that many years down the track after her cruciate operation, she is able to run once again. We don't do much throwing for her, though. We're still aware she has a weakness in that leg.)

If it's a long way away, she will circle in a way that makes me think she's depending more on smell than sight.

having heaps of fun on a hot morning

So, it's still hot in Melbourne. But that doesn't mean Penny can't have fun, as long as we go out early.
The shadows are long and the grass is burnt brown, but there are still patches of green to investigate. I wonder why this nice-smelling spot is green?

We hurry along to the swimming spot and Penny fetches her Whirl Wheels. The river's brown, but here's hoping it's not polluted. (The Yarra is always brown; that's why some people call it the upside-down river.)

But wait! Someone's coming. Penny is aware of the newcomers before her human notices.

So now she's not going to swim. She will sit at the top of the embankment and guard her toys.

But that doesn't mean the others can't have fun.

 We went for a walk and Penny raced around on the grass chasing her toys - who'd have thought, all those years ago when she had her cruciate repaired, that one day she'd be running free once again?

Then we headed back for a last swim. A lovely morning that her human would have spent lazing in bed if she didn't have a dog to get her out on a hot summer's morning.

Thank Dog for dogs!

what is 'dog food'?

When Penny was recovering from her cruciate operation, I downloaded the incredibly helpful and FREE booklet from Dr James St Clair about post-operative care. (I'm not sure it's still free, but I hope it is.)
I have the greatest respect for him as a vet, even though I've never met him. (I live on the other side of the planet from him.) So when I read a post by him about the pet food industry, I expected  it to be good.

And it is.

our new Safe Stix

At last the Safe Stix is available here! After I received an email newsletter from our favorite shop, Murphys in Hawthorn, saying they'd imported it, I called over there to get one.

I was excited, but Penny wasn't. She was more interested in the view of our rainy street.

Until we played tug with it,

 


and Penny gave it a good shaking.

 

 Now I've put it away, having piqued her interest. Next time we go out we'll try it as a throwing toy (though we have to be super careful with that, seeing she's had her cruciate repaired); and, best of all, as a floating toy.

Penny's feet

Two days ago, when we were bathing Penny's feet in cool water - as we currently do after every outing - we noticed the skin of one pad was peeling back.

Of course we didn't freak out and wonder if our current regimen of cleaning twice daily for ten days with Malacetic wipes and applying Elocon once a day for three days has wrecked her skin completely, or given her some dreadful skin-destroying disease - of course we didn't...

But, just in case, we thought a re-visit to the vet might clarify things.

He said the peeling skin is a sign that something was wrong with it and it is peeling back to healthy skin. Phew! When I think about it, she's had a horrible hard patch on her paw (it looked like callus) since last November. And that's the paw that is causing the limp. BTW, he found a similar development on the other front foot, and suggested something in her gait may be causing this.

He once again checked her limbs completely, trying out every joint and reassured us that this latest limp is not likely to be joint-related. (Always a relief, given her previous cruciate repair.) He suggested we continue to work on getting rid of the hard, peeling skin, and gave us some chlorhexidine to use. We're to wipe the two paws every couple of days, working deeply to wipe or pull the loose skin off. When he did it she didn't seem to find it painful. But I do know that, like other dogs, she doesn't readily admit to pain.

PetPlace says of this medication:

Overview

Chlorhexidine is classified as a disinfectant or cleanser. It is used both to treat environmental surfaces, and in less concentrated forms, to treat the skin, ears and oral cavity. It is effective against bacteria, fungus, yeast and viruses.
Chlorhexidine is an OTC (over the counter drug) but should not be administered unless under the supervision and guidance of a veterinarian.
Chlorhexidine is used in veterinary medicine for the treatment and prevention of dermatological (skin) conditions and for the management of ear infections (otitis externa) and gum disease.

And

This drug can be used in the treatment of superficial skin infections, irrigation (cleansing) of wounds and as a medicated shampoo for the treatment of certain skin conditions (hot spots or acute moist dermatitis).
Chlorhexidine is not effective against infections caused by parasites (such as worms and mites).

Okay, that sounds like a good plan.

But then I remembered I hadn't told the vet I've been wiping Penny's paws with aloe vera gel. I simply break off a piece of leaf and gently rub it into the underneath of her foot. She didn't seem to mind this at all, even when the paw was quite sore.





PLEASE NOTE: Saturday 10th March 2012 - I have a subsequent post that looks at the pros and cons of use of aloe vera in terms of its possible toxicity.

I'm going to continue with the aloe vera, as well as the chlorhexidine, as I don't see that they should counter each other. In looking around to check this, I came across this informative answer at AllExperts to a query about paw problems. I like this answer because although it talks about alternative therapies, it doesn't dismiss modern veterinary medicine. I thought it had a good balance.

