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Well wishes from the 4th graders at Eastgate Elementary in Kennewick, WA
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Concerned animal lovers from across the country are interested in the health care of Chocolate, the injured 18 month old Chesapeake Bay Retriever featured in a number of Tri-City Herald articles starting February 5, 2008.
Read the Tri-City Herald articles:Watch the video report on KNDO/KNDU on Wednesday, February 6, 2008. Select "Injured Dog Receives Much Needed Surgery. "
Chocolate is now in the care of Meadow Hills Veterinary Center, which is coordinating his treatment.
We'd like to keep you informed on his progress and future.
Dr. Martinez has forwarded before and after X-rays of Chocolate's left leg to show the results of Monday's surgery. In the pre-op pictures, you can see that Chocolate's foot is angled out to the side, rather than lining up in a straight manner with the rest of his leg. In the post-op X-rays you will see this angulation has been corrected. Dr. Martinez had to make a cut through the tibia to make this correction. The bone plate will hold the bone in place as it is healing. We are all very optimistic that this surgery will improve function in Chocolate's left front leg.
Questions:
The abnormal appearance of the bone is due to a healing process called callus formation. The body deposits a large amount of new cartilage and bone in the area of a fracture to stabilize the area as it heals. Over time the callus will become smaller and the bone will become more dense. The body has much work to do as the process continues.
The injury to this leg was very extensive. Dr. Martinez concentrated on making major repairs that would be most beneficial to improve the leg's function and Chocolate's comfort. Additional procedures performed at the time of the original surgery could have risked compromise of the blood supply in this leg and could have resulted in an inability of the leg to heal.
In addition, it is often impossible to predict exactly in what position the bone, muscles, ligaments and tendons will heal after surgery. The fact that the left leg healed with a slight angulation of the foot could not be anticipated with certainty at the time of the first surgery. It is not unusual for major injuries of this type to require more than one surgery. This occurs in human medicine also.
Dr. Martinez called tonight to update us on Chocolate's surgery today. Chocolate had a "corrective osteotomy" to correct the angulation and rotation in his left front limb. Dr. Martinez reports that he "couldn't be more happy" with the results of surgery. Many factors came into play to make this the optimum time to try to improve Chocolate's left front leg function. The muscle development in his shoulders has improved rapidly over the last few weeks. In addition, he has developed greater range of motion in his left elbow due to the incredible efforts of the physical therapy team at WSU. As Chocolate has become stronger, he will be better able to heal from the additional surgery which should give him better function in the leg.
If all goes well, WSU is projecting Chocolate will come back to the Tri-Cities in approximately four weeks. Please continue to watch for the adoption application to be on-line within the next few days
Chocolate will undergo surgery on Monday to correct persistent problems in his front left leg. After a full assessment at WSU’s College of Veterinary Medicine, Chocolate’s team of caregivers have decided that a corrective osteotomy on Chocolate’s left forelimb will give him the best chance for success. “We’re trying to improve the function of his left forelimb to match the right forelimb” said Dr. Steve Martinez, veterinary orthopedic surgeon at WSU’s Veterinary Teaching Hospital. “Even though he’s making great strides in improving his strength and muscle build-up, we think we can help him regain more function in his forelimbs.”
In recent weeks, Chocolate has made great strides in his rehabilitation. The team has even modified his regime to include more natural activities, such as chasing his ball, instead of walking him with the use of a sling. “He has shown tremendous improvements this last month in using his front legs again,” said Dr. Martinez. “Unfortunately, his left front leg continues to rotate slightly outward. Surgery is now the best option for him.”
Chocolate’s rehabilitation is growing closer to completion. In recent weeks, he has become more at ease around other dogs, and continues to grow friendlier to people with each passing day. Depending on his recovery from Monday’s surgery, the WSU team is hopeful Chocolate may be released as soon as early June.
News from WSU this week is that Chocolate's surgery is presently on hold. He has made some progress with his left leg since our last report and Dr. Martinez does not want to do surgery if physical therapy alone will work for Chocolate. The plan is to re-evaluate his left leg function this Friday and make a decision at that time.
