# Fho vs total hip replacement



## Maxs Mom (Mar 22, 2008)

Both are very good procedures. 

My Teddi had a total hip replacement for her first birthday. Yes there are potential complications but depending on the procedure it can be reduced. I think the "biggest" complication right now, is if you go "cemented" for the prosthesis, they are finding after several years that the cement breaks down and needs to be redone. A friend had a cementless one done but hers had "screws" to hold it in place. Teddi's was the Biomedtrix prosthesis, no cement no screws. It is not going anywhere. The test dogs are coming 15 years old and doing great too. Our surgeon post op told us "Teddi did her part, I did my part, now you must do your part". The rehab was hard and long 6 month little to no activity, a lot of crate time and as owners we had to be DILIGENT! We were and Teddi is GREAT as a result. No complications, she runs, jumps, lives her life as a golden retriever should. 

We had the option of the FHO which is cheaper, and my reason for going with the THR was a purely esthetic one. Our surgeon told us that with the FHO she would appear slightly "lower" on the one side, and possibly track a bit shorter on that side. I did not want to see that the rest of her life. Teddi is 24" and weighs 60# so big dogs "can" have it done, it just may take longer for the rehab. I know I have heard of Rotts who have had this procedure done.

One thing too that was told to me was "weight control, weight control, weight control. Like I said, Teddi is tall and THIN! Our vets all have told us try like heck to keep her as close to 60# as we can. She was that weight as a pup, and now at 3 years old she is still there. She is bi lateral HD, and has elbow dysplasia so we have to keep up with her so she does not fall apart. So take an honest look at your dog, if it is normal to overweight, try to get a few more pounds off it will help your surgery whatever your choice is. 

There is a canine HD yahoo board I highly recommend. The people there are pretty nice, and you will hear it all. The good and the bad. Some of the people there have done conservative management and had great success with dogs with REALLY bad hips, and the dogs get along fine. You would find a lot of experiences there. 

One last thing I want to add. The surgery is only as successful as the surgeon. Make sure whichever procedure you end up deciding on, your surgeon has done MANY times and has a high success rate. I live in MI, and our surgery was done at Michigan State University, it offered a price reduction since students (not techs) do the pre and post op care. They also had a top notch orthopedic surgeon who travels the country teaching other surgeons hip surgery techniques amongst other ones. My Teddi is part of his teachings, because she had a "situation" that is not normal but is not a complication. After her surgery her bone resorbed on one side of the prosthesis. However the prosthesis has not moved one little bit so all is well. 

Sorry for the long wind. I feel strongly for dogs who face this surgery. Good luck! Hope all goes well. Keep us posted with your decision.

Ann


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## GoldenJoyx'stwo (Feb 25, 2007)

Shadow had an FHO at 7 months of age and a THR at 11 months of age. He does fine with both sides, but you can tell he had the FHO. That leg is a bit shorter than the other and he places the paw a bit strangely. However, when he runs, you'd never know he has no hip and a fake one! At the time of the surgery the FHO was 1500.00 USD and the THR was 4,327.00 USD. He is now 7 years old and going strong.

I guess cement hips can give out about 5 years after the procedure. I was having a discussion about this with my Vet last month. He said this is true, but he has seen many dogs live long lives without issues. Shadow is now at year 6 and I worry about the hip coming loose, but so far so good. Our options, if this should become a problem, are to take the equipment out and he would be left with something similar to the FHO. My concern would be putting him through this again, I would be more concerned about his age at the time, but how would I let him go...Hopefully, I will not have to cross this bridge...

I really need to call Dr. Pond and find out exactly which Replacement Shadow had. It seems like forever ago...


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## fostermom (Sep 6, 2007)

My Jasmine had her first FHO at 7 months old and her second at 2 1/2 years old. She weighed 96 lbs for her second one and still was walking on that leg the same day as surgery. She is now 9 years old she does bunny hop when she runs, but she keeps up with the younger dogs, and actually still can outlast them up at the lake. Each hip cost about $1100.


