Sunday, June 28, 2015

Bi-lateral double pelvic osteotomy (DPO)

This is medical terminology that I didn’t ever plan to ever know much about.  I guess I knew enough to figure out what it meant from the root words, but not enough to know what it MEANS when you hear the words come from your vet’s own mouth.  And that is sort of the purpose of my blog for the next few weeks (months?).  When we came home with a diagnosis, I tried to find out everything that I could.  And while I could find x-rays and details about the surgery, I couldn’t find out enough about what the initial days of living, post-surgical, would be like.  And the worry kept me up at night. 
So, for any of you that are curious and especially for those of you that have heard the words coming from your dog’s doctor, this is Tulla’s story.  I don’t guarantee that I will keep up with it daily, and I’ll try to include photos whenever possible, but it is pretty difficult to take photos and hold on to her at the same time.  And remember that this is just ONE dog’s story, your experience may be different.

The sign.

I got Tulla from a farm just before Christmas 2014.  I knew that without a solid pedigree of clean
hips, eyes, ears, etc, that I was taking a chance and so I have tried to be ultra-conscious of any signs of problem.  Some people thought too much so.  Of course we immediately played games to be sure that her hearing was okay.  Check. Whew.  We played on the tippy board and got a nice tight sit at all angles, and she loved to stand on it while it balanced.  Her favorite game was running across the pool cover, which sort of behaved like a trampoline.  She was building up nice strong muscles. In March when I headed to Reno with my other dog for AKC Nationals, I was happy to leave Tu with a friend who has a wide network of veterinary friends, and a substantial knowledge of dogs and puppies herself.  During this time, Tulla got to visit with a veterinary ophthalmologist who proclaimed that her eyes were fine!  Check.  Whew!!  But over the next few weeks I noticed a little something odd in her gait.  Some people also saw it, some said I was over reactive. 
Let me say right here though, that even those my Spidey sense was kicking in, my orthopedic sense was not.  I sort of thought something was wrong in her front.  We went to see a well-renowned veterinary orthopedic doctor and I explained my concerns.  After a thorough exam, he proclaimed her fit and suggested that perhaps as she was growing, it made her gait odd on occasion.  He didn’t see or feel anything.  I relaxed for a couple of weeks, but I could not let it go.
One warm spring day the dogs were playing around the pool deck… splashing with the hose and chasing one another.  And that is when I saw The Sign.  When I saw Tulla’s wet footprints on the cement, I noticed that her right rear leg did not travel as far in each stride as the left.  Even though she didn’t limp on it, I knew that this short stride was what was making her gait look a little off to me.  It wasn’t her front at all… it was her rear.
At this appointment I knew that x-rays would be necessary, and I kicked myself that I didn’t ask for them the first time-though frankly, I don’t know if it would have made a difference- maybe not.   Before we even did x-rays though, the physical exam showed that her right hip was loose in the socket and would click as it snapped in (I now know that this is called Ortolani's Sign).   Our vet was very straightforward saying that we would shoot the x-rays, but almost certainly she had hip dysplasia and following the x-rays we would talk about the treatment.  We talked about all the options, from DPO to doing nothing and treating it later when arthritis had set in.  And the possibility that she could live (as a pet, not a performance dog) a long life with no treatment.  But certainly, it would cause her pain, even then.  This surgery would give her the opportunity to be “normal.”  Apparently there is a small window of time to do the DPO surgery- before there has been damage, and the x-rays tell them if she is a candidate.  The x-rays looked good (for surgery) and we were in the “perfect” time window, and so it was scheduled.  I went home and googled “DPO” and “DPO” recovery.  I found some on TPO (triple pelvic osteotomy- which is similar, but an older surgical method- It sounded gruesome).  And a lot on TPLO (a knee surgery, it turns out, and not at all helpful in my search).  And without much of an idea of what was to come, we went home to wait until our day. 

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