# Bump on back leg at knee joint



## thegoldenjoyride (Dec 18, 2005)

My girl is 9.5 yrs.

She had a fatty lump removed from her back approx. 3 yrs of age and another fatty lump (underside/belly area) removed at the end of May/into June (both large). The second time around was a challenging month (stitches not healing/swelling/redness/lots of discharge/she was re-stitched/we’re in a house with many stairs so she was barricaded in the living room and the family took turns sleeping on the couch to be with her) – thought perhaps it was due to age (longer time to heal?) but vet said maybe it was the area of incision (irritated when sitting/lying down).

She went swimming for the first time this summer last Saturday. During the beginning of the week afterward (approx. Mon/Tues) she refused to go on walks (would be excited to go out but won’t even make it past the driveway – she’d stop) – thought maybe it was the sun (though we left early enough in the morning so it was still cool). On Thurs it was cloudy and she still refused, so I felt around her legs and discovered a bump on her right back leg at the knee joint (it’s not as movable as her fatty lumps).

I took her to the vet that morning and she’s scheduled for a biopsy and x-ray on Monday. He said it could be swelling due to an injury (however, she’s not rambunctious) or a lump (what kind?). She’s on anti-inflammatory for the week.

This leg appears to be bent inwards as though it seems weak. She’s still able to run when she sees things in the backyard, goes up/down the stairs, and jumps up/down her couch, but she doesn't want to play or show interest in her squeakies (many of 'em). She’s not "limping" but her walk esp. on that leg seems “off.” For the most part she’s been spending time alone in the basement (carpeted living area) sleeping/looking sad 

She seems to have lost _some_ interest in food in the past couple of weeks (thought perhaps it was due to hot weather, but she’s never been motivated by food either so we weren't too alarmed by this at first)…but she still eats/drinks when brought to wherever she is in the house (sometimes basement) instead of the usual spot (she's fed mix of canned/dry evo).

She had some diarrhea/loose stool last week/this week (been on/off her entire life so it wasn't too much of a concern again at first). She’s on canned gastrointestinal food for the next while to help firm up (she showed good stool this morning).

I’m driving myself crazy as I’m thinking about worst case scenarios (too much reading about hind leg problems and other things considering her age, although she still acts very much like a puppy - however she hasn't been lately, which is upsetting).

Anybody familiar with this and have insight?








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## Elisabeth Kazup (Aug 23, 2008)

Saying a prayer for you both that her "symptoms" are just a coincidence. Hoping for a clean biopsy report.


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## thegoldenjoyride (Dec 18, 2005)

The lump was fatty. Blood work came back clean; x-rays were fine except for the right knee and hips. She’s on supplements for the joints.

She had TPLO surgery on Thurs. She’s on anti-inflammatory, pain killer (tramadol) and antibiotics. First night was rough. Should I ask for sedatives? She has follow-ups for the next 3 weeks (to receive injections to help strengthen joints/muscles/etc - similar to the supplements).

She’s not using the other leg much/at all… it’s a bit concerning but the vet said to give it a few days as she’s still recovering from the surgery.

Our house is rehab nightmare (stairs, flooring)...and it gets hot during the summer (basement is now off-limits due to the many stairs/obstacles getting there). 

The living room has been torn apart…I’ve laid rugs and towels and she has 2 beds to choose from (regular bed and a new ortho bed)… Our lifestyle allows for somebody to always be at home; my brother and I are taking turns sleeping on the couch (I work shifts).

Getting in/out of the house is challenging (6 steps of stairs) but her rear legs are supported the whole way through (using a towel either to lift all the way up or just touching). I bought a 6ft ramp but it’s not long enough/angle is not right/and she won’t even step on it even if placed halfway through. She has a crate (bought for the purposes of transporting in/out of the vet…but she was never crate trained…loves her couch/her bed/being with others)…I’ve thought about crating her to get her in/out of the house (e.g. lift the crate up/down the stairs) but this isn’t ideal for one person if nobody else is at home (and it's another challenge getting her inside).

I’ve skimmed through the Help ‘Em Harness thread and it looks like a good option. I tried to navigate their site but it doesn't say if they ship to Canada. I was hoping to buy local – anybody from Vancouver BC area (know other alternatives)? I’ve also tried to look at the size charts - but I’d like to know, if you have it, what size do you have for your golden? 