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## GoldenJoyx'stwo (Feb 25, 2007)

I truly feel the dogs that are not couch potatoes do very well even during rehab. Shadow is always ready to roll. Tucker walks back in the house leaving me and Shadow outside playing. Tucker is soooo much better about placing the ball in my hand. Shadow makes me bend for it...For Shadow, it's all about constantly moving. He even makes me do it!


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## www (Mar 17, 2009)

*Thanks*

For the great feedback. Very helpful. I'm trying to get a feel for the market for these procedures. Does anyone else have some data points on the costs of each of these procedures. Also, how does the recovery differ for both of these. I had read you basically want to keep them in a crate for six months? Finally, any suggestions of good places or doctors for both of these procedures in the new York city general area?


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## GoldenJoyx'stwo (Feb 25, 2007)

Shadow's recovery for both was amazing. I used Dr. Melvyn Pond in New Haven CT. He's awesome. I have no idea what the cost is now. 

Shadow was not in a crate at all. I set it up for him, but it stressed him more than I thought was necessary. We rearranged our entire home, most rooms are on different levels, to be near him. We also placed area rugs on the hard wood floors. I kept him in the livingroom. I placed enough furniture around so he wouldn't zoom or run. I did have to sling him to get him outside to do his business. As for rehab, it's so long ago, it was all done by walking. At first walking at a certain pace, avoiding hills, then walking further and then using a hill as a tool. It was years later that a rehab facility came to town. I wished I had access when he was recovering, but I guess we didn't really need it.

I have photos of Shadow outside and walking right after surgery. I was parasailing down the street in a short period of time after surgery. I will say, I feel he recovered more quickly from the THR, but I do know he was in more pain for the first few days home with the THR. His surgeon was amazed at how well he did and how he retained muscle. We walked a lot and always had, but always following instructions.

Right hip FHO: The FHO was done a few days before the photo of him walking with his purple Ollie...












Left Hip FHO


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## Karen519 (Aug 21, 2006)

*Www*

WWW

IF you google FHO and THR for canines, I'm sure you will come up with a wealth of information.

How old is your dog?

Many years ago we had FHO for our female Samoyed, she was 2 or 3 years old, and she seemed to do very well walking after it. The vet had said she had two of the worst hips he had ever seen. It took Munchkin about 1-2 mos. to put weight on that lady-the vet said she was being a baby and depending on the degree of pain a dog is in prior to the surgery, most dogs he had FHO on, walked out of the animal hsptl, and had less pain from the operation, then they had prior to it.


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## Maxs Mom (Mar 22, 2008)

www said:


> For the great feedback. Very helpful. I'm trying to get a feel for the market for these procedures. Does anyone else have some data points on the costs of each of these procedures. Also, how does the recovery differ for both of these. I had read you basically want to keep them in a crate for six months? Finally, any suggestions of good places or doctors for both of these procedures in the new York city general area?


I paid $4800 at the time of surgery for Teddi's hip at a teaching hospital. Then there were the follow up visits. Isn't Cornell your way? Look into a teaching hospital as an option, it does usually reduce the care expense. Unfortunately these are expensive procedures. There are options like "care credit" that can help work on a payment plan. We kind of went that route. 

Kimm - I would like to touch base with you about why you had both hips done? Teddi still has a bad left side. She is doing GREAT and I hope we never have to worry about it, but just want to talk to you what was up with your dog. Our surgeon said he has never done a bi lateral THR, do the worst side and you should be fine. We are hoping we can get along that way.


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## GoldenJoyx'stwo (Feb 25, 2007)

Shadow had no hip sockets on x-ray. Even after the FHO he was not acting like a normal puppy. He threw the left side out running at the dog park and the FHO was an emergency. They tried to place it back in the socket, but it wouldn't stay because there was no socket. He came home with it out of the socket and swinging in the wind. That was a stressful weekend for sure. The FHO was our only option and was done by a different surgeon.

The second surgeon told us we could wait and see how he did with the right side. When he asked me a question, I thought I should proceed. He asked me about his quality of life. He said if he was running around happy and not feeling any pain, he would wait. Shadow pretty much was acting like the dog I had to put down 11 months earlier. She was 17 years old and had more energy and life than he did. 

