Canine Total Hip Replacement

By Bonnie Sweebe

“All I Want for Christmas is a New Left Hip”…Kimber

No one raising a puppy or an adult dog wants to hear the words “hip dysplasia” let alone “severe bi-lateral hip dysplasia” coming out of the mouth of a veterinarian. However, when you’re raising a puppy to be a future service dog, those words also mean an immediate release from the program and the stark realization that the bundle of joy with the wagging tail that you’d hoped would aid the disabled, might soon experience pain and immobility herself unless a medical plan is put into place.
Meet-KimberMeet Kimber, a golden retreiver-Labrador cross who at the time of the surgery was thirteen months old. This is Kimber’s journey from start to finish written in an effort to bring hope and calm the fears of those who might also receive the dreadful diagnosis. (Note that not all dogs with hip dysplasia need surgery. There is a range of hip dysplasia from mild to severe and some dogs live their entire lives mobile and relatively pain free. That would not be the case for Kimber.)

I’m a hands-on puppy raiser. While training her in the basic commands, I felt a clicking in her hips. I let it go for a couple of months thinking it might be some growing quirk and backed off on any jumping that required more than twelve inches. Kimber climbed stairs well. She sped through the house like a rocket, chasing my other two adult golden retrievers. Kimber thought nothing of hurling over their bodies if they blocked her way.

Except for the clicking hips, there were no other signs (except an inability to jump into the back of my Jeep that I attributed to its height and her age). Kimber was a happy, playful puppy. Her training was on track and she appeared to be a very healthy dog.

Dog and HorseKimber was the last girl born and the ninth puppy out of a litter of ten. She was the smallest girl in the litter and the feistiest. She grew to be pretty and smart with a good attitude and a willingness to please. She was courageous and on-board to try anything. (Please note that no other pups in her litter so far have exhibited Kimber’s clicking symptoms and all pups will be tested. Kimber’s Mom and Dad had hip clearances. The finding of hip dysplasia does not necessarily mean bad breeding. Hip dysplasia can appear out of the blue in a litter, which makes it so frustrating. German shepherds, Labrador retrievers and golden retrievers are three breeds that are targets for this malformation.)Staying-over-for-hip-x-rayWhen she reached a year old, the clicking had not gone away. So I returned Kimber to the service dog program manager for further evaluation. The Orthopedic Foundation for Animals (OFA) hip x-rays confirmed my assumption. Kimber had severe bilateral hip dysplasia and, as should be, was released from the service dog program.

Determined to correct the problem and give her a full life, I adopted Kimber and took her home. She was already showing signs of pain, whining and limping from the awkward positioning required for the OFA x-ray. I scheduled an appointment with an orthopedic surgeon. Upon further examination, there was no doubt in his mind that surgery was in her near future.
WelcomePup.comThe left hip (shown on the right hand side when viewing the above picture) was far worse than the right hip, the left hip socket being malformed to the point where there was hardly a socket for the ball of the femur to set into. That meant that her left hip was out of socket most of the time. Her right hip at least was partially in a socket, although the surgeon felt it pop in and out.

Our immediate concern was for the left hip, and the only option available was a total hip replacement. If the right hip needed to be addressed down the road, there appeared to be more options.

Kimber’s age wasn’t a factor so I scheduled the surgery immediately. She’d get a cementless total hip replacement for Christmas. This is Kimber’s story.

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Monday, December 1, 2014 – Let the Whining Begin!

I didn’t get breakfast this morning. That should’ve been my first clue. Then Mom put me in the car and we drove for forty-five minutes to see Dr. Daye, my orthopedic surgeon. I have no idea what an orthopedic surgeon is or what the fuss is all about. Humans…sheesh!

Waiting for doctor2

I had a 9:30 a.m. appointment and Dr. Daye was prompt and very nice. Mom gave him some papers and a DVD with pictures on it. He said that Mom was right, I had something called severe bilateral hip dysplasia and although both of my hips were malformed, the left one was dislocated out of the socket. He said I had to be in pain the way I was lame in one leg and holding it funny. I could’ve told him that! Why didn’t he just ask me?

