Ahi's Shoulder - Should we do surgery this time?

BradA1878

Well, Ahi has hurt her shoulder again. Do you think we should put her through the surgery to fix it this time or try the "natural route" again?

Obviously, the "natural route" will probably mean this is a reoccurring injury as that seems to be what is happening this time.

The surgical option might not make this issue reoccurring, but it would require more recovery time for her and yet another surgery (she's already had 4 surgeries in her life).

I guess my question is, do you guys think there has been enough of a break from her last 3 surgeries to do another one? I just can't make up my mind on it. I hate that she is injured like this again. (

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tjbart17

Fill me in...Ahi's shoulder is popping out of place and they want to surgically make sure it stays there?

BradA1878

About 2 years ago Ahi tore one of the muscles in her shoulder. She did this shortly after she had gone through 3 knee surgeries. The options for her shoulder were to let it heal naturally, which would take longer but be less restrictive on her, or have surgery done to fix the shoulder.

Due to how hard the knee surgery recoveries were on her, we didn't want her to have to go through another surgery, so we went the "natural route" - you may recall her "fancy pants" (basically a hobble) that she wore for 6+ months. She healed and has been fine until a week or so ago, out of nowhere, she started limping again.

So now we are faced with the same choice - surgery or natural.

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sunyata

Well, in all honesty, I would look at the surgical route. This seems to be a recurring injury with her, and no one wants to see her in pain. If this was a one time injury, I would absolutely go with the natural approach, if feasible.

However, since this is not the first time she has had this injury, I would look very seriously at the surgical route. If an orthopedic surgeon (or whatever type of surgeon you choose to go with) feels very strongly that they can fix the problem permanently, then I would go that way.

Other than this, Ahi has been healthy for over a year, correct? If she is otherwise healthy and the surgery will correct the problem (instead of a temporary fix), then choose the surgery. She is a tough gal and will be okay through recovery and rehabilitation.

Hope this has helped... This is the approach I would take with either of my dogs and even with myself. Good luck, and give Ahi some hugs from us here in VA!

dlroberts

Are you sure this is the same injury as before? I wouldn't rush to surgery for her. She's a tough dog and seemed to bounce back during her natural recovery just fine last time. Furthermore, she's been symptom free for 1.5 years. I'd give her some time to recover and see how she does. If in a few weeks she's not significantly improved, then I'd think about surgical options. Having gone through a surgery recovery with Lucy, I know it's no fun for anyone, dog or human.

StaticNfuzz

What was the cause of her shoulder instability last time and what did they find on the x-ray? As Dave asks are you sure it is the same thing and on the same side? It could also be a carpal injury.

What a tough call. If it is medial shoulder instability and she snapped a piece of elbow you don’t want that rolling around under ligaments shredding them. However, if she merely has strained herself then going in for arthroscopic surgery is going to be a large cost to only explore where the irritation is. What did the doc say the last time around? What are the abduction angles at this point vs. last time after rehab was finished?

You probably can order a second set of the hobbles from the company and get her in them now and see how it goes along with getting some radio freq treatments.. It will take 16 to 24 wks either way. Overall the recovery from surgery is pretty good if done with laser and they remove the loose chip, if that is actually the issue.

Those bold active dogs often require a lot of managing to keep them from over extending themselves. We were told that continued range of motion exercises are a must in preventing recurring of muscle strain and to keep full rotation flowing. Usually there will be crepitus inside the joint after surgery regardless. If they hear popping and clicking now when you take her in, know that it she is building up some calcification and maybe there that has been something going on for sometime. The range of motion and determining how restricted she with abduction measure may help you come to a better conclusion.

Snf

tjbart17

I'm with Dave on this one. Unless that muscle was so important to holding the shoulder in place, then I would go the natural route right now and wait a little bit. Ahi is still relatively young and is healthy. I would wait a bit.

I wouldn't wait if the muscle holds the bone in place. One of my friends recently tore a muscle that actually holds your shoulder straight in the socket. Without it, the bone has moved sideways in his socket, limited motion, and is quite painful. He needs surgery to correct it because nothing else will. If Ahi's case is as serious as this, then I would do surgery right away.

Boy I have a knack for rambling.

shibamistress

I don't know what I'd do. It often depends on money, too, unfortunately--what I can afford and not. I guess I'd tend to wait, myself and see how it goes. My vet thought Toby would need surgery for his luxating patella because it looked bad for awhile, but now it's slipping much less and doesn't seem to bother him at all, and last time we checked it out, it looked much less bad that we'd initially thought.

Mostly, I'm sorry you're having to deal with this, and I hope she's ok.

