UT Pre-Vet Association Presentation, February 13, 2017

PowerPoint Introducing Small Animal Mobile Veterinary Rehabilitation Practice –

My Presentation to the University of Texas Pre-Veterinary Association February 13, 2017

Click here for some other media and publications about Rehabilitation and Conditioning for Animals!

My Volkswagen Vanagon Gracemobile parked by the tower on the University of Texas campus for the University of Texas Pre-Veterinary meeting
University of Texas Pre-Veterinary Students Rehabilitation Presentation

Post-FHO Homework Suggestions for Dogs (Hip Surgery)

Femoral Head Ostectomy/Removing the Ball off the Femur at the Hip Joint

First and foremost: pay attention to the discharge instructions your veterinarian has given you. During this surgery, there was cutting of muscle and other tissue that will require care and time to heal. You do not need to wrestle with your dog in order to apply ice to the surgery site; I no longer recommend icing  nor prolonged use of anti-inflammatory medications after most surgeries or injuries in keeping with the advanced research findings over the past 5+ years.

While other tissues are also disrupted during a FHO, muscle requires a little over six weeks to achieve a normal collagen ratio and will take longer to heal more fully. This should be considered when you think your dog is ready to chase squirrels at two weeks after surgery. Don’t let them if you hope for the best outcome from the surgery. On the other hand, the bone that was cut does not require the same care that a fracture repair or a TPLO would; there is no need to be concerned that you will cause further damage to the bone with exercise.

In physical rehabilitation after FHO we should aim at keeping the “false” joint comfortable after surgery by promoting hip flexion and extension through therapeutic exercises that stimulate leg use, leading to muscle strengthening and avoiding chronic disuse of the operated limb. Since the dog will move as they are comfortable and are made more comfortable with the right amount of the right pain medicines, I DO NOT recommend pet owners try to do range of motion.

After about five days, and especially if your dog is not using the leg much, then I recommend you speak to your veterinarian about finding some additional pain control medications that will suit your dog. Recovery will improve if your pet feels less pain and is able to use their leg more “normally”, yet gently. Pain medicine along with the right kind of exercise at the right time helps achieve this, and it seems the medications are needed for an average of eight weeks for dogs after this surgery, if not more. No, as popular as it might be, your dog does not need a water treadmill workout to start walking again!

In light of this information, I believe the best outcome from surgery will be realized with a rehab consult from me to give instruction and homework specific to your pet. In-person consultation will always be better than the generic homework given over the internet. Otherwise, until I publish the booklet for specific post-op instructions after this hip surgery, please follow the first four weeks of work outlined in this book:


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All of these exercises should be done very slowly so as to encourage more weight-bearing. When the dog goes too fast, he/she can “cheat” and not use the repaired leg much or well. Too fast could also prolong the inflammation and pain as well as create additional damage to the area of the muscle at the end of the femur hip and upper thigh muscles. Too fast and too much activity will elevate blood pressure and likely cause the blood vessels to open up inside…keep calm and allow the vessels at least two weeks to heal.

We hope to create a slightly and increasingly calloused area in the muscle tissue at the end of the modified/cut femur. This will make the tissue feel the end of the bone less and less and will create a cushion of sorts. You can do this with the moderate & slowly increased exercise I begin to outline in the book…slowly increased exercise…not randomly increased because you think he’s better and able each day…slowly according to the plan I’ve written or one similar that allows for adjustment and healing in the body. I write these words having worked hundreds of cases that were allowed to do too much too soon, and it’s much harder to heal under those conditions 🙂

Running & rambunctious play during this time will upset the scar tissue I want you to help your pet create. On the other hand, not enough exercise, which is usually the problem after this surgery, results in too much scar tissue all around the hip, and your pet will experience decreased mobility and more continuous pain, especially when she is technically at a point that she may play and be wild. I often see these dogs months after surgery and they are still not using the surgery leg well.

If your pet is not using the operated leg after week 1, then I recommend calling your veterinarian or me for rehab intervention and to get them started on beneficial exercise. Range of motion is not an exercise that will be most beneficial at this time. With proper pain control, with good pain medication, your pet should use the leg for the exercises I outline in the book and in the future. Water treadmill is also not necessary for recovery from this surgery. If you follow the exercise prescription well and after week 4 of work would like advanced exercises, then a rehab consult is necessary.

I have some separate recommendations for cat FHO’s .

