In early June my 3 year old total mutt rescue dislocated his hip badly, luckily while our vet was at our house for the horses but she couldn’t reset it here. So off to the clinic where a surgeon, one I trusted, did an FHO (right?) where he rebuilt his hip. I asked for after care and he said just go let hin be a dog. Well this dog is a high anxiety type and now he will not use that leg at all. I’ve bicycled it and he will sleep on it under him but he will not put a foot down. I asked the vet and they said it could take 6 months for him to use it again but I’m highly concerned at the atrophy. In a crappy twist of fate we lost another dog in the meantime which highly sensitive dog considered his mama. So Mr Sensitive has had physical injury and emotional injury but nearly two months out now he will not use his rebuilt leg. The clinic tells me this is normal but is it? I’ve taken him for easy walks and a little swimming type things but he will not use it. I’m worried about an injury to his good leg if he won’t use the other… he was a very starved puppy when I got him and he seems sensitive to exertion. We dd a round of abx that seemed to help but now those are over. He isn’t eating well but it’s hot… we lost his mama dog just two weeks ago so not in the mix the whole time but still a thing. He was so bright and happy and loved to run before and now he just sleeps on the couch and is depressed and now I don’t know what to do. Is he sad? Is he still broken? Is it in his head or his hip? He pants a lot and fusses and is clingy but I would expect that from him just from losing the mama dog but now I worry about his hip too. I don’t know if I’m fussing too much or what to do. He still wants to go do things but he will not use that leg and cries if his balance goes to it. I feel like I lost two dogs in 3 weeks b/c the mama dog is gone and now he’s all messed up. I might be too caught up in everything b/c it’s been a rough few weeks but I’m pretty concerned. Any thoughts?
I’d be getting a 2nd opinion asap. I can’t imagine any surgeon sending a dog home after a hip replacement without a rehab plan, let alone just telling to “go let him be a dog.”
I’d want an xray right now.
They didn’t give you anything like this?: https://ucah.ca/fho-rehab-instructions/
A femoral head osteotomy is where the head of the femur is removed entirely. Is that what happened? Is this dog small (under 45 pounds)?
A second opinion is never a bad idea. But there’s also been a whole lot of trauma in that area, and it may just take some time and focused PT to get through recovery. Stability of the hip comes from scar tissue in FHO.
No after care instructions at all, that is a direct quote. “Go be a dog” I did look up instructions myself so have been following the protocol in that link (which is an excellent link, thank you!) but he just does not use it. He lets me move it around but he doesn’t himself. I did run it past the other vet in the clinic which is the vet we actually use and she thought it was normal.
It was an FHO and he weighs about 55 lbs, long legged yellow mutt genre. I keep telling myself about the trauma but after losing the other dog I’m even more concerned about this one. Any vet is 100 miles away so I’ve been trying to just trust the two that already told me to not worry but… still worried. I should just take him to the other vet we use but I keep thinking I’ll drive him all the way over there and be told the same thing.
It might be worth a virtual consult with a large referral clinic that sees a lot of hips. From what I’ve read, FHO is only appropriate for smaller dogs. There’s no longer a hip joint, and the scar tissue can only support so much weight. His leg no longer has a bony connection to the rest of his body, and that instability might be a little scary (and/or painful.)
Would you consider a total joint replacement? That might have been the more appropriate path given his size. Not sure how difficult it is to convert a FHO to THR, but perhaps worth asking about.
Anecdote: In the late 80s I had an 18 month old small Lab (50 lbs) who had been HBC at 6 months old with her previous owner. I adopted her through the large veterinary hospital where I worked (and where she was surrendered in the ICU after that HBC). On top of the healed injuries (femoral fx, spinal fx, rib fxs), she developed a luxating patella at 18 months PLUS was showing subluxation and arthritic changes in both hips due to hip dysplasia. At that time the vet surgeons did not want to do FHRs on such a young dog because they weren’t sure that the implants would last the lifetime of the dog. So she had bilateral FHOs. She healed well and was still running on those FHO hind legs at 14+ years old when we had to PTS for other health issues. I knew of a few other slightly larger dogs (up to 60lbs) that did fine with single FHOs.
IME as a vet tech, the dogs with one FHO were more reluctant to use the leg than dogs with bilateral FHOs. Perhaps because the FHO shortens the leg so the dog needs more encouragement/incentive to use the now shorter healing leg.
To strengthen the muscles in the hind legs for my dog we took her for walks on uneven terrain with hills, etc. She loved swimming but didn’t use the hind legs much swimming so we did walks in dog belly high water. If a nearby vet clinic has a hydrotherapy unit for PT that might be helpful too.
We had access to a physical therapist who worked with our vet on veterinary cases so that was very helpful.
Good luck!
I haven’t really every looked into either of these but your post made me wonder what the difference was. This is a good side by side.
This site does recommend FHO only for dogs < 45 lbs.