Edgewood

I am with Dave and Snf here. I would try and determine what the cause was first, and then, if possible, try the noninvasive treatments.

sunyata

Oh yikes... Guess I rushed to answer... I was assuming that this was the same injury that she had last time... If it is, then surgery may be the best route, if they can guarantee that it will correct the problem and not be a temporary fix.

Either way, I think seeing an orthopedic vet would be the best bet right now to determine if it is the same injury. If it is a different muscle (or other connective tissue) that is damaged, then maybe waiting to see if she can heal on her own would be best.

There are so many different situations, it is really hard to say what the best course of action will be.

Either way, I hope she is feeling better and will bounce back quickly, no matter which course you guys decide to take.

BradA1878

Thanks all for the input. I am assuming this is the same injury too, as the vet here has not found anything wrong which is the same way it went with her shoulder last time.

Obviously, we will get her to the ortho vet and get an official diagnosis before making a final decision...

I was just curious what everyone thought about her having yet another round of surgery.

Ahi is young, only 4 years old (turned 4 last week), so she has lots of time left. Sarah ( @TeamLaika ) gave me a call yesterday and we discussed things. She made a point I had not considered: Ahi is probably using her front-end more to offset any discomfort that is caused by her knees (and she mos def has discomfort back there) - which makes her front-end a bit more important in the long run and therefore makes me think a surgical option, assuming it has a good result rate, is something to really consider.

I really appreciate all the input, this is exactly what I wanted: a brain dump from all of you on what you would do. There is always an aspect that I miss when I look at the situation since I'm so close to her situation. Thanks all! Keep the thoughts coming! )

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Answers to your questions...

Other than this, Ahi has been healthy for over a year, correct?
>> Yes, she has been healthy for over a year save for the random cracked toenail or bruised pad (which is an everyday thing for our dogs here).

Are you sure this is the same injury as before?
>> No, we are not, but all signs seem to point that way (like nothing on xray to point a different direction)

What was the cause of her shoulder instability last time and what did they find on the x-ray?
>> A torn muscle in her shoulder, that was diagnosed by sedating Ahi and doing a range of motion test which concluded that Ahi's right leg could be moved outward further than her left - which says the muscle was either torn or stretched.

As Dave asks are you sure it is the same thing and on the same side?
>> Not, not sure, but pretty sure.

What did the doc say the last time around?
>> We had the option to do surgery or let it heal naturally. We let it heal naturally tho I am not sure it ever healed 100%... and now it seems to have come back.

What are the abduction angles at this point vs. last time after rehab was finished?
>> LOL... Doing a test like that on Ahi is not easy. She'll have to be sedated when we take her to the ortho vet. With Ahi, you test to see if she growls at you more when you do "x", if so then that may be the area she hurts. LMAO

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Leonberger

If it is the same injury, and if there are guaranties it will dramatically reduce her chances of a relapse, I'd go with the surgery.
I see it as better to stop for (for example) 6 months once than 3 months for 3 or 4 times, one / one and a half years apart.

I think the compensation thing is a good thought too.

BradA1878

This week we had Ahi on a pretty strict confinement schedule (filled with lots of raw bones and bulley sticks) to try and reduce the risk of her making her injury more serious.

Well, after a week of that she is no longer limping. I'm not convinced she is completely better, but maybe there is hope that, with added rest, she will improve even more.

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dlroberts

That's great to hear man! I really hope she was just messing with you guys.

JessicaRabbit

Miko was having a shoulder issue if you recall. She was put on super limited exercise and no play for six weeks and she fully recovered. Her shoulder issue was related to a bone spur apparently.

StaticNfuzz

Jessica out of curiosity how did you discover the bone spur? Did you have anything major done to remove it?

Snf

sunyata

YAY! Glad to hear Ahi is doing better. Hopefully she will continue to improve with no more relapses.

JessicaRabbit

Weird. I swore I responded to this.
As soon as Miko's limping lasted longer than two day I scheduled an appointment with the orthopedic surgeon that I am so fond of. He took numerous xrays and actually saw the spur on one of them. The issue really was that Miko had a soft tissue injury that left her muscle tissue inflamed and it was rubbing against the spur. Once we got the inflammation down, she was fine. We did however limit her activity for a number of weeks.

BradA1878

Well, now she is favoring her other leg! So, I see an ortho vet visit in our near future.

dlroberts

Oh geez. Silly Ahi. Always has to make things difficult. :-/

Maybe she strained the other leg because she was favoring the injured one? I know I've done that in the past with a sprained ankle causing some soreness in my good leg.