Chocolate will be scheduled for an additional surgery on his left front leg the week of April 28. Dr. Martinez is optimistic that function can be improved in that leg so that Chocolate will be able to bear weight more equally on his two front limbs. After another two to three weeks in physical therapy, Chocolate will probably be ready for his new home! Dr. Martinez is working with Meadow Hills to reach a consensus on the type of new home that would be best for Chocolate. We are all anxious for him to find a permanent home with a loving family, but he will always have some special needs that will need to be taken into consideration. More information will be available next week.
Watch this video report from WSU.
Today Chocolate received a large "get well" poster and cards from many of the students at Eastgate Elementary School in Kennewick, Washington. Mrs. Sue Conrad, counselor at the school, used Chocolate's experience to teach the children lessons about trustworthiness, responsibility, citizenship, caring, fairness, and respect.
Chocolate continues to be in good spirits and works hard at his daily therapy sessions. Unfortunately, his left front leg is not working quite as well as his right, which causes Chocolate to consistently throw more weight to his right side. Doctors are presently discussing the possibility of an additional surgery to help straighten out the left leg further so that it can "pull its own weight" to a greater degree.
In a previous update we mentioned that Chocolate was wearing booties to protect his tender paws from abrasion and soreness after working on the treadmill and walking on hard surfaces. WSU tells us that the company making the booties found out about Chocolate, contacted the veterinary teaching hospital, and is now furnishing booties for Chocolate at no charge!
Meadow Hills Veterinary Center will soon be publishing an application for those people who are interested in adopting Chocolate. Look for this development by next week.
Very positive news from WSU today! X-rays taken on Chocolate this week show all the metal implants in both legs are still in place. The physical therapist also reports small increases in Chocolate's range of motion in both elbows. Physical therapy time estimates have been extended out to 8-12 weeks, but though progress is a little slower than we all had hoped, it continues to move forward. Chocolate has adapted well to his life as a "university dog" and makes his caretakers smile everyday.
Tonight Chocolate will be featured in a news story on Channel 6 in Spokane.
Dr. Thorson was at WSU for a meeting last night and was able to visit with Chocolate and Dr. Martinez. The best news she had to report was that Chocolate seems very happy! He spends most of his day in the technician's office on a blanket with hourly walks, physical therapy and, of course, time in the hydrotherapy pool. He is bonding with the technicians and seems very eager to please, even though at times he can get very tired.
Dr. Martinez reports that they are having some difficulty getting Chocolate to shift his weight forward during his walks. He is so accustomed to walking on his rear limbs, and they are so strong, that it seems natural to him to give his front legs a rest. That is not what we want! One idea that has been suggested is to put Chocolate on a small cart that would sit under his rear limbs. These carts are sometimes used with dogs who are paralyzed in the hind end. Removing the possibility of weight bearing in the rear limbs would force Chocolate to move his front legs to get around and would increase muscle development.
Dr. Thorson also feels that Chocolate is in much less pain than when he was first brought to Meadow Hills three weeks ago. The technicians report that he almost seems surprised sometimes when he gingerly tries to step on his front legs and does not feel the overwhelming pain that must have been present for several months.
Chocolate is definitely making progress.
Dr. Swailes received another update today from Dr. Steve Martinez at WSU. Chocolate is trying his best on the underwater treadmill, but does have problems with stamina, limiting his sessions to about 5 minutes at a time. Two problems have limited his time on the treadmill: (1) Muscle wasting in his two front legs due to lack of use over the past several months. (2) Soft paw pads, also due to the fact that they were not used over the past several months.
Dr. Martinez is optimistic that muscle mass will return as Chocolate continues to work on the treadmill. He is bearing weight on both legs off and on, the right leg working slightly better than the left. To help with the soft pads, Chocolate has been fitted with booties to wear until the pads toughen up a little more.