He’s a slim and formerly very active dog so maybe that’s why he made the choice. It didn’t seem like the hip was going to stay in by his assessment (and ours watching him manipulate it) and considering how far we are from a clinic, any clinic, we didn’t want to run the risk of it failing to stay in with other methods.
I put in a call to ask the surgeon about it. He doesn’t have the best bedside manner as you might imagine and the whole time we were in the clinic he kept talking to my husband instead of me which I didn’t appreciate. I don’t really question his choice of surgery, I do trust his decision, but I need to buy a vowel on what to do with the dog now. It’s not been a real long time since the surgery considering the extent but it’s hard watching him struggle and be so withdrawn. I don’t want to miss an opportunity to help him heal better than he seems to be now.
Thank you for the encouraging words, DawnJL, I hope he recovers as well as your dog did! We can do a lot of creek walks here so I will start doing that on a more regular basis as long as the weather holds.
Hip pain or any chronic pain can be difficult for dogs. I have a dog with hip dysplasia. Is your dog still on any pain meds? If not I’d really push the surgeon. Stress quality of life and how his personality has changed and is very different. My dog is maintained on daily galliprant, gabapentin and methocarbamol. We’re also going to add adequan because she still really struggles in winter.
It also might be worth looking for a dog physical therapist that’s able to do virtual appointments. I found the exercises they gave to be really helpful.
Oh virtual PT is a good idea; I can do the exercises with him if I know what to do and what to watch for! He got 7 days of carprofen and that was it. I called my vet (in the same practice) for another week and she also did abx (a week) just in case and that’s been all. The injury was June 10. He jumped out of a second story window b/c we were at the barn doing dentals on the horses and he got an attack of FOMO. Ugh…that was an expensive day.
Because the end of the femur is removed in an FHO, there is no “bone to bone” connection any more so once the incision and muscle have healed there shouldn’t be pain. Weakness in the muscle that now holds the leg in place and the difference in the biomechanics of the FHO limb seem to create a reluctance in some dogs to use the weaker leg without physical therapy and exercise/activities that engage the FHO leg.
He’s definitely an anxiety prone type if there is something to be anxious about… but before this injury and the loss of the mama dog and probably my ensuing grief cloud he was very happy to play and run around.
Picture from the morning after. His incision looks messy here but after I cleaned this up I thought it looked pretty good and he never did fuss with it. Which shocked me, I thought he was going to need an e collar. It’s weird to see his leg when it still had muscle…
Aww buddy. Only a week of pain meds for such a big procedure seems like a miss. There’s a lot of trauma associated with the dislocation, and then a lot of trauma getting into the hip for the FHO. Getting aggressive on pain management seems like a good next move. Maybe pair that with an anti anxiety?
But as you look around for virtual PT, do really consider a virtual vet consult, too.
I will; I do have another good clinic I can take him to and make sure everything is making sense, one that is a lot more attentive. There were a lot of tries to get his hip back in and I can’t imagine how sore his whole body was after that, let alone the rest of the impact.
Thanks everyone so much; I’ve been really concerned about him. For such a happy sort he has had his hurdles. The rescue I got him from found him starving under a dumpster as a puppy which has worried me about how far behind the curve he might be for healing.
Gabapentin actually helps with anxiety too so that could be a win win. Poor pup we don’t know what we don’t know and have to listen to the experts. A few years ago I had a different vet who told me I had to get my dog off the pain meds or I was going to kill her by killing her liver. So I slowly weaned her off and did pt etc. she was so painful I switched vets and that one took one look at her X-rays and said what the hell literally…this dog has to be on pain management.
do you have anybody near you that does acupuncture? I think that in conjunction with some meds for pain and anxiety could make a big difference. The specialty place I used to work at did their best to send all their ortho cases to the acupuncturist as part of recovery. I can remember one owner in particular who sang that vet’s praises as her dog’s recovery from the second FHO was worlds better than the first (which was done in a different state with only western medicine).
I’ll add my support for acupuncture too. I was fortunate to work for a veterinary clinic that had one vet who did acupuncture and Chinese herbal medicine as well as traditional Western medicine.
My sweet Lab, Cassie, with the bilateral FHOs (plus spinal spondylosis from the HBC, and other orthopedic issues) responded very well to acupuncture for her orthopedic issues. She Since I was a tech at that vet hospital for almost 20 years, I saw a lot of patients that responded well to the acupuncture including several of my own in addition to Cassie.
For instance, the dogs in our practice that had osteosarcoma (bone cancer) and got acupuncture in addition to any level of western treatment (pain meds only for the folks opting for limited treatment to amputation and chemo plus pain meds for the owners opting for the most aggressive option) tended to exceed the typical survival window.
We did a lot of acupuncture on dogs with orthopedic issues – like arthritis from hip dysplasia or cruciate issues, etc. and often saw improvements in their comfort and mobility.
I know of one family that had acupuncture for their family member who suffered a catastrophic spinal injury because their dogs had responded so well to acupuncture for orthopedic issues. The family credits the acupuncture sessions right after the injury with a better than predicted retention of feeling and function in that family member.
