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wein

Confinement for Dysplasia

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My 7 month old BC puppy will be having a TPO for hip dysplasia. She will need to be confined to a crate for 6 weeks except for short trips outside to relieve herself. Does anyone know of any activities that will entertain her, allow her to use her intellect and maybe expend a little of her energy while she is crated? Without some activity I am afraid that both she and I will go crazy. Thank you.

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Sorry to hear about your pup! She must be pretty bad to have to undergo surgery so young! I hope that you have been able to inform her breeder.

 

As far as entertainment goes...tricks tricks and more tricks. Identifying toys, people, hide and seek (quietly, of course) I've found that expending mental energy is almost equally as tiring as physical. Oh...and my two really like rides in the car...lol

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Please get at least a second opinion on this. It seems very bizarre to me to do surgery on a pup that is still growing -- particularly one this young.

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Guest PrairieFire

I'm with Bill F.

 

How was this diagnosis made on a 7 month old pup?

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I just discussed this with aa friend who has bred her dogs for over 30 uyears. Hers is a breed where hip dysplasia is high on the list of frequency. She has never ever heard of a dog having surgery before it was mature. She can`t even imagine what they would be doing except prepare the dog for future repeated surgeries as it matured. Maybe an experiment for practice for a new surgeon??

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I would get a second opinion...

 

I thought TPO was for the knee/acl tear. Of course I am probably wrong but I would get another opinion. If it is hip dysplasia, and your dog is able to get around, there is no point in having a surgery at this young age and again when the dog is mature. I would wait if possible.

 

Teaching a lot of tricks will help the mental activities.

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Hi,

 

I do agree on getting a second opinion, but there is another factor to this. If the pups hips are horrible, which I would assume they are pretty bad if they are suggesting surgery now- they have the chance now to do the TPO. It is much easier on the dog to do the TPO than have to do the FHO or total hip replacement later. The trick is, if you do the surgery before there are degenerative changes, the success rate is better, the price is lower and the recovery time is quicker. I think its important to point out that surgery is not recommended for borderline or just barely dysplastic dogs. The youngsters that I have seen who are recommended for this surgery are severely dysplastic- and maturity is not going to change that. I have never seen a dog (not saying it never has happened) that got the TPO done as a young dog that had to have corrective surgery later. If you know that its likely the dog will have abnormal degenerative changes, its far better to do the surgery when the dog is young, not at full weight (heavier dogs have a really tough time recovering), and before they have degenerative changes that will require a more extensive, complex and usually far more expensive surgery.

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Thank you to Jaime R. Green. I have never used this kind of communication before and am shocked that so many people would offer so many ill informed opinions. If you are not educated on a topic please keep quiet. Why would you assume that I did not fully explore all options. I have agonized over this decision and your comments are painful for me to read. I would appreciate an answer to my original question as to how to keep my puppy entertained durinmg her confinement. Thank you.

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Guest PrairieFire

The only "opinions" you got were folks suggesting you get another opinion - and me asking how the diagnosis was made...

 

If that pisses you off, perhaps you should try "some other form of communication", wein...

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Having worked at a vet school for a few years, I saw a lot of these surgeries. TPO's are ONLY performed on puppies in an effort to save the hip if the dog is already severely dysplastic (it's not for minor cases). It is not bizzare to do SX on a pup this young, in fact it's ideal in some situations because by restructuring the hip joint, you can prevent severe debilitation as an adult and a THR or FHO down the road. Below is some information on TPO's since some of you are obviously not familiar.

 

Wein, I would definitely contact/inform the breeder of your pup!!! Good luck with the surgery and read up on clicker training, it'll help entertain a bored dog to teach them silly little tricks. Kongs and chew bones are also good for crate-confined pups.

