Surgery for Seger
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In the summer of 2021, and after months of watching Seger struggle with Panosteitis, my gut told me that there was still something else was going on, so I took him to see Dr. Peter Lotsikas at Skylos Sports Medicine, where he was subsequently diagnosed with Osteochondrosis in his left stifle, and Osteochondritis Dissecans (OCD) in his right stifle.
We spent countless hours researching the condition and weighing out the treatment options with friends and experts. The bottom line is this: while the chances of complete resolution in his stifles is questionable, at two years of age Seger’s best chance of comfort for the rest of his life is surgery. It was scheduled for Tuesday, August 10, 2021.
A conditioning plan was put into place in the months prior to surgery to prepare his body for recovery, including weight loss, daily walks, swimming and other exercises for muscle development, and introducing the daily stretches that will become part of his rehab program post-surgery.
Additionally I started thinking about what else might be important to introduce him to so that he’d have some experience under his belt prior to the big day, and put a plan in place. It’s been quite overwhelming at times, so I thought spelling it out in print might settle my mind a bit, and help others who find themselves in such a daunting position.
Conditioning Work
Swimming is a great way to build muscle without putting concussive forces on joints. Regardless of Seger’s surgical outcome, developing muscle to support his knees will stand him in good stead for life. We had tried introducing him to swimming when he was a young pup, pre COVID, but were unable to follow up during shut down. With restrictions lifted, swimming was re-introduced at a beach with some canine buddies, so that he could walk into the water and push off to swim more naturally than in a pool with a ramp or steps. Seger’s friends were able to model fun in the water for him, and it wasn’t long before he was the swimming like a fish. Now it’s a regular part of his conditioning program.
Passive Range of Motion Exercises
The great folks at Skylos put together an at home plan to prepare Seger for the Passive Range of Motion (PROM) exercises we’ll be doing to rehabilitate him post-surgery. These exercises will help to increase his movement and flexibility and improve his overall joint health. Getting started on them before surgery means Seger will already be familiar with them when he’s ready to start them after his procedure.
Seger assumes the position. It’s clear that he enjoys this work.
Pain Management & Physical Therapy
In addition to physical therapy Seger will be visiting Skylos weekly after his surgery for massage and laser therapy. He’s already visited a few times for treatments. It’s given him some relief while we wait for the big day, and set the expectation of things to come in the next few months as a way to provide some relief as he adjusts to his body moving in new ways. And that’s given me some relief too! When he’s ready, we’ll add some physical therapy to the mix as well.
Here he is enjoying some laser therapy.
Experience
Another consideration in preparing Seger for the recovery process is what he’ll experience outside of physical exercise. He won’t be able to use stairs for some time, and we live in a two story house and sleep upstairs. He sleeps in the bed with us!
We’ve already prepared an indoor fenced area for him to stay in so that he doesn’t have access to furniture or stairs, a place where the other dogs won’t interrupt him while he rests, and one that will prevent him from running and playing. He spends time enclosed in his pen, chewing on bones and kongs. We also we leave the pen open so that he’s free to come and go as he pleases.
Unfortunately there’s no access to our home that doesn’t involve stairs, but we did have this wheel chair lift installed for my mom earlier this year. We’ll be using it to get Seger in and out of the house for potty walks, so we’ve spent some time training him how to ride in it calmly and only exit when prompted. We also do his daily PROM exercises here, from the elevated position, since it’s uncomfortable for me to work on the floor with him for an extended period of time. He doesn’t have to jump up, and I don’t have to get on the floor.
In the first few days post-surgery he’ll likely need some help getting up and down, and possibly balancing and walking. He’s been getting used to his Help ‘Em Up harness, which has handles over his shoulders and hips so that we can give him the physical support he needs to navigate to and fro during what will be a challenging time for him. Here he sports his harness while playing outside.
