So Your Dog Needs a TPLO

Among the frequent causes of hind leg limping in dogs, a Cranial Cruciate Ligament (CCL) injury stands out. Comparable to the ACL in humans, the CCL is a crucial ligament in a dog’s knee. Its primary function is to prevent the shin bone (tibia) from sliding forward concerning the thigh bone (femur). When the CCL is partially or completely torn, it leads to an unstable and painful knee, which manifests as a limp.

In some cases, dogs experience a complete CCL tear, resulting in an abrupt cessation of weight-bearing on the injured leg. However, a more common scenario involves sporadic limping. Over the course of weeks, months, or even years, dogs might exhibit on-and-off limping. Initially, rest and pain relief measures might alleviate the limping, but eventually, the situation worsens. This progression often occurs when a partial CCL tear transforms into a full tear or when dogs with a CCL tear also damage their medial meniscus, a knee shock absorber. Around 50-60% of dogs with full CCL tears and 5-7% with partial tears end up injuring their meniscus.

Diagnosing a CCL tear hinges on identifying “cranial drawer” instability during an orthopedic examination. While most dogs can undergo this examination while awake, some may require sedation due to pain, tension, or anxiety.

Multiple approaches exist for treating CCL tears in dogs. One widely employed technique is the Tibial Plateau Leveling Osteotomy (TPLO). The objective of TPLO is to modify the forces within the knee, creating stability even without a functional CCL. This involves making a curved cut in the shin bone, repositioning the cut bone segment, and securing it with a bone plate and screws. This adjustment provides a more stable platform for the thigh bone, enlisting other muscles and ligaments to aid in knee stability.

Having personally performed and assisted in over 1,000 TPLOs, I hold the procedure in high regard for its reliability and success. With an experienced surgeon at the helm, TPLO can offer dogs a favorable chance of complete recovery with minimal complications. Nonetheless, as with any endeavor, TPLO has its limitations, and individual factors can impact its effectiveness.

Precise preparation for TPLO mandates accurately positioned x-rays of the knee and shin bone, allowing measurements and surgical planning. This information guides the choice of tools, bone cut placement, and joint surface rotation. Tailoring the approach to factors like your dog’s shin bone shape, meniscus condition, or additional problems such as a dislocated kneecap may be necessary. In certain situations, an alternative procedure could be recommended.

If your dog is dealing with a continuous or worsening limp, we encourage you to reach out to Sunstone Veterinary Specialists for an estimate of the costs involved.

Lillian Su, DVM, MVSc, CCRP, Diplomate ACVS-SA

Certified Specialist in Small Animal Surger

Move Over, CT, We Have HDVI For Pets!


The team at Sunstone Veterinary Specialists is very excited to let the community know about a new piece of advanced imaging equipment we have acquired. CT or ‘cat’ scan is a well-known method of advanced medical imaging that allows us to “look” through the body, map organs, tissues and sometimes observe abnormal structures. CT (Computed Tomography) in simple terms, is a series of tiny x-rays collected by a computer as the x-ray machine is spinning around the outside of a patient’s body. Each tiny x-ray is then added together through software to create a bread loaf-like slice of the area that has been scanned. The slices, which vary in thickness depending on the machine, are then “stitched together” by the computer blending and approximating the space between the slices. 


COVID-19 Update

This blog post is likely a bit different than what you’ve come to expect from us here at Sunstone Vets but alas, here we are. We know that if you are anything like us, you have been inundated with information, news and opinions regarding the COVID-19 virus. As a company, we wanted to take the time to address the situation in regards to our pets and what we are doing to help keep you and our staff safe.


All About Endoscopy…. Part 2!

In the last installment of our blog, we introduced you to one of our favorite diagnostic tools- endoscopy! We went over the basics and talked about gastrointestinal endoscopy, the most common form of endoscopy we do here at Sunstone Vets. Here’s the link to that blog in case you missed it! This week, we will learn about the other types of flexible and rigid endoscopy that we offer and how they can help your four legged family member.


All About Endoscopy!

Welcome to the next installment of the Sunstone Vets Blog! This week, we will be talking about one of our favorite, minimally invasive diagnostic tools…..endoscopy! Endoscopy is a catch all term for a variety of procedures that allow us to examine the inside of the body. The medical suffix “-scopy” simply means to use an instrument for examination or viewing. When combined with other terms, it describes the body area we are looking at. For example: Rhinoscopy (the study of the nasal cavity); Cystoscopy (study of the urinary bladder); Bronchoscopy (the airways); Gastroduodenoscopy (stomach and small intestine); Colonoscopy (large intestine)…. you get the idea! In this and the next blog, we will describe each endoscopic procedure that we offer here at Sunstone Vets and what you can expect for you and your furry friend.