WelcomePup.com

I’m a one year old lab golden cross that was a service dog hopeful until Mom felt a clicking in my hips and had me x-rayed early. The x-ray showed that my hips had boo boos and weren’t strong enough for me to do hard work. My condition would prevent me from helping a person with disabilities, so they discontinued my training and released me from the program on a medical. They called it a “change of career”, a fancy way of saying that I’d lose my public access privileges and become a pet dog. Mom adopted me and promised to fix me up. She promised when I got better I could try to become a therapy dog. But a lot had to happen before that.

X-rays shouldn’t hurt, but for a dog with hip dysplasia, rotating hips into the perfect position to get an accurate radiograph is sheer torture. They had to put me to sleep for the first x-ray, the one that detected the problem. When I woke up, I was sore—real sore. It lasted for days. After that, when Mom officially adopted me, she took me another doctor who gave me an anti-inflammatory drug called Rimadyl (100 mg, a half tablet twice a day) and a drug called Tramadol (50 mg twice a day) that I was to take as needed for the ouchie hip pain. This doctor also made me start Dasuquin with MSM. Mom said it was a glucosamine chondroitin joint supplement. I was to take two tablets twice a day for a month, then one tablet once a day forever. They tasted like liver, not that I’ve ever tasted liver. Then Mom scheduled my appointment with Dr. Daye, the orthopedic surgeon.

WelcomePup.com

So I had to get another x-ray. Ouch! (Here I am so sleepy on the way out of the doctor’s office.) This was the super serious x-ray. The doctor would use this x-ray to take measurements so he could order the total hip replacement device for my left hip. (We’d worry about the right hip once I was healed. The right hip is bad, but not as bad as the left hip. The doctor thought he might be able to do a different procedure on the right hip. We’ll see about that.)

I also had pre-op bloodwork done. As soon as the bloodwork results and my new hip come in, Mom will schedule the operation. It will happen before Christmas. Ho ho…oh no!

Monday, December 8th – Surgery scheduled for Tuesday, December 16th

Mom started to arrange my new apartment. I will be in the laundry room for a long time. Mom removed the door from the laundry room closet and my crate is now inside. I have a memory foam bed to cushion my hips. Mom bought cheap carpet from K-Mart to put on the floor so that I don’t slip and screw up my shiny new hip. Then she bought a new gate that is really tall and has a door that opens and closes. She put it in the doorway so that I can visit with my two golden retriever sisters without them being able to touch me. Mom says I’ll be delicate for a very long time.
Recovery room

Monday, December 15th – Off to Metropolitan Veterinary Hospital to prep for tomorrow’s surgery.

WelcomePup.com

They wanted me there at 5 p.m. the night before the surgery. I guess they planned to do a patch test and shave a small area to make sure I had no skin conditions or reactions. They’d also test my urine to see if I had a urinary tract infection because Mom told them I had two accidents yesterday which were not at all normal. (I didn’t tell her that I was totally stressed out. I knew something was up!)

My white blood cell count turned out fine. No infection. Surgery was scheduled between 9-10 a.m. the next day and the vet assistant said the surgery would take about 1 ½ hours. No turning back. Major GULP!

Tuesday, December 16th – The Doctor called.

Around 11:30 a.m., the doctor called Mom. My surgery went perfectly. It couldn’t have gone better. My femur was straight so the femoral stem of the implant fit perfectly without touching either side of the bone. I now had a nice new shiny stainless steel ball and socket and they did it without the use of cement. Hooray! That was a good thing because that allows bone to grow into and/or around the device for stabilization.

Do you want to see a computer generated video of what they did? No blood, I promise. The only thing different is that they didn’t use cement.