Did I do the right thing? I hope so. Do I often wonder if we could have waited? Sometimes. I just remember at the time thinking he wasn't able to enjoy life fully. Something seemed to be in the way. After the second surgery he was able to go up and down our stairs without hesitation. It was sad to watch him. He'd go up one, then turn and go back to the bottom. He'd do this two or three times and then bolt up all of them. I never realized it was probably due to pain. We just thought he was getting confused. How dumb was I...


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## fostermom (Sep 6, 2007)

With the FHO, they want the dog using the leg immediately. Because it involves removing the femural head, the muscles and tendons take over supporting the let so they want them to start building up right away. Jasmine wasn't crated at all after either surgery. Like Kimm said, I think the higher energy dogs really recover quickly from the FHO (I can't speak for THO) because they want to be moving as soon as possible.


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## GoldenJoyx'stwo (Feb 25, 2007)

The leash is your best friend during recovery. I will add, I would make a face when poor Shadow had to have a bowl movement. The position they go in seemed to be uncomfortable. 

On a lighter note: I had Shadow outside and walking. A car drove by with an older couple and they giggled when they saw Shadow. My son was with me and he got very upset when the people smiled and laughed. I looked at my son and said, "Come on, look at him. He has no hair on his back, a naked butt and hip, he's wearing a lamp shade, and has a little tuffed of hair on his leg and, he's carrying a purple Octopus!" Plus, his tail was always wagging...


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## fostermom (Sep 6, 2007)

LOL! Love that visual Kim!


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## Cheree (Apr 8, 2010)

There are actually several options available to treat hip dysplasiain dogs. The ones used at our surgery center are:
- Cemented Total Hip Replacement 
- Cementless Total Hip Replacement 
- Triple Pelvic Osteotomy (TPO) 
- Bioscaffold implantation 
- Joint capsule denervation 
- Femoral Head and Neck Ostectomy (FHO) 

The procedure used in any particular case depends on a lot of factors: the progression of disease in the dog; the size, weight and age of the dog; the desired outcome of the family; and the financial constraints of the family. 

If your dog is a candidate for the cementless THR, it would be the recommended method if there are no reasons not to go this route (disease progression, finances) because the outcome is better. Given no mishaps and aftercare instructions are followed, your dog would be returned to pain-free, normal hip function -- which is what happens in 95% of our surgical cases. Here in Arkansas, the cost for a cementless THR is $5,695 for a 51-100 lb dog.

An FHO is still an excellent surgery, as others have commented here, and costs $1,884 for the same size dog. Sometimes this is the only option available, again, depending on the disease progression.

Another option which has recently become available that you might want to look into is the bioscaffold implant. There are only a few veterinary hospitals in the country who have been approved for this procedure which is still in the study phase. This is a non-invasive procedure which involves injecting embryonic-like collagen material into the joint which helps to regenerate tissue. This is a very promising procedure. The benefits are: no surgery, no long-term exercise restriction waiting for bones to heal, lower cost than surgery, almost immediate results. The draw backs: not widely available yet, still in the study stage so long-term benefits aren't yet known, but so far patients are still pain-free at their 8-month rechecks. You can go to http://www.trmatrix.com/Dog_Arthritis.html to find a hospital near you that is approved for this study. Your dog may or may not qualify. The cost for this procedure is usually between $1,200 to $2,000 at our facility. We have seen dogs walk normally the day after the procedure, and at their 6 month recheck (which is as long as we've been involved in the study) they are still fine. This site shows some amazing photographs of bone regeneration.

As many have stated here, depending on the procedure you go with, aftercare will probably have the single biggest effect on the eventual outcome. If you opt for surgery, exercise restriction and physical therapy will be critical for your dog's recovery. We also highly recommend giving your dog a joint supplement for life to help maintain good joint health.

Good luck. You and your dog can get through this. You'll be amazed at how much happier you both will be with proper treatment!


