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Hip Dysplasia / Fractured Hip Options

Discussion in 'Cat Health and Nutrition' started by Flora1972, Nov 27, 2018.


  1. Flora1972

    Flora1972 PetForums Newbie

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    I have posted in another thread but it was quite old and I wanted to hear peoples advice really so I hope its okay to post here again....

    We have a 2 year old BSH, total softie, acts more like a dog than a cat and he's very lovable. He is approx 6kg in weight. He had a limp on his back leg last year when he was 8 months old and weighed about 4KG at the time. He was X-rayed then and nothing untoward showed up. However they said because he still had 'immature' bones that we should get him checked again later down the line. Fast forward a year...

    He started limping in Oct and we had him x-rayed again. This time, there appears to be signs of Hip Dysplasia in his hips but its worse on the left where the femoral head has not grown properly (its thinner than the right). They also think they can see a small fracture in the left hip too, which may have been caused by the fact he's heavier and the bone is thinner.

    We've been offered the option of a Hip Replacement (HR) or Femoral Head Ostectomy (FHO). The HR will cost about £6-7K at Fitzpatricks and a FHO will be about £2K. My understanding is that a HR is the Gold Standard of treatment and offers a good chance of full movement once recovered. However it's more at risk of infection/complication in the joint if the recovery is not managed strictly and carefully. (I guess it's a longer recovery time due to the time it takes for the bone to 'knit' with the prosthetic joint - plus you're adding something rather than just taking it away). If a HR doesn't take for whatever reason, they can then do a FHO instead as a last option. But if we went for a FHO first, you can't then revert to a Hip Replacement if that goes wrong as there's no bone to attach it to.

    Luckily we have insurance which will cover both options, but I am quite stressed about the recovery time and risks involved in HR surgery for my boy. Presently he's on a diet and taking joint supplements, as well as having Metacam every day for time being. He's actually still very much 'himself' although still limping (not as severely as previously though), and is still able to jump up in places he shouldn't be jumping (esp when we aren't watching). He's still got a great appetite and is very playful. I am torn with the choice of managing his condition for a few more weeks or do we make the decision now to have surgery and have a long 3-4 months of rehabilitation where he's got to live in a cage, be in more pain and become quite depressed. It's a really hard decision and I want to be as informed as possible before we make the choice but am reading opinions on both online as to which is best long term. As he's only 2, we want to give him a chance of as normal a life as possible.

    Any advice would be welcomed...
    Sharon x
     
    #1 Flora1972, Nov 27, 2018
    Last edited: Nov 27, 2018
  2. Flora1972

    Flora1972 PetForums Newbie

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    As a quick follow up, as I referenced in OP, we have been considering Fitzpatrick Referrals as I hear good things about them. I don't often watch the programme but I know Mr Fitzpatrick has done some amazing things. I was wondering if they are just hugely popular because of the TV show or whether they were pioneering in their own right before that. There are a few referral places near us in Berkshire but I don't know anything about them. Would all of these places have the expertise as shown in the Supervet programme? Thoughts welcome as well...
     
  3. jill3

    jill3 PetForums VIP

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    Hello Flora
    A few years ago Archie our Britiah Lilac had a Femoral Head removal it coat me just over £1,000 and took a few months to recover.
    He runs around and you would not know that he has had anything removed.
    I don't know where you are but we went to a vets in Northants who was reccomended to us by our vet who said that they were more experienced in these operations. I do remember that a hip replacement was about £4,000. We choose the FHO as it was that area that was badly deseased.
    Aftercare was not too much of a problem. We took all the furniture out of one room and he stayed in there. We kept him company by being in the room with him reading, eating, and i did all my office work there on the floor with him. We then had a pet physio who came round and gave ua a list of exercises for him to do a month after the operation. That was well worth £50.
     
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  4. jill3

    jill3 PetForums VIP

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    Here are a couple of pictures of him just after the operation.
    If you Fur baby is not too bad at the moment I would leave any op till after the New year. Wll be less vistors at the your house and will be quieter and you will have more time.
    My Boy was so bad that he use to lay down to eat but we had to wait for other problems to go before he could have the op. 920880_10200487034319746_1788427176_o.jpg 1097673_10200487041799933_1057191429_o.jpg
     
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  5. Suzanne H

    Suzanne H PetForums Newbie

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    Hi Flora,
    I've read your post from last year with interest. My BSH who has just turned two (female blue/cream) has just been diagnosed with exactly the same as your BSH. I was wondering how he got on, what treatment you selected etc?

    We found out last week that Beau has hip dysplasia in her right hip. And also, as you've experienced, her left femoral head is thinner and has a small fracture. She started limping last week - hence the visit to the vet. At the moment the vet is recommending FHO. From reading around FHO seems to be a very effective treatment, and the long term results positive.

    We're yet to speak to the vet about surgery options and where the surgery will take place. But I'd be interested to know what referral options you were given, what they suggested and in the end what you chose. I have a friend who was referred to Fitzpatrick's - her dog had groundbreaking surgery there (and was part of the TV series) - this hasn't been suggested to us yet.

    Any suggestions, comments and feedback would be gratefully received.
     
