TPLO - Possible Misdiagnosis?

[BKellyinDallas]

Hello all, 

Has anyone ever experienced a misdiagnosis of an ACL injury with suggested TPLO- for something else?  Current vet said although the ligament is not yet torn, he expects it would happen soon and suggested TPLO.  I spoke to another vet, very experienced with greys (who is out of my area otherwise I would go see her), she said in her years of experience, she has seen only two with an ACL tear.  I asked her what mimics this, she said osteo.  

[krissy]

Knowing more about your dog would be helpful. Age, sex, why you took her to the vet in the first place, etc.

Greyhounds rarely tear cruciate ligaments because of the slope of their tibia. However, that doesn't mean it is impossible. One of the tech assistants who worked at my last clinic had a greyhound/whippet mix who tore both her cruciate ligaments in a year and had bilateral TPLOs.

If your dog is 9 years old and didn't start limping significantly and suddenly (usually after a minor trauma - running, jumping, a tumble/fall) then osteo is a likely differential. If your dog is 5 years old and came up lame after chasing a squirrel in the backyard... cruciate is probably more likely. 

Regardless, if you're uncertain it's probably worth a getting some x-rays done, or a second opinion since none of us here can tell you what's going on.

[BKellyinDallas]

Thanks, Krissy.  He is five and began limping about a week ago, seemingly out of nowhere- I really thought it was a corn.  No trauma that I am aware of.   X-rays were done, and we are getting a second opinion tomorrow.  

I am not looking for a diagnosis here. I am asking if anyone has ever had a mis-diagnosis with a TPLO suggested and if it ended up being anything different.

Edited November 12, 2019 by BKellyinDallas
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[HoundDad]

2 hours ago, BKellyinDallas said:

I am not looking for a diagnosis here. I am asking if anyone has ever had a mis-diagnosis with a TPLO suggested and if it ended up being anything different.

I had a 12 year old Greyhound's broken toe misdiagnosed as a knee ligament tear. Be very, very skeptical of a torn ACL/CCL diagnosis, they're quite rare in Greyhounds.

[Hubcitypam]

I had a grey with a torn ACL and was told that was a very rare occurrence.  Watched the video of the track collision when it probably happened..  Went to my vet and also to the surgical center on Trinity Mills.  Was told TPLO is great when it works but if it goes bad it goes very bad.  We opted with what Dr. Josh from  called "fishing line surgery". 

Not something I'd do proactively.

[greysmom]

If your dog is limping any cancer would likely show up on xrays - which should image the whole leg, toes to shoulder/hip.  And have them read by an experienced technician.  You can also send them to Dr Couto at the Greyhound Health Initiative for his opinion.  You can get his opinion even if it's not osteo.  He is a greyhound health expert and can likely give you guidance on future treatment or diagnostics.

[BKellyinDallas]

Thank you, all. It’s been some years since I’ve posted here (the last was probably about three years ago when we lost our last grey at about 13 years old), I cannot for the life of me figure out my sign on info so I created a new account. Greytalk has always been a great source for discussion and reference.

I am surprised at any of this as I really thought we were dealing with a corn and then to be reading about all the pros and cons of TPLO, the ups, the downs- the way far downs- it’s scary! I just want to do the right thing for our boy and this surgery I have never heard of before. And here I have been treating a non-existent corn with duct tape and booties...! 

[BKellyinDallas]

11 hours ago, HoundDad said:

I had a 12 year old Greyhound's broken toe misdiagnosed as a knee ligament tear. Be very, very skeptical of a torn ACL/CCL diagnosis, they're quite rare in Greyhounds.

How were you able to find out what it really was?

[racindog]

I would not believe anybody but a specialist if they said a greyhound had a knee issue.  I presented an 18 month old greyhound that I had seen take a bad step and scream and was totally lame in his hind leg to an emergency vet (name available on request).  Said evet quickly diagnosed his knee being torn up and referred me to a specialist and sent us on our way.  When I called the specialist I explained that the dog already had some sort of issue with the other hind leg and I feared he might go completely down waiting 2-3 weeks for an appointment. Therefore they expedited our visit. When I presented the dog to the orthopedic specialist (name available on request) in about 30 seconds he told me "Well, there is nothing the wrong with his knee. I don't know what's wrong with him but I will find out."  About 10 minutes later he returned and said his leg was BROKEN. It was a tibial crest fracture. It turns out that it is EXTREMELY RARE for a greyhound to have any knee problems due to their wonderful strong leg muscles etc.  Clearly the e vet that sent him home with a broken leg missed that lecture in vet school. So my poor guy suffered for a week with basically an untreated broken leg until the kind and skilled and, dare I say, knowledgeable specialist  was able to see him and diagnose it. So if a vet told me a greyhound had a knee issue I would automatically think that vet was not the sharpest knife in the drawer and would try to find one that was actually knowledgeable.

Edited November 13, 2019 by racindog

[HoundDad]

10 hours ago, BKellyinDallas said:

How were you able to find out what it really was?

X-rays. I had asked the associate vet at the practice to x-ray the entire leg because I'm always suspicious of osteosarcoma when an older Greyhound starts limping. She told me the x-rays looked fine, and that the knee felt loose and we were most likely looking at a ligament issue. I was suspicious of that diagnosis because I knew it was rare for a Greyhound to have an ACL/CCL injury absent a significant trauma, which my girl hadn't had. Her foot swelled the next day so back to the vet we went where we saw the practice owner who was our regular vet. He reviewed the x-rays and discovered that the rads the associate took stopped at the ankle. He x-rayed the foot and found the break.

[BKellyinDallas]

So, second opinion vet (I found him via a local greyhound group) said definitely not a pending ACL tear and definitely no TPLO. He said there is an injury of some kind but rest, anti-inflammatory should do the trick. He said there MAY be a couple of suspicious areas on the X-rays but if it’s osteo, not to worry because it doesn’t progress overnight..... He said we could pay to send the xrays to a radiologist for a closer look- which I will probably do after hearing what Dr. Couto has to say. 

Dr. Couto is AMAZING. He is incredibly responsive and he will be looking very closely at our boys xrays and has requested other things as well (pics, video). 

[greysmom]

Good update!  Keep us posted!

[Bizeebee]

On 11/12/2019 at 7:35 PM, greysmom said:

If your dog is limping any cancer would likely show up on xrays - which should image the whole leg, toes to shoulder/hip.  And have them read by an experienced technician.  You can also send them to Dr Couto at the Greyhound Health Initiative for his opinion.  You can get his opinion even if it's not osteo.  He is a greyhound health expert and can likely give you guidance on future treatment or diagnostics.

I just wanted to piggy back on this that we had a dog develop a mysterious limp and when nothing showed up on first set of xrays we assumed a soft tissue injury. However, after a couple weeks the tumor grew large enough to be seen on scans. I'd suggest another set of xrays in a couple of weeks if nothing shows up right away.

[GreytMom]

Re: TPLO repair for ACL. My 13 yo terrier had it about 6 months ago. Xrays didn’t show it. My regular vet couldn’t diagnose it/feel the tear.  Ortho surgeon said “well that took literally 2 seconds to diagnose.” Fully torn. My terrier is difficult to handle so I couldn’t do any PT after the surgery with him - but after a few ups and downs on the road to recovery you wouldn’t be able to tell which leg it was. And he is back to running with my greys. (We don’t tell him they are only trotting when he is running full out. )