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## BayBeams (Jan 3, 2010)

My rescue boy came to me at the age of 6 having had FHO on both hips at some point in his life. He gets around reasonably well, though he does have some limitations. He can run and play though he is more easily knocked down than my other golden. I suspect he didn't get adequate rehab following the procedure as he was extremely overweight when he came to me and has some decreased movement in the hips. That is just an assumption since I don't know his history.
My understanding is that FHOs, typically, have better success with smaller dogs and is not usually done on dogs the size of a golden. My Golden boy is doing much better since his weight is down, something that is important whichever procedure you choose. He is also one happy, jolly guy so he doesn't notice his limitations.
I wish you the best in the decision process. You are doing the right thing by researching different options.
Good Luck!


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## Maxs Mom (Mar 22, 2008)

Kimm said:


> The leash is your best friend during recovery. I will add, I would make a face when poor Shadow had to have a bowl movement. The position they go in seemed to be uncomfortable.
> 
> On a lighter note: I had Shadow outside and walking. A car drove by with an older couple and they giggled when they saw Shadow. My son was with me and he got very upset when the people smiled and laughed. I looked at my son and said, "Come on, look at him. He has no hair on his back, a naked butt and hip, he's wearing a lamp shade, and has a little tuffed of hair on his leg and, he's carrying a purple Octopus!" Plus, his tail was always wagging...


I agree wholeheartedly, and we found a harness worked easier than a collar. Teddi "thought" she was better. She got smart the only moving she was allowed was potty walks, and walk she did when she had to go potty. She would PULL us around the yard, well with the collar on she could not put her nose down to find the spot. The harness made it easier to hold on to her, and allowed her to find her spot. 

We would let Teddi out of her crate to sit with us at night. She had to stay quiet and she was very good about this. If she fussed she went back in her crate. One day I came home from work and TEDDI greeted me at the door. DH was holding the wrong golden from moving around. No harm done thank goodness. One of those things we look back at and laugh now. She could have slipped running to the door. She didn't. DH was MUCH more careful after that. 

Ann


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## goldenME (Jan 11, 2012)

*please help our family decide*

I google searched hip replacement surgery for goldens and came across this site and have read all the replies here and just want people's take on the whole thing (this is my first post here, I apologize):

we have an 16 month old golden. Earlier last month was hit by a car. Fortunately his only injury was a dislocated left hip. Was reduced, placed in a splint, had the splint removed and seemed well on his way to recovery. Then 3 weeks out from his initial injury, while he was out for pee/poop walk (on a leash) he slipped on ice and it popped out again. Was reduced again... the long and short being, it's popped out... again (for a third time). 

We're besides ourselves. Don't know what to do. Our vet warned us this could happen. We'll be seeing our vet tomorrow. What should we expect? We want him to regain full function. He's a super energetic playful dog. We need him to be back to before his injury and seeing him like this is destroying us. 

What's everyone's experience w/ golden's who've had surgery on their hips and their outcomes? Do they regain full function? Please help...


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## mylissyk (Feb 25, 2007)

I have fostered dogs for rescue that had FHO done. They have done remarkably well, and are active, normal dogs. It is amazing to me how well they do.


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## goldenME (Jan 11, 2012)

mylissyk said:


> I have fostered dogs for rescue that had FHO done. They have done remarkably well, and are active, normal dogs. It is amazing to me how well they do.


based on the few things I've read tonight, w/ FHO, they seem to lose mobility. Yet w/ THR, there's always the risk of dislocation. I've been reading about TPO and that seems to be a pretty good choice for some dogs...


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## mylissyk (Feb 25, 2007)

goldenME said:


> based on the few things I've read tonight, w/ FHO, they seem to lose mobility. Yet w/ THR, there's always the risk of dislocation. I've been reading about TPO and that seems to be a pretty good choice for some dogs...


My current foster dog just had FHO surgery the week before Christmas. He is already using the leg about 95% normal, and wants to run and wrestle like normal. My foster just previous to him had FHO in July, then had heartworm treatment and didn't get to start rehab on his leg until November. In four weeks of rehab he regained full use of the leg and started building muscle again. A few years ago my foster had FHO surgery and never missed a beat, started walking on it the day after, and would have been running to play ball if he had been allowed, he was ball obsessed. Today that dog runs hard as long as he can get someone to throw the ball. In my experience FHO is a good option, and the dogs return to normal activity. 