In addition to time on the treadmill, Chocolate spends 2 to 2.5 hours per day in other physical therapy, such as passive range-of-motion exercises. He also has his "social time" in the technician's office.
Plans are underway to give Chocolate the opportunity for some weekend furloughs at the home of a WSU doctor who owns other Chesapeake Bay Retrievers. This will give Chocolate some time to socialize more with people and with some dog "friends" while he has time off from his rehabilitation schedule.
Dr. Thorson has a meeting to attend at WSU tomorrow (Wednesday) so is planning to meet with Dr. Martinez and Chocolate. We're hoping for some pictures!
Friday, February 22, 2008Great news from WSU today! Chocolate has completed his first week of therapy and doctors are very pleased with his progress. The muscles in his front legs are still thin and Chocolate gets very tired if he uses them for more than five minutes at a time, but he is using the legs in a normal fashion and bears some weight on both the left and the right.
Chocolate has become a favorite with the technicians and often spends time in their office on a blanket during the day. He needs to wear an Elizabethan collar until it is time for his sutures to come out (next week!) but when he is under direct supervision of the techs, they can take the collar off to give Chocolate a break. They have also been working with him on some basic obedience so that, hopefully, the new owners will be impressed with his good "doggie manners".
Present estimates on Chocolate's hospital stay are about five to six weeks. In this photo, Chocolate is resting after physical therapy. He's a cooperative patient!
We are excited to direct you to the WSU website for a video of Chocolate in physical therapy. He is doing a great job and everyone is very pleased with his progress. Although we can't wait to have him back in the Tri-Cities, we know that it is best for Chocolate to work hard at healing at WSU for now.
Monday, February 18, 2008Chocolate went back to work on the underwater treadmill today, pleasing his doctors by bearing weight on both front legs. His attitude remains upbeat and well-wishers continue to flood our clinic with cards and letters.
Chocolate had very sore muscles today after yesterday's physical therapy session, so only spent about 3 minutes in the therapy pool. Doctors are still very pleased with his progress. They plan to let him rest over the weekend and start back with physical therapy on Monday.
This was Chocolate's first day of physical therapy. He took to the underwater treadmill very well. (Chesapeake Bay retrievers are bred to retrieve in the water.) Dr. Martinez supervised this first session and was very pleased that Chocolate bore some weight on both front legs and worked for about 10 minutes before he became tired.
Chocolate's bandages were removed today and will remain off. Because there is a danger he could pull his sutures out before the incisions in his legs are healed, he will need to wear an Elizabethan collar for approximately two weeks.
WSU reports that Chocolate continues to have high spirits today. The bandages on his left foreleg have been removed and his right foreleg remains in a soft cast. Chocolate's right leg is now two centimeters shorter than his left but Dr. Martinez does not feel this will significantly affect his ability to ambulate. We already know that Chocolate has a great ability to adapt to physical limitations. Physical therapy will be the key to the rehabilitation of Chocoate's forelimbs and it is slated to begin either today or tomorrow.
10:00 am Tuesday
An update from Dr. Martinez confirmed that Chocolate tolerated his surgery well
yesterday. The radius had to be shortened in order to get the elbow joint back
into its correct anatomical position and a bone plate was placed to stabilize
the radius at the site where bone was removed. The radial head (the end of the
radius that forms the elbow joint along with the ulna and humerus) was also
trimmed and smoothed and a lag screw used to connect it with the ulna.
Unfortunately the right elbow only has 10-30% range of motion at this point and
Dr. Martinez did not rule out the possibility of future surgeries. Much depends
on physical therapy. Within the next day or two Chocolate will be on an
underwater treadmill at WSU's new therapy pool. We all wish him the best as he
starts on his road to recovery. The stamina and determination he has shown over
the last several months should serve him well!
5:16 p.m.
Chocolate is currently in surgery which will continue at least until 6:30 p.m. this evening. Veterinary Orthopedic Surgeon Dr. Steve Martinez is working to install a steel plate to help stabilize Chocolate's right leg. We will continue to provide updates as information becomes available.
