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What is Hip Dyplasia?
What are the clinical
signs of Hip Dyplasia?
Can you tell from my dog's x-rays
(radiographs) if he/she is a good candidate for THR?
What
are the treatment options for Hip Dyplasia?
What is a
Canine Total Hip Replacement?
Why choose a Total Hip
Replacement?
Is your dog a candidate for
Total Hip Replacement?
What can I expect from this
surgery?
How do dogs feel with a Total Hip
Replacement?
Does a Total Hip Replacement "Wear
out"?
Should both hips receive a Total Hip
Replacement?
What is the surgery like from a patient's
perspective?
What is the postoperative care for my
dog?
What is the success rate for a Total Hip
Replacement?
Are there any risks?
When should the surgery be performed?
My dog is on medication. Should I stop giving this?
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What is Hip
Dyplasia?
Hip Dyplasia
is an abnormal development and growth of the hip joint. Both hips are usually
affected, but only one hip may show symptoms. The onset of clinical signs may
not occur in both hips simultaneously. Hip Dyplasia is manifested by varying
degrees of laxity (looseness) of the muscles and ligaments around the hip joint
with instability and malformation of the joint components. Arthritis is the long
term consequence of hip joint looseness.
| A. Young dog with normal hips; note how the head of the femur sits
tightly within the acetabulum. |
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B. Young dog with CHD (Canine Hip Dyplasia); note how joint laxity
allows the head of the femur to
subluxate. |
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| C. Old dog with CHD and severe arthritis; note the flattening of
the head of the femur and added bone fillings around the neck of the femur and
within the acetabulum. |
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What
are the clinical signs of Hip Dyplasia?
The
clinical signs of Hip Dyplasia are lameness and pain which can be evident as
early as four to six months of age.
The
symptoms can initially be as subtle as:
- stiffness in the morning.
- slowness in getting up.
- not
wanting to exercise as long or as vigorously.
- a
change in stride of the back legs.
- "bunny hopping".
- wanting to sit down during walks or while eating.
- reluctance to stand up on the hind legs.
Sometimes the only observation is an "inactive" or "laid back" puppy. The
symptoms may not be present until a dog is middle-aged or older. Dogs showing
signs of discomfort can be any age and of any size. However, large breed dogs
are more commonly affected.
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Can
you tell from my dog's x-rays (radiographs) if he/she is a good candidate for
THR?
Radiographs show abnormalities in the hip joint and are used for choosing
the proper sized prosthesis but they are only part of the picture. To decide
what is best for your pet, the surgeon must evaluate your pet’s history, perform
a complete physical examination, evaluate your pet’s radiographs and interpret
laboratory data. Many factors must be evaluated before your pet is considered a
good total hip candidate.
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What
are the treatment options for Hip Dyplasia?
Several treatment options are available to address Hip Dyplasia. Young
dogs (usually 6-12 months of age) that are dysplastic and do not have any
arthritic changes present are candidates for a reconstructive procedure to save
the hip. The procedure is called Triple Pelvic Osteotomy (TPO). Ask for more
information if your puppy falls into this category. A total hip replacement
(THR) is a treatment option if the components of the hip joint are worn or
deformed from the ravage of arthritis and/or treatment of pain is unsuccessful.
Salvage procedures, such as removal of the femoral head (FHO - Femoral Head
Osteotomy), provides a "scar tissue" joint which provides limited stabilty and
range of motion. A total hip replacement can provide more normal stability and
range of motion.
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What
is a Canine Total Hip Replacement?
A
canine THR is a prosthetic hip that is implanted in a similar fashion as is done
in humans. It essentially replaces the arthritic joint.
The
prosthetic hip replacement has three components:
The
femoral stem.
The femoral head.
The acetabular cup.
The implants are
available in six sizes and are interchangeable to accurately fit the individual
patient and provide proper joint tensioning. The components are made of cobalt
chrome and ultra high molecular weight polyethylene.
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Why
choose a Total Hip Replacement?
THR's
are performed to relieve pain, improve hip function, and allow your dog to
return to an active life style. The arthritic joint is replaced with the implant
to eliminate the pain resulting from bone rubbing on bone in the arthritic
joint. The reduced motion of the arthritic joint is also corrected allowing your
pet to regain a full range of motion of that limb.
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Is
your dog a candidate for a Total Hip Replacement?
If
your dog has Hip Dyplasia, is over 9 months of age (with growth plates fully
developed) and weighs more than 30 pounds, you have a likely candidate for a
THR. A thorough examination to rule out other problems is a mandatory part of
the preoperative examination. Dogs that have had femoral head excision (FHO -
Femoral Head Osteotomy) are usually not good candidates.
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What can I expect from this surgery?
