Canine Femoral Head Ostectomy: Post-Operative Care

FHO Surgery: What to Expect

Femoral Head Ostectomy (FHO) is a common orthopedic procedure for dogs experiencing various hip joint issues. This surgery involves the removal of the "ball" portion of the hip joint, specifically the femoral head and neck, which is the top part of the femur or thigh bone (Source 1, Source 4). The goal is not to recreate a normal hip joint but to eliminate the source of pain and allow the body to form a "false joint" made of scar tissue (Source 1). This new joint provides pain-free mobility and improved function.

FHO is a well-established and effective treatment for several debilitating hip conditions in dogs. According to Kingsdale Animal Hospital, it is commonly used for hip dysplasia, Legg-Calvé-Perthes disease, and traumatic injuries (Source 1). Other conditions that can be corrected by FHO include hip luxation (dislocation) where the ball comes out of the socket, and severe hip fractures that cannot be repaired (Source 4, Source 5). The primary objective of FHO is to relieve pain and restore functional use of the limb, allowing most pets to run, play, and enjoy a good quality of life after recovery (Source 1).

Immediate Post-Operative Care (First 48 Hours)

The period immediately following FHO surgery is critical for your dog's comfort, safety, and recuperation (Source 2). Careful adherence to veterinary instructions during these initial 48 hours is vital for successful healing and to minimize complications.

Pain Management

Strictly follow the prescribed medication schedule provided by your veterinarian. Pain management is paramount to your dog's comfort and willingness to engage in early rehabilitation. Most medications are administered on the morning of release from the hospital (Source 2).

A pain patch may be applied to your pet's skin for continuous pain relief. If present, ensure this patch remains secure and does not become loose or come into contact with children (Source 2). You can typically remove the pain patch after the first 48 hours of release, as directed by your vet (Source 2).

Incision Monitoring

Check the surgical incision 2-3 times daily for any signs of discharge, odor, or abnormal appearance until it is completely healed (Source 2). It is crucial to keep the incision dry to prevent infection (Source 2).

Prevent your dog from licking or chewing the incision site, as this can introduce bacteria and delay healing. An Elizabethan collar (E-collar) is often necessary for this purpose. Contact your surgeon or primary care veterinarian immediately if you observe any drainage, discharge, abnormal appearance, or odors from the incision (Source 2).

Rest

Strict rest is crucial during the initial healing phase. Confine your dog to a small, safe area where movement and jumping can be minimized. This restriction helps protect the surgical site and allows the initial healing processes to occur without undue stress.

Rehabilitation: Weeks 1-8

Post-operative rehabilitation is a cornerstone of successful FHO recovery. The approach to rehab after an FHO procedure is distinct from other hip surgeries (Source 3). The hip area tends to tighten during healing, making early and consistent movement essential to prevent stiffness, unnecessary scar tissue, and contractures (Source 3).

Early Movement

Gentle, controlled movement should begin as early as your veterinarian advises. While your dog may initially be reluctant to bear weight on the affected leg, it is important to encourage gradual use (Source 3). Delaying movement can lead to tighter tissues and potentially painful stretching later (Source 3).

Passive Range of Motion (PROM) Exercises

Perform passive range of motion (PROM) exercises multiple times a day. This involves gently flexing and extending the hip joint without your dog's active participation. These exercises should be done slowly and carefully, ensuring your dog shows no signs of pain. PROM helps maintain joint flexibility and prevents the formation of excessive scar tissue.

Controlled Walking

Introduce short, leash-controlled walks on soft surfaces, such as grass, as soon as your vet gives the go-ahead. Gradually increase the duration of these walks as your dog tolerates them. Controlled walking encourages weight-bearing and muscle development without excessive strain.

Hydrotherapy/Swimming

Hydrotherapy, including swimming, is an excellent non-weight-bearing exercise option. It allows your dog to build muscle mass and improve range of motion without putting stress on the healing joint. This should be introduced under the guidance of a professional canine rehabilitation therapist.

Therapeutic Exercises

Incorporate specific therapeutic exercises to build hind leg strength and improve proprioception (awareness of body position).

• Sit-to-stands: Encourage your dog to sit and then stand repeatedly. This strengthens the muscles around the hip.
• Cavaletti poles: Walking over low poles helps with controlled limb placement and balance.

Weight Management

Maintaining an ideal body weight is crucial throughout the recovery process and long-term. Excess weight places additional stress on the healing joint and can hinder rehabilitation progress. Discuss your dog's ideal weight and dietary needs with your veterinarian.

Long-Term Recovery & Maintenance

Long-term care after an FHO is essential for maintaining the functional improvements achieved through surgery and rehabilitation. Consistent effort will help your dog enjoy a full and active life.

Continued Exercise

Regular, moderate exercise is key to maintaining muscle mass, joint flexibility, and overall fitness. While high-impact activities should be avoided initially, gradually reintroduce normal activities under the guidance of your veterinarian or rehabilitation specialist. The goal is to keep the muscles strong to support the "false joint."

Physical Therapy

Consider ongoing sessions with a certified canine rehabilitation therapist. These professionals can provide tailored exercise programs, manual therapies, and advanced techniques to optimize your dog's recovery and long-term well-being. They can also help identify and address any compensatory issues that may arise from altered gait.

Nutritional Support

Discuss nutritional supplements with your veterinarian. Supplements like glucosamine and chondroitin are often recommended to support joint health, although their effectiveness can vary. Your vet can advise on appropriate dosages and whether these supplements are beneficial for your dog's specific needs.

Tools & Products

Several tools and products can significantly aid in your dog's comfort, safety, and recovery after FHO surgery.

• E-collar (Elizabethan Collar): This is essential to prevent your dog from licking, chewing, or otherwise interfering with the surgical incision.
• Soft Bedding: Provide comfortable, orthopedic bedding to reduce pressure points and support your dog's joints during rest.
• Non-Slip Mats/Rugs: Place non-slip mats or rugs on slick surfaces like hardwood or tile floors to prevent slips and falls, which could injure the healing leg.
• Ramps/Steps: If your dog typically jumps into cars or onto furniture, ramps or steps can provide a safer alternative, reducing strain on the hip.
• Harness with Handle: A supportive harness with a handle allows you to assist your dog with balance and controlled movement, especially during early rehabilitation walks or when navigating stairs.
• Medication Dispenser: A plastic pill box or medication dispenser can help you accurately track and administer prescribed medications, ensuring your dog receives them on schedule (Source 2).

Risks & When to See a Vet

While FHO is generally a successful procedure, it's important to be aware of potential risks and complications. Prompt veterinary attention can prevent minor issues from becoming serious.

• Incision Complications: Watch for any redness, excessive swelling, discharge, foul odor, or if the incision appears to be opening. These are signs of potential infection or improper healing.
• Excessive Pain: If your dog exhibits signs of severe pain, such as whining, persistent limping, reluctance to move, or aggression, even with prescribed pain medication, contact your vet.
• Loss of Appetite/Lethargy: A significant decrease in appetite or unusual lethargy could indicate an infection or other underlying issue requiring veterinary assessment.
• Non-Weight Bearing: If your dog completely refuses to use the operated leg for an extended period beyond the initial recovery phase, it warrants veterinary investigation.
• Sudden Worsening: Any abrupt change in your dog's condition, mobility, or behavior should be reported to your vet immediately.
• Signs of Infection: Beyond incision issues, systemic signs of infection include fever, generalized lethargy, and a poor appetite.

Contact your veterinarian immediately if you observe any of these signs. Early intervention is crucial for managing complications and ensuring a smooth recovery.