Information Brochures

• Persistent lameness on one hind limb with muscle atrophy.
  
• Pain during hip manipulation and reduced range of motion.
  
• A noticeable weight shift to the front legs often accompanied by hyperextension of the carpal (wrist) joints.
  

• Obesity.
  
  
• Neurologic disease.
  
  
• Cruciate ligament rupture(s) or other orthopedic conditions that might cause hindlimb lameness.
  
  
• Bacterial infections of any body system, especially skin, ears, mouth, and urinary tract.
  
  
• Any use, within two weeks of the appointment, of steroids or nonsteroidal anti-inflammatory medications such as aspirin or Etodolac (Etogesic). (Use of Rimadyl is allowed).
  
  
• Pet is less than 2 years of age.
  
  

• Earlier appointments can be scheduled based upon the emergent, life-threatening needs of the patient. Hip dysplasia and other conditions that may necessitate hip replacement are not life threatening and therefore requests for earlier appointments often cannot be fulfilled. For more urgent circumstances, you must request to have the surgical resident on duty paged or may seek consultation with the general emergency service.
  
  
• While hip dysplasia is a painful disease, most patients are effectively managed with crate rest and anti-inflammatory/anti-pain medication such as Rimadyl until the appointment time. However, the use of steroids or nonsteroidal anti-inflammatory medications such as aspirin or Etodolac (Etogesic) within two weeks of the appointment, may make your pet temporarily ineligible for surgery (use of Rimadyl is OK).
  
  
• You may leave a message on our voice mail waiting list if you wish to be contacted if an earlier appointment becomes available.
  
  
• You may also choose to consult with a private surgery referral practice. To locate a board-certified veterinary surgeon in your area log on to www.acvs.org.

Bring a copy of the medical record and any pertinent radiographs (X-rays) associated with the problem. Your veterinarian should provide you with a copy of the record upon request. If possible, a cover letter summarizing the problem is appreciated. Medical X-rays are legally a vital part of the medical record that must be maintained by your veterinarian. Most veterinarians will loan the X-rays to you but these must be returned once the assessment is completed. X-rays that are left at the VMTH will be mailed back to your veterinarian.

In order for your pet to be considered for total hip replacement surgery, the VMTH requires that your pet be seen by your local veterinarian no more than 21 days before your appointment, for the following:

• Complete blood count (CBC)
  
  
• Serum biochemistry profile (Chem II Panel)
  
  
• Urinalysis and urine culture, collected by cystocentesis
  
  
• Careful examination of the skin

If surgery is indicated, your pet will be hospitalized the day of the appointment and surgery will be performed within 1-2 days. For this reason, it is important that your regular veterinarian performs the above tests and the results are available at the appointment. Failure to do so may result in delay or cancellation of the procedure.

The other major reason for delay or cancellation of the procedure is skin infection. Please be sure to have your veterinarian examine your pet’s skin a few weeks before the visit. If there is substantial skin disease the pet should be treated and the VMTH appointment delayed.

• A senior student will evaluate your pet followed by a consultation with the resident or faculty surgeon. The objective of the consultation is to review pertinent history, conduct a thorough general and orthopedic examination, review previous radiographs, obtain or repeat additional radiographs if needed, confirm the diagnosis, and discuss treatment options. It should not be assumed that your pet will have surgery; many dogs with hip disorders can be managed effectively with pain relief and reduction in body weight.
  
  
• The length of the appointment ranges from 1-6 hours depending on the need for sedation, additional diagnostics, and recovery from sedatives. Anticipate spending most of the day in Davis before your pet’s evaluation is complete. We advise you arrange your schedule accordingly and bring books or materials to entertain yourself. Many clients will be seen in the morning and may be asked to return later following completion of the evaluation. Drop-off appointments are not available unless previous arrangements have been made.
  
  
• Arrangements for the surgical procedure, if indicated, are determined at the time of the appointment. Surgeries are generally scheduled to occur 1-2 days after your scheduled appointment. All patients will be evaluated separately by the anesthesia service the day before the procedure. You should plan to hospitalize your pet at the VMTH on the day of the examination to facilitate preoperative assessments.

Overall, complications occur in approximately 5-10% of dogs that undergo hip replacement. Complications range from superficial infections to more severe complications requiring additional surgery, disability, and expense to the owner. Possible problems include dislocation, deep infection, and loosening of the components. With any surgical procedure there are risks associated with anesthesia. Prior to anesthesia, your pet will be evaluated by the surgeon and anesthesia service to assess risks and make recommendations to reduce the risk as much as possible. Fortunately, most patients with hip disease are otherwise healthy and anesthetic complications are rare. Mild complications associated with the surgical procedure include post-operative bleeding, bruising, reaction to suture material, seroma formation, and superficial infections. Fortunately, adequate post-operative care and strict adherence to discharge instructions will dramatically decrease the risk of such complications.

If you feel your pet has developed postoperative complications, or have specific questions regarding postoperative care, please contact the resident on duty, or one of the orthopedic service coordinators.

It is important to note the VMTH is not financially responsible for complications that may occur after surgery unless the complication is related to an error in administering the procedure.

Cases will vary, but general recommendations are for suture removal 10-14 days after surgery; this may be performed at the VMTH or by your regular veterinarian. To assess progression of healing, we recommend one additional recheck examination at the VMTH 6-8 weeks after surgery. This assumes that all is going well. If the dog is not using the leg well or there are any other problems, further recheck examinations may be required.

Please schedule your recheck appointment(s) before leaving the clinic, if at all possible, as the Orthopedic Surgery Service is often booked several weeks in advance.