 

Laura

Raleigh, NC

 

 

===================================================

Several treatment options are available for treatment of hip dysplasia. Young dogs (usually 5-8 months of age) that do not have advanced arthritic changes are candidates for a reconstructive procedure to save the hip. This procedure is called a triple pelvic

osteotomy (TPO). In puppies, the joint instability associated with hip dysplasia is painful and disrupts normal development of the hip joint. A triple pelvic osteotomy is performed to relieve pain, restore function, and, stabilize the hip joint so it, will develop more normally. Studies in human and in dogs show that if the abnormal weight-bearing forces across the joint are corrected early in the course of hip dysplasia, a more "normal" articulation will develop. It is important to realize that the objective is to stabilize the hip joint to prevent the debilitating arthritis of chronic dysplasia. The emphasis must be on early detection and intervention before severe joint damage occurs.

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Laura and Jaime,

Thanks for the explanation(s).

 

Wein,

Instead of taking offense at people's suggestions, perhaps you could look at it another way and be glad that so many people were concerned about the health of your pup.

Warning: Beginning of sermon:

First-time users of such boards often seem to become offended when they ask for opinions and then get them (even if the opinions are not completely related to the question). Please remember that very few of the people on these boards actually know each other (with the exception of those who are active in the stockdog trialling community) and so if you (not you specifically, but any poster) don't give complete explanations of a situation, then, people being people, folks may make incorrect assumptions. While it's tempting to blame the person whose answer offends you, remember that a little more explanation may have averted that situation. End of sermon.

 

In any case, I hope that your pup does well. It may be difficult to come up with tricks that also allow the dog to remain still and quiet, but perhaps parlor tricks like counting and the like would work. There was also a thread a week or so ago about what to stuff Kongs with--if you search for that you will find some good ideas for "eating entertainment" for you dog. Perhaps you can also do a search via "Google" or some other search engine and see if you can't find some web sites that can give you some ideas of neat tricks that require your pup to use her mind but not her body. I just heard a bit on NPR the other day (don't know if it was true or truly tongue-in-cheek) about a fellow who taught his dog to recognize written words. Might be worth a try if you get desperate.... (might get you on Letterman later, too!)

 

Good luck.

 

J.

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Julie,

Are you snowed in down there??? :rolleyes: I heard the coast got slammed with some snow. We only got 3-4" in Raleigh (and it shut the whole city down).

 

Laura

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Hey Laura,

I guess we got 5 or 6 inches here--hard to tell because the wind is blowing so hard! I live right across the street from an NCDOT compound so I had to listen to the back up "beeps" and the banging of the front-end loaders as they dumped sand into the sand trucks most of the night. But do you think they've managed to plow the road in front of the house? :rolleyes:

 

I'm about 45 minutes or so from Kitty Hawk--I understand the Outer Banks got the worst of it. Sadly, all I can think is that maybe at last my tick problem (well, actually the dogs' tick problem) will be diminished, and (gasp!) maybe even briefly eliminated (till the next warm spell)....

 

J.

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Guest PrairieFire

Yep, looks like all sorts of reasons to spend a bunch of money on a 7 month old pup - still begs the question about whether there is a second opinion or not...especially in "diseases" where "early diagnosis" can be just an opinion...

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Looks to me like Wein has disappeared, which is really too bad. I thought Julie's "sermon" was a very good explanation..... It's too bad that first time posters don't have thicker skins! The posters on this board are very passionate about their border collies and only want the best for THE DOG (not necessarily the person). I wish newbies would realize this and take all the advice here with "a grain of salt" (or sometimes, half a salt shaker :rolleyes:

 

Eileen - just a suggestion: maybe you can have some kind of "disclaimer" that first time posters get that prepares them for the passionate people at this site..... Too bad for Wein! I know I don't always agree with everyone here, but I sure do appreciate their comments and knowledgable advice.

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Yep, looks like all sorts of reasons to spend a bunch of money on a 7 month old pup - still begs the question about whether there is a second opinion or not...especially in "diseases" where "early diagnosis" can be just an opinion...