Everything went exactly as planned, but I don’t remember a thing about Tuesday. I heard they gave me heavy duty drugs. Mom said the doctor called again on Tuesday at 5 p.m. to say I was just as sweet as can be. (I know, right?) I already tried to get up and use the leg and they helped me out to pee. I had to use a towel under my belly as a sling to help me balance. I only whined when someone came into the room. Otherwise, I was quiet. Hey, I was lonely. Come on!

I heard that I have a 4 inch incision on my left hip that’s covered with a boo boo bandage. They also told me I received quite a haircut. Uh oh!. (Note: Take all Christmas card photos from the right side, please.)

Mom and Dad have scheduled an appointment with the doctor for 4:30 p.m. tomorrow. They’ll get a half hour of go home rehab instructions and then the doctor will discharge me. Home sweet home! That will be nice. That’s all for now. I’m going back to bed.

Wednesday, December 17, 2014

Mom and Dad came to get me. Hooray! The nurse walked me out with a towel underneath my belly for support. I was able to walk and I peed in the mulch before Dad lifted me into the Jeep. The lifting was interesting. Dad put one hand underneath my tail and the other around my ribs. He tried to avoid the incision and did a good job. The ride home seemed long and the road was bumpy. Even though I was laying down, I tensed my muscles with each bump. My muscles that normally stabilize my body barked at me–sore from all the surgical manipulation. Ouchie!

The nurse demanded that I have 8 weeks of crate rest. I’d only be allowed out of the crate for 10 minutes total per day. That meant 5 potties lasting 2 minutes each or 4 potties lasting 2.5 minutes. That’s a lot of performance pressure.

The nurse said that I might not poop for 5 days because of the anesthesia. But as soon as I got home, I went to the grass and pooped a big one. I forgot about the surgery and squatted like normal, It hurt so bad that I screamed and howled and Mom freaked out and then Dad freaked out and everyone fussed and yelled and Mom dropped the towel trying to adjust my leash. I lost my balance and almost fell. It was a total disaster.

After that, Mom switched from a regular long leash to a 1 foot leash with a handle. That way, she wouldn’t have to manipulate all 6 feet of the leash to get it the correct length for how fast or slow I walked or for how I needed support. I also promised not squat so deeply and push so hard next time I pooped. Live and learn.

Some of my stool was hard, some was normal, some was really loose and some had blood in it. Mom told the nurse about the blood and the nurse said that after surgery a little blood might show. Normally, that wouldn’t be a problem as long as the blood disappeared soon. It did. Phew! I took my meds and slept all night, except for when Mom woke me up to give me more drugs.

Here’s a video of my first day home on crate rest:

The hospital had me on a schedule of pills at 2 a.m., 10 a.m. and 6 p.m. This did not work with Mom’s sleep pattern, so we slowly switched it to 8 a.m., 4 p.m. and midnight. Here are the drugs that I took:

8:00 a.m.

½ tablet (total tablet 100mg) of Rimadyl (anti-inflammatory)

1 capsule (500 mg) Cephalexin (antibiotic)

2 tablets (50 mg each) of Tramadol (pain reliever)

4:00 p.m.

1 Dasuquin with MSM tablet (joint supplement)

1 capsule (500 mg) Cephalexin (antibiotic)

2 tablets (50 mg each) of Tramadol (pain reliever)

Midnight:

½ tablet (total tablet 100mg) of Rimadyl (anti-inflammatory)

1 capsule (500 mg) Cephalexin (antibiotic)

2 tablets (50 mg each) of Tramadol (pain reliever)

The schedule lasted 10 days, except for the Dasuquin joint supplement that I have to take for the rest of my life.

The pill schedule didn’t necessarily correspond with my feeding schedule. When it did, Mom just threw the pills into my food dish and I ate them. Then I tasted the Tramadol! It was very bitter and horrible and I spit it out. So Mom hid the pills in a large Jet Puff Marshmallow. Fresh marshmallows are wonderful and worked for awhile until I got sick of taking the pills. Then Mom switched to some yummy flavored squishy things called Pill Pockets. That worked for me!