The query was about an akita who was licking her paws. Here's part of the answer:

Allergies can cause constant licking and swelling of the paws and accumulation of debris, creating a moist, warm environment that can cause an overgrowth of bacteria, yeasts, fungi and demodectic mites. Chewing and superficial infection allow deeper penetration of these organisms into the skin, creating a very itchy, and hard to break cycle.

The problem is really two fold: If the suspected allergy is treated but not the skin infection, it is unlikely that your dog would have complete or lasting results.

So you see, because your dog is chewing at her paws, she's at risk for developing secondary infections on her skin, which can quickly get out of hand. That is why your vet told you to keep your dog's feet clean, and why you should strictly follow that advice.

Gently wash your dog's feet with peroxide, at least once a day. Dry your dog's feet very well. If your dog will allow it, a hair drier on the low setting would work well. If it's possible, wash your dog's feet when she comes in from outside too, since grass or pollens might be aggravating or causing the itch.

If you can't wash your dog's feet each time she comes in from being outside, simply soaking her feet for 5 or 10 minutes, four times a day, in cool water can help control licking. For additional relief, add a sprinkling of Epsom salts to the water (1 teaspoon in 2 cups of warm water). Again, it's really important that you dry the dog's feet well after a soak.

Your vet asked that you get back to her in a week, you need to do that if you haven't done so. Treatment for an allergy is a long term and complicated thing, it might take months to get it under control, and the first course of treatment might not work, so other medications would be needed.

Since the problem is continuing, your vet may want to run tests for fungus, bacteria, or parasites, or take a skin scraping sample. In addition, she may prescribe medications such as steroids (Prednisone) which quickly relieve irritation and break the "lick cycle."
These drugs have the added benefit of putting the brakes on the immune system, which produces the allergy symptoms. Finally, pets with severe allergies may undergo a series of shots to help desensitize them to whatever they are allergic to.
In some cases, the vet simply isn't able to find anything physically wrong, but can still treat for the symptoms.

And

Aside from the medication your vet prescribes, the following suggestions might help control the itching, but these are not a substitute for vet care, and you should tell your vet exactly what supplements or over the counter remedies you are using on your dog.

Along with washing your dog's feet with peroxide (which is important that you do), also try this:
Brew a cup of tea as you normally would (regular black tea, that you can drink), then soak a clean towel in the cooled tea to make a compress and apply it directly to your dog's paw for three to five minutes, up to five times a day. Tea can discolor fur, so don't be surprised if your pet seems to be wearing socks when you are done. Tea contains chemicals called "Tannins", which help dry rashes and ease irritated skin. Dry the paws well when you're done- with a hair drier if possible.


100% pure Aloe Vera gel (not a blend!) can be applied directly on the paws. Aloe Vera gel comes from the Aloe Vera succulent plant and contains enzymes which break down inflammatory proteins and enhance healing. It really stops itching, and you can use it on yourself too. If you happen to own a plant, just crack off a piece and rub it onto your dog's paws. You can use Aloe Vera gel 4-5 times a day and after cleaning or soaking the paws, or whenever you see your dog chewing at her feet. It's safe if your dog licks it.

There's lots more advice in the post, and I'm saving the whole thing to my computer, because it's one of the best overviews of paw licking that I've seen.

We're going back to the vet in ten days, so here's hoping that the problem will be resolved by then.

a dog swims to start the new year

It was a wonderful way for Penny to start the new year - she swam at her old favorite spot in the Yarra river. We were a bit nervous about her first free swim since her cruciate surgery, but she seemed to take it in her stride - hmm...mixed metaphor there!






We are following the advice of our canine physiotherapist regarding Penny's recovery, and only introduce one new activity at a time, so that if she suffers a setback we will know what caused it.

However, this evening she seems fine after her swim.

For the last month we've been swimming twice weekly at Dogs in Motion, and Penny has built up to swimming for thirty minutes, so I felt fairly confident she would cope with a short swim in the river, but it was still a bit scary seeing her go out there. Thank goodness we didn't have to jump in and rescue her.

weaving as therapy for Penny after her cruciate operation

Who'd have thought, six months ago, that we'd be thrilled with a thirty-five minute slow walk to the park, with Penny on lead? It just goes to show it's all relative. After ten weeks' rehabilitation from her traditional extracapsular cruciate operation, walking has become the highlight of our day.

I thought we'd add something extra yesterday, so we did some weaving between the poles along the edge of the park, with the idea that as she changed direction she'd be shifting her weight from side to side.



