FHO vs hip replacement for small dog

[hwake]

Looking for honest feedback from anyone who’s had either procedure done on a small dog. My rat terrier (adopted from SPCA, unknown stray history) has a chronic luxated hip, most likely due to some physical trauma years ago. Per CT, it’s been luxated so long it’s formed a pseudojoint an inch above the actual hip socket. His leg on that side is visibly shorter than the other leg.

We have gotten consult and CT with a board certified ortho surgical specialist. She originally recommended the hip replacement, however after the CT she expressed some concern. The hip prosthesis would essentially restore the leg’s original length (plus some… it would actually end up 1-2mm LONGER than the good leg). Short term this can cause sciatic nerve issues, usually transient. The bigger issue as she explained is that this can increase the odds that the hip will re-luxate - since the leg is suddenly 1 inch longer than the muscles/connective tissues are used to supporting. Like a bungee cord being stretched over a longer distance. 1 inch doesn’t sound super long but he’s a 15lb rat terrier with tiny chicken legs so it’s actually a big change.

Our other option is an FHO which is lower risk of failure (and considerably shorter recovery time) but would result in his affected leg becoming even shorter than it already is. He gets around generally fine right now but I worry about worsening compensatory issues, etc.

Pet insurance has already authorized the cost for the hip replacement so cost is not an issue. WWYD?

[Willesdon]

How old is the dog? Is it worried by the hip? Does it show pain? What is the rationale for doing the op?

[hwake]

According to his shelter papers, he would be 5, but we got his dental done in 2020 and the vet told us based on the condition of his teeth he might be several years older, so possibly 7-9 by now. Or he could actually be 5 and just have spent a year on the street eating garbage. Hard to know.

He is definitely bothered by the hip, we originally got xrays done because he had a worsening limp this summer. He had always had a funny gait (he prefers to pace instead of trotting) but in the past year he began refusing to use that leg when he went up or down stairs, and began being grouchy and isolating himself at home instead of hanging out with the family.

Dasuquin didn’t help. He’s currently on lubrisyn and rimadyl and much happier, but he still limps. His latest bloodwork show that his liver enzymes are going up so I can’t keep him on NSAIDs forever. Primary vet and consulting surgeon agree that surgical intervention is the way to go, I’m just stuck on which.

[Marla_100]

With the lesser procedure, how much shorter would that leg be?
Have you tried him on only Lubrysin without the rimadyl?
I don’t think long term Lubrysin is a problem w/ liver but Rimadyl certainly is.

Many human knee replacement patients end up w/ a shorter leg on that side. Sometimes it’s unavoidable. My sister is one such pt. and it doesn’t bother her much, if at all.
I also have one significantly leg shorter due to old broken femur and I’ve adjusted, sometimes limp, sometimes not. Rarely have pain. No compensation problems. My point is that’s not the worst thing to end up having.

[hwake]

I did ask the vet if she knows how much shorter the leg would be after the FHO. Hard to say for certain but since his dislocated hip is so chronic, she thinks the fibrosis and scarring would hopefully keep the femur within a cm of where it already sits… all the muscles and tissue “want” the femur to stay there since that’s where it’s already settled. But since the head of the femur would no longer be there to occupy space it’s possible for it to creep up.

We’ve tried lubrisyn without rimadyl (once for several days due to GI issues, once for a few days due to vet pharmacy error) and both times he was miserable.

[Marla_100]

I’ll link to a golden retriever forum where owners discuss the pros and cons of both types of surgery and the rehab and outcomes.
Sounds like many believe the FHO surgery was much easier rehab and many said their dog walked on the bad leg out of the vet office and thereafter.
Maybe hearing some of their stories will help you decide.
With the dog’s discomfort I think I’d go for the FHO soon if I could.
The main suggestion from the forum was to make sure the surgeon has done many, many similar surgeries. Just like in human medicine you want to know how many hip replacements your human surgeon has done. Do the same due diligence for your dog.

Fho vs total hip replacement