Decisions: Update #2

Reyna had her appointment at the NCSU vet school Wednesday. Its taken me a couple of days to get this posted, partly because of a crazy schedule and partly because I’m still absorbing the information.

Dr. Roe is the ortho vet we saw. He specializes in dogs with bad hips, due to dysplasia, trauma, or other joint issues. The visit went really well. Dr. Roe spent a lot of time with us and answered all of my questions (some of them more than once). The student who took Reyna’s history and did the initial exam was nice enough to not put Reyna through a complete physical exam twice – she let Dr. Roe do the joint manipulations. After about 10 minutes of ignoring him, Reyna decided to forgive Dr. Roe for messing with her shoulders and hips.

Dr. Roe confirmed my belief that an FHO is not the optimal solution for Reyna, given her weight, activity level, and general health issues, but he did say that it was always an option to consider. Surprisingly, though, he said that he thinks Reyna is a good candidate for a total hip replacement (THR). I say “surprisingly” because my regular vet had already told me he thought Reyna’s femurs were too deformed to do the replacement. Granted, an ortho vet should know more about it than a general vet. I talked to my regular vet about it today, and he said the condition of Reyna’s hips (based on x-rays from two years ago) are in the grey area where he can’t say a THR is clearly an option, but he thinks that if Dr. Roe said she’s a good candidate, then she’s a good candidate.

The THR sounds like a much better option for her – Dr. Roe estimates she’d be 95-100% pain free with minimal damage to the other bad joints. Reyna would eventually be able to do the things she loves like running through the woods, SAR work, chasing her ball, wrestling with Duncan, and spinning frantically after her tail. Dr. Roe said that only about 20% of dogs ever need the second hip done, and those are usually performance dogs or giant breeds. He also said that most dogs can stop taking pains meds completely, or at least significantly reduce the need to incident treatment versus every day maintenance.

The recovery is pretty rough. The first four weeks the dog has to be kept very quiet, with the only exercise being short walks outside to potty. The second four weeks allow for a bit more exercise, very short walks on leash. The third four weeks are still on leash, but with more time and distance to the walks. The vet sees the dog after three months for an evaluation, and determines how much more exercise the dog is allowed to do. The next three months progress much the same way, with gradual increases in controlled exercise. At six months, the vet sees the dog and (ideally) gives the dog a clean bill of health. Dr. Roe told me about a medication they’ve been using to keep dogs with anxiety issues calm, and they’ve recently started using it on post-op dogs to keep them quiet so they don’t damage themselves. He mentioned that we could put Reyna on it a month before surgery to make sure she’s responding okay and get the correct dosage, and then she’d stay on it through the recovery period.

There are some potential complications, like dislocating the new hip, infection, or a cracked femur. The chances are fairly low, but they’re still there. The biggest downfall, of course, is the cost. Its only a few thousand dollars. Not sure how I can manage it, but I have a few ideas. If I decide we’re going to go with the THR, the earliest we can do it will be February, because of my work schedule. So that gives me a little bit of time to try and save some money. And I’ll keep putting in applications for a part-time job. I told Reyna that she needs to get a paying job, and she just grinned at me. I’m thinking that means she’s not going to make any real effort on that. Maybe I’ll just put Duncan on a street corner with sunglasses, a cane, a tin cup and a sign that says “Donations Accepted!”