My one year old Golden Retriever, Jake, just reced a diagnosis of hip dysplasia. He seemed a little stiff after walks and slow to get up so I thought I would check. The vet put him out for x-rays and said his left hip is worse than the right. He said we should have TPO surgery within the next 1 to two months. If we don't we could be looking at full hip replacement in 1 to 2 years!!!

I have read all I can find on-line and it seems that there may be other options such as medicines, alternative therapy ect... Please can any of you advice as you all seem to have a lot of knowledge? I do have appointments scheduled with 2 other vets for 2nd opinions. Jake doesn't seem to be in pain, other that a little stiff!!

Does this vet seem too surgery happy?

I have copies of the x rays, but I don't know how to upload then into this message!!

http://www.workingdogs.com/vchipdysplasia.htm

Can you link us to the x-rays on a Photobucket-type account?

Is the vet who recommended the surgery the surgeon who would perform it if you decided to do it? Did he say that there are no OA changes yet? (Was the "couple of months" due only to the early age recommended for this surgery, or because he saw early OA changes too?)

Good for you about the second and third opinions.

What are you doing for inflammation now? Is the dog on fish oil and E?

Odd advice. I have been through 2 TPLO surgeries and I was under the impression it had nothing to do with the hip but knee.

I do know, in retrospect, I was too quick with the first TPLO. My boxer was not in noticeable pain. She occationally came up lame by with rest she would continue on for a month or so before another episode.

The specialist talked us into the surgery. At first I thought it was great because I realized how much my boxer was protecting herself. After rehab she seemed like a pup again.

Two years after the first knee the second ccl tear occured. Unlike the first knee ava was in noticeable and almost constant distress.

We might have done the first TPLO premature but I do not regret either surgery.

If I were you I would Definately get a second opinion because one thing the specialst told me is even though Ava needed knee surgery she had good hips. Seems odd you are being told the two are related.

There is a TPO (Triple Pelvic Osteotomy) surgery for HD:

http://www.vetsurgerycentral.com/tpo.htm

What I was told for my dog's HD (he's 2 years old) is that surgery is an option down the line but there is a lot you can do now to help the hips. There are certain things you should avoid doing and there are other things that are excellent for building up the hip muscles. Fish oil and vitamin E, Adequan therapy, glucosamine, Ester-C, Acupuncture...lots of things to try.

Good you're getting other opinions.

The O.P. was talking about TPO, not TPLO.



e.t.a. Sorry, Sarah; you were posting as I typed.

Edited by Connie Sutherland (01/07/2009 08:45 PM)
Edit reason: e.t.a.

 Quote: Sarah Morris

... What I was told for my dog's HD (he's 2 years old) is that surgery is an option down the line

TPO, though, is for young dogs only, I believe.

QUOTE: TPO is a procedure used in young dogs usually less than 10 months of age that have radiographs that show severe hip laxity, but have not developed damage to the joints. The procedure involves a surgical breaking of the pelvic bones and a realignment of the femoral head and acetabulum restoring the weight-bearing surface area and correcting femoral head subluxation. This is a major surgery and is very expensive, but the surgery has been very successful on animals that meet the requirements.END from http://www.peteducation.com/article.cfm?c=2+1569&aid=444

And other procedures at the same URL:

Total Hip Replacement: may be the best surgical option for dogs that have degenerative joint disease as a result of chronic hip dysplasia. Total hip replacement is a salvage procedure that can produce a functionally normal joint, eliminate degenerative changes, and alleviate joint pain. The procedure involves the removal of the existing joint and replacing it with a prosthesis. To be a candidate for this procedure, the animal must be skeletally mature and is usually performed on dogs weighing at least 20 pounds. There is no maximum size limit. If both hips need to be replaced, there is a three-month period of rest recommended between the surgeries. As with the TPO surgery, this is a very expensive procedure but has had some very good results.

Femoral Head and Neck Excision: Femoral head and neck excision is a procedure in which the head of the femur is surgically removed and a fibrous pseudo-joint forms. This procedure is considered a salvage procedure and is used in cases where degenerative joint disease has occurred and total hip replacement is not feasible. The resulting pseudo-joint will be free from pain and allow the animal to increase its activity, however, full range of motion and joint stability are decreased. For best results, the patient should weigh less than 45 pounds, however, the procedure may be performed on larger dogs.

Juvenile Pubic Symphysiodesis: A new, less invasive surgery for treating hip dysplasia, called Juvenile Pubic Symphysiodesis, is currently being evaluated. This surgery prematurely fuses two pelvic bones together, allowing the other pelvic bones to develop normally. This changes the angle of the hips, lessening the likelihood of arthritis. Early diagnosis is critical, since the procedure must be done before 20 weeks of age, preferably 16 weeks, and before any signs of arthritis are evident. END QUOTE

Sarah mentions Acupuncture. While I have no personal experience with that therapy, my brother and sister-in-law have a 12-year-old English Cocker with hip problems who has responded extremely well with acupuncture. I was amazed when they told me about it. I wouldn't even know where to start when looking for an acupuncturist for dogs, but would be happy to ask my brother (who lives in Maryland) for advice if you want to try that option. I was also planning to ask my own vet about it when I take Bear in for a check on his hips and stiffness later this week. It certainly would be a less-invasive treatment method, if it works for your dog (or mine).

http://i551.photobucket.com/albums/ii446/skrasevic/JAKE1.jpg
Here is the xray. Thanks for the info on the site. The vet would be the surgeon too! There are no OA changes, but he put him on Deramaxx 75mg a day. Thats it. I asked about anything else and he said that was fine...

The time frame is due to his age.

Edited by Connie Sutherland (01/07/2009 10:24 PM)
Edit reason: change oversize pic to URL

True was a young pup when he was diagnosed but yes, Connie, you're right...TPO is for young dogs.

Hip surgery is a major deal but according to what I've read and heard from people here on the board, it can be very successful. In my case, it was worth it to get as many professional opinions as possible and to try everything available first, keeping surgery as an option if the other things didn't work.

I have seen acupuncture performed on dogs with some pretty amazing results. It's in no way a cure for HD but it can certainly help with pain, stiffness, and discomfort. A holistic vet would probably be a good place to start looking for an acupuncturist.

As for the x-ray, I found the following to be helpful. Ed explains the importance of positioning and how to read a hip x-ray here: http://leerburg.com/hipart.htm

FWIW Sally, I did the same thing you did: posted on the board and read everything I could find. If it's a mild to moderate case of HD, without pain or discomfort, you CAN see a lot of improvement without surgery. JMHO.