While under general anesthesia, the pet’s breathing will be assisted with a ventilator and vital parameters such as heart rate, respiratory rate, core body temperature, blood pressure, oxygenation of the blood (pulse oximetry), exhaled carbon dioxide (capnography), and heart rhythm (EKG) will be monitored to ensure the pet’s well being. The surgical site will be clipped and cleansed with an anti-septic solution in preparation for surgery. Just prior to surgery, your pet will receive a sedative, have an intravenous catheter placed for the administration of intravenous fluids and intravenous medications, be induced under general anesthesia with medication(s), and have a breathing tube (endotracheal tube) placed to allow delivery of oxygen and gaseous anesthesia. The pet should not receive any aspirin within 1 week of surgery, as this medication will thin the blood and increase the risk of bleeding. The surgical team should be informed of any medications that your pet is currently receiving. An antacid such as Pepcid AC may be prescribed and should be administered by 6 AM on the day of surgery this treatment will help reduce the risk of esophagitis (heartburn) in the postop period. Water is usually permitted up to the time of admission to the hospital. The pet should be fasted prior to surgery, as instructed by the surgical team. In the event that your pet is not a candidate for a pelvic osteotomy, total hip replacement may be recommended. The angle at which the hip pops back in the joint should be less than 40 degrees (angle of reduction). The ideal candidate for a pelvic osteotomy should have minimal to no degenerative osteoarthritis on radiographs and a positive Ortolani sign (the surgeon feel the hip crisply pop in and out of the joint during the examination). A decision to perform a pelvic osteotomy should not be based only on radiographs. Some dogs seem to experience signs of hip dysplasia when they are a couple of years old and others in the geriatric years.Ī diagnosis of hip dysplasia is based on a combination of history, clinical signs, physical examination findings, and radiographs. Bunny hopping, stiffness on rising after a rest, lameness, and atrophy of the muscles of the hind limbs are typical clinical signs. Early clinical signs of hip dysplasia start out as exercise intolerance (puppy only plays for short periods of time) or an awkward gait of the hind limbs. Occasionally, only one hip has dysplasia, but more commonly both hips are affected.Ĭlinical signs of hip dysplasia can be seen as early as 4 months of age however, many dogs are 5 to 8 months of age when a problem is first noticed. This usually causes the pet to become suddenly lame. Occasionally, the hip joint will be very loose and it will become completely dislocated with minimal trauma. Arthritis develops in the joint and causes pain. The socket becomes shallow and the head of the femur becomes flattened. If the joint is loose, the hip partially dislocates with each step the dog takes and the joint will gradually become deformed. It is important to do a complete orthopedic examination to determine if the hip joint will pop in and out of the hip socket. One can be fooled by plain x-rays of the hips as they may appear to be fitting very well, but in reality they are quite loose. Look at Fig 1 and 2 below and see the looseness of the left (L) hip joint (ball of femur not seated in socket) versus the right hip joint labeled R. In addition, pooly developed muscles of the hips can be a factor. The first stage of hip dysplasia is looseness of the hip joints due to laxity of the ligament and joint capsule that holds the hip in place. If this is the case, the parents likely have hidden genes for hip dysplasia. Sometimes the mother and father of the affected puppy are clinically normal and seemingly have good hips. Bad genetics are a major contributing factor. This disease is the abnormal development of the hip as a puppy grows. Hip dysplasia is a very common disease that affects larger breed dogs. The muscles that surround the hip joint also provide very good support to the joint. The joint is held together with a very strong round ligament (sometimes called the teres ligament) and the joint capsule. This joint joins the hind limb to the pelvis. The hip joint consists of a ball (femoral head) which is at the end of the femur bone and socket (acetabulum). The ilium joins the lower part of the spine called the sacrum. In the immature animal, these bones are not fused together, but as the pet matures, these bone fuse together in one confluent bone. The pelvis is made of four bones: the ilium, acetabulum, pubis, and ischium. Success rate for this surgery is about 90% Lameness typically resolves in about 3 months after surgery The triple or double pelvic osteotomy is surgery used to treat hip dysplasia in immature dogs
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