While he’s familiar with the dreaded Cone of Shame, reintroducing it will set the stage for his comfort when we’ll need to be sure he doesn’t have access to his incisions. This style is called a Comfy Cone, which consists of nylon sleeve filled with sturdy sheets of foam. Easier on his body and ours!
Once Seger is out of his harness we can also switch from the Comfy Cone to these Lick Sleeves, so that he can move around a bit more freely and his incisions will still be protected. (We’ll still be using the Comfy Cone when he’s unattended.)
We’ve got one more experience to put in place prior to Seger’s big day: overnight camping! We’ve already set up an air mattress close to his fenced area where one of us will be sleeping while he’s unable to use stairs, and will be overnight camping while he’s in his pen a couple of nights prior to his surgery.
While Seger was in a cone and an expen for the first two weeks post surgery one of us slept downstairs with him. When the cone came off we were able to transition from an expen to a crate at night, but we weren’t sure how he’d feel about sleeping alone, and wanted to be available to him if he needed us, so we purchased a baby monitor to see how he’d respond. With the monitor on our headboard and the volume turned up, he can wake us if necessary, and we can peek in on him for piece of mind while also getting a good night’s sleep for a fresh start the next day.
What Else?
Slippery floors! We’ll have to take great care to see that Seger gets out for his potty walks safely, determine what that path will be, and add non-slip mats where needed to be sure his new knees (and the rest of his recovering body) are protected.
We’ve given some thought to the triggers in our house that send him racing around like a nut, like running to the door to bark at intruders or when my husband comes home from work. Creating a plan that will prevent those things from happening will be critical to his recovery.
We’ve strategically placed his pen in a spot where he can’t look out the glass door to see when vehicles drive up to the house. But what to do about the other dogs who can see outside? We’ll have to put something on the glass so they won’t be able to see out and alert either, because Seger likes to join in.
He’s very serious about protecting his home from strangers, and drivers show up daily with deliveries from UPS, Amazon, Instacart and more. Mostly they aren’t seen or heard, but occasionally they feel the need to knock on the door or ring the bell to let us know they’ve delivered something. Attaching a laminated sign to the front door will hopefully prevent that, and keep Seger from feeling the need to jump to his feet out of a good rest.
Additionally my husband and I have discussed a plan to prevent Seger from his loud and boisterous celebrations when Alan comes home from work. Texting me when he turns on our street will give me an opportunity to prepare Seger for his arrival in such a way that he can greet Alan quietly and without turning himself into a pretzel. Updated 8/13/21: Nice thought, but this wasn’t working to keep Seger calm after Alan walked in and sat down. Seger was just too excited and wanted to climb all over him. So, we changed things up a bit, starting with Seger in a crate when Alan walks through the door. First, other dogs outside so they don’t add to the excitement. Second, Seger in a crate. Third, Alan greets Seger calmly while crated, then tosses treats on the floor in front of the crate to give Seger something low to the ground to focus on. Once he sees the treats Alan opens the door and Seger searches for treats. He continues tossing until Seger calms down. Then they great calmly. Here’s a video of the whole thing.
Pills! No doubt Seger will be coming home with daily pain meds and antibiotics, so we’ve been giving him treats wrapped in Pill Pockets, and occasionally we add a wrapped supplement capsule instead. Learned this and many other helpful hints from the Cooperative Care Certificate program. All he knows is that he’s getting extra cookies, and he’s pretty pleased with that!
No doubt we’ve forgotten something, but at least we’ve got a lot in place to make this whole experience a lot less trying for all of us. If you have additional ideas, feel free to share them below. They might help us. They might help someone else!
You’ll find updates on Seger’s recovery and rehab posted below as they become available, so check back here for more if you’re interested.
Surgery Day
8/10/21
7:50 am
Off he goes…. I’m comforted in knowing that I’ve given him all the skills I could possibly think of, and that he’s done this before, when his stifles were scoped, so he’s familiar with how this goes. They’ll call when he’s being prepped for surgery and update me as soon as he’s in recovery.