>>>Bill

 

Bill,

 

I'm not sure I'm reading this right, so if I'm not, go ahead an correct me. Are you saying you think this is reccommended so the vet can make money of a young pup? If the vet really wanted to make money off that pups hip problems he'd advise waiting till the pup was older, do a total hip replacement and be guaranteed a lifetime buyer of anti-inflammatories. Yes, it is one vet's opinion at this point- and two or more opinions would be a good idea- but its not just a subjective opinion, but one based in veterinary science. Maybe hip dysplasia is partially environmental, but no 7 month old pup is going to have time for its environment or weight to do to their hips what I've seen it do. I'm not a vet, but any fool can look at a poor hip x-ray and tell that there is a serious problem, and yes.. a disease as well.

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None of us knows anything about this pup. Wein was right that I did presume that there hadn't been more than one opinion, although I did notice that he or she never did say that they have gotten more than one.

 

Whether it's commonplace or not, I would always get a second opinion on surgery on a developing pup.

 

It seems to me that some vets diagnose this condition and perform surgery in a very high percentage of dogs, while others don't. The cynical side of me says this is a moneymaker for the vets. The more forgiving side says that these are vets who have trained themselves to look for a particular condition and to treat it with a particular set of procedures, and that they may be cut off from the reality of whether it's a.) necessary or b.) even helpful.

 

To have condemned the hips of a seven month old puppy seems strange to me, considering the amount of changes that a Border collie goes through from the time it's seven months old until it is physically mature.

 

Jaime presumes that the hips are "horrible" or this procedure wouldn't have been recommended. Perhaps that's the case. Perhaps not. That's why I'd want a second opinion if it were my dog, and I'd want it from someone who doesn't perform a lot of TPOs.

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Guest PrairieFire

Bill F. said it Jaime...

 

To paraphrase the old design engineer's warning, "When your only tool is a hammer, the only fix you are likely to use is a nail".

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Jaime presumes that the hips are "horrible" or this procedure wouldn't have been recommended. Perhaps that's the case. Perhaps not. That's why I'd want a second opinion if it were my dog, and I'd want it from someone who doesn't perform a lot of TPOs.

>>>Bill

 

At least in my area, most candidates are referred to specialists for these surgeries. The general practice vet has the patient consult with the ortho specialist- he is the one who does the surgery. It is likely that a dog WILL have a first opinion from a vet who DOES NOT do the surgery. The second opinion is likely to come from the orthopedic specialist. In our area, there's only two and they come in from out of town once a month each, but could probably come in three times as often and have a full book. They make a lot of money aleady on necessary procedures and have clinics competing for their services, there is no need to push someone into doing any procedure that is not warranted. - I guess I don't understand why you think vets would reccommend an invasive, expensive procedure just for money. I have worked for money grubbing vets that probably would do something like you suggest- but none of them were qualified to do it.

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Jaime,

 

I guess my feelings are more along the lines of what Bill suggests -- if all you have is a hammer, you're likely to use it. And a corrollary: if you have a hammer you're likely to be looking for places to use it.

 

I am sure that some dogs *need* this procedure and that it helps them live better lives. I am sure that some dogs die on the table (this is true of any surgery).

 

What happens, in my experience, is that people -- vets included -- see something that works well and try to use it more often. We are all looking for the Magic Bullet.

 

I think that when it comes to hip dysplasia there are lots of Border collies that are being treated for a disease that might not ever manifest symptoms if the dog was allowed to grow and exercise properly. And the fact that some vets see a much higher percentage of dysplasia than others leads me to the conclusion that they may be looking for it.

 

I don't think this is strictly because they are money-grubbers; I think it's because they have a mindset that says they should be as pro-active as they can in using surgery to *prevent* the possibility of future disease. I don't believe that's generally a wise course.

 

But it's also a cover-your-assets course. If the disease doesn't develop, the surgery spared the dog a life of pain. If it does, well then at least you've done everything you could do. There's no way to test this, but I'd wonder how many of these cases, left to nature, would actually develop disease, as manifest by lameness and pain.

