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Kwali's Knee Journal

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I'll post updates as I'm able; sometimes, I get very busy, of course, attending to Kwali, but also, to Kumbi, and even sometimes to Prancy The Cat.

Red-Hock Bandage Change

Saturday, 9 Jul 2005, 20:55

Since the new Red Hock-bandage was attached with adhesive tape to Kwali's skin and hair - a standard technique to keep bandages on dogs from slipping - Kwali has been increasingly uncomfortable with her new bandage. She was in obvious pain when I tried to put a sock over the bandage to take her out. Her communications were very clear. Also, she was avoiding taking any weight on the leg or paw, and I finally realized that the tech had remarked, "She may take a while to discover again that she has a leg," and that I'd taken that as a signal not to be concerned. But it's uncharaceristic of either of my dogs to restrict themselves more than necessary, and by early this morning, I realized that Kwali was feeling pain if she put any weight at all on the paw - and that it was almost certainly the pull of the tape on skin-and-hair that was causing the pain.

The only way I could confirm that was to notice Kwali beginning to chew at the adhesive tape. Sometimes, I am really slow.

Therefore, early this morning, I put Kwali on the Grooming Table. She was shaking in unhappy anticipation of more pain, but allowed me to work on her anyway. It took me about half an hour to soak and pull the skin-and-hair away from the tape, sliding a swab soaked in mineral oil along the edges of the tape, then working my way under the tape. Kwali shook part of the time, but began to relax after I'd been working for a while. Once or twice, I reached an obvious sensitive spot,as Kwali flinched, and sometimes gave a very light grumble-growl and gestured toward the source of pain. When that happened, I laid off for a bit, to give her time to recover, and then changed my angle of working on the tape. I've made similar adjustments when trimming nails, and find both dogs very responsive to my adjustments; they continue to cooperate as best they can.

Once I got the old bandage off, Kwali practically sighed with relief. She allowed me to apply a new pad-with-cream, gauze, VetWrap, and tape over the wrap (not on skin-and-hair!) without any fuss at all, lying cooperatively quiet while I worked on her leg.

I lifted Kwali off the table, and tethered her to her wire crate on Our Bed, and she sank into the pillows, and rested in very obvious relief. I can't imagine a larger reinforcment for my attention and care than Kwali's obvious pain-relief and settling thereafter. For the rest of the day, she allowed me to put a sock over her bandage to take her out without any fuss at all, and she began to take a little weight on her paw, which was when I realized that the tape had been preventing her from doing that before.

Of course, once I was finished with Kwali, Kumbi insisted on having a turn, so I put him up on the table and trimmed his nails, and that satisfied him that I loved him as much as I love Kwali.

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Kwali gets a Red Hock

Friday, 8 Jul 2005, 04:10

We went cheerfully to Saseenos Veterinary Services yesterday, me expecting to get Kwali's bandage completely off, and so free of putting on plastic booties every time we go out for elimination-excursions, every time it rains or we get some dew in the early morning.

As we walked in the parking lot, a young man with a young field-bred Black Lab came out of the clinic. The Lab was unleashed. He ignored his human's repeated commands, and came playfully up to Kwali, though I'd asked the man not to let his Lab do that.

"My dog is friendly," said the young man.

"Mine isn't," I said.

But it was too late anyway. This utterly charming young Lab danced sweetly before Kwali, he was hardly twice as big as she, of slight build, leggier than the Show-Bred Labs. A puppy, still, really - six months old.

As the Lab came up, since we had no choice, I made sure Kwali's leash was loose, and we both, Kwali and I, used calming signals with the Lab, who returned them, if a bit rapidly. But Kwali knows rapid calming signals; uses them a lot herself. So, apart from some slight dancing on her still-bandaged leg, the encounter went delightfully. Kwali is by no means always friendly, but thank goodness, she still had the support of the Robert Jones bandage, and she used all her wisdom and sageness, coping with this young Lab.

