femoral head ostectomy

Hello world! I’ve been away from the blog and completely absorbed in life lately — with my biggest focus being Emmie’s recovery from her dual surgeries the last few weeks. 🙂

Before we decided to do the surgery, I Google’d like a mad woman to find experiences and footage of other dogs who had also undergone femoral head ostectomy (FHO) surgery, but couldn’t find any of a dog that was undergoing both FHO and patella surgery at the same time (in fact, though many other surgeons had done it, our vet had not and we were both a little unsure at how long the recovery would take). So I decided to document hers and throw it on YouTube for other owners who were doing their own crazy Google searches!

Ignore all of my overly cheesy “GOOD GIRL!” right into the mic — oops, I was a little too enthusiastic for her progress! 😉 Also don’t mind the fact that Gizmo has learned he loves nothing more than to be the focus of every photo and video and sneaks into everything. And ignore my “I’m a nice wife” commentary in the pool video… Sean, ever self-conscious, whispered, “I’m not in this, right?” and I nodded no… then forgot we were trying to not make comments and blurted that out. Sigh. Videographer I am not.

24 Hours Post-Op: Very groggy, a lot of spaced out wobbles, but she was standing!

3 Days Post-Op: She surprised everyone by deciding she could use the leg about 2 weeks early.

And had to be reminded that no, she couldn’t climb stairs or conquer the world. 😉

4 Days Post-Op: More “Ahead of the Game” footage.

To get an idea of how ahead of the curve she was, most dogs don’t even begin to “toe touch” the ground until about Day 14-16. She was so ahead of the game that she actually overdid it and lost all confidence that she could use that leg – and we had about a two week set back that worried everyone to the point we ran some basic physical therapy tests early to ensure there was no nerve damage and was indeed all in her head (it was).

5 Weeks Post-Op: Hydrotherapy Begins!

One of the toughest obstacles, outside of convincing the dog the leg still works (which consisted of doing physical therapy exercises at home 4x a day), is rebuilding the muscle that inevitability gets lost during the few weeks of recovery that the leg is utilized less. Luckily for us, Emmie loves to swim and swimming is the top rebuilding method for these type of surgeries, so once we got the green light? We set up a 36″ deep temporary pool and begin doing swimming exercises several times a week in conjunction with her walks.

So far she is doing well. She’s still on sporadic pain medication as one of the toughest parts of this surgery was the fact that the lone leg she was left to rely on was just as bad as the one we were fixing, so she gets a little sore. We’ve got a few more months of therapy and focusing on getting as much from that leg as we can for optimum success, but I already feel it was worth all the money and stress — and stress it has been. It’s definitely a commitment to do the physical therapy at home, to carry a dog up and down stairs four bajillion times a day, to watch her struggle or hurt or be unsure of herself. How do I know it was so worth it, though? She wags her tail far more than she has in the past year or so – a clear sign that her constant pain has at least reduced by half! 🙂

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“A person can learn a lot from a dog, even a loopy one like ours. Marley taught me about living each day with unbridled exuberance and joy, about seizing the moment and following your heart. He taught me to appreciate the simple things-a walk in the woods, a fresh snowfall, a nap in a shaft of winter sunlight. And as he grew old and achy, he taught me about optimism in the face of adversity. Mostly, he taught me about friendship and selflessness and, above all else, unwavering loyalty.”

Casa di Moo is having a quiet few weeks in right now. As I have babbled before, our resident princess (Emmie) has always had joint issues – she was just born a little faulty. 🙂 She was born with double luxating patellas, something that can be pretty common in smaller breeds, which is fancy wordin’ for two kneecaps that slip out of their “track.”

Hers were built even a little more wonky, as while most dogs with the condition have their kneecaps slip out of the track when they bend, Emmie’s were most at risk when her legs were straight – so, pretty much, anytime she walked. The result was, as she grew, they tended to stay out of the socket and get harder to manipulate back into place throughout the years, causing her have a “peg leg” gait – but it didn’t seem to bother her any, pain wise, and a review with an orthopedic  surgeon at her 1 year birthday told us we could probably sneak by with pain management and massage for a few more years.

Enter her fifth birthday. She’d been getting a touch slower on walks, and had a few cries and whimpers when she would get up from laying for a long period, or if someone smooshed her a little too much on the bed (I don’t know why, but the entire zoo feels a need to sit on top of Emmie to snuggle, lol). I highly suspected that her bow-legged stance had leg to unnecessary wear and tear on her hip sockets, causing hip dysplasia. I’m pretty familiar with it, as growing up, we had a dog who was in a wheelchair because of the diagnosis (and a nerve disease prevented hip replacement surgery).

A quick trip for some x-rays confirmed my thoughts – for you science nerds like me, below are Emmie’s actual hips! The top is a set of healthy hips. The femoral head (the ‘ball’ part of the joint) is rounded, smooth, well-formed… and it fits well into a smooth, round, clear-to-define hip socket. The bottom view is Emmie’s hips. As you can see, the dysplasia (and bone-to-bone contact from poorly formed ball and sockets) has led to severe dysplasia – cloudy, rough edges, etc.

So after discussing several options, we decided to trust our vet’s instinct (have we mentioned how much we adore him?) and go with an FHO surgery (femoral head ostecomy) on one hip and undergo a knee surgery at the same time. Unlike replacing the femoral head with an artificial joint, they actually cut the entire thing off. It makes one go, “So, uh, how exactly will her leg work without anything in the SOCKET?” 😉 Clever you are! Basically – and this is the part that worries me most – she’ll form fibrous scar tissue on the end, enough so that it becomes a faux joint in the socket… and without bone to bone contact, she gets a pain free hip joint! Until that forms, her hip muscles help to keep her “floating” thigh bone, where it needs to be.

We also went with a patella surgery that doesn’t include pins. For as bowed as her legs are, we are fortunate enough that the knee piece is actually fairly aligned, so our vet literally just dug out a deeper, longer “track” for the kneecap to situate in. Many patella surgeries include breaking the knee, moving it where you need, and pinning it. I’ve ready too many stories of pins coming lose, or the rare potential for a blood clot to form and cause the dog to die, that I wasn’t comfy cozy with that form!

So here is our little lady a few hours after surgery – isn’t she a pumpkin?! Excuse the iPhone photo quality!

We’re now on Day 4 and I’d like to say she’s been quite the rock star! It’s a long healing process – but she’s taking it in stride. The first two days she couldn’t do much, but she’s figured out how to potty (and I essentially thought Chariots of Fire should have been playing the first time she got up the energy and willpower to try it, because it’s painful when you’re missing a hip and have a knee surgery as well), and she’s learning daily to tripod it around. We’re doing physical therapy at home, three times a day, for the next few weeks until her sutures come out. From there, she can go do hydrotherapy to help increase the range of her hip movement.

She even tries putting weight on it every few steps – which is what she needs to do – and keeps trying to do things she isn’t ready for (like the stairs, sigh). We slept the first night on the floor with her, but she seems content to stay snuggled with everyone on the big bed, so my back is super thankful we’ve been able to move her. And no lampshade collar for us because she doesn’t touch her sutures at all (THANK GOD)!

It’ll be about 3-5 weeks before we can try real walks and stairs, and about 5-7 months for us to get a feel for how well it went (which well then determine if we need to do the other side in a year or so).

So that’s about it in the House of Moo this week! 😉

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