We'd also appreciate any tips for our long road to recovery! Thanks.

Here’s my Joy from today. 







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## kellyguy (Mar 5, 2014)

Such a sweet face. Sorry she's having to go through surgery and rehab. I had to look up TPLO, I wasn't familiar with the term. Hopefully she will have a much better quality of life once the rehab is complete. Was the lump on the back of the joint from a torn ligament or something unrelated?


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## Thalie (Jan 20, 2008)

I am sorry for the ACL tear and the surgery but happy it was "only" that. We are facing the same problem with Flem who will have surgery on July 30 (not TPLO but the old fashioned extra-capsular repair) and went trough it in 2009 with our Lab Spip. 

The best rehab guide I have found is here : Download TPLO Home Rehab Guide - TopDogHealth.com . It is free but you need to given an e-mail address; I could not upload the .pdf because it was too large. It gives a week by week rehab schedule with illustrations about PROM, etc. It also tells you what is normal or not. If you are like us and do not have access to a rehab facility, it is a very good resource.

As you know, it is imperative to apply exercise restrictions strictly during the recovery. You are doing all the right things with the rugs and the stair situation. Would it be possible for you to build a ramp that would have a better incline ? It would come handy later on in the rehab process to do "hill" work. 

The Tramadol should act as a sedative but if you feel she is in a lot of pain, do call the vet back to see if you can up the dose. Since you will be giving NSAID (anti-inflammatory) for a while, I would ask the vet about adding milk thistle (human supplement) to act as a liver protection. 

There is a Yahoo group called "Orthodogs" (https://groups.yahoo.com/neo/groups/orthodogs/info) that is full of people having gone through all kinds of orthopedic surgeries, very supportive, lots of ideas. You need to become a member to access it.

We never had to use a harness with Spip because she was toe-touching and weight bearing the day after surgery but we had one. I'll look to see which one and what size. I cannot tell you anything about shipping to Canada though.

Recovery is a long process (less so for a TPLO than for what we are doing) but the day will come when Joy will be off restrictions and seeing her go back to her usual life will be priceless. Hang in there and let me know if I can help you.


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## Brave (Oct 26, 2012)

You can look up my Bear's thread. I'll try to find the link. He had bilateral TPLOs on 8/28/13. We're almost a year post-op. And you can't even tell he was lame or that he had surgery.

Our thread details pretty much everything we went through recovery wise. 


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## thegoldenjoyride (Dec 18, 2005)

The lump was something unrelated…scary timing and positioning…!

I went ahead and bought the first lifting aid I saw after searching through the city – Solvit CareLift Full-body Lifting Harness…it’s difficult to figure out…but I hope that it’ll help once set up.

I’m hoping to get a ramp built but not any time soon-soon…for now I guess we’ll work on building our biceps lifting her up/down lol.

Thanks for the resources – I will look into them!


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## Thalie (Jan 20, 2008)

That looks like a good and comfortable lifting harness; I like that you can leave it on her if you use the full body setup.


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## thegoldenjoyride (Dec 18, 2005)

Joy's first/last swim of the season! I hope that there will be some more to come after recovery...








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## Thalie (Jan 20, 2008)

How is Joy doing ? 

She most assuredly will swim again, if not this season, the next one for sure. Hoping everything is all right with both of you.


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## thegoldenjoyride (Dec 18, 2005)

Joy’s started lying down on the bandaged leg without complaints and tries to use both legs when up. She prefers to walk on her own now without the towel holding her but I keep one handy just in case. 

She’s used to sitting outside alone to observe (looking up and around and smelling the air…) Since the surgery we have been doing this together (I feel as though I need to carry around a chair with me lol). I think she’s stalling sometimes… it’s very hard to get her to go back inside. She sits a lot while out, sometimes lies down…I’m exhausted and running on naps and all I want to do is go back inside after she does her business, but nope… 

Her first stool since being home was nice and firm. But now her stool has been very soft (dark on the outside, yellowish on the inside when picked up/cleared off the grass) for the past few days. I think it might be the switches on her diet that triggered it. Could it be the meds? Stress? She’s not used to being confined in an area… She’s eating and drinking fine.