I don't trust TPO, I think it has a high risk of failure during recovery. My vet said it is not a surgery she would ever recommend.


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## cgriffin (Nov 30, 2011)

Ohhhh, I don't know what just happened. I just typed a long post and it was one in the blink of an eye! 
Anyway, my golden "Toby" had FHO done on his left hip just about 6 weeks ago and he is doing great. Yes his little foot is placed odd when he walks down stairs or when he tries to run, but he does not care and I do not care. His leg is not shorter and even if it was, I would not care, as long as he is happy and pain free. I could not care less about esthetics. 
I chose FHO because of the risk of slipping this time of year and the fact that Toby had already been on restricted exercise and confinement for 8 weeks because of a TPLO on his opposite knee. I just did not think that Toby would mentally be able to go through another 3-4 months of confinement and restrictions. With FHO, the dogs have to be active fast to built up the muscles that take over for the joint. 
When Toby had the surgery, the surgeon called me and said, that I had made the right decision for Toby, because his acetabulum was so worn flat and thin, he would not have been able to do a THR. That made me feel better, because I was already beating myself up, wondering if I made the best choice for Toby. 
Toby is doing great and he is back to his spunky, silly old self. The surgeon had told me that it is not really true that bigger dogs don't do well on FHO. He said it always depends on the owner and if they are willing to do aggressive rehab with their dogs. 
Toby was very painful the first couple of days, but was putting weight on his leg the entire time. By day three, he felt so much better. At two weeks suture removal and recheck, the vet said, that Toby is walking as good, as a dog that had THR at this stage of recovery. There are some dogs, that won't put weight on the leg after FHO for several weeks. So, I am really happy with Toby's progress. 
After week two, Toby had no more exercise restrictions and he is walking with my other two for their normal 5 walks a day. He keeps up with no problem. I am sure as time progresses he will be able to run again. He jumped on the couch successfully yesterday, lol. Most of the time, I help him up. So, that is progress. 
THR does need a lot more time and owner compliance than the FHO procedure, because of the risk of dislocating the new hip joint and the risk of the cement breaking down, in the cemented joints. My surgeon said at the two week recheck: Truthfully, if you have a THR done, you will have to worry for the rest of the dog's life about that new joint." So, it certainly takes committment, doesn't it? 
The goal of either surgery is for the dog to be walking painfree and can get off the pain meds. 
So, whichever decision you make, I also think that the procedure is only as good as the surgeon who does it and as good as owner compliance with the rehab process. 
Good luck to you!
Oops forgot, the price for the FHO was 2100 dollars, the THR would have been 3500-4000 dollars. The surgery was performed by a board certified surgeon. But money was not a factor in my decision at all. I am in Tennessee, I can imagine that the NY area is much, much more expensive.


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## goldenME (Jan 11, 2012)

So it sounds like FHO is the way to go... I guess I'll see what my vet says later today, thanks everyone


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## cgriffin (Nov 30, 2011)

Well, I think you should listen to what your vet says first. Don't base your decision solely on the choices we made for our dogs. Not every dog and every situation is the same. Also, I think it greatly depends also on how old your dog is. If he/she is very young, I would be more inclined towards THR, if I get all the facts about whether the cement implants last or not. But really, just ask your vet, get all the info, sleep on it. That is what I did and I did what my gut said, was the right thing to do. I am sure you will make the right decision for your fur baby.


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## OutWest (Oct 6, 2011)

Cheree said:


> There are actually several options available to treat hip dysplasiain dogs. The ones used at our surgery center are:
> - Cemented Total Hip Replacement
> - Cementless Total Hip Replacement
> - Triple Pelvic Osteotomy (TPO)
> ...


The link above did not work for me.


