Ziva came to Edinger Surgical Options at the end of May 2019 because she had been limping on her right rear (RR) limb, periodically for about a month. Ziva’s family noticed her reluctance to jump on and off of furniture, that she would sometimes hold up the RR limb, and when her family would pick her up, they perceived her kneecap to be moving in and out of place.
On physical exam our surgeons noted that both of Ziva’s patellas (kneecaps) moved medially (toward the inside) of her knee, a problem known as Medial Patellar Luxation (MPL). To describe their severity, MPL’s are graded on a scale of one to four, with four representing most severe. Ziva’s right patella was graded 3/4, and her left patella was graded 2/4. This means that her right patella generally remained outside of the patellar groove, but was easily put back in, while her left patella generally remained inside the patellar groove, but was easily pushed out. After discussing their options with our team, Ziva’s family decided for Ziva to undergo bilateral MPL correction (both at the same time) and stay at ESO for two weeks after surgery, in our RECOVERY STAY™ program. This was especially helpful for Ziva’s family who live quite a distance from Madison.
MPL correction is a surgical procedure that can involve a combination of three procedures including: soft tissue repair, tibial tuberosity transposition, and/or groove deepening by a trochlear wedge recession. Soft tissue repair involves removing or tightening a section of the stretched tissue around the patella and suturing it in a more secure position. Tibial tuberosity transposition involves making a cut at the front of the tibia bone and moving it to correct the alignment of the patellar tendon. Groove deepening by a trochlear wedge recession involves making the patellar groove deeper so that the patella is less likely to move out of its groove.
In Ziva’s case, all three of these procedures were performed on each knee, and she came through anesthesia like a champ! For the first overnight following surgery, her back legs were placed in soft bandages to help minimize the expected initial swelling. The morning after surgery the bandages were removed and her physical rehabilitation was started.
ESO’s RECOVERY STAY™ program includes sessions with the certified canine rehabilitation therapists of HEAL Integrative Veterinary Center (HEAL). Ziva’s initial rehab sessions included cryotherapy, laser therapy, massage, and passive range-of-motion. During her two weeks of RECOVERY STAY™ at ESO, Ziva enjoyed the consistent, 24-hour care and medical attention of our nursing team and the rehabilitation sessions with HEAL, while her family received peace of mind knowing that she would be cared for, comfortable, and have the best opportunity for an optimum recovery. Her owners received daily updates of her progress from our nursing team, and they were welcome to schedule family visits.
By the time Ziva finished her two-week RECOVERY STAY™ she was no longer in need of pain medications, and she was quite comfortable while walking. Before leaving our care, Ziva and her family met with HEAL to review rehabilitation exercises her family would need to continue at home for her full recovery. Because of the distance Ziva’s family lives from ESO, her four-week recheck was performed by her family veterinarian, who prescribed an additional therapy exercise. When it was time for her six week recheck at ESO, Ziva was doing great! She was enthusiastic, using her legs normally, and showed signs of wanting to play with her housemate and resume her regular life. We were very pleased with her progress: her patellas were stable and Ziva’s radiographs showed her tibial tuberosities to be healed. Ziva was allowed to start reintroducing normal activities gradually, over the next four weeks. Our team communicated with Ziva’s veterinarian throughout her recovery process to ensure continuity of care and to allow her the best opportunity for an optimum recovery.
“When we found out that our Little Ziva had issues with both her rear legs and that we should take her to one of two options given to us for a consultation as to what should be done, we first were going to take her to a much closer place to us as I have a real problem with driving! I am so grateful, that we changed our minds and chose Edinger Surgical Options instead!
“From the initial trip through the consultation and the surgical plan laid out to us we knew that we had made the right decision. They laid out exactly what they planned to do, that they would keep her after the surgery for a recovery period so that they could start therapy and watch her progress to be sure she was on the right road to recovery before we would have to work with her at home. We were sent daily follow-ups with pictures so we could see for ourselves how she was progressing! I lived for those follow-ups as she is my little girl and I missed her so!!
“The entire staff was so wonderful and I know that their care is the reason that our little Ziva mended as well and as quickly as she has! We can never thank them enough for all they have done for her and all the care they have given her to return her to us with legs that now work as they should have from the beginning of her life!
“Thank You to all who cared for, worked with and loved our little Ziva while she was in your care!!”
-Mary & Kelly Schmid