 

As I said, I know nothing about wein's puppy. It could be a case where this is a needed and helpful procedure. It just strikes me as strange that CHD so widely diagnosed and treated in Border collies in the US, while it is virtually unheard of in the same dogs in the UK.

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Hi,

 

I'm really not trying to be ornery about this but I guess you aren't getting what I'm trying to say. These are not "borderline" or "suspicious" hips that are reccommended, in my experience. These are poor hips, there is no maybe about it. I think you also will find more vets look for it because they practice good medicine and reccommend screening even animals who are altered. Our clinic recommends hip xrays for appropriate breeds when they are fixed. I don't have statistics about the incidence of dysplasia here as opposed to the UK. If you have, I think that would be an interesting question- so point the way. However, I suspect that you are using anectodotal evidence both ways. If I used only what I experienced, I would say I have rarely known (in fact, can just think of one and it wasn't severe) a Border Collie with hip dysplasia. I have never met one, personally, that had to have surgery. Yet you say its "widely" diagnosed and treated. The truth would lie somewhere between those two statements. We do have the 12% stats of OFA, but we don't know if those dogs were or were not treated for it, and it just differentiates between dogs that pass or fail, not whether it was severe enough to cause sypmtoms. But as I said before, the common candidates of this surgery that I see, who are not border collies, are severely dysplastic and without exception, are already exhibiting symptoms. So this is not a case of "preventing" a future disease, but controlling a present one. Dogs can and do die on the table- rarely. I'd rather bank on the younger dog to go through the less complicated surgery than to face putting an older dog through it.

 

Also, there is another "fix".. not just one hammer. But in this case, instead of using a good, proven hammer its more like using a child's toy to build a house. If clients can't afford or don't want to do the surgery, no one forces them too. We give the dog anti-inflammatories where merited and most are back in a year or two to do the more invasive surgery. The rest are back to be put down because they can't walk.

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Guest PrairieFire

Pretty silly, Jaime...

 

All Bill and I have pointed out is that such a "diagnosis" should recieve more than one opinion - and that one of those opinions should NOT be from a vet that specializes in such surgery - yet that makes you go on and on, nearly endlessly, defending your veterinary practice that DOES do such surgeries...

 

One might ask why you would fear folks searching out such a second opinion?

 

Oh yeah, and I asked how the diagnosis was made, and just recieved a snotty, "Keep your opinions to yourself" answer...

 

All in all, pretty silly...

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Our six and half year old English Golden was diagnosed with severe hip dysplasia when she was about six months old.We were told by our vet that she wouldn't see two without an operation. To look at her today you would never know she had it. We take her for long walks and hikes in the winter and she swims in the ocean everyday in the summer. These two things along with a low dosage of Rimadyl and keeping her weight on the light side have given her a pain free and active life. She will give Jake the BC a run for his money when chasing for a ball. This is not to say that she won't have a problem later in life but sometimes there are other methods that will put off surgery and still give the dog a happy life.

 

We had specifically gotten an English Golden for the supposed lack of hip problems they are to have compared to the Goldens in the U.S., The breeder we purchased her from said she never had a litter of any pups with dysplasia so I guess it's all in the luck of the draw.

 

Jody & Jake

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Jody,

 

Your dog is the perfect example of what I'm talking about. The film says the hips are bad, but the real world says they're at least servicable.

 

I suspect that the difference between the US and the UK lies in how much stock is put in radiographic diagnosis in the absence of symptoms.

 

I won't even start on whether a certain amount of laxity is desirable -- indeed even necessary -- for a Border collie. I belive it is, and I think there are others who will agree with me. I know that the OFA doesn't condemn hips based solely on laxity, but I think that's often what people look for on the films.

 

Jaime's right -- my opinions are based on anecdotal evidence on both sides of the Atlantic. I don't know of any other kind of evidence, though.