WSU reported on Chocolate's condition this morning. "He is doing really well," said fourth year WSU veterinary student Lindsey Ehlers. "He is on light pain medicine and has even been out for some light exercise. So far, he has had a really great attitude."
The WSU team has been using a harness to help support Chocolate's weight. "He has already shown signs of wanting to use his left leg," said another student. "He has even tried putting weight on the leg."
These reports are very encouraging. Chocolate will need to work hard in physical therapy to re-build muscle in those front legs as he has not used them for support for quite some time.
Chocolate is scheduled for his second surgery at 12:30 pm today. WSU veterinarians caution that additional surgeries could still be required and it is too early to tell what the final outcome of surgery will be.
10:30 a.m.
Dr. Steve Martinez called to let us know that Chocolate was resting comfortably this morning and seems to be responding well to his pain medication. Surgery yesterday was very extensive. Tendons which allow the elbow joint to move the foreleg had adhered to the fracture site during the healing process. These adhesions were broken down and repair of the tendons as well as the radius and ulna was attempted. Although the range of motion in the elbow increased from 10 to 80% after surgery, Chocolate will need to undergo several weeks of physical therapy to maintain this improvement in elbow function. Dr. Martinez felt that physical therapy may be able to start as early as Wednesday next week.
5:44 p.m.
Chocolate is out of surgery! "I am pleasantly surprised at the range of motion we have in the left leg," said WSU veterinary orthopedic surgeon, Dr. Steve Martinez. The procedure involved removing muscle and ligament tissue that had become adhered to the bone callus formed when the broken leg healed improperly. The WSU Team measured an increase of range in motion in the elbow from only 10%, to now 80%. "It leaves me very optimistic that, with proper physical therapy, Chocolate will dramatically improve the use of his left leg," said Dr. Martinez.
All our best wishes are with Chocolate as he recovers over the weekend and prepares for surgery on his right leg on Monday.
5:00 p.m.
WSU reports that Chocolate went into surgery at 12:30 p.m. today and the procedure is anticipated to be complete around 5:30 p.m. Because the injuries were so extensive, only the left leg was repaired today. Chocolate is scheduled for surgery on the right leg on Monday at approximately 12:00 p.m. Over the weekend, Chocolate will stay in the intensive care unit at WSU so he can be monitored around the clock and treated for pain as needed. It is our understanding that Chocolate still has his yellow ball for comfort. (photo by Henry Moore Jr. - BCU/WSU)
4:00 p.m.
Chocolate worked cooperatively with the WSU radiology and surgery departments today and had his pre-operative bloodwork completed. The staff describes him as a dog with a "great personality" Surgery is scheduled for tomorrow afternoon. We hope to have updates for the website by early evening.
3:00 p.m.
Right: This radiograph shows the right elbow on the right side of the picture, the radius and ulna (foreleg bones), and part of the right foot in the lower left hand corner. The ulna (the smaller of the two bones) is fractured at approximately the midpoint of the bone. The radius (the larger of the two bones) has been displaced from its normal position where it normally works in conjunction with the ulna and humerus (upper leg bone) to form the elbow joint. The radius has fused to the lower edge of the humerus and, because of this abnormal position, the elbow can no longer function. The fuzziness in the picture is due to the fact that the body has tried to stabilize the injured bones by forming calcium deposits in the area.
Left: The left radius and ulna have an obvious fracture at the midpoint of the bone. Again, the body has tried to stabilize the fracture by forming numerous calcium deposits, called a callus. Unfortunately, because the bones were not set correctly, the bones have healed at abnormal angles and the sharp edges can actually be felt just below the skin. This elbow joint, though not dislocated, is also non-functional. This may be because the calcium deposits appear to extend up into the muscle tissue or because Chocolate has held the leg up for so long his tendons no longer stretch as they should.
11:00 a.m.
Chocolate was thoroughly examined by Dr. Steve Martinez, after which time he was transported to the radiology department for additional X-rays. We will update the website as the radiology results come in and surgery is scheduled.
