Information Brochures

There are a number of examination techniques that may be used to determine if your pet is a surgical candidate. Not all dogs are surgical candidates. In some cases, arthritic changes may already be too severe for TPO to be of benefit to your pet. For these dogs, alternative procedures such as total hip replacement or femoral head ostectomy may be considered. In addition, many animals can do very well without surgical intervention. Pain and clinical signs settle in many dogs when they are 12 to 14 months of age.

One of the recent ways that we evaluate candidates for TPO is by arthroscopy. This is performed under anesthesia immediately prior to the intended surgical procedure. Arthroscopy involves putting a camera directly into the joint, which allows us to make a final judgment of the state of the joint. If there has been significant damage, then currently we do not recommend proceeding with the TPO.

• Appointments for an orthopedic evaluation to determine if your pet is a candidate for TPO surgery are scheduled by referral only with the Orthopedic Surgery Service (530-752-1393).
  
  
• The Orthopedic Surgery Service is often booked several months in advance. When you call to make an appointment for a TPO evaluation please be certain that your appointment is within the next 2-3 weeks. If there are no appointments available, please ask to be forwarded to one of the orthopedic service coordinators.
  
  
• 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.

• 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.
  
• 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.
  
• Please anticipate leaving your dog for surgery. In general, we avoid consultation visits followed by surgery at a later date as this delays necessary surgery and makes scheduling more complicated.
  

• Based on our selection criteria, the overall complication rate for dogs that undergo TPO is very low (less than 5%). The most common complications are minor superficial infection and seroma; rare complications include implant loosening or breakage, nerve damage and bone infections. The risk of implant failure is significantly reduced if there is strict adherence to the post-operative care protocol.
  
  
• 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.
  
  
• If you feel your pet has developed post-operative complications 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 following 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 4 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.
  
  
• If the second hip needs to be operated, then it is often scheduled at the 4-week recheck exam. This assumes that your pet is weight bearing well on the previously operated side and that healing is considered adequate based on the recheck radiographs.
  
  
• 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.