[PyrNet-L] Health, Chat: Boris arthritis update

[EandUnge@aol.com]

Took Boris in for a surgical consult at a veterinary surgical center in 
Concord CA regarding his arthritis.  The vet spent an hour with Boris, 
watching him trot around the parking lot, moving his joints, feeling him up,  
etc.  The upshot is that both anterior cruciate ligaments in his back legs 
are shot, and he has arthritis so bad in his knees that clinically he should 
not even be walking around!   But he is, with no apparent complaints.

We had a very interesting discussion about anterior cruciate ligaments and 
surgery.  We were told that in humans, there is now a very effective knee 
surgery (arthroscopic) that resolves the problem and practically makes human 
knees whole again, but the same surgery does not work for dogs very well.  As 
a result there are numerous surgeries out there for the doggie problem, none 
really resolving the problem long term or mending Fido as though nothing had 
happened.  However, one procedure  may be rising above the others that was 
recently developed by a vet in Oregon.  This fellow apparently discovered 
that unlike a human tibia (the leg bone) that is "flat" on the top where it 
contacts the femur (thigh bone), the doggie tibia is bevelled and sloped 
slightly backwards -- so when the "usual" surgery is done, the bones can and 
will still slide apart from one another as the dog puts weight on his foot, 
causing the ligament inside the bone to be stretched and potentially tear 
again.  At the very least causing pain at the least bit of over exertion.  
This Oregon fellow designed a surgery where a chunk of bone  that is flat on 
top  and will not allow the femur bone to slide across its top is attached to 
the top of the doggie tibia via a metal bar/plate.  Since there is no more 
bone sliding, there is no more straining of the acl.   We were told that dogs 
after this particular surgery were becoming high level atheletes again.  But 
not enough surgeries had been done over the appropriate period of time to 
render any true clinical results yet.   As a layperson I may not be 
explaining it quite right, but it was very graphic what with the model we 
were shown of the dogs movement.  There are only a few vets currently trained 
in the procedure but it is growing.  I wish I could remember the name of the 
procedure, but it is a long latin name and I didn't catch it long enough to 
memorize it. 

As for Boris, I don't think its really for him.   The expense involved is a 
consideration (about $2500 per knee and he'll need both knees done) but more 
importantly, there is no guarantee that the surgery will prolong anything 
such as the natural aging process or really help him in the long term since 
it doesn't get rid of the preexisting arthritis,  there is a slight risk it 
will upset the balance and cause him to be worse, and since his body has 
apparently adapted and compensated for the arthritis and he is doing "OK" 
when he should be down for the count, there is no pressing need for the 
surgery.  Plus the recovery time is 2-3 months for each knee -- so that's 6 
months of recovery time in a dog that may only have a few years.  I wish I 
had a crystal ball because if I had some guarantees I'd probably go for it.  
But even the Drs. weren't getting all fired up to do it.  I guess we are just 
going to have let nature take its toll.....  :(  Guess it teaches you to take 
each day as it comes and be happy for the two plus years Boris has been in 
our life.

Elisa