CASE STUDY: Use of cart in post-op

Maddie Road to Recovery in Walkin' Wheels Wheelchair

4/9/13 – Maddie had an excellent session with Jocelyn this morning and she was joined by Julie who is also a Massage Therapist! She had double the attention and loved every minute of it! She also was fitted with a boot to work at getting her better traction on her left foot which seems to give her problems. It went extremely well, as did the climbing on the bench FIVE times!!! Whew! THAT was a lot of work but then Jocelyn had her hold herself there, with front feet on the floor and rear feet tucked up under her without tilting either direction. That took a lot of strength and was a great exercise.

Here are a couple other videos that were taken this morning:

Maddie 4/9/13 with her new boot on grass: Maddie with new boot

Maddie 4/9/13 with her new boot for traction: Maddie on grass with new boot

Maddie Road to Recovery in Walkin' Wheels Wheelchair

4/6/13 – It’s been a busy couple of months for our Maddie. She has made some great progress, as Jocelyn worked with her and made some changes. Along with the Myofascial Release therapy, Jocelyn also did Electric Muscle Stimulation, working to get the top side muscles to contract, to help the tied down rear muscles to release. It’s worked wonderfully as Maddie’s range of motion in both legs is now normal.

She is beginning to build muscle, and while she still squats as she walks, every day she is getting stronger and her desire to do more is bigger. We hope to take advantage of her natural puppy curiosity and the better weather, by giving her more places to explore in her cart. All of her work isn’t just stationary, as we continue to ask her to naturally push herself.

Maddie Road to Recovery in Walkin' Wheels Wheelchair Maddie Road to Recovery in Walkin' Wheels Wheelchair

On 3/20/13, Maddie was spayed and she again developed an inflammatory response after her surgery. Not as severe as her second surgery, but she still spiked a 102.9 degree fever, that took several days to get under control. We believe it is a reaction to the anesthesia, and are hopeful that she never has to have another surgery again.

Before Maddie was spayed, part of her therapy was climbing up on a bench with a little help and encouragement from Jocelyn. It was actually Maddie herself, who decided this was something important to do, as she became determined to get some much needed attention on the couch, and wasn’t taking no for an answer. So Jocelyn incorporated it into her therapy. Yes we know this may be something her future home may not like, but it’s something we appreciate by how far she has come.

Because Maddie’s ‘habit’ is to balance primarily on her front, and use her rear very little, we added the front wheels to her cart. This allows us to support/raise the front and force her to use her back legs to push. It is important for her to learn that her rear legs can extend, and push strongly to build more muscle. She also needs to regularly place her rear feet firmly on the ground and not tiptoe. With this change, and Jocelyn working on her massage therapy, Maddie now has noticeable muscle tone in her rear legs that has never been there before. We know it’s still going to be a long road to travel, but we are hopeful more than ever, that she will continue to a more efficient movement.

One unexpected thing of adding the front wheels….our smart little girl has also added her own twist. She has learned to ‘fly’ in her cart! When she runs at a fast pace on pavement, she lifts her back feet as she rolls along…. (yes we are working on video of this new ‘trick’) But, while she thinks it’s fun and it IS entertaining, she needs to work those legs. So we are working more on grassy areas, and possibly with some boots to keep her thinking about those feet/legs working. She definitely has challenged our imaginations, as well as educated us on a survivor instinct with a happy attitude.

Milestones of Maddie’s progress comes in the small things. The muscle tie down being gone, the rear feet being placed flat on the ground to push off, the ability to slightly stand on her rear feet, in order to climb up on something, and the straight forward tracking of her rear feet as she walks in her cart, are all great strides to progress. Then there is the obvious visual comparison of the thickness of her knees. They were not normal size, at just 6 months old, each were at least 3 inches wide from side to side, where currently they are no more than 2 inches. To top it all off, the pain she was living with when she came to us, was huge. Now it is nothing in comparison, and we are actually working to remove all pain meds to an ‘as needed’ basis.