Too bad I didn't get the Lab's name. I like to know names of lovely dogs like that. The owners are not planning to enter their dog in trials. I was glad to hear that, considering how the training usually goes for trials.

Kwali was her usual wonderful self as Nancy the Tech removed her bandage, cleaned up the pressure sores (ouch!), applied a light, this time, red, bandage to Kwali's hock, and treated the abraded pad.

During the procedures, we heard yodeling from the back, a dog, afraid. I asked who that was, and Nancy confirmed, it was the young Lab - afraid of the blood draw. Poor Labby! It's scary. I expect he'll recover, and gradually learn things aren't that bad for that long. Although I thought the Lab's owners, man and woman, could use some additional information, they handled their Lab quite nicely, and I believe he has what qualifies with me as a really good home. Lucky young Lab; lucky young Lab-keepers. This was a nice touch in our day.

I did notice that Kwali tensed up a lot during the Lab's yodeling. She responded to the sound of fear. Nancy Reinders, being the fine technician and animal-handler she is, simply let up on Kwali for a bit during the yodeling, just pausing a few moments, and then going ahead with the procedures. Kwali relaxed again, as the yodeling had stopped. I could feel all this in her body, as she was leaning against me. Dogs are such wonderful animals, and will trust to their depths, given the opportunity and encouragement. Thanks, Kwali. Thanks, Nancy.

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Sunday, 3 Jul 2005, 11:45

Kwali and Kumbi and Prancy and I have gradually developed BandageTime rituals and routines together. We have about five days of BandageTime left, assuming all goes well, and it looks as though all should continue well, providing all of us can maintain our equilibriums.

Kwali sleeps in her BedCrate at night, with the door shut, and Kumbi lays himself across the crate door, maybe as a kind of Guardian. I (Mum) sleep right next to the crate. Prancy has taken to coming up on the bed and sleeping between my knees, so I'm surrounded by my animal companions.

Kwali thanks Auntie BraySing for her Bracing thoughts on crating, which she quite agrees with. Kumbi does also; he says, "Crate are fine, if I can see out in all directions and I'm right with my family.

Daytimes, Kwali spends much time on the couch, tethered to its back. Kumbi goes outside in nice weather for a time, doing his Sentry-Stuff on the Front Stoop. Kwali and I join him for little on-leash excursions, for elimination and various short diversions, except when Kumbi chases Mister Mousie, at which time I need to remove Kwali from the scene, as it's too much for her to try to resist chasing Mister Mousie also

Kwali and Kumbi are, meantime, entertaining themselves by carrying on more conversations about the Stinging Mantra. I listen in when I can, as I quite enjoy their conversations.

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Saturday, 25 Jun 2005, 19:10

Kwali's toes disappear again

Kwali got a new Fat BlueLeg today, after Kumbi expressed his urine - oops - his opinion - last night, on the RedLeg. At first, I thought Kwali had peed on her own bandage, but as I reviewed events in my mind, I realized that it had been Kumbi, who tends to cover Kwali's pee-spots.

That's right; I wasn't fully attentive, and so only half-noticed, and was at first surprised to discover the wet spot - not large, but possibly significant, on the lower inner aspect of Kwali's RedLeg bandage.

The wet spot wasn't large, but we couldn't risk irritation nor weakening of the support by wetness, so in we went today for another bandage-change.

Such trips are stressful for the dogs, but they do fine; they only need some extra rest afterwards.

Dr. Kim Beare did the bandage honors today. Thanks, Dr. Kim!

Thursday, 23 Jun 2005, 18:40

Kwali's toes appear

With Kwali's bandage-change today, her toes are now exposed. I'll need to watch that she neither wicks nor licks excessively. Dampness could wick right up into the bandage, for instance, in early morning dew, so elimination expeditions may require that I enclose Kwali's bandage in a bootie.

I'm pleased that Kwali is starting to take weight on the leg, just a tiny bit. After two weeks of having to drag the leg because the bandage was so long, she can now cope better, with the bandage somewhat shorter, and the toes exposed as well.

