Ema's severe HD - DR consult - German Shepherd Dog Forums
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post #1 of 19 (permalink) Old 09-22-2013, 10:55 PM Thread Starter
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Exclamation Ema's severe HD - DR consult

Well we met last week in ABQ with Dr. Peter Schwarz. Excellant consultation and he talked to use about all the options, even the do nothing situation. Emma's only option is full hip replacement both sides. He is uncomfortable even considering the TPLO procedure or others based on her size and age. Good news is her knees and elbows and paws are good - no issues. Emma as usual did not like him and I had to use the muzzle during the exam process.

After care will be a 3 month nightmare for each side keeping her created and only out for potty breaks on a leash and sling to support her. I can do it, but it will break my heart to put her through it - especially twice. Ill also need a bigger crate and to build a ramp on the steps - not a big issue. The price is 6 K each side plus local vet bills and x rays every 2 weeks.

Big issue is we cant afford this right now. Son in college and my own medical bills, etc. However, I'm starting to save for this and watch her closely on activities. Limited tug is OK, but no ball fetching. Now if I can only explain this to Emma that she is not supposed to run around the yard like she does. She gets the zoomies a lot and will not respond to me during these events. I am going to start her E-collar training this next week to see if it helps control her a bit. I want her to have fun, but not hurt herself. In the house I can keep her activity a bit lower, but she still jumps on and over the couch is something is going on outside.

Please let me know your thoughts

Keith
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post #2 of 19 (permalink) Old 09-22-2013, 11:43 PM
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I think it's great that you are going to have the surgery done. It will seem like forever waiting for her to heal. In the mean time is there a place to take her swimming? That is good for burning energy and hips.

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post #3 of 19 (permalink) Old 09-22-2013, 11:52 PM
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How much are you walking her? My first gsd had severe bilateral HD and I walked her at least 5 miles a day. That helped a lot. She needs good muscle mass pre-surgery because it will help her heal more quickly.

Massie did have a THR but only on one side and I waited until she was 5 years old (she was diagnosed at just under a year). Her recovery time was more like 6 weeks and she was only on bed rest for a little while. I was able to take her on short walks pretty quickly afterwards.

I got her surgery done in Phoenix (was living in Abq at the time).

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post #4 of 19 (permalink) Old 09-23-2013, 12:17 AM Thread Starter
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Thanks
She gets short walks every day as advised - nothing strenuous, no running or jumping.

We hope to be able to afford this - trying to save and look at other options, being retired and on a limited budget does not help. Were going to give it a few months and see how she does.

Right now were spending thousands on my son to go to college ( has 2 years left) and just about the same on the wife's horse - she is allergic to hay Certain hay pollens cause her to have breathing issues, so we are doing allergy injections and currently strong antibiotics to eliminate a current lung infection. We did have a laugh at the Vets office that Emma just might be more expensive than her horse Lillie.

The after care will be hard on me, especially supporting her to go out and potty. At least being retired I will be home all the time. The rehab instructions do have her limited walking after a week or so, but doctor was very concerned about following things exactly and limiting her activity. Ill email him and ask about her walks now to build muscle mass as you suggest. However as bad as her hips are I don't want to get into any pain situation for her.

My local vet does have a therapy pool with a tread mill, so I will be checking on this. However she is afraid of the water, even jumping over puddles and streams on our Santa Fe vacation. She also hates baths too . She also now hates the vets office too - wonder why.
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post #5 of 19 (permalink) Old 09-23-2013, 12:38 AM
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So sorry to hear. I am going thru the same thing with my 8 month old. Also had thr suggested. I am researching stem cell since mine is still young before I make any decisions. The adequan is helping alot. I have to find a new way to give glucosamine. Was hiding the human grade pills in his food. But hes gotten smarter with age and spits them out. Ive even tried hiding them in hot dogs to no avail.

Did you post pics of her hips. Is she in pain. How do they determine if they are severe?
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post #6 of 19 (permalink) Old 09-23-2013, 06:54 AM
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Yes - would love to see those xrays for people who know xrays (I do not).

Please look into the FHO.

When you google it, you will find articles from vet surgery centers that do the THR who say how it's really not a good procedure, vets who will say it's not used anymore, it's a salvage procedure, that it's only used for tiny dogs and cats, and you will pretty much feel like a bad pet owner for doing it.