We might have done more, except that the heavens opened and we got half-drowned in the deluge. (Still welcome, though. We know southern Australia is still in drought, even if it's raining at the moment.)

great dog book to read

I've just finished reading Frank Robson's book, Lucky Goes to Sea.

It's the sequel to Lucky for Me, which I loved.

I notice that in this sequel there's a small section that I've read previously in an article Frank Robson published a couple of years ago. He says he and his partner

refuse to be cowed by Australia's official war on dogs: if all the no-go zones were observed, dogs wouldn't be seen anywhere except sulking in backyards, which is crazy.

I wrote about how I felt Penny reacts to being on lead, after I read that article. It's interesting to me to look back at what I wrote, because for the last five months Penny has not walked off-lead at all, and in fact has even been on lead every moment she is in our own garden. She seems not to be bothered by that.

I can't wait until we are given permission for her to walk off-lead. The other day I asked the physio if we could let Penny off-lead in our own garden and she said, yes, certainly...if we could guarantee that Penny wouldn't run or jump. And that's not likely!

Anyway, back to the book...

It's wonderful. I loved every word of it. What I like about it is that the dog is the central point of the book, not like some stories where the dog is just a means of telling the story of the humans. In Lucky Goes to Sea, of course we find out what is happening in the humans' lives, but the love of their dog shines through.

And it's not depressing, as many dog stories are. It's upbeat and optimistic.

He does write about the inevitability of aging, but hopes Lucky will be around for many years to come:

He's our once-in-a-lifetime dog, and even if he lives to be twenty (not that unusual among small breeds) it won't be enough.

I sure know how he feels!

home therapy after cruciate operation

One of the problems with a recovery after surgery is boredom, and maybe even depression - and that's just the human, lol!

Anyway, back to the needs of the patient... having to do therapy three times a day helps pass the time. Here we are trying to follow the instructions we were given for the next few weeks. We don't go back for a review until another three weeks, so I sure hope we're doing the exercises correctly. But at least we're having fun.

Though I must admit Penny didn't seem too happy about the last exercise on this clip, to judge by the height of her tail.

a dog discovers she still has a left hind leg

Eight days out from the cruciate operation (extracapsular) and we were still having to either entice Penny to move, or having to carry her. And yet the receptionist at the physiotherapy clinic said that the sooner she started using the leg the better the recovery was likely to be (within reason, of course). The vet thought she would be touching it to the ground in the next couple of days. But it wasn't happening. Why?

And then I thought of some of the old advice about training puppies and dogs:

• don't fuss over them;


• don't keep watching them or they might feel overwhelmed by the attention;


• if they don't eat their food quickly, take it away;


• make them come to you, don't go to them;


• don't give a command or ask for a behaviour if you know they won't do it.

For months, we've been ignoring these suggestions, and Penny has ruled the roost as we worried about what could be wrong with her leg. Training went out the window, along with discipline. And now we've been seeing the result. She pulls us at a three-legged run when she goes out for a toilet break (despite the physio instruction that she should move slowly everywhere she goes) and she waits on her mat for her food to be delivered, and believes it should be pushed right next to her mouth if it's more than ten centimetres away from her.

So... it was time yesterday for tough love. Luckily I had a strong-minded friend visiting, who helped me stick to my resolve.

I put a biscuit on the kitchen floor, in a place Penny could see from her comfortable place near the front door.



I waited.

The crying began softly at first. Then louder. Then louder. I might be anthropomorphising, but I think it said, 'Oh, I'm a poor little hungry puppy with a sore leg and it would be a long painful journey to the kitchen to get that delicious-looking biscuit. Won't someone bring it to me?"

We drank our cups of tea and stayed firm.

And then... click, clicketty, hoppitty click. Penny hurried past on three legs, occasionally touching her left rear leg to the ground. She had remembered that she does have four legs and she can move around.If the motivation is strong enough.

Those biscuits can work miracles. (As I've discovered in the past.)

one week out from the cruciate operation

I dropped in to Cindy's dog training last night, to see how everyone is getting along. I miss it so. It was great to see eveyone (two-legged and four-legged) and I was thrilled to hear that Cindy's dogs go to the same specialist as Penny did. That makes me feel even more confident of a good recovery.

Penny had the Robert Jones bandage on for a week, instead of the recommended three days. Both our own vet and the specialist suggested we do this. In one way I'm glad we did, as it supported her knee, but on the other hand she seems to have had a skin reaction to the elastoplast that held the bandage on. He poor leg is red raw at the top where the top of the bandage was, and at the bottom. No wonder she wouldn't go anywhere.

She's been set up near the front door for the last few days, so she can look out to the street.



Every so often we carry her out to the back yard or to the street, waiting for more urination or defecation (I thought that might sound more professional than saying we spend ages every day waiting around for her to wee or poo, lol).