Below are some links to video’s we have taken as Maddie has progressed through the last couple of months. One thing to watch for is the alignment of Maddie’s rear stride. Watch where she is placing her rear feet and how she’s placing them with more push on the ground from one video to the next. The large green foam pieces added to her cart are for padding. The one on the rear is because she was backing into things, and we needed to save some walls, but is now removed as she’s gotten the forward gear working well. The one on the side is because her left is the side she favors the most and shifts herself in her cart sometimes. So this helps keep her centered better and reminds her she can’t do that. Of course her happy tail is hard to miss, and her excitement is contagious, so be prepared to smile as you watch her maneuver herself in her cart!

Initial therapy starting with Jocelyn – 1/29/13: Initial therapy with Jocelyn

Working to get her feet under her – 1/29/13: Getting her feet under her

After muscle stim therapy 2/11/13: Post first muscle stim

Maddie after therapy 2/21/13: Post therapy, a little tired

Adding the front wheels:

After therapy 3/5/13 (four wheel drive): Post therapy, four wheels

Maddie outside 3/5/13 (four wheel drive): Outside, four wheels

Below are videos of Maddie walking without her cart. The first one was taken in August of 2012.

Maddie walking without her cart, after therapy, a little tired 2/21/13: Maddie walking, post therapy

It’s not ALL work!

A girl has to play in the snow sometimes!

Maddie Road to Recovery in Walkin' Wheels Wheelchair

1/23/13 – Happy Birthday Miss Maddie! You’re one year old today! A big celebration with extra pizza crust!

To bring everyone up to date, Maddie was examined by her Surgeon, Dr. Docton, last week, and it was determined that both knees are in place and the biggest thing holding Maddie back is the lack of muscle tone, muscle tie down and muscle memory. So to our surprise, Dr. D’Amico and Megan (Veterinarian Technician at Waynesville Veterinary Hospital) arranged for Jocelyn Metzger, OTR/L www.sunshinetherapeutics.com to assess and treat Maddie with Myofascial Release Therapy. Myofascial Release Therapy is sort of a deep massage process of getting the ‘kinks’ out of the fascia (the membrane that surrounds the muscles). The individual doing the release technique slowly works their way over the tight areas and many times works in places that do not look to have a problem but directly affect the big areas. It is sort of like turning the threads into elastic on a tight sleeve of a shirt that’s gotten too small and is holding your arm from being extended. It literally releases the muscle to be fully contracted and stretched.

This technique seems to be agreeing with Maddie, as after the first treatment, we noticed a little more extension on her left leg, which is the one that she favors and will typically sit sideways on.

While a lot of the therapy is done with Maddie lying down, some of it is done while Maddie is in her cart. The photo below shows Jocelyn shaping and holding her leg, so Maddie can begin to understand what it’s supposed to ‘feel’ like in the correct position, with the correct energy.

Maddie Road to Recovery in Walkin' Wheels Wheelchair

In Maddie’s second session with Jocelyn the video below shows her movement in her cart after therapy. Notice her left leg is tracking straight. This is the first time ever, that she has not pointed her toes out with that leg. We know this will be a long process, but are hopeful that we are on the right track to teach her how to use her back legs, and to build enough muscle that she won’t need her cart in order to run. Jocelyn explained it that “we must focus on stability before mobility. You have to have a stable foundation before adding in movement”.

Watch Maddie in her Cart after her second session with Jocelyn!

Jocelyn is working on a game plan for Maddie and some specific steps we can take to keep making forward progress. We are working on getting the muscles on the top of her legs to contract to help take some of the pressure off the tied down muscles in the back of her leg. She is also doing a lot of abdominal, pelvic and hip release, which is a lot of the cause of Maddie favoring her left side. In between each session, we are working on holding her legs in a compressed state for a couple of minutes, then extending them. Which is helping with the release. Jocelyn also started us sitting Maddie between our feet, to hold her in a ‘sit’ position, with her back feet flat on the floor and her knees held against her body by our legs. So she is in a nice normal tight ‘sit’. This is a technique also used for competitive Obedience to teach a dog/puppy to ‘sit pretty’ without it’s legs flopping to the side. Straight sits in Obedience save points, and straight sits in therapy are going to build muscles!

