Orthopaedic surgery refers to surgery performed on bones or joints. It is performed for bone fractures and joint or ligament disease. While numerous veterinary practices now redirect such cases to specialist centres, we have invested heavily in the latest equipment to treat these conditions in your much-loved pet. This includes a new Siemens CT scanner that allows us to diagnose and plan orthopaedic conditions with a higher degree of confidence.
The procedures we are experienced in include those that treat medial luxating patella, cruciate disease, limb fractures, hip dislocations and tendon ruptures. We are also experienced in treating more complex procedures like arthrodesis of joints, dislocations and fractures of joints and tendon injuries.
When the patella (kneecap) shifts from its typical location in the knee (stifle) to its side, it's termed Medially Luxating Patella or MLP. In milder instances, the kneecap can slide back and forth, leading to the deterioration of the cartilage beneath the kneecap and the femur, manifesting as pain and limping. As these progresses, some luxating patellae eventually remain dislocated.
Pet owners might observe their pets hopping or skipping intermittently. This behaviour follows the kneecap's dislocation as the animal tries to snap it back into position. Pain typically arises when the cartilage is lost, causing direct bone-to-bone contact; at this point, the animal exhibits limping rather than occasional hopping. An orthopaedic examination can determine the kneecap's position and if it can shift quickly. Additionally, crepitus (indicative of cartilage loss and bone rubbing against bone) might be detected.
In milder cases, where the animal only occasionally hops without limping, managing weight, avoiding activities involving abrupt turns, and medications maintaining the cartilage might help avoid surgery. However, surgical intervention becomes imperative for severe cases of pain and limping due to cartilage degradation. Our surgical approach involves adjusting the tibial crest and repositioning it using a pin, which ensures the patella remains in place. We also deepen the femoral groove to prevent the patella from easily dislocating when indicated. The soft tissues are closed to provide additional stability to the patella. Sometimes, the medial adductor muscles are detached from the thigh muscles to avoid undue pulling on the patella.
The procedure at our facility ranges between $2000 and $3,000. We frequently perform this surgery with excellent results.
After the procedure, restricted activity is required to allow adequate bone healing. We will provide detailed instructions for your pet on how to do this. We also recommend medication that can reduce inflammation and help support cartilage healing.
The knee joint, by design, is a hinge. It lacks the stability provided by interlocking bones and relies heavily on several ligaments, including the cruciate ligaments, to maintain its structure, permitting hinge-like motion and restricting sideways movement.
Two primary culprits behind cranial cruciate rupture are trauma and the gradual deterioration of the ligaments. A sudden change in direction while running can impose immense stress on the cruciate ligaments due to the combined body weight and sheer forces, usually affecting the anterior or cranial ligament. Such injuries are painful, rendering the knee unstable and causing limping. Chronic cruciate damages arise from sustained trauma or arthritic conditions. Initially, this may cause slight, periodic limping, but the ligament can completely rupture with continued strain.
Obesity increases the risk of a cruciate rupture, even with minor knee trauma. Dogs with pre-existing knee issues or those who've previously ruptured a cruciate ligament in one knee are more susceptible to subsequent injuries in the other knee.
A common symptom in dogs with traumatic cruciate rupture is a sudden halt in movement or a cry of pain, followed by an inability to bear weight on the affected leg. 'Toe touching', or minimal weight bearing on the injured leg, is common. During a lameness exam, vets look for a specific motion known as the cranial or anterior drawer sign and tibial thrust, indicating knee joint laxity. To accurately assess this, sedatives may be administered. Radiographs (X-rays) can further assist in diagnosis and are necessary to plan surgery if indicated.
The knee joint houses menisci cartilage, which cushions the femur and tibia. When cruciate ligaments rupture, the menisci are frequently damaged and typically mended during ligament surgery.
Smaller dogs (under 10 kg) might recover without surgery with strict activity restrictions. Larger dogs, however, usually need surgical intervention for knee stabilisation. Over time, most dogs will need to have surgery.
At North Richmond Vet Hospital, we recommend the tibial plateau levelling osteotomy (TPLO) procedure, which is currently considered the gold standard of therapy.
The surgery costs range from $3500 to $4500. We aim to make this essential surgery accessible to more pet owners by offering competitive rates.
