This is a "living" diary of our dog, Chelsey, and the journey we travelled when she was diagnosed with hip dysplasia and undergone a triple pelvic osteotomy (TPO). I was inspired to do this because of the incredible comfort we got from two other families' stories on the web (Booda and Doug & Kim). Right now, it is still early days but I will update it with progress regularly until our beautiful puppy is completely rehabilitated.

Wednesday 20 June 2007: When it all started
After going for a walk with Chelsey doing her usual super-energetic run/jump/skid routines, we notice her walking with quite a severe limp. We have also been hearing a clicking noise for the last month in her hind leg and decide to take her to the vet urgently. The vet books her for a series of x-rays for the next day and for the first time ever, she wimpers with pain on and off through the night.

Thursday 21 June 2007: First series of X-rays
The first series of x-rays reveal severe hip dysplasia. We listen to our three options:
- Total hip replacement
- Femoral head ostectomy
- Triple pelvic osteotomy (TPO)
We are advised to do a femoral head ostectomy as:

• Chelsey was considered a bit too old for the TPO (there is a very specific window of opportunity for the TPO), and
• there is no one left in Cape Town that can do a hip replacement

We book Chelsey for the coming Monday for the femoral head ostectomy then. Over the next day or two, I climb into Google and find out as much as possible. We also get some valuable information from a colleague at work, who owns a dog that had the same operation. We phone around across the country and we email. And wherever we get information, all conversations seem to end with two important little words: Dr Gray. Yes, even the guy who came in to do an assessment on our leaking bath that day turned up to be a dog lover and while he had his head tucked under the tub said, dude, you gotta speak to Dr Gray of Panorama veterinary clinic. We also hear about a wonderful vet that specialises in rehabilitation - but more about that later.

My message here is: Get A Second Opinion. It's your dog. It's family. If the first vet takes this personally, that is not your problem. Get a second and a third opinion, if you feel like it. It is your right.

Monday 25 June 2007: Second opinion
We take Chelsey to see Dr Gray. By now she knows the smell of veterinary clinics so well, she digs in all fours when we get to the door and we have to carry her inside... Busy, busy clinic! After the examination we go through all the options again and a few things are clarified, which boils down to the following, in my own layman's terms: that means don't quote me, clear the information with your vet, please! :)

Scenario 1: TPO
The TPO would be the preferred choice, but not all dogs are suitable candidates. It must be done early in the dog's life before there is any damage (arthritis) to the area and the tilting of the hip should provide a good enough solution to actually solve the problem. To confirm this, another set of X-rays would have to be done.

Scenario 2: Let's see what happens...
The dysplasia is so bad (a grade 4) that a femoral head ostectomy may possibly not be much of an improvement. With the ball being rather way out of the socket, there is not much friction between the two bones and the motivation for doing the femoral head ostectomy is to relieve the friction. Some dogs actually adapt quite sufficiently without any surgical interference but keeping an eye on correct and the right level of muscle building e.g. through swimming, and also, as always: weight control (a very important thing to remember with all hip issues). It would be rather recommended to just leave things as they are and see whether it gets much worse over, say, 18 months, at which time it would have become possible to do hip replacement surgery in Cape Town.

We book her in for another set of X-rays the next day.

Tuesday 26 June 2007: Second set of X-rays
I get a call at work saying that Chelsey is a very good candidate for the TPO but that we should do it as soon as possible. I said that they must go ahead as soon as possible, which would be the next day. Chelsey spends her first night in hospital. We go and visit her very late that night, after a music concert that I had (the hospital is open 24 hours - isn't that convenient). She must have been in deep sleep before we arrived as we just got a very sleepy, unexcited dog that looked at us with eyes that said: why on earth don't you love me anymore. That was really, really sad.

Wednesday 27 June 2007: The TPO surgery
We start calling the clinic from around 13h00 or so, but the surgery seems to go on forever. Eventually we get news that everything went really well and she is waking up. When we go to visit, she is really drowsy, shivering (from the drugs/trauma) and groaning. We spend a long time just sitting with her, hugging her head on our laps and comforting her. I start thinking that this must be the worst and things will now get better. We then have to leave her behind for her second night in hospital.

Thursday 28 June 2007: An unexpected second operation
I took two days off work and we spend some time taking out old carpets from the garage so that she doesn't slip on our wooden floors when she comes back home. Just after nine, I miss a call from the vet because we're outside. Crap. Unfortunately the clinic is really busy, so he was only able to get back to us a while later, where we got what he called "good news and bad news", but to me was really devastating news. The vet was not convinced that the hip is stable enough and could still slip out during the rehabilitation phase. He wants to go back in and secure it with something. I don't have all the facts of the operation he did, but I will update this last bit when I do.

Late Thursday evening we get a call saying that the second operation was a huge success and that the hip is now very secure. Dr Gray also mentions that there is something really interesting he discovered, something about a missing ligament and Chelsey being a most interesting case. He reminded me a bit of Dr House at that point, and I mean that as a great compliment. I got the call while Grant was playing a game of squash. I wondered whether I should wave him off the squash court, but decided against it...he was distracted enough. I need to mention that, at this stage, we both agreed that we were completely mentally exhausted by the turn of events. My tummy felt like it was stuck in a tumbling dryer and we were both walking around the house the whole day like we weren't sure exactly where we are suppose to be going or what we are suppose to be doing.

We went through to the hospital after the squash game finished and when we walked into the area where all the animals are, Chelsey must have heard our voices as we just started hearing a bang!-bang!-bang!-bang! as her tail wagged against the one wall of her metal cage. Oh, the relief and joy I felt at that sound! The nurse told us he just gave her a morphine shot, almost as we arrived, and that we only have a few minutes before she is going to get sleepy. Those were such precious moments. She was ok. She was happy to see us, those deep loving eyes of hers told us that she still loves us and that she knows, everything is going to be good. We just hugged and smooched her until we saw her eyes started fading into drowsiness.

Friday 29 June 2007: Back home!
She's back home and she's ok... I blogged about it here.

Six weeks later:
Since she came home, her progress was remarkable. Every day, we could see how she walks better and with more confidence. Yes, she was careful in lying down and for a few days, there was obviously still some pain, but on the first day she was already walking up and down stairs and within two weeks, she was running and trying to jump ("NO! No Jump Chelsey!!!"). The two week x-ray session went very well and Dr Gray was very happy with the progress made. He also gave us an x-ray, here it is:

Next week is the final check-up. More news then...



I want to thank everyone who has supported us with good wishes, prayers, advice and love during this journey. THANK YOU.

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Adeleida Bingham June 29th, 2007 06:00:52 AM