1/13/13 – It’s been a couple of months since our last update on Miss Maddie. She had a wonderful Christmas and on Dec 2nd, she LOVED being center of attention at South Central Newfoundland Rescue’s Annual Christmas Tree Pull at Dull’s Tree Farm near Thorntown, IN. We aren’t sure how many cookies she ate but we’re pretty sure she had her share and a few others. Who could resist a Newfie puppy with her Christmas scarf?

We have some good news and some not so good news. First, after three visits to the underwater treadmill, she had a seroma (fluid pocket) come up on her right surgery knee the end of November. At that time we also notice that her left knee was starting to collapse at times, as seen on some of our video from the underwater treadmill. So it was determined to go forward with operating again, on her left knee as soon as possible. On December 4th she had her second surgery on her left knee and it has been a success, in that her patella is now in the correct position in the front of her knee and has stayed there. It was a little bit of a challenge recovering, as there was drainage that kept the incision open, and Maddie did not like having a bandage on her leg at all. So she was wearing the dreaded cone a little more than she liked, but has come through it in typical Maddie fashion and destroyed the cone in the end.

Now we are faced with some challenges that we’re not sure how we are going to handle. If you ask Maddie, she’s happy and content just as she is, and is down to a half of a Previcox, once a day. She will stay on the Dasuquin and probably the Lubrisyn for the rest of her life. However, she has muscle tie down in the back of her left leg, which keeps her from extending it, and daily stretching over the last month has not helped it. With a visit to her physical therapist last week, we were told she isn’t sure there is much that can be done. So we are on hold with no under water treadmill or therapy at this time.

We will work on getting a video of how Maddie walks without her wheels, as it’s difficult to explain. However, she does compensate for the muscle tie down, by pulling her left leg under her bottom and literally resting her pelvis on the top of that hock. Sort of like a stick, and balances most of her weight on her front. This makes it harder on her front, as she is pushing her elbows out to accommodate the knees being up so far as she is hunched over. She does fantastic in her wheels, and it really does give her the freedom she needs, it’s just not something she can use all the time as she can not lay down while in them.

So…..right now, we are looking into a variety of things to see if we can get Maddie to stretch out and build some muscle as we go. She has another Vet Appointment with Dr. D’Amico, and Dr. Docton on Tues, Jan 15th. to check her range of motion and the severity of the muscle tie down. We are not giving up, and we know that we are fighting a battle that few have ever done. We believe that sometimes the unknown turns people off, but we are prepared to think outside the box. One example of that, is we are considering purchasing or building the front wheels for her current cart. If we do this, we would literally use it to lift Maddie’s front legs off the ground and make her use her back legs to move. It would be a drastic step for her, and we will be taking her swimming again soon, but we need her to mindfully push with her rear legs by extending them. Something that she has never really done and is what limits her ability to succeed in the under water treadmill. This will be key to Maddie making progress from this point forward. She loves to retrieve, so we’re hoping to build that into her activity.

On a brighter note, she’s becoming more vocal in her demands. She thinks it’s her duty to let the neighborhood know it’s breakfast or dinner time, so we’re working on the ‘quiet’ command for our little smarty!