(Photo courtesy of Henry Moore Jr. - BCU/WSU)
Chocolate's trip to WSU with Mr. Bill Stokes was uneventful. Chocolate proved to be a great passenger. A stop was made at the halfway point to Pullman for a "potty break" and Chocolate was in great spirits when he arrived at WSU. He was expected by the veterinary hospital staff and was immediately transported into the hospital for the night.
A big thank you goes out to Mr. Stokes who ran into a blizzard and white-out conditions on his way home from Pullman. The drive, which normally takes about 2.5 hours, expanded to four hours. We are very grateful that Mr. Stokes arrived home safely.
7:00 p.m.
Chocolate arrived in Pullman at the College of Veterinary Medicine's teaching hospital. He has settled in comfortably for the night (with his yellow ball) and will meet with his surgeons early tomorrow morning. The surgeons will examine Chocolate thoroughly and take additional X-rays to determine which surgical procedure will have the greatest chance of success in this case. Bone plating, pins, bone grafts, even an artificial elbow joint have all been discussed as possibilities for Chocolate. Check our website tomorrow for further updates.
3:30 pm
Chocolate left Meadow Hills Veterinary Center for the WSU Teaching Hospital. Transportation was provided by Ann and Bill Stokes, who generously donated their time and vehicle to make sure Chocolate was transported safely and treatment could begin as soon as possible.
11:30 a.m.
The College of Veterinary Medicine at Washington State University in Pullman has assigned orthopedic surgeon, Dr. Steve Martinez, to Chocolate's case. After an in-depth review of the radiographs by Dr. Martinez and the radiology department, a tentative plan has been developed for extensive surgical procedures to attempt repair of Chocolate's two front legs. Surgery would be followed by four to five weeks of physical therapy at the WSU facility. Tentative costs have been set at $5,000 for surgery and $1,500 for physical therapy with total costs of up to $10,000 possible. Until doctors actually are able to evaluate the injuries during surgery, however, all plans are subject to change. Donations for surgery and physical therapy continue to come in to Meadow Hills Veterinary Center. Watch for further updates this evening.
10:30 a.m.
Isaac and Sonia Ayala, who rescued Chocolate, were here to visit the very excited dog this morning. They expressed sincere appreciation for the outpouring of donations and good wishes from the community. An anonymous donor even dropped off a bag of treats and a blanket at the Ayala residence this morning.
9:00 a.m.
Chocolate is in great spirits this morning! He has a voracious appetite and Dr. Swailes has added an extra meal to his feeding schedule today.
Chocolate loves to go outside and has a vigorous tail wag for everyone who says hello. Updates on surgery should be available by noon today.
Chocolate is resting comfortably tonight at Meadow Hills Veterinary Center in Kennewick, Washington. After months of pain and suffering due to fractures in both front legs, freezing temperatures, and near-starvation, Chocolate was recently rescued by Sonia Ayala of Pasco, Washington. A feature story this morning in the Tri-City Herald inspired a client of Meadow Hills Veterinary Center to offer his financial support for sedation and radiographs of the fractured legs. Meadow Hills donated a thorough examination, vaccinations, and de-worming for the injured pet.
Because of the extensive injuries uncovered by the examination and radiographs, veterinarians at Meadow Hills are presently consulting with orthopedic surgery specialists at the Washington State University School of Veterinary Medicine. Updates on the case are expected by tomorrow morning and will be posted on this website. Donations for Chocolate's medical care are being accepted at Meadow Hills Veterinary Center, 8802 West Gage Boulevard in Kennewick, WA 99336, or by calling (509) 783-0399.
A note to all the wonderful people who have donated to Chocolate's care: As of Wednesday, February 20, it appears we should have enough money to cover all of Chocolate's medical and surgical expenses, as well as his physical therapy. If additional surgeries are required or if rehabilitation costs surpass our estimates, we will be sure to put the word out. Thank you again for helping to give Chocolate the best chance possible for recovery. If he could, he would share his yellow ball with you!
