fourleg.com

Hello Laurie and Co,

I have a 4 yr old Samoyed 22kg with bilateral THR. . Left cemented, right cementless. . We’ve been round the block a few times treating psoas before getting the correct diagnosis . The right has become loose and although the dog seems remarkably happy at low level exercise soon gets pain and multiple compensatory problems when activity increases. Now they are faced with a choice of revision of THR or FHO. She is on the border line of weight apparently. FHO seems the once and for all less risky option for the right hip but they are concerned that function will be restricted and also about the strain it will put on the left hip and stifle ( she has had left psoas pain and an episode of patella tendon thickening or bogginess around it that resolved quickly – cause unknown). She is an active dog and competed to a good level in Rally obedience (Crufts) during good spells. Ideally they would like to progress Rally, do scootering and long hikes as they have another dog doing this. They wonder whether THR revision is an options and what the relative risks and benefits are. Keen to have input from a range of vets and therapists before making a decision.

Kind Regards

Kay

Hey Kay,

Well this is a tricky question!

Firstly, larger dogs can do okay with an FHO. A colleague of mine did her Master's research on bilateral FHOs in large breed dogs. And she found that they did well. I don't think I have her abstract, and I don't believe she published it... but I do remember her findings.

Secondly, the affect on the opposite side is the unknown, and perhaps the biggest concern. If the loosening of the THR caused soft tissue strains on the other side, it is reasonable to be concerned that a FHO will do the same. You'll have a shorter leg on the FHO side, and it's weight bearing ability will be altered as compared to the THR-side.

So, UGH! It's really a 'crap shoot'. Given that the other leg is already 'compromised' (i.e. limited ability to adapt / shift / alter how it can be used) because of the THR, I'd actually suggest the revision over the FHO in this case. If the other side was normal, I'd say FHO.

My 2 cents and 'current' thinking about it anyways!

Cheers,

Laurie

Thanks Laurie,
Its good to know that even large dogs with bilateral FHO can do well if all else fails including the left THR. If anyone comes across the paper (or wrote it) it would be interesting to read. If the vet thinks the risk of revision is too great ( he is the most experienced revision vet we could find) then at least we can still manage the compensations on the left . This dog is lucky that it has super committed owners and she is a very sweet compliant dog too which will help enormously with whichever op she needs rehab for. Id be interested to get a surgeons perspective on this too. As a physio, like Laurie, Id like to think the revision was possible but its not a physio that has to go in and actually do it.