Hydrotherapy for Dogs

11/11/12 – Maddie is such a great puppy! She just keeps going, no matter what life thrusts at her, she takes it in stride and keeps going. After recovering from her other knee surgery and the fever two days later, she seemed to be on the right path to begin more therapy. She finished her antibiotics and we removed the Tramadol, keeping her on her supplements of Dasuquin and Lubrisyn for joint health. Then we changed her from Previcox to Meloxicam in order to reduce the cost. A few days into the Meloxicam change, she started acting lethargic, wouldn’t eat and spiked another fever of 103.7. After several days of her temp going down to normal during the day but spiking at night, she finally responded completely to the meds that Dr. Joe prescribed and came out of the fever. Dr. Joe and his staff were wonderful and took great care of Maddie on the days she spent with them. They did such a great job with her that she would no longer eat her normal food without something special on top, when she came home. However, her excitement for all food, finally prevailed and she decided that all food was great again.

Due to the bloodwork results, we believe most of the fever was caused from another internal inflammatory reaction, probably from the Meloxicam. She responded quickly once removed from the Meloxicam, however we did find that she had tape worms, so that could have been a part of this issue. Yes, just for the record, she has been on a monthly heartworm and monthly flea/tick treatment since coming into our care. She also had a clear fecal check, but as we know, tape worms don’t always show up. She more than likely has been positive since we took her in, so she is MUCH better now. This should really help with her adding a little weight as she was on the thin side. She is still small for an average Newfie of her age, but has really gotten long / leggy and is all of 74 pounds. Given all she has been through, she is doing amazingly well.

Now for the more important information: Maddie’s second knee surgery appears to be very successful. Her knee cap has stayed perfectly in place and she uses that right leg to balance herself and has good extension on it. The problem is, the left leg seems to be giving out again. We will be evaluating that over the next couple of weeks as we believe she may need surgery again, to bring that left knee cap into the correct position. As we mentioned before, sometimes these surgeries for luxating patellas do not work the first time. However, it is definitely better than it was before surgery. We are going to do a few weeks of under water treadmill to see how much we can strengthen her back legs.

Maddie started her first under water treadmill therapy session with Shawn Zimmerman RVT, CCRP at MedVet Veterinary Rehabilitation of Cincinnati, OH, last Thursday evening. Maddie was a little uncertain at first but settled with confident reassuring and great cookies. She will be going twice a week for the next couple of weeks, and we will assess how she is responding.

Just a heads up to anyone still wanting to donate to Maddie’s care. All funds go to her specifically. They are not spent on anything but her Vet care. (Her daily care is covered by her foster home) Her Vets and therapist have been wonderful in giving us huge financial breaks on their bills with the exception of the unexpected visit to the Emergency Center that we were only able to get the typical 10 percent discount for non-profit. She will still need to be spayed and have her cherry eyes fixed, and may need at least one more knee surgery, so if you are doing Christmas donations, please remember Maddie. Thank you for your generous donations to date. Without you Maddie would still be in a lot of pain, and we believe right now, she is probably at least 70 percent less painful due to the surgeries and pain management. She’s a survivor and we’re in this to give her the best chance we can. THANK YOU!

10/7/12 – Well, it was a rough week following Maddie’s right knee surgery. We’ll start by letting everyone know, she is back to her sassy self and doing well again. Her surgery on Tues, 9/25/12 was uneventful, and she came out as expected. However, on Thurs evening she wasn’t acting like herself, and didn’t want to eat dinner. For Maddie that is just unheard of, so the monitoring began.

At 10pm she had a elevated temperature of 103.7 that went to 104.3 at 11:40 pm. So off to the emergency she went, and her temp was 105.3 upon arrival, with her surgery leg very swollen. IV fluids and antibiotics were started along with Hydromorphone for the pain, and she spent the rest of the night there to be monitored. Her temp taken every three hours and reported to us. After several hours it started dropping back down, and x-rays showed clear lungs and the pins/clamps still in place from the surgery. So it was assessed by all the Veterinarians involved, including her surgeon, that her temperature and high WBC, was a direct effect from the inflammation from the surgery. She finally came home at 9 PM Fri night, with a normal temperature loose stool and lethargy over the weekend. The inflammation showily went away, and on Monday, she was reassessed by our regular Veterinarian, that everything was still okay and she is back on schedule.