Oh, and I found out that because I have a hip replacement, every single infection I get could jeopardize the area. Therefore, at the first sign that anything could be wrong (i.e. urinary tract infection, ear infection, etc.) I need to be on antibiotics immediately. Also, if I go in for a dental cleaning, I need to be on antibiotics prior to the cleaning. Evidently, the mouth is a huge breeding ground for bacteria. No bacteria allowed. None!

So how did the crate situation go? Well at first Mom had me in a sectioned off area of the laundry room. She put carpeting down so that I wouldn’t slip, took the door off a closet and slid my crate in there. But that would mean 8 weeks in a crate in the closet and I couldn’t come out and see anyone. So Mom put the crate on a small carpet and slid me into the kitchen by her computer. I felt better there, but sometimes I still whined–especially because I had razor burn on parts of my legs. Talk about a close shave! That hurt almost as much as the stitches.

Nap time…

Thursday, December 18, 2014 – Uh oh!

Blood in my stool. Mom called the doctor. They took me off Rimadyl, the anti-inflammatory drug. Blood in the stool is a side effect of the medication. Clearing up the bleeding is good, but not taking away the swelling is bad. Swelling hurts.

Friday, December 19, 2014 – My First Day without Rimadyl

Oh, this was not good! There was still blood in my stool and I was in pain. The swelling hurt. I didn’t sleep at all the night before. I cried and moaned and whined. Don’t I look dead in this picture? I’m not.

Day Five - Pain

Saturday, December 20, 2014 – Mom Calls the Doctor Again!

They gave me a new medicine, Metronidozole. I had to take a ½ tablet twice a day to clear up the blood in the stool. Mom also switched my food to EN, a special food that they give dogs that have gastrointestinal issues–like my sister Sydney. The food should calm my tummy and together with the new medicine, should stop the bleeding.

The doctor also asked if I’m using my left leg. Mom said no. The doctor instructed her to put a towel under my belly to assist me as I walked, just in case of a slip and fall. Here’s what she did:

They asked Mom if she’d been lifting up on the towel to relieve pressure on my leg. She was. So now Mom can only to have the towel under my belling in case of emergency. She should not use the towel to hold me up. Now I’d have no support when I pottied. I’d have to try to use the leg. Rats!

Monday, December 22, 2014 – Is that a bump?

Mom called the doctor again wondering if it is normal to have a bump at the incision site and wanting to be reassured that it is not a dislocated stainless steel ball. She emailed this to the doctor.

WelcomePup.com

He said the swelling at the site was not unusual and that it was not a dislocated ball.

Thursday, December 25, 2104 – I’m walking on the leg and the blood in the stool is gone!

Merry Christmas to me!

Ten days after hip surgery, I was walking on the leg. The hair was growing back, too.  The incision has scabbed and some fell off and the swelling was down at the site. I whined more because I was so bored, but Mom was a stickler with rules. I could leave my crate for 5-10 minutes per day to go potty only. I was not going anywhere else soon. I was so bored, but look at me go! This was day twelve.

Did I mention that I was so bored? Mom would come into my cage to visit me. I loved that.

WelcomePup.com

Sometimes she’d open my crate and read to me. That was nice, too. I liked the petting.

Welcomepup.com

And once, I was allowed supervised visitation with my sisters. I should say sister. Sydney slept through the entire event. It was a Nylabone chew-a-thon!

Friday, January 2, 2015 – My first post-op check-up!

Today’s re-check appointment went great! I’m doing very well, however the only additional privilege I was granted is a bath—which I don’t need because I haven’t gone anywhere. Crate rest is to continue for six more weeks so that the bone can heal, with light physical therapy 3x a day. Mom is supposed to stand me up, support my mid-section with her one arm and manipulate my boo boo leg, starting at the toes. She’s to gently bent the toes, then the ankle, then flex the knee and finally extend the leg behind me. When that is finished, she’s to bend my knee naturally until I bunch up my leg against my chest and then release. Finally, she will lift my good leg off the ground forcing me to put all my weight on the boo boo leg. That will get my leg ready for normal use again. I’m not to use a towel to support my belly when I go outside anymore UNLESS I’m on extremely slippery surfaces like polished floors or ice. During my next re-check appointment in six weeks, I will be sedated and x-rayed. This x-ray will hopefully give me the okay to resume a normal life. We’ll see…

Friday, January 9, 2015 – I’m in trouble!

