Not too long ago, veterinarians had to be proficient in all aspects of veterinary medicine and animal health. For example, my father, a veterinarian whom I still practice with today, will soon be crossing the 50-year mark in veterinary practice. When he began his career there was no such thing as a board-certified veterinary surgeon. He and his classmates had to learn and become proficient in all aspects of soft tissue and orthopedic surgery. Over the years, utilizing skills learned in veterinary school, internships, veterinary textbooks, and, of course, some trial and error, he has become a master in surgeries.
With that being said, that does not mean that I am personally, or any general practicing veterinarian is incapable of learning such procedures by any means. It’s just that pet owners today expect a higher level of skill for their pets when it comes to the “major” surgeries. Remember, it is more important to focus on being a master of a few skills than trying to be a jack of all trades.
This brings me to the point of whether or not both you and your pet need to seek out the expertise of a board-certified surgeon when the time comes.
The College of Surgeons
Founded in 1965, the American College of Veterinary Surgeons now includes more than 1,470 Diplomates. These individuals who have been accepted and accredited by this College have taken it upon themselves to attain additional skills and techniques in the world of animal surgery. They are now the best of the best when it comes to surgery. Not only have they completed four years of veterinary medical schooling, but they have also been required to spend an additional four years of advanced medical and surgical training. That in and of itself is a HUGE commitment.
The Take Home
Now, this does not mean that every surgery that your dog may need requires the skills of a board-certified surgeon. In many cases, there are several more “routine” soft tissue or orthopedics surgeries that can adequately be performed by a general practice veterinarian.
My only point is this: know that they exist. Know where they are in your local area and don’t ever be shy or embarrassed to discuss this with your veterinarian when the time comes that your dog may need that additional skill level to get them back to 100%.
Dr. James, thanks for your reply. I’m sorry that I hadn’t gotten back to your response sooner. My dog is now 6 months post surgery, and still has lameness. We are keeping him inside for the most part and only leash walking him, a shame because he is so energetic and wants badly to go out and have fun. I took him to a board certified surgeon who comes to our area once a week for a consult last week. He found that yes, there is some patellar tendonitis, some inflammation around the implant, and that the angle of the knee is too steep, steep enough in his opinion to cause the ongoing lameness. His recommendation was to remove the implant and do a TPLO! Another observation was that the bone had not completely healed in where the spacer is. He said he needed to do his homework about removing the implant. Is it too soon to do that surgery with that bone not healed in completely? Does this seem like a sound approach? I’m worried my insurance will balk at paying for another very expensive surgery, but at 7, I want my dog to be as comfortable as possible for the rest of his life, and if doing it could offer him that, I would do it.
Betsy this is no doubt a tough situation. That said it is not uncommon to have set backs in the recovery process and usually what I do with my patients is have the owner rest significantly (ie. stop all forms of therapy) and use an anti-inflammatory and pain medication like tramadol for 5-7 days. If the dog is not better at this point then we investigate more. Did you veterinarian take an X-ray this last time? Did they do a joint tap to make sure that there is no infection? These would be things to discuss with them… One more point is that one of the more common complications with the TTA surgery is a patellar tendonitis. Do you feel any excess heat when you put your hand over the joint compared to the other normal hind leg?
I was very concerned about finding a board certified surgeon for my dog’s cruciate rupture recently, but I live in an area where we don’t have any, and my vet supposedly is proficient at orthopedic surgery and has other vets refer to him from all around the central valley. So, with trepidation, I agreed to have him do the TTA on my Aussie, who is normal weight and 7 years old.
Tomorrow is four weeks post sx, and we are having complications. The day after the surgery he was walking on the leg, and things seemed to go along well like that, until last weekend when things seemed to take a turn for the worse. He became very painful, uncooperative of the ROM movements, and started packing the leg again. The pain is worst over the kneecap area/point of the knee. I took him to be checked last Monday and to have K-Laser, but they said everything seemed ok and to rest him for a few days and give him meloxicam for a few days. Well, here we are Thursday night and he is no better. I have been icing him twice a day but am reluctant to do the ROM since he vocalizes in pain.
What could be causing such a problem when the vet check found everything to still be “ok?” There’s a place that does rehab but it is 45 minutes away. I’ll do it if they can help get him back on track. I fear that I have allowed this to happen somehow. I kept him on leash around the home and outside for walks, but there were a few occasions where he pulled suddenly or dragged the coffee table he was tethered to when he got excited.
I now question my decision to have my vet do the surgery, but don’t know if that is where the problem lies or what?
Yes that does help. Thank you!
This is a great question and actually brings up the point that I should probably right a blog post on this topic. I think I will do that very soon. So my brief answer would be this: If you eliminate the financial component (ie. depending on the type of surgery it could run anywhere from 1,000-4,500)……then I think there are other factors you have to consider. 1) The weight of your dog? If you have a large dog then often times a TPLO is a great option. If you have a smaller dog then maybe the lateral suture repair will be fine. 2) Who is going to do the surgery, a general practitioner who performs cruciate repairs or a board certified surgeon? 3) How active is your dog? How well behaved is your dog? These are very important considerations because some of the surgery options are much more invasive and if you dont have good control over your dog the seriousness of post-surgery complications i,s in my mind a huge consideration. In your situation…I think your most important factor is finding the surgeon and the facility that you feel the most comfortable with. Then I would interview the surgeon and really ask them..IF this was your dog? What surgery do you feel the most comfortable? Which surgery have you done the most of? What is your success rate? >>..Hope this helps
How do you decide as to which surgery is used to repair the cruciate? I have an 82lb rottweiler. Her main activities are tracking, scent detection and just being a dog. My vet has suggested TTA but I’m hearing mixed reviews. Other people suggest TPLO.