Orthopedic Surgery

Amputation

Limb amputation

The surgical removal of a leg. Limb amputation is the treatment of choice when certain types of cancers (such as bone cancer) are affecting the limb, a bone cannot be repaired, or tissue damage is too extensive.

Pricing:
- Feline Limb Amputation $1400-1800
- Canine <80lbs $1400-1900
- Canine >80lbs $1900-2200
histopathology is an additional $300 if needed

Digit amputation

The surgical removal of a toe. This is needed when a toe is affected by cancer, a non-healing bone, or a non-healing wound.

Pricing: $1000-1300, histopathology is an additional $250

Tail amputation

The surgical removal of the tail. This is typically needed following a trauma of some kind (caught in a recliner or door, hit by car) or for removal of a tumor on the tail.

Pricing: $1000-1200 cat, $1100-1300 dog; when not due to trauma, histopathology can be added for $250

Knee surgery

TTA - Tibial Tuberosity Advancement

There are two main types of surgery that are recommended for medium and large breed dogs that have CCL tears: the tibial tuberosity advancement (TTA) and the tibial plateau leveling osteotomy (TPLO). The TTA is a somewhat less invasive surgery and gives similar results to the TPLO. Dogs that receive the TTA procedure will recover quicker initially, however, by 4 months after surgery both procedures have similar outcomes.

The TTA procedure should not be used in dogs that have a steep tibial plateau, therefore your dog’s surgeon will make a decision which procedure is the best option for your companion. The TTA procedure involves making a cut in the front part of the tibia bone (tibial tuberosity) and advancing this portion of bone forward in order to realign the patellar ligament so that the abnormal sliding movement within the knee joint is eliminated. A specialized bone spacer, plate and screws are used to secure the bone in place. Bone graft is collected from the top of the tibia and placed in the gap in the bone to stimulate healing.

TTA surgery is a well-established and effective treatment for ruptured CCLs in dogs. It can restore knee stability, reduce pain, and allow dogs to return to their normal activities. However, it is important to note that recovery requires time and effort, and potential complications should be considered.

Pricing: $4000.00 (price includes the orthopedic consultation, sedation and x-rays; surgery, 2 week recheck, and 8 week recheck with x-rays)

Lateral suture

This is a traditional procedure for cruciate repair that has been around for years and is still used routinely. In this procedure a prosthetic ligament made of strong nylon suture material is used to replace the function of the torn CCL. Since over time the suture material can stretch and break this is a temporary stabilization. This procedure ultimately relies on development of fibrous tissue around the joint taking over the function of the suture material and stabilizing the knee joint. This procedure is less invasive and quicker to perform but can have mixed results in large dogs. This is why it is preferred for smaller patients (30 pounds and under).

Pricing: $2000 - 2600

Post-operative CCL repair care instructions:

Immediately post-op:
- Strict activity restriction - strict crate rest is required, no running, jumping, or stairs. Your pet should be confined to a crate or small room. Leash walks only to go outside to use the bathroom.
- If your pet will tolerate it you can apply a thin washcloth wrapped ice pack or frozen peas to the incision 3 times daily for 5-10 minutes each time for the first 3 days.
- On day 4 you can switch to heat therapy. Apply a warm pack or sock filled with uncooked rice and heated in microwave to the incision 3 times daily for 5-10 minutes each time for the next 3 days.
  - Test the warm pack on your wrist first to make sure it isn't too hot.

Immediately post-op:
- Following surgery it is recommended to begin rehabilitation therapy with your pet. Community Pet Healthcare in Zionsville is our rehab partner.
  - They have multiple modalities available including underwater treadmill, laser therapy, and rehabilitation equipment (wobble balls, cavalleti poles, etc.) to create a personalized rehab plan for your pet.
  - https://communitypethealthcare.com/indy-pet-core/
- 2 weeks post-op:
  - Present to your primary DVM or rehabilitation partner for stitch removal.
- 5 weeks post-op:
  - Present for your recheck visit with us for x-rays to confirm appropriate bone recovery from treatment (If addigtional sedation is needed for this appointment there will be a $100.00 charge)

MPL repair (medial patellar luxation)

An MPL is when the "knee cap" slides in and out of natural position. It is graded out of 4 depending on the severity of the luxation. This is a very common disease in small dogs but can also be seen in some larger breeds such as labrador retrievers. MPL's are not always problematic and many mild cases can be medically managed. However, if the MPL is causing lameness or is a grade 3 or 4 surgery is indicated.

Early surgical intervention is recommended in these cases to prevent worsening disease progression, osteoarthritis, and secondary complications. MPL's can cause excessive strain on supporting ligaments including the cruciate ligament. It is not uncommon for a pet with an MPL to also have a CCL tear.

Pricing: $2200 - 2600

Miscellaneous orthopedics

FHO (femoral head osteotomy)

An FHO is performed with conditions such as hip dysplasia, hip luxation, osteoarthritis, and aseptic necrosis of the femoral head (Legg-Calves-Perthes disease). In a normal hip the head of the femur will fit snuggly into the hip socket (acetabulum) and rotate smoothly. In certain disease this rotation is disrupted causing grinding in the joint leading to pain. An FHO eliminates the source of the pain and creates a false joint through the formation of scar tissue. This procedure is most successful in dogs less than 45 pounds.

Pricing: $1800-2200

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