So last night Mom left me in the crate again and went out to eat. I kept busy. When she came home, she found that I chewed a hunk of my dog bed and there was memory foam everywhere. I didn’t eat it, so what was the big deal?

Anyway, when Mom got home she put up the tall gate and now I’m allowed to go into the laundry room for short periods throughout the day. She threw carpets all over the floor so I wouldn’t slip and she even put a dog bed in there. Now I can chew my nylabone and stretch. My sisters can’t play with me, though. Oh well, I’m content at least for now.

Mom spent a lot of time with me doing something called mental stimulation. She thought I was depressed. I was bored, not depressed. Actually, I’m feeling much better! So anyway, she used the skills I already learned for service dog work and taught me to open a door. Now I can help with the laundry. Watch this!

Only 4 ½ weeks to go!

Friday, January 16, 2015 – Check out my boo boo!

I can’t believe how much I’ve healed! My hair is growing back! Yahoo!

dog hip replacement surgery

I’m so happy I could dance. I got my wag back!

Dad groaned at the end of the video because I’m getting to be a handful again. I think the surgery worked!

Thursday, February 12, 2015 – Hip Injured 6 Days Before the Final X-Ray

So I had to have hip surgery during the worst winter in decades! We have below zero temperatures in Cleveland, Ohio with snow mounds over a foot high. Then it rained so the top layer of the snow turned to ice. I tried to go potty and fell through a snow mound and somehow injured my hip. I’m limping.

Mom called the doctor. They said this is the third call they’ve received regarding the horrible snow and ice conditions and their hip surgery patients. They think that because my muscles have atrophied somewhat from non-use, I could’ve pulled a muscle when I fell through the iced snow mound. Now I’m on complete cage rest for the weekend. If I’m no better by Monday, they’ll want to see me ASAP.

Wednesday, February 18, 2015 – I Made it to the Final X-Ray…Hooray!

They were right. Cage rest for two days cleared up my muscle pull and I’m not limping anymore. The x-ray was taken this morning and the surgery was a complete success! The artificial hip has not moved one bit and I’m now on the road to recovery. Check out the before and after!

canine hip dysplasia before and after total hip replacement

Amazing, right? I am now on total hip replacement rehab. This is my rehab schedule:

For the next two weeks no rough play with my sisters. I’m allowed free access in my home on the first floor only. I can go upstairs to sleep with the family, but I must be on leash and walk slowly with a handler. I can go on 15 minute leash walks now. The trouble is, there is so much snow and ice outside that we can’t walk anywhere. We’ll have to walk indoors.

Week three and four are the same as above, but with 30 minute leash walks.

Week five and six are the same as above, but with 45 minute leash walks. The doctor said that is total time. I could break the walks up into two or three shorter walks to equal the 45 minutes.

Week seven and eight consists of all of the above on a retractable leash. However, Mom hates retractable leashes so she’ll just use a longer web leash. I also can have free roam of the entire house.

During week nine and ten, if I’m feeling good, I can now be off leash with supervision. At the end of week ten, I can return to full normal activity!

To prove that the surgery worked, check me out. I’m the crazy one with the red ball. Good as new!

The doctor suggested that I go back once every year for an x-ray to make sure everything has remained in place. I also have to stay on Dasuquin the rest of my life, but I like the liver flavored tablet so it’s no big deal.

As for the right hip, we’re going to see how it goes. Oftentimes, one hip replacement is enough to compensate for the other hip that is not so hot either. I’m hoping this is all I’ll have to do…Kimber