We'll have to see how all this goes.

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Saturday, 18 Jun 2005, 19:40

Kwali progresses

In our family, each member helps another as best we can. So as Kwali needs extra help right now, I ask her how I can best help, while we follow instructions from the vet.

Over a period of several days, Kwali told me the Cephelexin (antibiotic) I was feeding her was upsetting her tummy, even to the extent that she began refusing food. This is very unlike Kwali. Finally, Thursday (two days ago), after I urged her to eat and she made a real effort, she lost her supper short of an hour later.

When I phoned the vet to check, indeed, they thought likely it was the Cephelexin upsetting her tum.

So I discontinued it. The next morning (yesterday), I drove to the vet's, taking Kumbi along for the ride, while Daddy George kindly stayed the morning, to see to Kwali's well-being.

Saseenos Veterinary Services was wildly swamped when we got there, so I had quite a wait, till things calmed down enough for Dr. Amanda (Booth) to prescribe. She ended up saying she thought Kwali would do all right if we simply discontinued the antibiotic altogether, so that's what we did, and Kumbi and I came home to find Kwali in good condition, naturally, under George's care.

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Crating, Penning and Tethering

Like most North Americans, I believe in acclimating dogs to being crated or penned. I draw the line at tethering; I don't like what I call "dead" tethers; that is, a tether that doesn't have a live human at the end away from the dog.

Kwali and Kumbi, both second-hand dogs, came to me already crate-trained; in fact, it was I who, some twenty years ago, introduced crates to my breeder! Ever since, my breeder has used crates with her dogs.

When Kumbi had his cruciate surgery last year, he accepted being crated or penned for the entire twelve weeks required. Kwali, though, finds it too difficult, so, in consultation with her, I've tried first live, then dead, tethers, to allow her some time outside crates or pens.

Last year, Kumbi learned to cope with a dead-tether in the car, because Kumbi-with-bandage wouldn't fit in his car crate. So I tethered him instead, for car rides, till the bandage finally came off after four weeks.

Kwali is enough smaller so Kwali-and-bandage do fit in her car-crate, so she escaped car-tethering. At home, though, I tried dead-tethering Kwali to her Bed Crate, so she could lie on the pillows at the head of the bed, where she's accustomed to resting. This worked out very well, since I can supervise even from my computer-chair, or, also, I can lie down on the bed with her and supervise that way.

Kumbi is ever so gentle and sweet with Kwali. Does he remember his ordeal last year? Surely he does. Above all, though, he and Kwali are good buddies, and when one is in distress, the other typically attends, and does all possible to soothe the other.

Kwali has very demanding groans and grumbles she uses when she wants something very badly. Should I jump to fulfill her requests? Well, why not? As I mention in my article A Dog's Real Needs, a dog whose needs are met is a well-behaved dog. So, if I can jump to meet a dog's needs, I do that. And sure enough; if I've been sensitive and observant enough to guess correctly about what Kwali wants, or needs, she quiets right down when the need is met.

So, last night around 8:30 p.m., Kwali asked to go to bed. She had been resting in her Wheel-Crate, which is Kumbi's crate, lashed to a chest on casters, but she often sleeps ten to twelve hours at night, so I tried moving her to her Bed Crate, and sure enough, she quieted right down and fell asleep.

And as I write this, it's not even quite 7 p.m.; yet Kwali groaned at me, and because she's had her supper, been out, had a variety of resting-places this afternoon, I moved her to her Bed Crate despite the early hour. And sure enough, she has gone to sleep, in minutes. Kumbi moved up to rest beside her. Sweet, sweet Kumbi. Clever, demanding Kwali.

P.S. Twenty minutes later: Kwali grumbled again. Oh! She needed to go out. So I took her. What could be eaiser?

Since it's still a bit early, I now have Kwali tethered to the couch, so she can lie on her tramp bed, now in the open, instead of hidden under Our Bed.