What to expect at your pets Internal Medicine Consultation

By the time you get to Sunstone Veterinary Specialists for your pets Initial Consultation, we know that you have likely already invested time, energy, money and worry into their illness. You may have been referred to us by your family veterinarian or maybe you simply decided to seek another opinion. However you found us, we want to give you the tools to help ensure a successful first visit. Read on for insider tips on what to expect at your pets Internal Medicine Consultation.


Summer Pet Safety by Jenne!

Keep your fur friends safe during this heat wave. Follow some simple tips to stay safe in the heat:

1. No car rides! Leave the pups at home. Even in the morning time, your car can rapidly heat up, and that cracked window does nothing to keep them cool. A car can overheat in minutes at 70 degrees.

2. Exercise them in the early morning, when the air and pavement are coolest. Hot pavement can easily burn their paws, and exercise in the hot afternoon can lead to heat stroke.

3. Make sure they always have access to cool water. Use ice cubes, give them frozen veggies as snacks (mine love frozen green beans and carrots). You can even make frozen low sodium broth cubes in ice cube trays to encourage hydration.

4. Keep them safe at the river/lakes. Bring potable water with you for them to drink and prevent them from drinking from river/lake. If you wouldn’t drink it, don’t let them drink it. If they are swimming, use a doggy life jacket to keep them safe. Keep an eye out for algae advisories-some locations have toxic algae blooms going on, and this is dangerous for both humans and dogs. Also, watch out for dead fish!! Dogs love to snack on them, but in our area they can get a parasite from eating fish that can make them very ill (commonly known as salmon poisoning, although other dead fish can carry it).

Jenne, BA
Referral Coordinator

Tech Talk – Springtime Safety!

Have a Pet Safe Spring!

What has certainly been a LONG winter will soon be coming to a close. Colorful blossoms and sunny days are more than welcome and hopefully will be here soon. Spring is right around the corner! Unfortunately, parasites and other seasonal risks can put a damper on all the fun. However, you and your furry friend can still look forward to this wonderful time of year by following some of these basic springtime pet safety guidelines.

Road Trips and Outdoor Activities

One of the first things you may want to do as the weather turns warm is travel. This may include a day trip to a beautiful outdoor park or a vacation to a new destination (spring break, anyone?). When traveling with your pet, keep the following safety precautions in mind:

·      Make sure the destination is truly pet-friendly and that your pet is travel-ready. When in doubt, consider a good boarding facility.

·      For road trips, don’t forget your pet’s crate or seatbelt harness. Bring plenty of water and other daily care essentials.

·      If your plans include hiking, avoid a wildlife encounter by keeping your dog leashed, vaccinated, and supervised. Remember, skunks, coyotes, and other animals can transmit deadly diseases.

·      Microchip your pet and keep ID tags updated.

Lawn and Garden Care

Spring is a great time to tackle the yard and clean up the garden. But wait! Many products can be toxic to dogs, cats, and other animals. Before beautifying your backyard, be aware of the following poisonous products:

·      Mulch containing cacao bean hulls

·      Slug and snail bait

·      Rose care products

·      Compost (often contains potentially toxic foods and dangerous molds)

·      Plants such as lilies, sego palms, and crocuses

·      Fleas, Ticks, and Mosquitoes…Oh My!

Although parasites can threaten the health of pets (and people) any time of year, spring can be when most fleas, ticks, and mosquitoes come out in droves. That’s why it’s critical to keep your furry pal on a year-round preventive. Remember, administering an over-the-counter product without consulting your veterinarian can place your pet in harm’s way.

Pet Allergies

Another springtime risk to keep in mind includes protecting your pal against allergies. If you notice your pet itching, losing fur, sneezing, or developing hot spots, please contact your Veterinarian. There are many great treatment options available to ease the discomfort of your pet’s seasonal allergies.

In general, spring means more outdoor time with our pets, which means greater distractions and more risks. If you are in doubt, remember to contact your Vet about any products that could be harmful to your pet.

We hope these tips can help you spend more quality time with your pet and enjoy a much deserved springtime.  Remember awareness and preventative action is everything!


Surgery Assistant

Tech Talk – The Chronicles of Hank

The Chronicles of Hank!

My husband Cory and I recently adopted a 10 week old Labrador mix puppy! This is our first foray into dog ownership together and his first dog ever. To say that Hank has changed our life for the better is an understatement. While there are challenging moments, (do you have to chew on EVERYTHING??) Hank has enhanced every aspect of our life.

