Heart Broken - German Shepherd Dog Forums
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post #1 of 62 (permalink) Old 07-29-2014, 06:54 PM Thread Starter
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Heart Broken

I am so upset and angry. I took my dog to the vet because he seemed to injury his leg that he had a THR done on 13 weeks ago last thursday. He was due for his 12 week post op xray so the timing worked out.

I am angry because the conversation I had with the vet went like this. Hi, the hip is in place however I don't like something I see. I can't tell if it is an infection of the bone so we are going to put him on antibiotics but I don't think you have anything to worry about. Now we have had 2 other times that we brought him in since his hip was replaced and everything was minor and those conversations all went the same way. So I just went with it.

I got the pills yesterday and started him on them last night. Today when I gave him his pill I thought to myself why does he need so many pills if its nothing to worry about at 450mg ever 12 hours. Which lead me to google which lead me to Osteomyelitis and how f'in serious this really could be.

I just got off the phone with the vet and told him that if I was in front of him I would have punched him in the face for down playing this. I spent so much money at his office and do not even deserve to be told the worst case I have to figure it out on my own.

I don't even know how to feel right now. The worst case options have my head spinning but it sounds like the thr could be a total failure. He told me that if the dog is not walking better after the weekend we could probably rule out injury and it is in fact a bone infection. From our conversation it sounds like antibiotics do not have a high success rate.

Anyone have any experience with post op osteomyelitis. Can anyone lend any advice for me to look for? I am due back in three weeks which at that point we will tell if it has progressed where we can determine for certain its a bone infection and the three weeks of antibiotics have worked or not. All that I ask is please do not sugar coat your experiences.
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post #2 of 62 (permalink) Old 07-29-2014, 08:26 PM
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was the surgery done by a board certified surgeon? If not, I'd be looking for one. If yes, I'd be looking for a second opinion

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post #3 of 62 (permalink) Old 07-29-2014, 09:08 PM Thread Starter
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He is board certified and is rated one of NY's top vets. I really want someone to blame right now but the fact is I have heard nothing but great things about him
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post #4 of 62 (permalink) Old 07-29-2014, 09:15 PM
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can you PM his name to me?

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post #5 of 62 (permalink) Old 07-29-2014, 09:39 PM Thread Starter
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He has not been diagnosed since x rays do not show a bone infection as of yet but the dr wanted him on antibiotics to get started in case it is a bone infection.
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post #6 of 62 (permalink) Old 07-29-2014, 11:58 PM Thread Starter
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Got a second opinion and if he has the infection the hip will most likely need to come out. Antibiotics cannot get to the infection site on the prosthetic which is why it needs to be removed. I am being told there quality of life is still better then before because the body creates a false joint. The other vet stated that unfortunately infection happens with surgery however down playing the severity of this really makes him question how good a vet he is. There is nothing worse then a post op bone infection.
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post #7 of 62 (permalink) Old 07-30-2014, 11:39 PM
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Ugh. Sorry to hear this. I know with Rudy, I was warned of possible infection.
If they take the implant out, maybe they can bathe the area in antibiotics, then they do an FHO. If so, your dog will be in good shape, hip wise, as long as they get that infection under control.
Recovery from FHO isn't as restrictive as THR.
Keep us updated. I'll be thinking of you and your buddy.

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post #8 of 62 (permalink) Old 07-31-2014, 12:05 AM
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The surgeons that I work with are completely crazy about sterility when it comes to a THR more than any other procedure because you are taking an implant and putting it into a major bone within the body that produces important cells for the body. We literally bleach the whole OR down from ceiling to floor, take everything out, bleach anything that will need to go back in from top to bottom, make brand new scrub and alcohol for the patient, we aren't allowed to use anything to keep them warm that potentially could blow things around (normally we can use a bair hugger that uses warm air to help keep a patient warm). They culture the site at the time of surgery, are super cautious about things being sterile and having implants on hand for the procedure that were ordered close to the procedure to ensure the best sterility. It is not something that should be waved off.

I even was recommended to have my dog have a dental a month or so pre-op to ensure any bacteria that could be slipping in via the gums to be taken care of.

I was very careful afterward, but the stinker managed to lick some at her sutures. They got a bit red and the vet decided that giving her antibiotics then would be a good idea. It isn't the amount of the drug or the times that you give the drug that indicate how serious of a drug it is. It is more the actual antibiotic class and what the drug covers in what it can take care of. The drug of choice for most orthopedic procedures (human or animal) is cephalexin. Most dogs will end up getting a gram of it twice daily post op. But there are other stronger drugs based on what class they are in and what they can penetrate. If they start talking IV antibiotics, then you can be more worried there.

If they worry about implant failure due to infection, they will remove it and culture the hardware/area it was removed from.

Speaking from experience, when I noticed that Kenai's incision was a little redder than usual while at one of her acupuncture appointments, I mentioned it to the main surgeon for it and he hadn't thought much of it, and just gave an antibiotic to cover just in case. There was never a sign of trouble on the radiographs however. How old is your dog? I think the only time that we ever removed a THR implant was a dog who ended up with osteosarcoma, was very, very old on top of it all. Otherwise we haven't had issues.

However I only know my surgeons, and we're out in Idaho. It would not hurt to perhaps ask for the surgeon to call and express your concerns, ask him what is happening and why he was not as concerned. There may be a reason for it that you and the person whom you spoke with are not aware of. Not all vets are of the same making, however the ones who went through extra training/residencies and had to pass yet another exam and set of requirements you would hope were a little more up to speed than others.

Hope everything turns out okay for you guys.
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post #9 of 62 (permalink) Old 07-31-2014, 12:28 PM Thread Starter
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I have been extremely proactive with getting other opinions. What I have learned is that my surgeon is one of the best in the world. One vet actually said I have no business even questioning someone of his expertise. One who has dealings with him told me (right or wrong) guys that get this high up on the food chain can have a poor bed side manner. They can be socially awkward and forget about our emotions.

No one can see the osteomyelitis on x ray because its most likely at the prosthetic and it has not been infected long enough to make its way down to the bone and show conclusive evidence. With the dog being on antibiotics since Monday and his condition is getting worse its safe to say the worst is here.

On Monday they are making a small incision at the site of the hip replacement and will be doing a biopsy. A biopsy which is not even 100% conclusive will let us know what kind of bacteria the infection is and we could try to treat that bacteria for two weeks.

At this point we pretty much know there will be no success story here and to prepare ourselves that the hip is coming out. My dog is in good spirits. He wants to play and he is eating well. Just can't put any weight on that leg.

I am hanging on by a thread. I am devastated that I have put him through this for nothing. We are getting married in 4 months, we are going away to Europe in the 2nd week of September and its all been paid for. I am trying to get this figured out as soon as possible so I can get him recovered before that. Its just an immense amount of pressure and heart ache.

Thanks for listening everyone. I truly appreciate it
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post #10 of 62 (permalink) Old 07-31-2014, 12:38 PM Thread Starter
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Originally Posted by M&J View Post
Ugh. Sorry to hear this. I know with Rudy, I was warned of possible infection.
If they take the implant out, maybe they can bathe the area in antibiotics, then they do an FHO. If so, your dog will be in good shape, hip wise, as long as they get that infection under control.
Recovery from FHO isn't as restrictive as THR.
Keep us updated. I'll be thinking of you and your buddy.
I am not a 100% but I don't think an FHO is possible after a THR. No one has mentioned that to me as an option unless I am misunderstanding something

From what I have learned the area of infection is basically compromised. The prosthetic will be removed and the dog creates a faulty hip joint where the prosthetic was. Its better then before but no where near as good as a THR.
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