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Discussion Starter · #1 ·
So my rescue GSD has severe bilateral hip dysplasia and is currently on NSAIDS, but she still seems to be under the weather. She’s not as painful as before, but she gets easily tired from short walks and prefers to lie down most of the time. She is around 6-7 years old and I imagine her condition will get worse as she gets older. Is surgery a good alternative? THR isn’t an option, but FHO seems to be the best fit. My only worry is that she won’t use the leg, or that her back muscles aren’t strong enough to support it. She also despises water so hydrotherapy isn’t an option in her recovery. Would love some advice or help on this situation.
 

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What size is your girl? Maybe the recommendation varies depending on the orthopedic surgeon, but I remember our doctors saying that FHO wasn't recommended for dogs over 50-55 pounds. They said it wasn't an option for our big boy, but that's been ten years or so ago so maybe things have changed.

For our Ferg, we did Adequan injections as well as daily Dasuquin supplements. Healthy diet with some added Longevity powder supplement (Springtime Inc.). Kept his weight low. Set him up with a physical therapist (which sometimes involved hydrotherapy, but there were other treatments too). In last 2-3 years of his life, we limited walks and his favorite daily exercise was mostly short but fun jaunts through the woods since that was his favorite thing to do. In his last years, we added daily Gabapentin for pain relief in addition to the NSAIDS.
 

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Discussion Starter · #3 ·
She’s pretty small, about 55lbs. Her muscles aren’t well developed though which is my main worry.

Thank you for the help, I’ll be sure to look into the injections. I already walk her in natural areas (dirt is better than concrete for her joints).
 

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She’s pretty small, about 55lbs. Her muscles aren’t well developed though which is my main worry.
I understand the worry. The orthopedic surgeons who saw my dog said that FHO works best on small-to-medium size dogs with a wiry muscular build.

Good luck in finding something that helps her.
 

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We are in a similar situation with our 11 month old female, Millie (~58 pounds). 2 different vets, an orthopedic surgeon, and a Physical Therapist have all concluded that Millie has some of the worse hips they have ever seen. This may be way too much information but wanted to share in case its helpful for you and also see if folks have any additional insights for me (us) :

Relevant History: Millie began limping on the right back leg around 11/20/2020. Radiographs revealed bilateral hip dysplasia with pronounced subluxation and early osteoarthritis. Millie is not considered a candidate for a Total Hip Replacement due to the severity of the dysplasia but will likely need bilateral FHO surgery in the near future (current recommendation is to do both hips at the same time which scares us to no end).

Current Medication/Condition: Carprofen 50 mg 2x daily; Gabapentin 100 mg as needed for pain (we rarely give her this as she doesn't exhibit a lot of pain but now that we're taking her for PT, the recommendation is to give her 1 about an hour before each session); monthly Legend injections; Pentosan injections (1 shot every 4 months); monthly chiropractic adjustments, and Dasuquin daily. She goes for a daily slow walk of about 25 minutes and likes to play ball but we have restricted this for now and find other ways to occupy her. We also have a ramp for truck/car, she sleeps on an orthopedic dog bed (Big Barker), and we gently massage her hind limb muscles 10-15 minutes a day.

Exam Findings from Physical Therapist: Millie presented bright, alert, responsive and ambulatory with a shortened stride in the hind limbs and grade ⅖ lameness on the right hind limb. She has a narrow stance and sit. Front digits, carpal joints and elbows are within normal limits bilaterally. Shoulder flexion and extension is within normal limits bilaterally. Tarsal joints have mild hyperextension, worse on the right. Stifle palpation and range of motion is within normal limits bilaterally. The left hip has moderately reduced extension and abduction with discomfort noted. The right hip has crepitus and instability during passive range of motion. Flexion is within normal limits but extension and abduction are reduced with discomfort. The muscles are underdeveloped in the hind limbs with the left very slightly smaller than the right. Millie has grade ⅖ strength (moderate weakness) in the left hind limb but grade ⅕ (inability to perform the assessment) on the right. Neurological screening is within normal limits. Stance analysis shows the following average weight bearing: 29% left front, 31% right front, 21% left rear, 19% right rear.

Goals/Exercises: 1) Manage pain & discomfort; 2) Strengthen hind limbs with PT; 3) Delay surgery until full grown (if possible); and 4) Get her used to PT prior to surgery. Home PT includes every other day of ~7 reps of 2 sets of cavalettis (1 set at 3 inches; 1 set at 4 inches); 7 reps of front legs only on a 4 inch step (5 second hold); and 7 reps of an up/stand/dismount on a 4 inch step with all 4 legs. We go back to the PT in 2 weeks to see how well we've been doing our homework! Our future goal is to get her into the pool but we need to wait a bit to for the water to warm up for her.

Apologize for the lengthy response - hope you find it helpful and again if folks on this forum have any opinions, suggestions on our current course of treatment, that would be most appreciated.
 

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Discussion Starter · #7 ·
Thank you for taking the time to type all of that out, it’s extremely helpful in terms of deciding what to do with my girl... hope everything goes well with your pup
 

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Our rescue's vet has done many FHOs on GSD-sized dogs. All came out fine and resulted in pain-free lives. They won't ever be athletes after that surgery, but it does give them good mobility without pain. It's a salvage operation. THR may be preferred, but there are legitimately times when the best, most expensive option it's not in the cards for a dog (sometimes there isn't access to an ortho surgeon in a region, or it's simply cost-prohibitive for the owners). In those situation, the second-best FHO option may still be considered by the vet to give the dog better quality of life than doing no surgery at all.

Many of these dogs need to be started on Adequan as soon as you can do it, and kept on it to slow down the degenerative joint changes while you decide on whether to do surgery. That's an important conversation to have with a vet. If Adequan isn't available in your country (or is out of budget), there is a generic called "Ichon" is the same active ingredient and some vets have found works similarly when injected on the same schedule as Adequan (at a fraction the cost, but it's an off-label use).
 

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Discussion Starter · #9 ·
THR was what I wanted for her but sadly no vets in my country (that I know of) do THR. Our vet’s assistant was the one who mentioned FHO, but the actual vet said the recovery was “too difficult” and wasn’t recommended, but after researching more and more on the surgery I’m considering it, I’d just have to find a good rehab place.

I’ve never heard of Adequan, but I’ll most definitely look into it.
 

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Depending on your access to rehab specialists, you might even be able to do a teleconsult (Skype, Facetime, Zoom, etc.) with one to show you the rehab exercises. I know of one who uses software to email out the exercises to clients -- it has videos of how to do them. Our regular (non-specialist) vet showed them to a foster volunteer for a rescue dog, and she did them at home herself -- it wasn't rocket science.

In the U.S., a bilateral THR (= both sides) runs about US$10,000 -- most people can't afford that! The FHO costs far, far less.

Is there a national university in your country that trains veterinarians? You're likely to find the best surgeons and rehab specialists at a place like that, if they have a "teaching hospital" associated with the program, where the faculty are training veterinarians.
 

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Discussion Starter · #11 ·
I found one rehab place that is close to where I live thankfully. As far as the actual surgery, there is a veterinary clinic that specializes in ortho surgeries a couple hours away.

There is university that trains student vets here, but I much prefer the clinic that has experience with these types of operations.
 
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