I just went to my vet with a dog that our rescue director knew of, and the dog's owner. The dog is a 108# Mastiff/Dane mix who has a broken hip. They were quoted either the $6,000 THR or $3000 (?!?) for an FHO but with an additional thousand in rehab. They did not recommend the FHO on this dog. The family, including three kids, were unable to do this, and were afraid that they would have to put their young, otherwise healthy dog down. She goes Wednesday for her FHO at the vet office I go to. Rehab - none in my vet office ever go to rehab, the owners all do it. To say this family is happy is an understatement - you could see the relief in the woman's face.

My vet did say a bigger dog (this giant girl) may be less agile (she probably is anyway!), that the leg length size might be a bit more noticeable, but that the dog would likely do well (as in all surgeries there are potential complications) with the FHO.

With the FHO there is no crate period, no time where the dog can't move, much less worry about them hurting themselves, and I am going to guess, less concern about infection as there are no foreign bodies implanted. Check that though!

My dog who had one is 50# or so, and she's done amazing with it - there is no difference in muscle tone between legs, she may be able to do more than the typical dog - she can jump, pivot, more - but she's a nutball.

Here is the interesting thing - when we were all at the vet, there was a 4th year student from Purdue University - and when the owner was saying that the FHO is bad, and I said salvage, I saw the student make a face like "huh?" Later she told me that at Purdue, the THR is the rare procedure, the one they consider salvage and that the FHO is preferred. Sooooo....a very interesting regional difference.





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post #7 of 19 (permalink) Old 09-23-2013, 07:17 AM
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I second the swimming idea. If she's afraid of the water, try coaxing her in, but let her get in on her own terms.
Ozzy was fine with lakes, but wouldn't come within 5 feet of clear, blue water (pools). I got in with a tennis ball (his most favoritest thing in the whole wide world) and he made his way in. Within 30 minutes, he was jumping off the diving board. (Though I probably wouldn't suggest that part for her).

But he still HATES baths. Haha.

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post #8 of 19 (permalink) Old 09-23-2013, 08:10 AM
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I third swimming, even if you can find a PT in your area that has a water treadmill and actually finding a good PT that can give you some advice/suggestions on muscle building..

Dogs are pretty stoic, even tho the rehab time is 3 months, they can usually get around / compensate better than WE do when they go thru surgeries like this..

Good luck to you, your a great dad to want to do all you can for her

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post #9 of 19 (permalink) Old 09-23-2013, 04:56 PM Thread Starter
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FHO or femoral head ostectomy (removal of ball at hip joint) was not recommend due to Emma's expected adult weight. http://dcvets.org/surgical/fho.pdf



Dr. Peter Schwarz went over this as a less expensive option, but felt it would not prove satisfactory in the long run. Dr Schwarz is board certified and used to teach at the Colorado University Veterinary school. He is highly recommended - in fact no one has ever mentioned anything bad about him.


I have checked prices around Colorado/Utah/NM too and all are comparable. He is very insistent about after care as he does not want the new hip replacement material driven deeper into the bone as can happen if dogs get active too soon.


Msmaria - I don't have postable pictures of her hips. Its on film only, but believe me they are both very bad. Where the ball socket should be is almost flat. So flat the the TPLO procedure where they break and rotate the hips would not work. They have been looked at by at least 4 orthopedic doctors - all respond the same that THR is the only course of action other than treat pain and ultimately have to put her down later. As for how long to get to that point, no one knows.


Now as to how to give the glucosamine. I use the Sam's "Simply Right" triple strength glucosamine/chondroitin 1500/1200 vanilla flavored human grade pills. Emma will chew them up if I do get them in her right, but I usually hold them between two of my fingers, have her open up (use the other hand and gently squeeze at the back jaw joint) and place the pill at the very back of the mouth in her throat. I then gently hold the mouth closed and rub under her chin/throat. She swallows with no problems. A treat is usually given after too.


Yes I have also looked into care credit, but do not want to go deeper in debt. Were looking at options, but as she needs to be a bit older before the procedure can be done, we have a few months.


Thanks Folks
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post #10 of 19 (permalink) Old 09-23-2013, 05:38 PM
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If your saving the money anyway, care credit is not bad. Depending on the amount, they offer so much time interest free.

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