 

The ABCA estimates that 25 percent of the breed is dysplastic, based on the guess that half of the bad films aren't sent in. (I may be paraphrasing this badly: see the Health and Genetics section of http://www.americanbordercollie.org) My response to this is: Where are the lame dogs? If one in four dogs would show up as being dysplastic on film but somehow many of them -- apparently the vast majority -- remain asymptomatic, isn't it possible that there's a problem with radiographic diagnosis? I think there is.

 

And since radiographs are *usually* the sole diagnostic tool that's used to recommend surgery on young pups, I don't have a problem at all suggesting that CHD is overdiagnosed and overtreated, based on anecdotal evidence.

 

I would love to be able to see a study that somehow compared real dogs in the real world with similarly "bad" hips to see if early surgery was really necessary, because I suspect that what we would find is that many "cases" of CHD diagnosed in young pups would not develop into symptomatic disease, particularly if the dogs were fed and exercised sensibly.

 

For some reason, it seems to fall to me to prove that CHD *isn't* as big a problem in Border collies as the veterinary community seems to think it is. I can't prove a negative. All I can do is point across the ocean to a group of related dogs that don't have nearly the degree of problems that are dogs supposedly do and ask the question: if their dogs are sound, what's wrong with ours?

 

Overdiagnosis is one of the most plausible answers that I can come up with. Another is diet: UK dog food is generally much lower in protein than US dog food. But I can't get around the fact that I don't see the number of lame dogs that there should be if the statistics are correct, and that keeps tipping the scales in favor of overdiagnosis -- at least in my mind. Plus, diet doesn't explain the genetic components of CHD, and I don't think that the only dogs that were exported to the US were the lame ones.

 

So I guess to strip and shear away all the other stuff, I'm wondering if CHD is at least sometimes a diagnosis that doesn't relate to any actual disease condition, particularly when it's made in pups as young as six and seven months old. Let's remember that CHD is defined as bilateral osteoarthritis with joint remodeling by age two.

 

It's hard for me to imagine that films are actually showing osteoarthritis in pups this young -- I'm sure Jaime will set me straight if I'm wrong on that point.

 

When people say "my six month old pup has hip dysplasia," I wonder if what they actually are meaning is "my six month old pup has hip conformation that my vet fears could lead to the development of hip dysplasia at some point in the future."

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Guest PrairieFire

The problem, Bill, is that discussing the OFA and hips is (more than a bit) like discussing religion...

 

The entire supposition of OFA ratings, and much of the myth behind CHD, is based on, quite simply, "faith".

 

Faith that ANY dog displaying a certain hip structure IS DISEASED - no matter how that dog displays itself...

 

Faith that "nurses" and "doctors", who have never even SEEN a working dog - much less worked one - can tell that a dog simply cannot work by reading its xrays...

 

Faith that these same "ignorant" (used in it's true form) folks can tell that a 6 month old dog will live a life of pain - unless they operate (at great expense and using life saving, god given, skills).

 

Faith that these same people can "read" an Xray of an unknown dog and PREDICT how that dog will behave...several years later.

 

Remember, EVERY SINGLE ONE OF THESE RATINGS is done without ever seeing the dog...or seeing it move...or researching the parents, siblings, or any relatives or offspring...

 

And remember, EVEN IF THESE RATINGS WERE 100% CORRECT - there is still no way to predict the quality of the hips of the dogs offspring...

 

Yet an entire priesthood and complete mythology has sprung up around this esoteric knowledge...

 

Arguing this mythology is similar to arguing with ANY "true believer" - it simply can't be done...they take their beleifs on faith and want to know absolutely nothing of science.

 

But then, much of what is called "science" is simply faith...especially "medical science"...human or veterinary...

 

Now, I know there will be the usual fools that will take what I say out of context, because they are scared or vindictive or simply stupid (as distinct from ignorant), but there are reasons to xray and "predict" - just as there are reasons to subject a pup to surgery - but there is no magic scale that never makes a wrong reading, or a wrong prediction, or a wrong diagnosis.

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