When we went out yesterday it was cold and damp, so we set her up with a nice plastic underlay, plastic over her bandage - can't get it wet - on her old familiar mat, and we waited for her to do something.



Hmmm... not much action. Except for frantic licking of what we now realise was a horrible rash at the edges of the bandage.


Now that it's off, we realise we have to be even more careful as she moves around. Hmmm... not a big problem yet. She won't even get off her mat for dinner and has to have it delivered in bed.

Penny's limp was a partial cruciate tear

At last we have had a definite diagnosis of Penny's lameness - and an operation on the same day!

Here she is, sad and sorry but finally on the way to recovery, after an operation to repair a partial tear in her cruciate.



We've agonised about what to do, for weeks. In one way, I feel sad that Penny has been in discomfort, if not pain, as we researched, discussed, visited a variety of specialists, and finally came to a decision.

However... we were originally booked for Penny to have a TWO, an operation somewhat like a TPLO, involving the cutting of her leg bone. But today the specialist told us that over the last few months there has been research from the US suggesting that the traditional, less invasive cruciate repair gives just as good recovery for dogs of Penny's size. So, while we have been thinking it over, so have the experts.

Here's hoping for a steady but successful recovery.

Penny gets to go places at last

First, I must thank LS and Happy for the award they have given us. It's lovely to get something like that. Seeing I'm not organised enough to keep track of who I've ever passed awards on to, I'm going to just sit on it and enjoy it!

Penny got to go on a walk today!! Ta da!

It suddenly occurred to me that even though she can only go on ten minute on-lead walks, there's nothing to stop us doing it away from home, as long as the terrain is flat. So we went off to the local golf club and wandered around the car park. Yep, the car park. Penny seemed to enjoy sniffing around the garden beds and the ground was firm underfoot and I knew we wouldn't meet other dogs (who might tempt her into playing). We walked sedately down the edge of the course.



I'm feeling much better about trying to manage her possible cruciate tear with a conservative approach, as we've been to see an animal physiotherapist and she, like the vets, thinks Penny's knee is stable, and therefore possibly able to recover without surgery. Even if we do end up with surgery, we'll know we tried all avenues beforehand, and took care of her leg in the meantime.

As well as the supportive and informative Yahoo group about orthopedic issues, we've joined another one dedicated to managing without (or after) surgery, and already I've found a great article that sets out the process by which a partial tear might recover. As I understand it, the ligament can't regrow, as it has a meagre blood supply, but scar tissue can form and with the proper care, tht scar tissue will support the knee, as long as it's not too tight. In other words, we need to keep Penny moving. Seeing that's the way I'm dealing with a disk problem in my back, it seems a logical course at this stage.

I'm looking forward to posting about the underwater treadmill next week. Penny hopped in happily last Wednesday, when the vet nurse threw in some treats and soft toys, so hopefully she will adapt quickly to it when it has water in it.

There's an interesting article at Pittsburgh Dog News that describes an article in the Wall Street Journal about dog knee injuries. Apparently, in the US there are five times more knee operations on dogs than on humans, despite the fact there are five times more humans than dogs. By my calculation, that means dogs are twenty-five times more likely to have such surgery.

It explains that dogs' knees don't lock, as humans knees do, and so the dogs' knees are always bent. However, I have to wonder how wild dogs manage without access to modern surgery, and how dogs have managed over the centuries. I wonder if we have bred this problem into the species.

the saga of the sore knee continues...

I tossed and turned for most of last night, worrying about Penny's upcoming surgery, saying to myself. "What are we doing? We're going to arrange for a surgeon to saw through the bone of Penny's leg and join the bone together again with metal and screws." And in the morning I rang the vet hospital and cancelled the surgery.

Oh, it's so hard to know what to do for the best...

The receptionist at the hospital said it's common for people to cancel surgery. She was very compassionate with our indecision and said we should make sure we are comfortable with what is best for Penny.

So, this evening I went back to our own vet and he agreed with our decision. He said we shouldn't give up on the 'conservative' approach. We're going to try a course of anti-inflammatory medication again, with joint supplement and only lead walks around the streets. We tried anti-inflammatories a few weeks ago but Penny vomited, so we discontinued. We started on a very low dose yesterday and she seems to be moving more easily and to be tolerating them.

If she shows any bad reaction to them, we are to go straight back to our own vet and he'll prescribe a different type of anti-inflammatory.

He says it's possible to make sure she is not in pain while we consider all our options and try for a recovery without surgery.

I think our next step might be an arthroscopic examination, to see what exactly is going on. But hopefully that won't be necessary.

I know modern medicine is wonderful, but I still believe the least possible intervention is the safest course.