Triple Pelvic Osteotomy – TPO

a procedure that can be performed in the early stages of hip dysplasia to prevent the progression of osteoarthritis in the hips and reduce the likelihood that a patient will need total hip replacement later in life.

The objective in TPO surgery is to change the orientation of the shallow hip socket (acetabulum) which limits concussive motion of the femoral head. This in turn increases stability of the joint and minimizes the progression of degenerative joint disease as the patient increases in age.

Symptoms:

(for younger dogs, less than 1 year old)

- Hip pain

- Rear lameness

- Reluctance to run or play

- Easily tired

- Shifts standing weight to front legs

- Lack of or loss of muscle mass in back legs

- Pain on hip manipulation

- Popping sensation in hips when walking

Procedure:

This procedure is generally performed on younger dogs 4-16 months, but can be completed on any dog that suffers from hip pain that has not developed significant arthritis. It is not an alternative to total hip replacement, but can slow or halt the progression of osteoarthritis if changes in the joint are caught early on. The surgery has a very low complication rate and has been proven highly successful. The most common candidates for this procedure are young, large and giant breed dogs that are displaying signs such as sitting to the side, reluctance to jump, exercise intolerance or difficulty rising and sitting.

The surgical procedure requires the pelvis to be cut in three separate and specific locations. Once cuts (osteotomies) are made, the acetabulm can be rotated to catch the femoral head (much like covering a tennis ball with a tea cup) and the pelvis is stabilized with a steel plate designed for this purpose. If both hips are involved, the procedures are best tolerated if they are staged by doing the second hip 4-6 weeks after the first.

After Care:

Hospitalization:

- Your pet will need to stay overnight one night and a pick up can be scheduled during our regular business hours, 7:30 am to 5:00 pm the day after surgery.

- When you get your pet home, place your pet in a cool/warm (season dependent), quiet and dark room. If you leave your pet alone, he/she will sleep and be comfortable. You can increase your pet’s anxiety by doting. Your pet will have adequate medication for pain so you do not need to worry about discomfort.

Medication:

- A transdermal pain patch will be sutured on to your pet and will provide pain relief for three days following surgery. On the fourth day after surgery, you may remove the patch by clipping the sutures with a nail clipper and peeling it off like a band-aid. Please dispose of the patch by flushing down the toilet.

- The transdermal pain patch used for pain relief can cause constipation. Dr. Dew will ask that you feed your pet a certain amount of tuna in oil (Starkist®, Chicken of the Sea®, Etc.) for four days following surgery to prevent constipation. The tuna in oil is to be given in addition to your pet’s regular feedings.

- If your pet is not already on a joint supplement, Dr. Dew will send home a sample of Glycoflex®. Glycoflex® will supplement the cartilage and improve your pet’s joint health. Your pet may stay on Glycoflex® for the remainder of his/her life. The charge for a full bottle or bag of GlycoFlex® is NOT included in the surgery fee; this will be an additional charge to you.

- Your pet will also be sent home with a 14 day supply of Previcox®. Previcox is a non-steroidal anti-inflammatory that is used for the control of pain and inflammation associated with osteoarthritis in canines. Please follow the package instructions.

Food & Water:

- When you get your pet home, offer him/her a small amount of water. If your pet drinks it and does not vomit, then offer twice the original amount.

- Two hours later if no vomiting has occurred, offer ¼ of the amount of food in a normal meal.

- If your pet eats and no vomiting occurs in a 2-hour time period, then you may resume normal feeding(s).

- Please call Dr. Dew’s or your veterinarian’s office if your pet does not drink within the first 6 hours of being home or if vomiting occurs.

Rechecks:

- Your pet should be rechecked by Dr. Dew 10-14 days following surgery. Please call (866) 838-4282 to schedule this appointment.

- Radiographs (x-rays) will need to be taken 8 weeks following surgery to assess healing. These radiographs may be taken by your veterinarian or by Dr. Dew. Once the radiographs have been taken, Dr. Dew will need to review them; please schedule an appointment. The charge for the radiographs is NOT included in the surgery fee; this will be an additional charge to you.

Exercise Restriction:

- For the next 3 months, your pet will need to be restricted to leash activity only.

- Free running, rough play or jumping on/off furniture or decks should not be allowed.

- For the first two weeks, your pet should be walked in the yard on a leash 3-4 times daily.

- The third week, you may take your pet on 2 daily walks of 1-2 blocks.

- After the third week, you can double the length of the walks each week. You wish to see slow steady progress. At the end of each week, limb use should be improved slightly. Call if you have questions concerning progress.

- If his limb use is not improving, or you notice a sudden decrease in limb use, please call immediately.

Physical Therapy:

- Your pet may appreciate some assistance rising and walking for the next 1-10 days.

- Please during his treatment and healing process do not allow him to play with other pets.