The
goal of surgery is to return your pet to pain-free, mechanically sound, normal
hip function. Generally, dogs are found to be more comfortable and have an
improved quality of life. Many owners report that their pet can do things they
have not done since they were a puppy. Increase in muscle mass, improved hip
motion, and increased activity levels have been observed in most patients.
Working dogs have returned to full activity. Some mean dogs have even developed
a leasant personality when the pain was eliminated from their hips.
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How
do dogs feel with a Total Hip Replacement?
Most
dogs walk on their new hip immediately after surgery. Most pet owners report
that their dog's personality improves because their hip pain is eliminated.
Gradual return to their normal function takes place between 8 and 12 weeks after
surgery. A long term study found THR to be a very effective method of treating
disabling conditions of the canine hip. The majority of these dogs displayed
marked improvement in walking, sitting, climbing stairs, standing, running,
getting into cars, playing and exercising following surgery. THR's have been
successful in both pets and working dogs.
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Does
a Total Hip Replacement "Wear out"?
The
life of a THR in humans can be over 20 years. Replacement of implants due to
wear and tear has not been necessary in dogs partially because dogs weigh less
than humans, their weight is distributed on four rather than two legs, and their
average life span is considerably shorter.
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Should
both hips receive a Total Hip Replacement?
Only
one hip should be replaced at a time. However, if debilitating pain is present
in both hips, then both hips should be replaced. The most painful hip should be
replaced first and an interval of at least 2 months should elapse prior to
performing the second hip surgery. Dogs with both painful hips benefit greatly
if both hips are replaced.
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What
is the surgery like from a patient's perspective?
The
surgery takes 90 to 120 minutes. The patient is placed under general anesthesia
and vital signs such as heart rate, heart rhythm, tissue perfusion, respiratory
rate, blood pressure and temperature are monitored.
The
surgery is performed with extensive attention paid to sterile techniques. A
great deal of attention is paid to preoperative preparation of the patient,
instrument preparation, aseptic technique, and environment control in the
operating room. The hair on the patient's leg is clipped and the skin is bathed
a few days prior to surgery to ensure that the skin shows no sign of
infection.
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What
is the postoperative care for my dog?
The
postoperative care for your dog is critical. The surgical incision must be
monitored daily for redness, swelling or discharge. Your dog must be discouraged
from licking the incision. This sometimes requires placement of a special collar
to prevent your pet from reaching the incision. Your dog’s attitude and appetite
should be monitored daily while the incision heals. Ten to fourteen days after
surgery the sutures may be removed from the incision.
The
activity level of your pet must be strictly controlled. For the first month
after surgery your dog should be allowed outside, on a leash, to urinate and
defecate and for a short walk. Your pet should be immediately returned to the
house afterwards. Inside the house your pet should avoid stairs and slippery
floors. If your pet must go up and down some stairs, you should go with the pet
using a leash or your hand on the collar to control the speed of your pet on the
stairs. Good footing is important. Absolutely no running, jumping or playing is
allowed in the first 2 months after surgery. When your dog is not under your
direct control, he/she should be kept confined to a small room. Some owners find
that a large cage or airline crate is an ideal place to confine their pet when
they are not at home.
For
the second post-operative month, similar restrictions apply but you may begin to
take your pet on longer leash walks. The length of the walk will depend on your
dog’s abilities. After the end of the second month, you may return your pet to
full activity.
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What
is the success rate for a Total Hip Replacement?
Total
hip replacements have been successfully performed in canine patients since 1974
and have enjoyed excellent results. Over 95% of patients return to normal
function after the surgery. Most dogs will run, jump, play normally, and have an
improved quality of life.
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Are
there any risks?
The
incidence of complications is very low. Risks exist just as they would for any
surgery. Infection, implant loosening, technical problems, and anesthesia
complications can never be totally eliminated, however, extreme precautions are
taken to minimize these problems.
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When
should the surgery be performed?
Surgery is recommend when pain or lameness is present. The hip will be
painful when extended and/or abducted. Radiographs of the hips are used to
confirm the diagnosis of degenerative arthritis. A conservative approach using
pain relievers may be initially recommended. Surgery is recommended if
medication is needed over an extended period of time or if
ineffective.
Long
delays in performing surgery can lead to longer rehabilitation time. THR is
ideally performed before the hind leg muscle begins to loose its mass (atrophy).
Additionally, a delay means less time for your dog to enjoy the improved
pain-free function provided by the total hip replacement.
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My
dog is on medication. Should I stop giving this?
Medications for health problems / conditions such as diabetes or low
thyroid function should not be stopped. Medications for hip pain should be
stopped prior to the initial examination. Oral steroids (even for skin
conditions) should be stopped 1 week before the exam while other
anti-inflammatory drugs including aspirin should be stopped 3 days before the
exam.
Information gathered from BioMedtrix
For more
info visit www.biomedtrix.com
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