I tried to put her back on regular dry after having the vet’s canned “recovery” food when she returned home… and I tried to mix her dry with canned (of the same brand – Evo) because she wouldn’t eat her kibble by itself and I needed to hide her meds)… she’s gone back on canned gastrointestinal for the time being... lots of changes. She prefers canned over dry these days. She’s had the same brand since puppyhood. She’s a very fussy eater and we’re used to putting dry treats on top of her kibble. I did some research and I just started inserting the syringe into the side of her mouth and it seems to be doing the trick (for now) – no more hiding because she knows.

She just finished tramadol yesterday and is now only on antibiotics, anti-inflammatory and supplements. She’s seeing the vet on Thurs for a follow-up.

Sometimes I think her legs get a bit stiff from lying down a lot but we also haven’t been doing any home therapy exercises because the affected area is bandaged and any of the home therapy exercises I’ve read didn’t have dogs in bandages. Any tips? Her vet’s instructions, in general, were lots of rest and increasing frequent walks over time depending on Joy’s comfort level.

She’s been wearing the front lift part of the harness…it’s loose and it might already be adjusted to the end (even though it’s the “large” size of at least 70 lbs and the “medium” size of less than 70bs might be too small). I haven’t had to use the full body harness to carry her entire weight; I’ve just been lifting her rear with a towel and using her collar or front lift to guide her (up/down the stairs). 

This morning Joy walked to the end of the lawn/driveway, sat, and looked down the street for a good while.

Here she is lounging around on Sunday morning (day 3 post-op).








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## Thalie (Jan 20, 2008)

Glad to see that all in all she is fine and progressing. Her willingness to use the leg (does she toe touch or is she putting some weight on it ? ) and to lay on it is good. I remember the first time Spip laid on her surgery leg just a couple of days after surgery, my eyes were like saucers but I told myself that if it felt fine to her, it was fine.

The meds might be part of the reason the poops are a bit soft but you are right, the stress and the changes of diet might also be factors. As long as they remain pickable from the grass I would not worry too much but would mention Thursday at the vet if they have not improved; perhaps some probiotics or stool hardener might help. 

Like your vet told you the first week after surgery is devoted to rest with some increasd walking. When she walks, it is important that she does so very slowly because that's what will "force" her to use the surgery leg and. Become more and more weight bearing on it. The only other thing is to ice especially in the first 72 hours post op to lessen the swelling and inflammation but with the bandage it was probably useless to try. Spip came home without bandages and I expect the same thing with Flem so I have no insight about that. 

Since you feel she is a bit stiff. I would massage the affected side up to the bandage and perhaps do,some PROM on that side hip as well as massage the other side and do full PROM (hip, knee, ankle) on it. If you can, measure her muscle mass on both legs (mid tight is ideal but perhaps not possible with the bandage so just try to do it at the same place on both tights ). It will give you an idea about muscle loss and muscle rebuilding as her rehab progresses in the coming weeks. The goal is to have the same measurements on both legs after recovery and rehab.

Since she has a bandage you probably do not have to put a cone on her now but I would have her in one for when the bandage comes off. It is a very long surgery line and it is very important that she cannot reach it (even when the stitches or staples come off because it will be itchy as you know).

I hear you about the exhaustion. It is a. 24/7 job because we want them comfortable, still happy despite the pain and the restrictions and there is so much worry. Been through it once and preparing myself mentally for this round.

I hope she will have a good checkup Thursday and will look for updates. Take care.


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## Thalie (Jan 20, 2008)

How was Joy's checkup ? I hope you are both doing OK.