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## goldenME (Jan 11, 2012)

cgriffin said:


> Well, I think you should listen to what your vet says first. Don't base your decision solely on the choices we made for our dogs. Not every dog and every situation is the same. Also, I think it greatly depends also on how old your dog is. If he/she is very young, I would be more inclined towards THR, if I get all the facts about whether the cement implants last or not. But really, just ask your vet, _*get all the info, sleep on it*_. That is what I did and I did what my gut said, was the right thing to do. I am sure you will make the right decision for your fur baby.


it seems I won't have the opportunity to sleep on anything. I was referred to a specialist in the area, have an appointment in 2 days and by the way they made it sound, depending on what they chose that day, they'd be ready to go right away. Was told not to feed him that morning. THR does not seem like a good option. So it's down to TPO and FHO ... my boy's 16 months old and weighs 69 lbs if that matters (??)


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## cgriffin (Nov 30, 2011)

Okay, but the choice is still yours to make. If you need an extra day to think about it, they have to honor that. I don't understand the comment: "they decide". Isn't it your dog, your money, your decision? Alright, I know, I am being a stubborn German now, lol. I really don't go for pressure tactics myself. Luckily, I had a very understanding surgeon that told me himself: sleep on it. It was MY decision to make. 
I am not familiar with TPO, so I cannot comment on that. 
Either way, I wish you and your fur baby good luck and a speedy and full recovery!


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## HiTideGoldens (Dec 29, 2009)

I was told by our ortho vet that TPOs are the most successful on younger dogs (i.e. under a year old). For a number of reasons we decided that if our Chloe (who is 17 months) ever needs surgery for her hip it will be a THR.


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## cgriffin (Nov 30, 2011)

Yep, I just googled TPO and it says it is for pups preferably up to 6 months, 8-12 months tops, depending on the growth of the pup. So, I would think at 16 months, your dog would not be a candidate for that. 
Anyway, seriously, it is YOUR decision to make, not the specialists.


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## cgriffin (Nov 30, 2011)

My goodness, I must be getting old. I just realized that we are talking to two different posts here about FHOs and THRs. 
Noticed that the person with the original post and question has not commented for a while.


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## Sally's Mom (Sep 20, 2010)

I have seen some TPO's go South... FHO is a salvage procedure, once it is done, you can't go back.. Who are you going to?


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## cgriffin (Nov 30, 2011)

Trying to bump this up. I am just wondering what both who posted with questions about FHO vs. THR have decided on and how the dogs are doing, once they had surgery.


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## goldenME (Jan 11, 2012)

cgriffin said:


> ...
> Anyway, seriously, it is YOUR decision to make, not the specialists.


That's true but they'll sway your decision based on their preference/experience and I guess your dog's situation. Our golden who's about 16 months, was hit by a car (look at my first post above) and ultimately the surgeon decided his best bet would be a capsulorraphy (?spelling) of his femoral/hip joint... FHO is like a salvage procedure and he may need that later on if this fails or if he develops severe arthritis as a result. According to the x-rays she saw, he already had a very small amount of dysplasia, not helping his case.

btw, he had his surgery on Friday (the 13th) and is doing well, shaved hip and all. Is in a sling and will remain on a leash for short walks for the next 8 weeks. Our first follow-up is this Friday... will keep this thread posted on his progress


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## goldenME (Jan 11, 2012)

Just an update: Was going to post earlier this week about my golden - that he was doing great, slowly working his way to full activity, 12 weeks out and doing awesome. But procrastinated. 

A few days ago on a routine walk, he got startled and jumped very abruptly and forcefully towards the side of his bad hip. He didn't yelp but he seemed to be almost limping at times otherwise seemed normal. Last night we thought he was trying to avoid weight-bearing on it. We weren't sure, so we had him walk in the backyard, takes a few steps... then "YELP!"... his hip it out again.

At this point we're more than $5k into his medical bills, we seriously considered surrendering him to golden retriever rescue. Our vet talked us out of it and we'll try to work something out financially... seems like FHO is our only option at this point


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## cgriffin (Nov 30, 2011)

Did I miss something? Which surgery did he have done on Friday 13th? THR and he messed that up? 
Anyway, I wish your furbaby good luck and that you can come to a financial agreement with the vet that suites all of you!


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