Management Plan:


Jocelyn is a young dog with hip dysplasia and minimal degenerative joint changes.  
Coxofemoral joint subluxation is the prominent radiographic finding.  She has not 
responded well to conservative treatment (Rimadyl).  To slow the progression of 
degenerative joint disease, we recommend a surgical approach to treatment.

Jocelyn is a good candidate for a triple pelvic osteotomy (TPO).  Total hip replacement 
would be ideal but too expensive and not necessary for her life as a house pet.  Osteotomy 
of the ischium, ilium and pubis are performed.  The acetabulum is rotated and lateralized in 
order to increase coverage of the femoral head.  A bone plate is used to secure the 
acetabulum.  Only one side can be done at a time, the second surgery attempted when 
discomfort associated with the first is gone.  This procedure has few complications.  
Reports of long-term function are good to excellent.  There will still be some degenerative 
changes seen radiographically, but these are much less than what would be expected 
without surgery.  

As with the more conservative approach, exercise, antiinflammatory drugs and weight 
control will be an important part of the treatment.  She should be limited to leash walks 
during the first six weeks or until radiographic evidence of healing of the osteotomies is 
complete.  Duration of leash walks can then be increased.  Walking on hard surfaces 
should be avoided, exercises such as swimming may be beneficial.  Carprofen (Rimadyl) 
should be given on painful days.  She also needs to be fed based on daily energy 
requirement rather than free choice to maintain weight control.

If the clients opt for a less expensive procedure, a femoral head and neck ostectomy can be 
done.  However, post-operative function for large breed dogs is unpredictable with this 
procedure. It is usually considered a salvage procedure.