Femoral Head Ostectomy

[suzanne]

I did search for this and only found a couple of topics... hoping maybe new info has been gained and you guys can help me out.

I work in a veterinary clinic, I know dogs and cats who have had the FHO done, I've seen one recently recover from a bi-lateral surgery and she's doing well, but she's only about 25lbs.

I was wondering if anyone had personal experience with a larger dog having an FHO done? My dog is about 56lbs.

Sepp has a crappy right hip that is now starting to give him a little bit of trouble. He probably had some type of trauma as a puppy because his left hip is perfect. About a week ago I noticed he was less bouncy [but not by much, it was subtle] and his back was sore. I had a vet check him out, he strained his iliopsoas muscle on the right side and he was only giving 75% extension on his right hip. Two vets I work with say that the FHO would make him unable to do what he does now - training for IPO and just starting to play around with agility, and eventually I want to get obedience titles on him. I'm going to talk to an orthopedic specialist on the 30th but I cannot afford a total hip replacement, it's about $5k - the implants alone are $2k.

Googling it I found a hunting dog forum with field labs who went on to continue retrieving, but that doesn't involve a ton of jumping around. I was wondering if we did the FHO now if he could build up enough muscle that the lack of a joint wouldn't matter? At this point he does not have muscle wasting on that leg.

Pretty much the vet who looked at him just told me he didn't want me to put all of my faith in the surgery, have it done, and not be able to do anything with my dog.

That being said, I will definitely put him on adequan.

Any input is appreciated. I don't really care if Sepp can't be titled, I just want him to be comfortable and able to still jump around and be crazy without being in pain. I wish I could afford the total hip replacement but it's just not possible right now.

He's been on rest since Wednesday of last week, he's on Carprofen[75mg 1x day], Tramadol[25mg 3x day], Methocarbamol[500-1000mg 3x day], and Ace as needed for sedation. I was going to put him on the treadmill today because we have obedience class w/ some agility mixed in on Tuesday but I felt him up and he's still really sore, so we're going to wait until Thursday.

Obviously we're going to see what the orthopedic specialist says, I was just wondering if anyone here had experience with the surgery. This whole thing kind of bums me out, he's a very active dog so it's hard seeing him in pain, and really sad having to sedate him - even though it's what he needs right now.



Photo taken by my friend Kay - this is what he normally does LOL.

[suzanne]

I should add the Carprofen is a slightly low dose. I had a bottle of 75mg caplets. Thinking about changing to meloxicam.

[Misskiwi67]

I should add the Carprofen is a slightly low dose. I had a bottle of 75mg caplets. Thinking about changing to meloxicam.

Why change to meloxicam? I don't feel it works any better, and its not any safer in larger dogs (much safer in smaller dogs with pinpoint dosing). You also have to stop the Rimadyl for 10 days before you can start a different drug.

Can your dog do agility and such now with his hip as-is? If so, then manage it with supplements. If its not going to work out for him and be pain-free, then I recommend doing the FHO, sign him up for rehab post-operatively, and find out what he can do. FHO is a salvage procedure, its to prevent pain and discomfort long-term. If you want your dog to have the best possible change to be a performance dog, you will likely need to find a way to do a hip replacement.

I have seen good success with the surgery in large hunting breeds, but they were kept lean and did not have a job to do, so no experience with success in performance dogs.

[suzanne]

Why change to meloxicam? I don't feel it works any better, and its not any safer in larger dogs (much safer in smaller dogs with pinpoint dosing). You also have to stop the Rimadyl for 10 days before you can start a different drug.

One of my DVM friends said the same thing so I just adjusted his dose, he's getting 56mg 2x a day of the carprofen. We also upped the tramadol to 50mg 3x day. So, thank you

Can your dog do agility and such now with his hip as-is? If so, then manage it with supplements. If its not going to work out for him and be pain-free, then I recommend doing the FHO, sign him up for rehab post-operatively, and find out what he can do. FHO is a salvage procedure, its to prevent pain and discomfort long-term. If you want your dog to have the best possible change to be a performance dog, you will likely need to find a way to do a hip replacement.

Well, he could up until this point. It's been a week and I don't see a massive improvement as far as pain goes. He's at least not limping anymore - which he was limping at the peak of all of this happening. Honestly, I don't really care if he can be titled - so much as he can continue to play pain free. The thing is, if he's limping without surgery he can't title, so if he limps after having the FHO it's not a big change. This is honestly the first time he has been 'broken' but he's REALLY sore. I worry that we've hit his peak physically... but I tend to over-worry so maybe he just needs a good break.

I will know more when we talk to the orthopedic vet, but my personal wondering was - if we do it now when he does NOT have muscle wasting, would he have a better chance of success? Instead of waiting until he has muscle wasting and cannot gain the muscle back? I mean, is this something reasonable to even wonder or am I way off?

The 2nd vet I talked to said the same thing you said - salvage procedure and he felt it should only be done if I cannot control Sepp's pain.

A hip replacement is definitely not in the cards at this point. Mostly I just want him to be comfortable and still be able to be crazy dog.

Thank you so much for your reply.

[Misskiwi67]

I will know more when we talk to the orthopedic vet, but my personal wondering was - if we do it now when he does NOT have muscle wasting, would he have a better chance of success? Instead of waiting until he has muscle wasting and cannot gain the muscle back? I mean, is this something reasonable to even wonder or am I way off?

Thats really a question for the ortho vet, I don't have enough experience with FHO to know if it will make a difference to wait or not, most people put it off as long as possible. My parents have a boxer mix, about 80 pounds, that has one horrible, painful hip. I told them to do FHO years ago, but they haven't done it yet, I'm starting to think they never will.

I do know that if you have access to rehab, you would be surprised how much of that muscle you can build back up again.

[suzanne]

I thought I would update this just in case anyone runs into a similar situation and are debating on doing an FHO.

After going through the surgery and the rehab I feel that the odds of success are based on your ability to rehab the dog, and the dog's ability to heal. Although many still consider it a salvage procedure, I think that discredits the surgery a lot because if you wait until your dog has no muscle mass left, I feel that it would be harder for the dog to recover.

We are only a little over 3mos post surgery. Right now we're going through a period where he isn't making a ton of improvements. I mean, it's just steady right now. He uses the leg most of the time. When I saw the orthopedic surgeon he recommended a rehab vet who would not call me back, even with a referral. The only other place I knew of at the time was booking 1 month out and was $270 for a CONSULT. We did range of motion exercises and multiple daily walks until he was able to go swimming, then we did swimming everyday, and then also started using a treadmill as well. I did just find out about another local rehab place and will probably take him in for a consult within the next few weeks and to try out the water treadmill. We also started bite work training again two weeks ago and it seems to be good PT as well.

Anyway I have been blogging about it:
http://lifewithseppel.blogspot.com/" onclick="window.open(this.href);return false;

Camera quality is bad, but here is him doing some obedience 9/18:


Here he is chasing the flirtpole yesterday:


I need to get an updated video of him walking. He still isn't putting full weight on the leg, but we are getting closer!