Femoral head ostectomy (FHO) Advice

[sheshistory]

So if you've been following the "Limping Puppy" thread, you know that 15 week old Truman has had an undiagnosed hip issue since he came to me five weeks ago. He was doing better but still limping and sitting funny so he went to a follow up appointment this morning, which included a physical exam and x rays.

The exam and x rays were conclusive. Truman has hip displaysia. His one hip (the bad one) is actually not in socket right now, which is causing the limping. The other hip is still holding strong but the doctor sees evidence in the x ray and the way he stands that it could be a problem in the future. So basically, he needs one surgery for the out of socket hip, another surgery for the in socket but still dysplasic hip.

In order to fix the bad hip, the doctor recommended an femoral head ostectomy, where they remove the head and neck of the femur, making a false joint, relying on the tendons, ligaments, and muscles to hold the joint together without pain. Despite their size, bulldogs are good candidates for this because they are so front heavy.

In order to help the other hip, the doctor recommended Juvenile Pubic Symphysiodesis (JPS) surgery, which fuses the growth plate in the lower section of the pubic bone allowing the upper part to grow up and around the femoral head and form tighter joints. This is ideal but it is a fairly new procedure.

So it is a worse case scenario - two surgeries needed for two bad hips. They can do both at the same time and neuter him, which is good, but it also comes at a hefty, hefty price tag with no clear prognosis. It could work in both cases and make him whole, or he could be looking at future surgeries.

I turn to you on the board - if you have any experience on either surgery or hip problems or advice, I would be most grateful. He is an otherwise happy and healthy puppy - but his hips are awful.

Truman, for his part, is resting well this evening - none the worse for wear other than having to miss a meal because of the this morning's x rays! He was NOT happy about that.

[Gertie's Mom]

I am so sorry you didn't get better news! I haven't dealt with hip issues, so I'm of no help. Just wanted to mention, if I were you I think I'd get a second opinion. Do you know your vet really well? Have you been going to the same one for years? I had an experience about 12 years ago when we first moved to Az. I had a limping dog and I didn't have a vet down here yet, so I just picked one out of the phone book. She proceeded to tell me all sorts of things were wrong with my dog and how she needed an expensive surgery, etc. Well I couldn't afford any of it, we had just moved from another state, so I waited and hoped her limp would go away. It did, she was fine for years and years after that. I'm not suggesting your vet would try to rip you off, but there are those out there who do that sort of thing. As young as he is, is there a health warrenty thru his breeder?

[bullmama]

I have posted this on our facebook page hoping for some insight. I will post again in the AM. I am of no help unfortunately, but I am CERTAIN someone out there has been through this and I am gonna find them!

[sheshistory]

Thanks Desertsky - appreciated, I hope someone has dealt with this, even in another breed.

I've been going to the same vet for a while and I have used this orthopedic surgeon on Bentley when he tore one, then another ACL. I trust them and there's no denying something is wrong. The limping, the sitting - you can tell his hips are bothering him - not to mention the x rays now show shallow hip socket and a dislocation.

As I said in a previous post, the breeder said he'd take the dog back and euthanize him (which one of our second opinions also recommended after an examination, so he wasn't just being callous, Truman probably has never known a day without some hip discomfort) but instead I opted to keep him and deal with his treatment (whatever that may be) and take my money back for him. I think that was fair since he was not obligated to do that.

I do have a suspicion this is not the first puppy with orthopedic problems he's dealt with; when I first told him about Truman's hips, without flinching he said he may have to spay his mother if another set of bad hips turned up amongst the puppies. How did he know it was the mother if supposedly neither parent had orthopedic problems? Not that it matters now, but still.

I just want to figure out what's best for Truman now and I am scared because I really feel like I don't know. From my research, this is not a common procedure for bulldogs, which makes it more confusing.

[TessaAndSamson]

I am so sorry to hear the news isn't better. I have never dealt with hip problems myself with any of my dogs. The closest thing I have experienced, it's really not that close but Samson has had orthopedic surgery. At about 5 months old he broke his front leg in the joint. Could not be corrected without surgery, so surgery or a lame leg for life. So he got the surgery, there are 2 pins in his joint. He recovered WONDERFULLY, never has seemed to cause him any problems whatsoever. Not a limp, nothing. The vet said he would develop arthritis to some degree at some point in his life no matter what because of it but 4 years later, at 4.5 years old he still going strong. The orthopedic surgeon that performed the surgery was VERY good, very respected by his peers (other vets told me he was WONDERFUL). It was a very awful experience, I was devastated as I know you are. I hope though like with us, Truman can get the surgery and it will allow him to live a much more normal, active life. Hoping for the best for you

[cali~jenn]

I am SO SORRY!!!! I was SO hoping for a miracle with him. This is so heartbreaking to hear of. I also have no experience with this which is of no help to you but I am sure with fb postings there will be some help somewhere. I will also cross post on my fb and hoping that with my bulldog/dog friends I will get some kind of response.

[cali~jenn]

I have only heard back from 1 of my bulldog friends so far but this was her response, if it helps any. Will hope to come across at least 1 person who has been thru this tho.
I have no experience with this issue but, I believe 15 weeks is much too young for any type of hip surgery. I would treat with Adequan shots and pain meds if he is in a lot of pain. Then I would reevaluate in a few months.

[sheshistory]

Thank Cali~Jenn, I guess you have to see him try to get around, sit, and the x rays to really put your head around the idea this is a real problem and time is not going to do him any favors, particularly with a hip out of socket. There are advantages of treating him young, one of which is the JPS for the "good for now" hip, which will dramatically decrease the likelihood of surgery on that one and can only be done between 16-20 weeks of age. Also, being a puppy, he is resilient and active, which usually means a better recovery. I appreciate the input though!

[TessaAndSamson]

Also, being a puppy, he is resilient and active, which usually means a better recovery.

I know from Sam's surgery that putting a puppy thru surgery is a tough thing to get your mind around. He seemed like just a little baby and it was really a tough experience for me. However I would have to agree that him being so young actually helped because he was still growing and I think that helped heal his leg more than if he was an adult.

[Gertie's Mom]

I guess I missed the posts regarding his breeder. At least you did get some relief from him, but I'm sure it's very heart-breaking to see your baby in pain. I hope you find the answers you need.

[cali~jenn]

someone did also email me this link. I doubt this or anything is helping you at this point but I am still hoping someone has been thru this and will email me back.
http://www.vetinfo.com/dhipsurgery.html

[Bobettev]

Hello-
This is Buddy,our 6 month old had surgery 6 weeks ago for a femoral fracture.We were offered 2 options as well.
We went with putting in pins hoping to repair the fracture.1st return visit was not good.They said the bone is not receiving blood flow.
Heat compresses & stretching was recommended. Femoral head removal was suggested if things don't improve.
Any advice from other owners?