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## thegoldenjoyride (Dec 18, 2005)

Thanks for checking in and sorry for the delay…between work and Joy it’s hard to find time for anything else! I steal naps when I can 

Her follow-up went well. The Dr. and vet tech were happy with her progress (she was trying to move lots/using all legs/looks to be putting weight on her leg – always good news). The Dr. said that soft stool is due to the antibiotics. He wasn’t going to give anything for it until I asked for probiotics… He gave enough for 5 days (2 tabs every 12 hours) - so far they haven’t been helping. Her stool is consistently soft (but not loose)…she’s still eating and drinking fine…

Sooo…apparently she didn’t have the TPLO . When we picked her up after the surgery the Dr. wasn’t there. When we picked her up after the x-rays few days before that, he gave us a couple options…he described them but didn’t drop names, so somehow I assumed it was the TPLO. I asked about physical therapy during her follow-up, but because she’s still bandaged until next week he didn’t give much info; he just said she’ll need some massages… I would have preferred for him to give some support/resource for post-op (other than “rest” and increasing walks) including ways of preventing the other leg from going out - if at all possible  I have been doing some PROM on the other leg…

Anyway, an ACL surgery is an ACL surgery and my Joy is on the mend. She’s beginning to explore just past the driveway now…she knows her limits and won’t go past that if she feels uncomfortable. She kind of/almost looks “normal” when she’s walking – so proud of her! She still prefers to sit and lie down on the grass though.

She can prob. be left alone in the recovery room (i.e. confined in the living room) overnight with the cone but I feel so bad that I continue sleeping on the couch to keep her company  am I nuts? She’s been wearing the cone when nobody has eyes on her. She wakes me up by poking me with it and sometimes it’s hard to tell when she needs to go out (she doesn’t…) or if she enjoys driving me batty (she does…) :bowl:

I took off the lift harness; it wasn’t that useful and she just didn’t like it…more padding might be better. The Dr. said that she can go up/down the steps without being helped as long as she’s leashed and we’re beside her (i.e. she’s not ahead)… We’re going to continue helping her up/down the steps anyway just in case… I’ve been wrapping my arm around her hips (where the towel would be) to help her.

She’s going back on Wed for another injection.








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## Thalie (Jan 20, 2008)

I am glad Joy had a good checkup, that is always reassuring. The looser poops will very probably indeed resolve once the antibiotics are over. Do you give the probiotics separate from the antibiotics ? I think that a couple of hours apart is what if more efficient.

Mmm, if Joy did not have TPLO, the one other surgery that I think they would keep her bandaged for for two weeks would be a TTA. Both TPLO & TTA involve cutting into bones and some implants while the extracapsular techniques (Tightrope & ECLS) do not. The bone remodeling ones offer a better knee stability from the start and typically have a shorter rehab time. Knowing exactly which surgery Joy had would influence which exercise and what intensity you can start when so I would ask again when you go on Wednesday.

The fact that she is willing to walk, that she puts weight on the surgery leg, and that her gait has improved so much is very very good. The more she will walk (slowly, on a short leash, and very incrementally), the less muscle she will loose on that side and the less the other side will need to compensate both in intensity and duration. While the stats are what they are, do not feel doomed about the other side tearing. Spip the Lab had ECLS done when she was seven and never blew the other one so it is possible. The rehab process, on several weeks with low impact exercises, helps tremendously in that aspect. We will see what happens with Flem and cross that bridge if it is ever needed.

I would keep on helping Joy on the stairs for a few more weeks. Going up and down stairs slowly is one the last exercises in the rehab and also one of the ones that is most taxing from the non-surgery side so it needs to be delayed for both legs' safety.

You are not nuts for still sleeping with her. We have been sleeping in the living room with Flem also but will move her to an overnight recovery pen probably tomorrow because that's where she will have to stay when we go back to work in a few days and we want her to get used to it. Otherwise, we would probably have spent way more time sleeping with her and still will if we feel it helps her.

What are the injections that Joy is getting to help ? We are not doing injections but have been prescribed six cold laser sessions for Flem.


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## thegoldenjoyride (Dec 18, 2005)

She gets Cartrophen every week. She has 2 more to go. I think it's helped her overall..


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## thegoldenjoyride (Dec 18, 2005)

She had her bandage removed this week. Vet said she’s healing well. He also said the surgery he did was extracapsular repair.

