Joint Success
by Dr. Don Rushton & Dr. Ernie Prowse
Used with permission from Pet Country Magazine
Two veterinarians team together to perform a modern procedure called TPLO to help dogs with ACL injuries regain an active lifestyle.
image left: Veterinary Team of Dr. Don Rushton and Dr. Ernie Prowse.
What is happening to my dog? He seems to have aged recently and has difficulty doing things he did before. He is also favouring one of his hind legs and seems to only touch his toes to the ground when he walks or stands. What could be the problem? If your first thought is hip dysplasia, you are likely wrong. Over 80% of ALL orthopaedic problems found in dogs involves a ligament in their leg which helps to stabilize the knee joint. This ligament is called the Anterior Cruciate Ligament (ACL). For unexplained reasons, there seems to be an epidemic of ACL problems. These problems are showing up in all breeds of dogs, but are especially prevalent in Labrador Retrievers, Golden Retrievers, Newfoundlands, Bull Mastiffs and Rottweilers.
Benson, a Chocolate Lab from Antigonish, Nova Scotia, is one of many dogs suffering from ACL problems. Benson's family noticed he
was finding it difficult to continue his normal active lifestyle, and he
needed help. Benson was introduced to TPLO surgery, and thanks to
this new option, Benson is about to receive a new outlook on life.
image right: Benson and his best friend Leah Grant from Antigonish, Nova Scotia.
Doctors Don Rushton and Ernie Prowse are classmates from Ontario Veterinary College. They have repaired ACL problems like Benson's for over thirty years. In the past, most of the surgical techniques they used to repair ACL problems were developed from human medicine. Those techniques generally accomplished favourable results, but complication rates were still high in many young athletic dogs, especially the large breeds. A problem commonly shared by these dogs was "big knees" which stemmed from secondary arthritis and inevitably caused lameness. The doctors were convinced there must be another way to help these dogs.
Their research led them to Dr. Barklay Slocum, a renowned
veterinary orthopaedic surgeon and physicist in Oregon who had
developed, and patented, a new technique called TPLO surgery,
Tibial Plateau Levelling Osteotomy. Incredibly, Slocum’s research was
able to get field trial Labrador Retrievers with ACL ruptures back
into competitive trials. Slocum’s “thinking outside the box” showed
that humans and dogs are very different with respect to the forces
in their knee and the ACL ligament. Dr. Slocum developed a model
which is used in hospitals to demonstrate his theory so doctors and
clients can clearly understand the concept. It shows why many of the
procedures veterinarians once extrapolated from human surgeons
in the past were not successful in repairing ACL injuries in dogs. In
2003, Doctors Rushton and Prowse traveled to Dr. Slocum’s practice
and studied to become two of only thirty or so TPLO licensed
veterinarians in Canada at the time. Following their studies, they
spent time in Tampa, Florida, working with an orthopaedic surgeon.
The team then returned to Nova Scotia, and, as they suspected, the
TPLO technique proved to have remarkable results.
image right: Dr. Rushton and Dr. Prowse performing TPLO surgery on Benson.
Five years later this team performs up to five TPLO surgeries per week. To say they are pleased with the technique is an understatement. Dr. Rushton says, “We are often doing the dogs nobody else wants to touch because of their size or athletic ability, and we are getting dogs back to an active and pain free life. This is amazing.” Dr. Prowse believes,”…it is the team approach to this surgery that has made it so rewarding. We see very few complications, and often bounce ideas back and forth when an unusual case is presented.” They both are rewarded by seeing animals months and years later with no mobility restrictions, and no secondary arthritis in the knee.
image below left: Dr. Prowse measures the plateau angle of Benson's knee joint.
TPLO surgery requires specialized tools that are driven with compressed
nitrogen. During Benson’s surgery, a cut is made in the bone to allow
rotation of the top of the tibia in order to “level” the plateau. Levelling
of this plateau will stabilize the knee joint and improve movement.
A variety of bone plates are available, and the correct one is fitted to
stabilize the site. After surgery, the site is closed and a bandage is
applied for about twenty-four hours. Benson will receive an epidural,
using morphine for pain control, and anti-inflammatory for a week or
so after his surgery. Post-surgery x-rays should confirm that all is well,
and the new plateau angle is recorded. Benson will have his staples
removed in ten to fourteen days, and after two months, more x-rays
will be used to assess his healing. When healing is confirmed, Benson
will start rehab and quickly develop his lost muscle mass. After four
months, most dogs like Benson are off leash and back to normal.
With the incredible results these two doctors have achieved through TPLO surgery, their work is truly considered a "joint success"
image left: Dr. Rushton & Dr. Prowse pose with Benson less than 24 hours after surgery.
With the extensive specialized surgical tools available, these two doctors are able to perform TPLO surgery on all sizes of dogs, from the toys to the giants. They have done Guide Dogs, Police Service Dogs and even a racing sled dog. All have gone back to their active working lifestyles. Most patients, however, are family dogs like Benson, with an active lifestyle and a loving family that only wants the best technique available to help their pet return to normal as quickly as possible.
When it comes to the doctors, life has its strange turns. Not only were these doctors in the same graduation class, but also on the same surgical rotation. After selling busy practices in Truro and St. Johns, they are now back together as a surgical team improving the activity of dogs suffering from ACL injuries. After more than 400 TPLO surgeries, they are still delighted to be together as a team, and keep this aspect of their professional careers dynamic. With the incredible results these two doctors have achieved through TPLO surgery, their work is truly considered a “joint success.”
These doctors also do other orthopaedic surgeries, as well as repair select soft tissue conditions. Appointments with these doctors can be arranged by referral through your veterinarian. Thanks to new techniques, like TPLO surgery, and dedicated professionals like Dr. Rushton and Dr. Prowse, Benson and the many dogs still suffering with ACL problems, can return home to their families and be the active dogs they used to be.
For further information on TPLO surgery, or any other orthopaedic surgeries email: westwoodvet@eastlink.ca
Joint Success by Dr. Don Rushton and Dr. Ernie Prowse Westwood Hills Veterinary Hospital, Tantallon, Nova Scotia
Westwood Hills Veterinary Hospital
4 Westwood Blvd Hubley Centre
Upper Tanallon, Nova Scotia
Canada, B3Z 1H3
Tel: 902-826-1933
Fax: 902-826-9466
Stock photography by Pet Country Magazine