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Tuesday, 14 Jun 2005 11:00

Kwali and I work out crating procedures

For the first couple of days after I brought Kwali home, I helped her lie down in the crate, and also, later, outside the crate, on the quilts and pillows at the head of Our Bed.

The Fentanyl patch was keeping Kwali far more comfortable than Kumbi was last year, when he had knee surgery, but it doesn't stop the pain entirely, and I could see from Kwali's panting and restlessness that she was having some pain, sometimes worse than at other times.

Lying down with her bandaged leg propped up on quilts or pillows seemed to help quite a lot. I also applied some simple TTouch (Tellington Touch), which is well-known to help relieve pain and calm an animal.

While she was out of the crate, I tethered her to the crate by her leash. I haven't taught my dogs specifically to be tethered, but Kumbi adapted beautifully to it last year, and Kwali has also done so. Under duress, my dogs do well; I believe it's because we commmunicate, and essentially, my dogs trust me to do all I can for their real needs: safety, health and comfort, in that order.

Kwali complains loudly at being crated

Somehow, the last couple of days, I was making errors. Kwali complained loudly. She panted and nested, digging up quilts in her crate, she yodeled and panted more.

How could I have forgotten about changing conditions, timing, and needs to adapt to current conditions?

Well, I hadn't, really, it's just that my guessing was pretty poor.

I had put quilts or pillows in Kwali's crate, having attributed to her a love of nesting, and of lying luxuriously in the soft padding.

Also, the first couple of days after coming home, Kwali appeared to appreciate having her crate covered.

But as Kwali felt better, she began not to appreciate having the crate cover on, so finally, I took it off, and she quieted some, just as she had quieted before when I covered the crate.

She still had problems with the quilts or pillows, though; she would dig and nest, lie down, sit up again, dig and nest again, whine and pant, and then begin yodeling.

Once she yodeled for an hour, practically non-stop. This was too much, and I told myself I was being a Bad Dog-Mom, so I went and applied TTouch. That helped a lot.

I am careful with Stinging Mantras, so although I ignored the yodeling, I considered what it likely meant.

This morning, I removed all pillows and quilts from Kwali's crates. Suddenly, I have a quiet Kwali! She is much more comfortable today. Maybe part of that is improvement, less pain, but part of it, also, is that I have managed to meet her needs better than before.

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Saturday, 11 Jun 2005, 08:40

Day Two is probably the most painful

Kwali had a bit of a tough night from midnight on, visible in her panting and restlessness. She couldn't seem to get comfortable. All the same, she wasn't nearly as badly off as Kumbi was when he had his cruciate surgery last year; it's clear that Fentanyl patch on early, the night before surgery, makes a big difference.

Predictably, Kwali made several attempts to get under Our Bed; at least, she gestured in that direction.

So this morning, I put the sturdy cover over her crate - the real one, made for the purpose. The quilt I'd put over it last night wasn't sufficient to keep light out from my bedside lamp. When I put the cover on, Kwali settled right away.

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Friday, 10 Jun 2005, 22:00

Kwali comes home after surgery

Picking Kwali up at the vet's was uneventful. Kwali didn't want to walk even one step. Just as well; I'm to carry her for elimination duties. She's not to walk for two weeks - till the bandage change two weeks from now.

I'd prepared a tether in the car, in case Kwali-with-bandage wouldn't fit in the crate, but it wasn't necessary, Kwali-with-bandage did fit into the crate.

Arriving home, I set Kwali down gently inside my double-baffle gate; George and Kumbi on the inside-fence-side; Kwali and I in the channel between the two gates. George was armed with treats, and I took some, and he fed Kumbi a couple, and I fed Kwali a couple, and the two dogs went nose-to-nose, ever so gently. Kumbi is such a gem - a real sweetie-pie. He's been supervising the activities for two days, and I'm sure he knew Kwali was coming home.