8/10/21
5:15 pm
Seger’s waking up from surgery. Left stifle was debrided and drilled to stimulate bone growth. The larger lesion in the right stifle was cleaned up and a SynACART implant was installed. Can’t wait to have my boy back in the morning.
8/10/21
8:05 pm
Hi mom!! The staff was told me u were asking about me. I’m doing well! Currently I’m resting , I’ll be going outside later for a walk and to to eat. The staff here are giving me lots of love and cuddles. Can’t wait to see you tomorrow. Love, Seger
8/11/21
6:30am
Seger did very well overnight ! He slept ALOT do he should have plenty of energy when u come for pickup ☺️ He gets up fine without a sling. Slow to walk as expected but doing great.
Recovery Begins
You’ll find the rest of Seger’s story at the end of this post. More helpful, I think, is to share some of the things we did along the way to keep him mentally stimulated during his very long rehab.
Boredom Busters
Keeping Seger busy mentally while his body healed physically wasn’t as difficult as I thought it might be. Here are some of the games we played to keep him satisfied. If you’ve got your own ideas to share, feel free to post them in the comments!
Trick Training
Learning new tricks and practicing the tricks he already knew in new ways kept him pretty busy, too. We focused on tricks that didn’t involve the limbs he had surgery on. You’ll find plenty of trick ideas on the Do More With Your Dogs website. You can even earn some trick titles along the way.
Incorporating Tricks into Physical Therapy
When the time came for Seger’s physical therapy to start, I worked with the rehab veterinarian to design some games we could play using tricks he already knew, while he exercised his body in the way the doctor intended us to. Don’t go it alone! This is where you need the expertise of someone who understands how the body works and what the specific goals of rehab are. You might also be better off just leaving it to the professionals.
The Rest of Seger’s Story
You’ll find some videos of the rest of our journey below, along with an update on where we are today.
One Year Post Op
It’s been a year since Seger’s surgery and he’s a very different dog today, much more comfortable in his body and moving so much more freely. A couple of months ago we started giving him Adequan injections to take his comfort and movement to the next level, so that he could start using his muscles in the way they were intended. That was a game changer for him and allowed us to transition from rehab to a conditioning program. Within a couple of weeks we started noticing all sorts of new things. He started jumping on us, placing his front paws on our shoulders. During meal time he stands on his hind legs while peering into his food bowl on it’s way down. It’s been fun watching a three year old dog discovering how to use his body in new ways. His alarm barking has disappeared altogether. And things just keep getting better and better.
Two Years Post Op
Seger got high marks for his flexibility and fitness today. Muscle mass 5% less on the right than the left rear, which is actually considered within normal limits, no more significant than most dominant sided individuals. Hips feel good and well supported, so that’s no worry. No big surprise that his stifles are a bit creaky but still well muscled. Back feels good. And here’s The Big News: if his surgeon agrees with the rehab vet, we’re inches away from a big, fat YES to Seger and Buzz playing in the yard together for The. Very. First. Time. You can count on video if that comes to pass.
We got the OK! Here’s the video…
We’re keeping busy with training with nose work, trick training, rally and obedience, where he’s earned a whopping total of 53 titles to date. Seger also became the fourth German Shepherd in the country and eight in the world to earn his Grand Champion Trick Dog title with Do More With Your Dog.
With the implant in his right stifle, we’ll spend the rest of is life being thoughtful about how he uses that leg, and which activities he will and won’t participate in, so that we can keep him sound and happy. It’s been a long road, but we’d do it all over again to end up where we are today.
Deepest thanks to those who have helped us along the way: Seger’s fabulous rehab vet and technicians at Skylos Sports Medicine, breeder and mentor Suzanne Clothier, canine body worker Courtney Molino, canine chiropractor Donna Gigliotti, and the hundreds of Seger’s Facebook fans who gave us so much encouragement along the way. Your support means so much. I can’t imagine having gone through this without you.