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cmaccoll 04-02-2014 08:50 AM

total hip replacement in puppy
 
My adorable 11 month old GSD puppy has severe left hip dysplasia and is going to get a left total hip replacement next week. I'm terrified of the recovery period as he needs to be kept quiet and calm for 2 months so not to injure new hip. Anyone with experience with this?

DWP 04-02-2014 08:51 AM

Fho
 
Look into FHO before you get the hip replacement. Look at all options.

blackshep 04-02-2014 10:03 AM

I agree about looking at all your options, if you haven't already. I have a pup with HD in one hip, and I'm not going to do surgery unless she is really, really lame on it. She is getting around ok, and yelps occasionally, but until it is affecting her quality of life.

How lame is he?

wyominggrandma 04-02-2014 10:06 AM

Do an FHO procedure. They are up and walking the next day, you WANT to do mild exercise. RAnge of motion exercises help healing Swimming is wonderful.
There is no having to replace hip hardware in the years to come... No metal is left in dog. Scar tissue forms and the dogs do great.
I can't imagine doing a THR on a young dog. My first GSD had both hips done with FHO at about a year old. She healed fine and went on to do search and rescue for 9 years. She was fairly big at 1 year. In my girls case, one hip had NO acetabulum at all, hip was totally sublexated and the second hip was severe.. I did them about 10 or 12 week apart.

RebelGSD 04-02-2014 10:15 PM

I had FHO on a foster and she did great. Walking around after three days.

Colie CVT 04-03-2014 12:09 AM

Generally speaking, from the veterinary aspect of things, we prefer to do FHOs on smaller dogs because the false joint that is created is not as strong as the previous joint. We have done THRs on dogs around that age and not had any problems with it, the recovery or the lifespan of the implant in the dog. One client who has a now... if I remember right, 16 year old chow/shepherd mix, had her hip replaced back when she was 1.5 years of age, and it still does her just fine now! Think of how long ago that hip was placed compared with how long that has been a common procedure done by board certified surgeons. It's come a long way!

And I can speak from experience as my first dog had her left hip replaced when she was 8 years of age. The confinement definitely gets to be hard, especially after a month or so along after. My dog was not able to take NSAIDs, so she basically had acupuncture, tramadol and a fentanyl patch for pain. One week after surgery when going home from an acupuncture appointment she lost balance and fell between the seats of my ford taurus. I had to stop, throw the car into park and contort around to help her get out of that position. She had seemed okay, but the next day she was limping a little more than she had been (and for the record most of these guys are up and walking after the procedure too, you have to sling walk EITHER procedure for at least an 8 week period to ensure that they remain stable as they heal). X-rays revealed that things were still okay, and it healed up fine. My baby girl had 3 legs for the first time in her life and the sheer joy of watching her run is something I'll never forget.

I don't believe we've ever replaced hip implants honestly. The vets I work with are helping with a new kind of hip procedure that they're trying to get implants working for, and the THR still is better. -shrugs- Personally I would go with that procedure again with the success I have seen in our patients and my personal experience with my Kenai.

And for the record, she stood up after being extubated just fine. ;)

wyominggrandma 04-03-2014 11:10 PM

Working with vets for over 35 years, we have done many many FHO on big and small dogs. As you know, FHO are also done a lot on dogs that have been thrown from trucks and land on their hip/leg. These are usually big dogs, fat labs, etc but as a salvage procedure it works.
My GSD that had FHO's done on both hips at about 12 months old was big then and matured to over 70 lbs. Her FHO's were perfectly fine during her lifetime and she did search and rescue missions until 9.
I never did a sling walk on FHO's. I had them up and walking if they wanted, started range of motion exercises the next day and did plenty of swimming. Not much to "heal' in a FHO, the femoral head is cut off, muscle is put over the top bone for cushioning and it is left to form a false joint to the acetabulum.Nothing to slip or move during healing. I have had FHO's done on three of my own dogs, two big, one small. Have helped many clients with FHO's on their dogs and never had an issue healing and dog never had any issues afterwards since there is not longer bone to bone contact so no pain.

Colie CVT 04-04-2014 12:11 AM

I work at a large referral and emergency hospital for the 3 board certified surgeons. If they can, they prefer to do a THR over an FHO with a larger dog (and honestly smaller ones too, since the smallest we've done is a boston terrier) because they have a true joint instead of a false one made of scar tissue and shifts within the muscles to compensate for the lack of the ball and socket style joint. You have to do passive range of motion with them because if you don't help them get the leg moving (which honestly most FHOs that I have seen don't want to put weight onto that leg even a few days after the procedure) the muscles will not end up in a functioning manner, but rather just tighten and stiffen up. It's the big issue with femur fractures also, the muscles can get extremely tight and then its truly hard to get them working right again.

It is, as you say, a salvage procedure. Which generally means last choice. If the OP feels comfortable with the veterinarian they are working with and with getting the THR done, then why shouldn't they? I never regretted getting Kenai's hip replaced. I saw a dog who had to bunny hop to run, had her legs literally fall out from under her, run like she was a normal dog once she had healed from surgery. It was like she had a third leg to stand on, and I still feel immense joy watching videos and seeing pictures of her running after the procedure.

Both procedures still have to heal. You cut bone and shifted muscles. The body has to learn how to adapt to a new configuration. The loss of the joint that it relied upon. You still have healing, the patients still experience pain. We wouldn't be running them on fentanyl CRIs or sending them home with things like fentanyl patches, tramadol and morphine if it didn't hurt! Not to mention NSAIDs like rimadyl and meloxicam. Orthopedic patients generally go home with a good two weeks worth of pain medication and anti-inflammatories.

Veterinary medicine has come a long way, and the advances that have happened really are for the better. Our patients with THR can walk, stand, etc on their own. We exercise the caution to give the bone the chance it needs to heal. Specific exercises at different times of recovery, acupuncture, lazer, e-stim, hydrotherapy. Any surgery that deals with bones is only as good as the after care you put into it. -shrugs- I may be a minority voice, but I do believe that THRs are not the evil devil everyone wants to make them out to be. And my reasoning is from helping with the procedure and after care many times working with the exceptional team of vets and techs that I work with.

BowWowMeow 04-04-2014 01:28 AM

There are many people on this board who have had FHOs done on their dogs. Several of those dogs are older now and are doing fine.

My dog Massie had a THR at 5 years old. If I had a dog who needed surgery today I would go with an FHO.

wyominggrandma 04-04-2014 07:18 AM

Gee, ColieCVT , I guess my experience for years in the same field, DOING THE SAME SURGERIES AND AFTERCARE makes me less knowledgeable than you? I KNOW what the surgeries entail, have assisted in both types and done aftercare in both types.
I thrilled to death that YOUR BOARD CERTIFIED SURGEONS recommend the THR over FHO.......... That doesn't mean it is the ONLY and BEST procedure. THR's also give the vets more money in their pockets. Dogs do just fine with FHO"s......BIG or SMALL.


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