After the dogs had greeted each other, I picked Kwali up again, opened the gate, and went in, turning my side to Kumbi, so as to split-up the two dogs. Luckily, Kumbi isn't one of those who jumps up at dogs-in-arms - at least, not if it's his Good Buddy Kwali who is in arms. Kwali would do so, and did the day Kumbi tore his cruciate last year, but I used a splitting-up maneuver then, which stopped the action instantly.

Kumbi donates his livng room crate

Kumbi donated his living room crate to Kwali for the duration of her confinement, accepting the use of Kwali's tramp bed instead. The tramp bed is over 45 years old - an aluminum frame with canvas covering it, rather trampoline-like. Usually, it lives under Our Bed, and Kwali often sleeps there, especially when she's hurting, as she's done quite a lot in the last few months.

I helped Kwali into Kumbi's crate. She went in easily, and immediately settled there; I added a couple of towels for a combined padding-and-nesting. Kwali lay down and propped her bandage on one of the towels, lying against the other. Kumbi watched, nosing up close to the crate a few times. George sat on the couch just above Kumbi-now-Kwali's crate, and as direct sunlight was on the crate, and Kwali looked uncomfortable, George covered one end of it, blocking out the direct sunlight. Sensible George, grateful Kwali!

I fed the dogs about half an hour later, putting Kwali's Metacam in her food, and following with her Cephelaxin dose, also in food. Kwali neatly extruded the caplet, so I merely reached in through the open crate roof, and popped it down her throat. She was backed into a corner, so couldn't avoid it; therefore, she cooperated nicely.

Before long, Kwali asked to be taken out, so I helped her into the Potty Pen. She was prompt in doing her duty, and I took her back in to settle once again in the crate.

A while later, Kwali asked, definitively, to get up on the couch with George. We decided to allow this, as she clearly had no intention of going anywhere; she wanted a cuddle with George. Cuddling went really well. Eventually, as George and I sat down to a very late supper, I helped Kwali back into her crate, where she remained comfortably, and she's still comfortable there as I write this.

This is a huge contrast with what poor Kumbi went through with the same kind of surgery; he was in severe pain for days thereafter. Having the Fentanyl patch applied the night before surgery is, I believe, what made the difference.

I'll take Kwali out again in an hour or so, let her pee, and then help her into her crate - her own crate this time, which is on Our Bed; where else would it be, when she is so confined?

George and Kumbi have gone to bed, really tired. George mowed the entire driveway (tall grass) today, after the very strenuous awning work yesterday, and he also cut back a lot of brush. Kumbi worked just as hard, with all his supervisions and assessments.

It's good to see Kwali really resting. Of course, it won't be long before it will be hard to keep her quiet. I'll cross that bridge when we come to it. I couldn't do this without crates.

Kwali feels well enough to thank those who are providing many kinds of assistance. She says good night to all, and I say the same.

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Thursday, 9 Jun 2005, 20:10

Dr. Amanda Booth operated on Kwali this morning. She said indeed, the cruciate ligament was torn right through. She said the condition of the joint wasn't too bad. She cleaned out the fragments, and put in the stabilizing sutures. When I have time to look it up, I'll post a link that shows something about the method she uses; it's called "Modified Flo lateral imbrication."

I phoned around noon, and the techs said Kwali was already sitting up and watching them! They have kennels in the main backroom area, next to the operating room, where they have a couple of tables on which to treat animals, and monitor their recoveries. They're so well set-up!

They said I could phone as often as I like. I phoned again around six p.m., to a report that Kwali was doing really well. Dr. Amanda took the time to talk to me again, and she said something about Kwali's "energy level." I know all too well what she means. Kwali was running on the knee yesterday; when she gets excited, she doesn't care what hurts or how much it hurts. She just goes.

This means I will need top-notch precautions in place to prevent Kwali from overdoing things.

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Daddy George does a mammoth job on rain-protection

Daddy George came today and found me sleeping. I woke up, of course! He stayed with Kumbi while I went on my weekly hunting expedition to bring home the family basic-foods.