  6. Flora1972

    Flora1972 PetForums Newbie

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    Hello Suzanne
    Goodness it seems like ages ago I wrote this post (although it was only a year ago). We ended up opting for the Total Hip Replacement THR in the end. Our insurance covered it and having spoken with the vet surgeon at Fitzpatrick Referrals, we felt it offered the better long term solution. She told us hip replacements in cats aren't as common as dogs but they are still highly achievable and she was extremely confident in doing it. Her name is Sarah Girling and she's the head of ortho at the practice.

    There was a bit of a wait from Teddy's initial diagnosis and x-rays last October, so his op didn't happen till Feb 2019. We managed his pain with Metacam in the interim.

    He was in for about 4 days I think and came through the op like a champ. We bought the largest dog cage we could find on Amazon and kitted it out with a bed area and an area for his litter tray. I rigged up a cardboard partion between them so he had a 'private loo' and also to stop the litter going everywhere!! The first week of having him back was nerve wracking...

    A) it's vital they don't groom/lick their sutures so the use of a cone was essential. However Teddy HATED the plastic ones and wriggled out of inflatable one on the second night home. I caught him licking his stitches on that occasion .. cue a visit to my vet, who confirmed it was fine, he hadn't ripped them open. The lifesaver was a soft cone we bought from our vets which was more comfortable for him and he could sleep with it in.

    B) It's imperative they don't skid or try and jump, or walk on slippery surfaces. A nightmare when your entire downstairs is laminate flooring. We went to IKEA and bought the biggest rug we could find so his 5 min exercise periods (you're encouraged to let them exercise for small amounts building up the muscle strength again) were strictly supervised of him walking on that area only. You need to watch them like a hawk as we turned out back for a split second and he jumped on the sofa on about day 3. He started limping and I was convinced he'd popped the hip out. Cue a panicked phonecall to Fitz's. Thankfully he hadn't, and was back to not limping shortly afterwards.

    Once that first week passed, each following week became easier in some respects as he was getting stronger, but also harder to contain him. In the end we let him out in the days/evenings when he could be supervised, and he was happy to chill out on his 'rug' ... Then got him into the routine of 'going to bed' in his cage when it was bedtime for us. There were a few pitiful mews on occasion but he soon settled.

    It took till about June for him to walk normally again although he has got a bit of a swagger still. Fitz's said his kneecaps were rounder which is common for his breed, so it might take a while to adjust to his new gait where he's got the implant. The leg he had done is now fractionally longer so it's all about his body adjusting over time. The surgeon described his hip fracture like so... Imagine the top of his femur as an ice cream cone, with the femoral head being the ice cream ball. The growth plate had cracked somehow so the ice cream fell off the cone!

    Now 8 months on he's back to normal, running, jumping etc although I still tell my partner off for running round the house with him. I'm glad we opted for the THR and thankfully our insurance paid for it without question. Was about £7k all in all. Hope that helps x

    Ps, this is him up on his hammock

     
  7. Suzanne H

    Suzanne H PetForums Newbie

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    Hi Sharon,
    Thank you so much for your speedy reply and invaluable insight. Some fantastic tips there, which we'll certainly take on board once the time comes.
    I'm really pleased to hear you BSH has made a great recovery.

    I'd already thought about borrowing my parents dog cage - I don't think Beau will be too fussed about being penned in, she's used to sleeping in the downstairs cloakroom - aka 'her bedroom' - and already has a bedtime routine (as long as there are Dreamies involved!) But like you, we have wooden flooring on the whole of the ground floor - so a rug and a soft cone....

    Out of interest, was there a particular reason why you opted for the full replacement rather than the FHO? At the moment our vet is suggesting the FHO. But, if part of your rationale was due to the fracture or bone quality I'd be interested in knowing.

    Many thanks
    Suzanne
     
  8. Flora1972

    Flora1972 PetForums Newbie

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    Very quick hi, no probs - happy to help.

    Our vets gave us the option of FHO or FHR. Basically they can function very well with both options, but we were told the FHR is the Gold Standard of treatment. Also, if you opt for the Full Hip Replacement, and for whatever reason, it doesn't take, or the cat somehow injures the new socket again, THEN the other option is still an option as they are effectively taking the femoral head away (whereas the FHR is adding an implant to the existing femur bone). We were initially told that if you opt for a FHO then its difficult to then do a Hip Replacement after as there's less bone to work with.

    Having said that, the vet at Fitz's showed us an x-ray of a BSH who had had a FHO which for some reason hadn't been successful, and they had then performed a Hip Replacement, noly there were a lot more screws and plates etc holding the implant in place (as the femur had been shortened in the previous op).

    In a nutshell, the FHO is a shorter recovery time as unlike the FHR, you are encouraged to get them moving to build up the muscles asap to support the lack of hip socket. But there are some cases of arthritic problems further down the line in the back/legs where they are doing the job of the missing hips.
    OR, if you opt for the FHR, its a longer recovery as its imperative for the bone to knit with the new implant, but if all goes well, their hip function will return to normal and all being well, be pain free with lesser arthritis risk down the line. As our insurance covered us for the FHR, we opted for that.

    Hope thats helpful. Good luck with whatever option you go for. Wishing your kitty a speedy recovery x

    PS not sure why the photo didn't upload! :(
     

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