It was a very scary reaction but not unheard of, according to all the Veterinarians including her surgeon. The procedure calls for cutting into the muscles and leaving them open under the skin to encourage scar tissue on that side, which would help hold the patella ligament into place, due to it being stretched out for so long. The great news is, to see her now, you would not know there ever was a reaction to the surgery. She has one place on the incision that she popped a suture from the swelling that we are working on healing, so she’s still wearing the cone, but she does not let it slow her down! She has become quite the curious little girl who investigates everything!

SCNRescue is VERY grateful for the wonderful donations, as they truly have been lifesaving for Maddie!

THANK YOU!

Susan, Virginia and Leslie

Maddie Swimming with Toy Maddie in Red Life Vest Swimming

9/9/12 – Two steps forward and one step back but Maddie continues to be a happy girl, who loves life. She doesn’t let her difficulties hold her back! The good news is, her level of activity has increased, and Dr. Joe felt that she was definitely improved mobility. The bad news is that (6 weeks post surgery) the patella in Maddie’s surgically repaired knee (left), has slightly slipped back out of the groove. We are all a little disappointed with that, BUT, as Dr. Joe pointed out, and we agree, it’s still MUCH better than that what it was before surgery. The repair to the tibial crest is holding stable, so she is definitely in less pain which is probably why her activity level and strength has increased. One other bit of news that we’ve seen start appearing in the last week or so, is that she has the beginning of cherry eye in both eyes. So we are treating with drops and hoping we can get it to stop to avoid surgery. Otherwise her eyes look good and normal.

After much discussion, Dr. Maury, and Dr. Joe believe it’s important to go forward with the other knee, and we have scheduled that surgery for Tues, Sept 25th. Until then we are going on with full physical therapy to try and build as much muscle as we can in her back legs. So she is being re-evaluated by the therapist this Tuesday so we can get a better baseline going forward. I do have to share that one night last week Miss Maddie shocked me, and was literally running laps through the house! She has NEVER done that before, and when I say running I mean running! She was bunny hopping in the rear and pushing hard with her front, but she was having a blast, playing with her ball. This went on for a good ten minutes and I didn’t have the heart to stop her, and the other dogs just moved out of the way and let her play. It was awesome to see her have normal puppy zoomies, and I would love to see it again, as I was almost in tears! I will be working to get her on video doing it! I suppose it all goes hand in hand with her getting into more
mischief lately by chewing things, so now she’s found even more mobility.

Speaking of mobility…. Maddie went swimming today for the very first time, and it looks like we have a little ‘water bug’ on our hands! She was absolutely adorable and I don’t know who was more thrilled, her or us, to watch her retrieve a bumper and putter around the lake! She was not a happy camper to leave! I think she would have stayed out there forever, if we would have allowed. Please forgive the life jacket being a little too big, but she didn’t care, and that’s what is important. She explored the weeds, and made some new friends. She gained a lot of confidence with our friend Sharon, and her boy Ocho showing her the way. It was a sight to behold and we have a very tired pup tonight.

Swimming Maddie Maddie Sits Near Flowers

8/21/12 – Whew, it’s been a while since we updated Maddie’s journey to good health! She definitely is feeling better as she wrestles with three other Newfie girls. They all have learned to play on her level, but still jump up and run when she gets the best of them by biting their legs!

Overall, we are seeing her use her left (surgically repaired) leg more all the time, where before the surgery, it was the worse and she would sometimes drag her left leg. Now we see her drag her right and use her left one more.

Therapy has been a challenge to say the least, as she does not want to be cooperative. Typical puppy, who fights laying still, but she’s getting better, and her next Vet recheck appointment is Sept 4th. We were asked to keep her from full weight bearing therapy until that time, and have had her evaluated by a very good Physical Therapist, who started her on light weight bearing stretches with warm compresses to start and finish. The Therapist has also prescribed hydrotherapy when Dr. Joe approves it, so we will be making sure she gets that as well. We will begin regular visits with the Therapist in the next week or so, to stay on top of what is needed.