After the procedure, restricted activity is required to allow adequate bone healing. We will provide detailed instructions for your pet on how to do this. We also recommend medication that can reduce inflammation and help support cartilage healing. Adhering to post-operative guidelines should restore limb function within three months. However, arthritis might still develop with age. Surgical intervention can delay and reduce its severity. Nutritional supplements like glucosamine/chondroitin can aid in delaying the onset of arthritis. Physical therapy post-surgery can accelerate recovery and diminish complications.
Excessive weight can heighten the risk of cruciate ligament injuries. For overweight dogs, post-operative recovery can be prolonged, and the chances of injuring the opposite knee rise, especially during recovery. Weight management is as vital as surgery to ensure a swift return to functionality and to guard against future injuries. Your vet can guide you in devising a weight loss plan for your pet.
Limb fractures refer to breaks in the bones of an animal's front or back legs, feet, or pelvis. These fractures can manifest as straightforward breaks mid-bone or as intricate multiple breaks at various points, including the bone's ends or joints.
We can sometimes detect fractures on examination of your pet after an injury. Radiographs are necessary to identify the injury's exact nature and plan surgery. In some cases, a CT scan is recommended. Sedation or anaesthesia is required to do this to reduce the pain experienced by your pet as well as to position them adequately.
Our surgical approach is tailored to each patient. It often involves placing stainless-steel bone plates and screws to stabilise the fracture and allow a quick return to function and alleviate pain. In some cases, such as fractured involving joints, screws and pins may be used to repair the fracture. Our team will explain the surgical options after diagnosis.
At North Richmond Vet Hospital, fracture repairs generally cost between $3,000 and $5,000.
In most instances, pets can head home the same day or the day after admission. Our dedicated nursing team will guide you on post-operative care and necessary medications. We prefer to get pets home as soon as possible because most owners and pets prefer the comfort of their homes.
From day one post-surgery, you can walk your pet on a leash. However, unrestricted activities like jumping, running, or stair-climbing should be avoided for at least four to six weeks post-surgery. Typically, the recovery journey is smooth. Encouraging more lead-walking post-surgery facilitates a quicker recovery. We usually remove sutures two to four weeks post-surgery. We avoid x-rays at this juncture, as it's an added cost, and a normally walking pet is a clear sign of proper fracture healing.
A hip dislocation occurs when the hip is displaced from its socket, the acetabulum. While often resulting from intense traumas like car accidents, even minor incidents can cause it, especially in animals with abnormal hip joints, such as those with hip dysplasia.
The suspicion of a hip dislocation can arise during palpation due to significant pain when trying to manoeuvre the hip joint or moving the upper hind leg. A tell-tale sign is the positioning of the greater trochanter of the femur, which frequently elevates beyond a line between the ilium's top and the ischium in cases of hip dislocations. A definitive diagnosis is achieved with radiographs. Sedation is required to reduce pain and achieve the correct positioning.
Manual Replacement: This is manually repositioning the dislocated hip under general anaesthesia. It's a rapid and economical choice. However, the drawback is that the hip often re-dislocates shortly after the procedure.
Femoral Head Osteotomy (FHO) involves removing the femoral head and neck to prevent bone-on-bone contact between the pelvis and femur. It's a viable solution for many cats and dogs, but it's essentially a salvage procedure employed primarily due to financial constraints.
Surgical Hip Replacement: This involves surgically replacing the hip and securing it with a toggle pin through the pelvis's acetabulum, combined with nylon suture threaded through the femoral head and neck. This technique often results in restoring near-normal function within just six weeks post-surgery.
FHO is priced between $1500 and $2000.
The surgical repair of hip dislocation using a toggle pin and nylon suture is approximately $2000 - $3000.
Post-operative care is straightforward. It chiefly involves a four-week cage rest complemented by brief, leashed toilet walks. This ensures proper healing of joint capsules and muscles. Between weeks four and eight, it's beneficial to gradually increase the walk durations multiple times daily. This aids in regaining muscle strength and functionality. Complete off-leash activities can often resume as soon as 6-8 weeks post-surgery. We will provide detailed rehabilitation instructions after surgery.
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