Going down the stairs is fine (6 steps) but going back up is harder than it was during the first week. She’s hesitant and will lie down at the bottom…won’t even step up on the first step. I don’t know what to do but let her lie down for a long while (we’re outside for nearly an hour – okay, maybe approx 40-50 minutes – some walks included but definitely lots of sitting/lying down toward the end…this isn’t ideal every time we go out throughout the day). I’d try to carry her back up but she wouldn’t have it and would be motivated to try to go up on her own (I swoop in and lift her rear legs when she does). Maybe she might have strained her shoulders from this…she has arthritis and hip dysplasia. The harness we got her is not Joy-friendly so we haven’t been using it. This is hard 

I tried to switch her back very gradually from canned gastro to EVO…very loose stool…I’ve read that Innova/EVO might be too rich for some dogs but she’s had the same all her life (with on/off loose stool – a few were tested this year and all came back clean). Is it time for a change? Thoughts? We have a sample bag of Acana and I’m going to try to switch to that.








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## Thalie (Jan 20, 2008)

The incision line looks very very good and having the bandage off will allow you to do a bit more PT. 

Since she is already walking well on it, one exercise that you might try with her to help her build back muscle is puppy squats (Sit-to-Stand Exercise "Puppy Squat" - TopDogHealth.com). Start with 5 reps up to four times a day this week.

As far as walks, she should do about 10-15 minutes of walking several times a day (if possible with the temperatures; we cannot do that with Flem because it is way too hot for her to walk after work). If you walk way more than that she is perhaps just very tired when it is time to tackle the steps. Letting her rest a while is a good idea and I would use treats to encourage her to giddy up; you can use a towel under the belly to help her if the harness you bought causes more trouble than help.

Is she still taking any medicines ? Flem's stool has been a bit softer and bulkier during the antiobiotics & NSAID and I am expecting to see a gradual change now that she if done with them. Antibiotics can make loose stool appear up to several days or even weeks after they the treatment is over. When you say very loose is it still pickable with a baggie or pudding like ? Which Acana do you have in mind ? If she has always had intermittent loose stools on EVO, it is perhaps indeed time for a change.

Since she had the ECLS repair, she must not run or jump for a few more weeks. I am conservative and will keep mine on leash outside for about 12-16 weeks all in all at a minimum.


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## thegoldenjoyride (Dec 18, 2005)

*3 weeks post-op*

She started limping more since the bandage was removed last week. The vet said last week that this was expected. But it got worse a couple of days ago when we were out in the front yard and she saw something, got in a position where it looked like she wanted to step forward but then something happened – not sure if she pushed on her legs to bark/etc– but she ended up not putting weight on the leg and would even lift her leg still. She was checked yesterday and the vet didn’t feel that there was anything wrong – he was happy with her range of motion at this stage – so she might have pulled a muscle. He also mentioned that her hip dysplasia is kind of severe (diagnosed the same day when we found out about the knee – she didn’t show any obvious signs before this) and factors into the limp…

She doesn’t walk any more than approx 10-15 minutes at a time…but she sits and lies down lots so we’re out for longer than I’d prefer…I’ve decided to just bring a chair out with me and have a seat as well and eventually she gets bored and is easier to coax back in (although it’s not 100% effective!) This is fine in mornings but afternoons suck (hot hot). We continue with massages/PROM.

Her stool was loose – not pickable with a baggie but it firmed up since I added canned pumpkin to her diet – she gets approx 2 tbsps per meal (breakfast/dinner). And I’ve also decreased (by a bunch) the amount of EVO she gets (approx 1/8 to 1/4 cup per day? – is this too little? It’s the turkey/chicken formula of 82% protein. Her stool is a good size). She’s lost weight (from approx 79 to 73) – he wants us to maintain it at approx 70 – he said 65 might be too skinny.

We have a sample bag of Acana Wild Prairie (60% protein). But she still has a full bag of EVO…

She’s been off the antibiotics but is still on Apo-Meloxicam (and also synovial-flex soft chews that is ongoing).

I asked the vet about rehab/physical therapy that we could get her into but he was a bit hesitant IMO and mentioned that there would be costs (not cheap --- but I’m willing to at least try to make it work if they will benefit my Joy -- I've already cancelled one getaway/mini vacation already booked this month and plan to cancel the other one in November). He also said he wanted her to use her legs. He said to walk her for now and to return in 3 weeks time for a follow-up. We live at the end of the cul de sac and she’ll walk around it but not continue down the street so taking her out for increasing walks in general might be challenging…so we walk around the front yard, down the driveway, around the cul de sac, and then detour in the backyard but it’s not the same as walking down the street. He said we can drive to a park/another destination and walk her there if it’ll get her moving. What is it – her confidence? Pain?