While I was out, George wasted no time. I came back to find he'd laid down lovely substrate in the potty pen, reconstructed the pen-arrangements to make a wonderful gate to prevent dogs from shooting out and away from the Front Stoop, and he was most of the way through constructing a set of awnings to keep rain off the Front Stoop entirely.

He worked another couple of hours, fine-tuning a set of awnings. Meantime, Kumbi tested the new substrate in the potty pen, and approved.

I'll probably be bringing Kwali home tomorrow afternoon. Once I get her and Kumbi settled, with George's help, as he's staying an extra night, I'll try to post another update.

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Wednesday, 8 Jun 2005, 21:20

We went out our double-baffle gates, and as the dogs began to pull - after all, they haven't had a walk for a week! - I was planting my feet on the wet, slippery grass - but I got fooled. George had mown the grass a few days ago with the weedeater, and hadn't had time to rake the loose grass up.

I slipped, and fell on my bum, falling backwards, my feet shooting forwards out from under me.

Luckily, I fall well, despite my age, but I did seem to tear a few muscle fibers under my right shoulderblade. It's not too bad; we'll see how I feel tomorrow and the next day. Darn; I need to be in shape to lift Kwali.

On the rare occasions I fall, as a matter of principle, I just lie there for a bit, assessing the damage, if any. Invariably, the dogs turn and come back to me; there's no tension on the leashes at all. What is it about dogs? Well, you people, I believe, understand this.

Other than that, we had a good trip to the vet's, 40 minutes' drive away. Both dogs stress on car rides, so I took Kumbi out first, as he hadn't defecated before the ride. Sure enough, he had been desperate, and did his business without delay. Then I crated him, in the car, and took Kwali out. Though she had defecated before we left, she also did, so she should be set for a comfortable evening and night at the vet's.

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Fentanyl Patch

Dr. Amanda agreed to a Fentanyl patch, which will be applied tonight. Surgery is first thing in the morning, which probably means anywhere from 9:30 to 10:00, allowing for preparing the operating room after rounds, scrub-time, and the like.

Debbie DeskWoman, as I call her, the very simpatica Office Manager, said I could call around noon for recovery news. That's perfect, since I leave at 12:30 to take my neighbor shopping, and do my own weekly shopping. I won't have time to post an update till late afternoon, but will try to do so then.

Signing off for now on this report, probably back tomorrow with recovery-news.

  -- Carol

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Knee Surgery for Kwali

Kwali is scheduled for surgery to repair her torn right cranial cruciate ligament on Thursday, 9 Jun 2005.

Dr. Amanda Booth, owner of Saseenos Veterinary Services, Ltd., will do the surgery, with one or more of her staff assisting. She will use the method called "Modified Flo lateral imbrication."

I have been a client with Amanda for many years; she is truly a great vet, and I have no fears concerning medical care for Kwali. She's in the best possible hands.

Preparations are in order and going well

Dr. Kate Fulkerson told me, last year, when Kumbi had such terrible and destructive pain after his surgery, that the method of choice for pain relief when considerable relief seems likely to be necessary, is to apply the Fentanyl patch the night before the surgery.

So when I was picking Kwali up last Friday, after her exams, I requested that one be applied tonight. Debbie the DeskWoman (office manager) said it was up to the vets to make that decision, so she herself couldn't just accept the request. So I said, "Well, I'm the client." And she said, yes! We had a good laugh over that one!

I added, of course I leave such decisions to the vets, especially, to Dr. Amanda Booth, who has such high qualifications besides her gentleness and very strict managing so that she only gets wonderful vets to join her practice, and instructs staff all-around, so the techs are equally great, down to the people who clean the kennels.

Debbie just phoned and said Kwali will indeed have the patch applied, tonight. She'll have a nail trim too, cutting the nails back as close as possible. They're sort of half-trimmed now, because Kwali has such a bad history with nail-trims, and I don't dare nick the quicks. It's six years or so since I did, maybe seven, and Kwali allows me to trim nails, but I leave them a bit long.

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