We explored the Cold Laser Therapy, but there is some concern that using it on a puppy could prematurely close the growth plates, so we are adhering to what our Therapist suggests and staying away from it. There still needs to be more studies on this, but we cannot take any chances.

Maddie has been doing lapse up and down the street in her wheels, since we got the new ‘saddle’. This has been a huge learning experience for us and the ‘saddle’ that came with the cart was not the simplest to get her into. She also kept trying to pull her leg up and out of it, so the new ‘saddle’, which is fabric, has made a great improvement. We need one more modification, to the width on the ‘saddle’, which may be just an adjustment to the straps holding it, as it is a bit wide for her frame. Causing her toes to point outward, instead of straight ahead but she is growing so fast we have already needed adjustments to the height and front harness so this will be a continuous thing as we go forward over the next few months.

Like a typical Newfie learning to do Draft Work, and going on walks, she goes much faster coming home than she does leaving. She also does not want to go on by the house, but greeting the neighbors is a great incentive to keep moving, and it’s working wonderfully.

Overall, we are extremely pleased with where Maddie is at this point, and we know this is going to be a long road but we’re prepared to make every step with her.

SCNRescue has been totally humbled by the donations that have come in for Maddie. It is a wonderful thing to know there are so many caring people who have stepped up to help this little girl. We greatly appreciate it, and Maddie is working hard to show you your heart is right!

Thank you!

Maddie in Walkin' Wheels Dog Wheelchair Walkin' Wheels Brace

8/2/12 – Well!! Look who got her wheels and is doing pretty darn good in them already! Her stitches were removed today, and we’re proud of Maddie’s progress. Given all that was done to her knee, we are taking the conservative approach to her recovery. Dr. Joe, wants to wait a month before she starts any real physical therapy, but we are to start massage therapy and stretches, along with cold laser therapy as soon as we can. Her incision looks great and we’re hoping the laser therapy could possibly help with the right knee as well. So we will be exploring having both knees treated, and see how it goes. We can already see that the wheels are going to really help her have some independence and let her use her surgical knee without weight bearing. It will also let her get some much needed physical exercise so she doesn’t get bored. It will be used, sort of like a child’s walker, where they can learn balance and walking with the safety of not falling down. We have set the wheels just so she can toe touch with her surgical leg, since it is a little bent (hence the need for massage therapy), but flat footed with her right leg.

THANK YOU Kim Sedam for taking these photos and the others below!!!! THANK YOU to all those who have donated to Maddie’s care!! She’s a lucky girl to have all of you in her corner, and just so you know….now that she’s feeling better she is exploring more…..shoes are not to be chewed on, and bugs are not to be eaten!!! No matter how appealing they are….

Maddie Smiles in Walkin' Wheels Dog Wheelchair Getting Use to the Walkin' Wheels

Maddie Riding in Style with Walkin' Wheels Maddie in Dog Cart

Maddie Road to Recovery in Walkin' Wheels Wheelchair Maddie Road to Recovery in Walkin' Wheels Wheelchair

Maddie Road to Recovery in Walkin' Wheels Wheelchair

7/30/12 – Maddie continues to do very well! She’s a little frustrated at the moment with her lack of freedom, but that will soon change as she should be getting her new “Walkin’ Wheels” on Wednesday! After way too much time spent trying to get all the measurements required for a ‘custom’ cart, it still was not enough. So it was suggested we go elsewhere, and that is what we are doing. The Walkin’ Wheels are fully adjustable, so we can modify it to Maddie’s specific needs as she grows, and go forward towards her other knee surgery. No need for a second cart as she grows as we can purchase different components if needed.

7/27/12 – Woohoo! Maddie gets her bandage off today! She’s being a VERY good girl as long as she wears the horrible cone or has a nice bone to chew on. She’s beginning to use her surgery leg to push herself around a little, but she has a long way to go. There is a possibility that she will have her wheels in around a week, if we can get everything worked out today with her specific needs. So keep your fingers crossed for that to happen!