Also, any thoughts on hydrotherapy and cold laser therapy? I found both in the region.


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## Thalie (Jan 20, 2008)

The more limp after the bandage came off is logical. It was offering her extra support and now that it is gone she is on her own. Even though our vet does not bandage after that kind of CCL repair, we had the same setback with the leg up you describe yesterday. Straining in the yard on a short leash to reach a lizard on the fence and poof, leg up, more limping (Flem was also diagnosed with hip displasia, elbow displasya as an aside in an investigation into other heath questions). We delayed our first out of the yard outing because of it. The muscle mass really disappears fast, especially on older dogs; Flem's leg look like the leg of a chicken who never ran in its life right now so any extra straining makes it hurt. Take it easy, consider Joy more in week one or two after surgery than in week four. Make her walk but do not worry about distance, more about frequency. Use treats to make her take a few extra steps if needed. We are in the same boat with the heat so we tour the yard along the fence line every hour before and after work and will have to do outside walks on weekends only for the time being. Keep on doing the PROM inside; do the moist heat before and the icing after if you can, those can only help.

We did 6 sessions of cold laser within the first two weeks after surgery. It was optional in our surgery package and we opted in. I only have one other dog to compare with but to me it seems it helped with the pain, the bruising, and the willingness to work through the PROM. We do not have access to hydrotherapy but I would really consider if if we did. When Flem broke my leg and ankle about eight years ago, underwater treadmill walking is how they started my PT and it made a world of difference to me. It helped me regain confidence in my leg, rebuild some muscle, and loosen up the "frozen" joint. I imagine it would work the same with a dog... building confidence, strength and flexibility.

I had a look at the EVO formula you are feeding. Based on the calories and if Joy needs to reach 70 lbs to be at her optimal weight. I think she should get about 1.25 cup per day at most. The problem with such dense food is that the dog does not feel full so I would moisten the kibble for at least fifteen minutes before feeding so it swells and she feels fuller. If she did not have tummy trouble I would advise adding a cup of unsalted cooked green beans (frozen or canned) to her meal but I am not sure it would be wise in this particular case.

Will she be on the Apo-Meloxicam long term ? NSAIDs, while very useful in case of chronic pain and inflammation, can cause some digestive upset as well as some liver trouble. There are ways to mediate that - slippery elm to soothe the gut and milk thistle to protect the liver. Both can be obtained from health food stores on online and are easy to give.

Thank you for updating about Joy.


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## thegoldenjoyride (Dec 18, 2005)

Thanks for responding and keeping up with Joy. It’s comforting to know that there’s someone out there going through the same thing (unfortunately…!) 

Joy won’t accept treats outside of the house…she knows what I’m up to. She also won’t accept food from strangers (at the pet store, etc)…she’ll accept the same treat from me when we get in the car though (I guess she doesn’t want to eat in public…! ) So I’ve stopped worrying about the distance and just increased the frequency…it’s tiring…and I just want to fast forward to when she’s 100% better! Her limp has improved and she’s going up/down the stairs better than before, but I still watch her like a hawk (eh, I try).

She’s on the Apo-Meloxicam (decreased dosage) until her next follow-up…Her vet wants to manage pain/inflammation to help build muscles.


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## Thalie (Jan 20, 2008)

Sorry I did no reply sooner. I hope Joy's recovery is proceeding smoothly. I think frequency is more important than time or distance. Up to a point, letting Joy decide how much she can do is not a bad idea; it's her knee after all and she is the one feeling what it is like to walk on it . If she does not like walking off property you can perhaps do extra sits and ups with really good treats. Setbacks will happen, days when you think she is worse than the day before will happen but healing is taking place and she will be 100% again. Some take a bit longer but it does not mean you will not get there. I hear you on the tiredness; between work and my three and with Flem's additional needs at this time, there are days I only manage to sit for more than 15 minutes in a row late evening and then I fall asleep where I sit.

Hoping all is well with you and Joy.


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