© 2007  Deborah Carroll

Reviewed 4/2015

Rehabilitation and Conditioning for Animals

Zoe, Great Dane Hip Surgery; Setbacks, Exercise

Hi Deborah – Hoping you can give me some exercise and muscle building tips for our great dane Zoe. After her hip surgery to repair the right side femoral subluxation about 9 wks ago, she had a few setbacks, not able to tolerate many meds and attacked by a large dog which we think caused some soft tissue sprain/soreness. Consequently, she refused to use the leg, and now has some significant atrophy in her limb.

We finally got her to tolerate some Deramaxx and using heat, massage, and alternative remedies (herbs, acupuncture, laser), she is using the leg pretty normally now and is feeling MUCH better the last 2 weeks or so. She is up to 2-3 ten to fifteen minute walks a day. Time to try building up some muscle to even out her legs and hips. Any suggestions? Our rehab specialist here says we can start small slopes and cavalettis. Since you know Zoe well, what can you tell me about helping her build her strength and conditioning back up?

Thanks, and we miss you!!!

My Replies:

I know her and I know you guys, so I don’t mind being a little more specific on here for you…but I do wish I were there 🙂 I really am beginning to think about a trip…I know we have exchanged some texts and emails about her in the past few months…

Did you guys ever find my FHO homework and start on that fairly strictly, beginning at week one? I see that you are taking her on 2-3×15 min walks daily…how slowly? Wedding march or “wagons ho” is the speed I want to see, with consistent walking (no piddle & sniff) and consistent weight bearing. You may be doing that, in which case, I need to know if she seems more lame, lame at all, or not lame after those walks.

If she is not lame at all, then my preference is to advance to 2 weeks of 2×20 min walks before adding in hills. Let me know where you are on that. The most prevalent difference I find between what I say vs what people are having their dogs do is in the speed of the walk. The pain meds help encourage leg use and the slow speed forces individual limb use. She needs that individual leg use to encourage weight-bearing and healing. So, no sense moving on to hills if we cannot get 20 min of persistent, consistent leg use on the flats. Let me know about that and then we will talk about type and frequency of hills. Thanks for the great post!

LouDog FHO Almost a Year Ago – Still Lame

Ryan
Submitted on 2014/02/13 at 8:23 pm
My dog had FHO almost a year ago. He was slow to gain muscle tone but everything looks good now. The doctor said to make sure he wasn’t rough housing and not to run for a specified amount of time. On our walks I would go back and forth across the street so he would get a good distribution of inclines (not much is flat near me).

My worry is that the leg he had the surgery on has a slight rotation outward, sometimes as much as a 30 degrees outward. And it makes me cringe when he rotates on it. My question is, is it normal for that to happen, and if not how could I correct it?

Thank you!

P.S. His name is Lou Dog and he is a border collie/lab mix

2/20/14

Hey Ryan 🙂

From what you describe, your dog is still compensating for pain by rotating his knee laterally, outward. I suspect he hasn’t yet built up muscle equal to the other thigh either…? If he isn’t using the leg consistently and building up from a very basic plan, only increasing slow walk time by 5 minutes, up to 30 min, (so that would take several weeks), then working on more muscle-building exercise, he won’t be able to build muscle progressively and well and use the leg with less pain.
That may make total sense, or it may seem like a vague answer…depends on how you understand exercise physiology, I think.
Typically we all try to push things faster than they are naturally designed to comply…and people really push the animals because our pets, especially dogs, are eager to make us happy and get about “normal” lives.
So, they end up ahead of themselves with lingering injuries and pain.
It sounds like you did well with basic recovery parameters…when you feel the thighs, are they equal in size? Get behind him and cup your hands loosely over the femur/quads and slide them up and down, from flank to knee. Also, stand and cup your hands, thumbs down, over the hams and slide your hands up and down. Usually the quads develop faster and more equally than the hams.
It really sounds like LouDog could use some pain meds or you could start with ice and vibrational massage prior to each walk to see if that’s enough pain help. Then start back at 2-4×10 min super slow walks daily with no additional running around. To alleviate the pain rotation or the functional deficits, I suggest you start back closer to the beginning so he may achieve success and THEN if/when he gets to a sticking point, a point wherein he is rotating again, you will know what to address…
Hope that makes sense-

POSTED BY REHABDEB | FEBRUARY 20, 2014, 1:14 PM | EDIT