Hank came to us from California. His mom was found as a pregnant stray and was taken in by a foster family down there. She gave birth to 11 puppies (!!) and they all lived in their foster home for about 8 weeks. Some of the pups were adopted in California, and the rest came up here for adoption via the Oregon Dog Rescue. My friend Alysse ended up fostering two of the male puppies for them. She knew we were in the market for a puppy, but that I wanted to adopt one instead of buying from a breeder. So, when we got the text with the adorable photo of the one she thought we would like, we had to go meet him!

We met him one night at her team’s flyball practice. I was surprised at how tiny he was! We fell in love and adopted him 2 days later on a snowy Saturday morning. Since we have brought him home, he has more than doubled in size from 10lbs to over 21 now! He is such a sweet friendly guy who loves people, kids, dogs and cats (though our cats Mama and Zoe are not too sure about him and would prefer that he went back to where he came from.) I am extremely lucky that he gets to come to work with me every day. He was not a fan of being in a kennel, but he is now the Sunstone mascot and lives up front with our referral coordinator, Sarah. Our clients love him and Aunt Sarah even plays him animal videos!

We have been going to Puppy Kindergarten classes at Dog Days NW in Vancouver, WA. At our first class, Hank got put into the “Small and Shy” play group, where he promptly bowled over a little Cavalier King Charles puppy. He now plays in the “Rough and Tumble” group and fits in much better! He loves the obstacle courses they have and has learned sit, down, stay, roll over, shake, and spin! Hank has taken a week-long trip to Trout Lake with my friend Alicia and I where he got to play in his favorite thing – snow! He also had his first beach trip last weekend. He is pretty sure the beach is the best thing ever!

He is now about 99% potty trained and is almost sleeping through the night. Potty training was definitely challenging but with consistency and positive reinforcement, he caught on pretty quick! We will also be happy when he outgrows the “puppy teeth chew on everything phase”, though I know that this phase of life will pass all too quickly. Being a veterinary technician, I work with dogs all day long. I typically see them when they are older and sick so I know all too well how fast the time goes by. Hank makes Cory and I laugh every single day and has brought so much joy to our lives. We are so grateful to everyone involved in bringing us together and also to my work family who loves Hank and puts up with his shenanigans.

This is only the first installment of the Hank Chronicles. Stay tuned for more…..


Head Technician

Tech Talk – Potty Training Pitfalls

Potty Training Pitfalls

My friends recently got an adorable new puppy who is just the sweetest little girl who caught onto potty training very quickly. She is now about 3 months old; and, as soon as she comes inside from going potty, she’ll go pee on the carpet by their bedroom. Not a lot but it was really starting to annoy them. I received a text recently asking what they should do as they were just about at their wits end and had gone through more carpet cleaner than they’d like to admit. I smiled reading her text as I knew exactly what they were going through all too well, having been there 3 times with my dogs when they were just wee little ones that liked to wee in places they knew they shouldn’t. 

Why, oh, why does she still pee inside?

It sounds as though your pup may not fully have control of her bladder. She is a puppy still, and though she has the basics down, she may not be completely emptying her bladder when outside. So when she goes back inside, she realizes this and just finishes up. Here are some tips to help get you through those piddle situations!

Tip 1: Stay outside a bit longer and see if your pup pees again. If she does, that’s a sign that she doesn’t empty enough the first time. Some pups may do this even 3-4 times given the opportunity. If your puppy pees quickly and then runs off to play in the yard, keep her on leash.

Tip 2: Take her to the same potty area each time. This will help to teach her that when she is taken to this specific spot, pottying is what needs to be done. No playing or other shenanigans in this area.

Tip 3: Don’t be a distraction. If she is outside peeing and you are too fast in praising/rewarding with a treat, you may be interrupting the urine flow. Don’t praise and/or give her a treat until she is completely done peeing and is moving away from the potty spot. And don’t walk away while she is peeing! Stay stationary as she may stop mid stream to try to follow you. 

 Tip 4: If she is treat motivated, and knows which hand/pocket/bag/etc they are in, she may not finish up doing her business completely because she wants that treat. And, at this point, reward her only when you are headed inside and you are sure that she has completely emptied her bladder.

Basically, your pup peeing inside after you’ve recently been outside is COMPLETELY NORMAL and just means her body is still learning, growing, and may need a bit more time outside (with some modifications). 

On occasion, some pups may develop a bladder infection causing them to piddle inside more. If you believe this may be the case, please consult your regular veterinarian.

Happy potty training!


Cardiology Assistant