Femoral head ostectomy

[D.Jorgensen]

Felix- Dog, 1 year old, male, medium poodle

The dog was diagnosed with Calves-Legg Perthes disease. The dog had already undergone one unsuccessful surgery (Femoral head ostectomy.) This resulted in pain and no use of the affected limb. New surgery was performed after 5 weeks. The second surgery also femoral head ostectomy was successful, but the dog would still not bear weight on the limb, probably psychologically related. The dog walks well on 3 limbs.
The dog recieve rehabilitation on our clinic two times a week.
We have tried:
-Weight-shifting
-Water treadmill
-Laser
-Manual massage and stretching
-Weights on Gastrocnemius
-Ball exercises
-Object under the other paws
-If forced to use the limb, the dog will rather fall over.
-Range of motion =70% of normal
-Allowed PROM: rotate, circle and stretch the leg
-The only way he will use the leg is some toe contact in floor during interaction with other dogs, or putting him out of balance while swimming.

What should be the next step?

[lehughes]

Was there a bone spur left behind on the first surgery or was it boney re-growth because the dog was under a year when the first FHO was done? How far along post op are we on this second surgery? I'd re-xray. I find that it's usually a bone spur or boney regrowth with these dogs that don't take to using their leg after an FHO.
But I did have a case, a long time ago in my career with a similar history. In the end, after the second surgery, I had to bandage / tape the 'good' foot into a flexed position and then walk the dog +++. BUT you need to know that there isn't a spur or regrowth.

If it's regrowth, it's not a great prognosis from what I've seen. It's often difficult to control / stop it.
Good luck... don't try for too long if the dog's not using it fairly quickly with aggressive rehab (as I described above) - get a re-xray if non-use persists for much longer.

Cheers, Laurie