7/26/12 – Maddie is so strong! She’s walking with little assistance and balancing with her repaired leg being held almost straight with its bandage that comes off on Friday. She’s one determined puppy, and yes she has the cone of shame as she decided to nibble on her bandage already. Overall, her mobility similar to before surgery, which is a huge relief, as we did not know if her other back leg was strong enough to help support her. However, her front is doing all of the work, supporting all of her weight, making her need for wheels even greater so her front does not break down. Measurements are done and a call to Eddies Wheels is on the agenda today to get things moving asap!! Susan is a member of Queen City Dog Training Club who has a beautiful, fully matted building and will be able to take Maddie with her wheels there, for some air conditioned walks during this humid weather. We will be contacting the local Pet rehab facility to work out physical therapy for when she is released to do more. Right now, she’s hanging out with her cone of shame and big bone to chew on!

7/25/12 – Wow! I just talked to the Vet Clinic and Maddie is doing extremely well! Actually better than they expected after such an extensive surgery. We’ll pick her up this evening and continue on with the healing!

SCNRescue can not thank everyone enough for their kindness and generosity. We received notice this morning that someone is donating the funds to purchase ‘dog wheels’ for Maddie. This will drastically help her be more mobile in the upcoming days/weeks and give her knee time to heal properly and her muscles to get stronger. She’s a fighter!

THANK YOU!

Susan, Virginia & Leslie
SCNRescue Co-Chairs

7/24/12 – Maddie’s did well through her left knee surgery. They have her on some very powerful pain meds and are keeping her at least for tonight. We are to call in the morning to see about her coming home. It’s a wait and see game now if this helped her and if it will hold. Maddie’s Orthopedic Surgeon, Dr. Maury Docton, at Waynesville Veterinary Hospital explained that Maddie had very little groove on the front of her knee for the patella to stay in and slide up and down with the bending of her knee.

One of the things that Dr. Docton explained was that with Maddie, her range of motion, goes beyond the length of the groove, which will still allow the Patella to slide out of the groove. However, with the changes he made in the groove, it forces the Patella to come right back into position. So while this is not ideal, it is MUCH better than what she currently has and is typical of one of the problems with this procedure. A lateral suture was also used, similar to what used to be used in crutiate repairs years ago. This will help give stability to her knee, helping the alignment between the tibia and femur keeping rotation down. Dr. Docton also cut internal muscles going up her leg that will help remodel the appropriate tract that they are all to be moving. This will form scar tissue helping to stabilize her knee even more and secure the proper alignment and patella travel as she moves.

Overall, we know there is a risk that this will not work, or it could fail to hold, but given Maddie’s severe condition, it is important to try and help her.

Dr. Docton literally said he ‘used ALL the tricks in the books on her’, and he actually checked her range of motion and stability at least 50 times during surgery. This surgery is a gradual process, and the Surgeon needs to assess what else needs done as they go through the steps of the repair.

For Maddie, due to her age and the severity of her condition, the muscles were so tight as her bones grew, they literally shaped the bones abnormally to fit where the muscles were pulling them. Sort of like a tree growing in the fence line and bends to the fence as it grows. Fortunately Maddie is still young and we have done this repair sooner, rather than later, so we are hopeful that the changes are not severe enough to cause failure.

Dr. Docton did enough repair on Maddie’s knee to support a 160 pound dog so we hope it’s stable enough for a 60 pound Newfie puppy. Given the repairs that needed to be done on Maddie’s knee, to create such a deep groove for the Patella it required a lot of filing and cutting, so her pain will be similar to a broken bone. This evening and tonight she is heavily medicated and they even put a pain medication inside of her bone to help control it initially.

There is a possibility that she will not put this left leg completely down for 6-8 weeks, so patience is going to be a definite challenge as we go forward looking for progress. We hope she feels it’s more stable and stronger now than before surgery and wants to use it. It will be a minimum of 3 months before we look at doing her other knee.

The cost is a little higher than originally quoted, as it will be ($1100-$1200) due to blood work and the extra procedures that were done, but SCNRescue wants to THANK each and every one of you for your kind donations, thoughts and prayers that have come to Maddie. We have achieved enough funds and pledges to cover this surgery and her next. We have someone who has offered to help us get some Doggie wheels, so we are working on that and Dr. Docton said it would be a very good idea to use them for the first 2-3 weeks as she gains mobility and strength. We are hoping to be able to find some used ones, and when Maddie no longer needs them, then they could be used for another Newfie in need.

Please know, any donations yet to come in, will be used for Maddie’s future physical therapy and water therapy as she gets stronger and we work to get her up on all four feet.

THANK YOU everyone for your donations and well wishes. Maddie has a long way to go but we will be with her every step of the way.

Thank you!
Susan, Virginia & Leslie
SCNRescue CO-Chairs

Maddie Road to Recovery in Walkin' Wheels Wheelchair Maddie Road to Recovery in Walkin' Wheels Wheelchair
Maddie Road to Recovery in Walkin' Wheels Wheelchair Maddie Road to Recovery in Walkin' Wheels Wheelchair

This is how she stands and walks, all the time.
It is a struggle.
She looks like a little kangaroo from the rear

Maddie Road to Recovery in Walkin' Wheels Wheelchair

Fortunately, her hips are really good!

Her knees….not so good!

Right Knee Maddie Road to Recovery in Walkin' Wheels Wheelchair Maddie Road to Recovery in Walkin' Wheels WheelchairLeft Knee

Both patellas are laterally luxated out. They are never in the groove on the top of the knee, and Yes, the tibial crest on both knees are separated. That is what is causing that groove in the front of her knees (bottom of x-rays). She also has large bone chips in the back of both knees.

7/21/12 – South Central Newfoundland Rescue does not know for sure what caused Maddie to be like this, but genetics and environment had to both play a part. She came from a rural Animal Shelter three weeks ago, in southern Indiana on the Kentucky state line. Maddie is a sweet, happy girl that deserves a chance to function as close to normal that we can get her. It is our hope that with knee surgery and the proper rehab, she will be able to stand without pain. She does not let her current physical limitations deter her from trying new things. We have a wonderful Orthopedic Surgeon, Dr. Maury Docton, who is willing to donate his time and Waynesville Veterinary Hospital with Dr. Joe D’Amico who is offering their services at a reduced rate, as nobody wants to see this little girl put to sleep. If nothing is done, she will eventually break down on her front and will not be able to walk at all, so we have to try.

Currently South Central Newfoundland Rescue funds are low, due to a lot of our Rescue Newfies needing major medical care, so we are asking for the publics help for Maddie. First is to fund her first knee surgery which is scheduled for Tuesday, July 24th and the minimum cost for one knee is $800. Secondly, we would love to get her some ‘Dog Wheels’, and anything used is perfectly fine. It is our hope that as Maddie rehabs from surgery, that we can adjust the height of the dog wheels for her to begin using her back legs in a more natural position, in hopes that the muscle memory can be retrained for future use without help. Of course there will be physical therapy, swim therapy, and anything else we can do for her.

Maddie is a VERY good puppy, and has good control of bodily functions, so we are doing normal puppy potty training at this time, but are expecting some setbacks with surgery. She loves to chew bones, and loves kids/people. She has had to be sedated for her x-rays because she is so happy and wiggly that she won’t stay still. She does have a soft heart murmur, grade 1 of 6 and it was found that she has a dilated aorta. The Canine Cardiologist at Ohio State University told us that it should never effect her in her life, and has cleared her to have her knee surgeries with no restrictions.

Currently, Maddie is on Tramadol and Previcox, to control her pain. She is proving that better living occurs through pain management, but we would like to see her not need them at all. Please, will you help us, help Maddie.