# Femoral Head Ostectomy V Hip Replacement



## rubymac (May 4, 2013)

Very sadly I have just found out that my 10 month old Border terrier, Sonny, has very severe hip dysplasia. The X Rays clearly show that the ball joints have not formed and what is there is unstable and crumbling.
I have been told that there are basically two options - hip replacement or femoral head ostectomy. The cost is approx £8000 for the replacement or £3000 for the other option. 
If we bring it down to money, the fact is I can afford option 2 but I can't afford option 1. My insurance, I think, will cover £2000. Having said that i really feel I need to know as much as I can about the two operations in order to make a decision.
From what i read Femoral Head Ostectomy can be very successful in smaller dogs and should give him a pain free and relatively easy recovery. He may very likely be left with an altered gait and perhaps a bit of a funny walk but pain is my main concern.
Have any of you any thoughts, ideas or experience you can offer me to help me get my head together on this? It's been such a shock to find this out.


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## Guest (May 6, 2017)

We fostered a lab years ago who had a FHO as the rescue certainly could not afford a total hip replacement. He was a big guy too. We were very diligent about after care, his leg had already atrophied a good bit before the surgery and I spent many months working with him after surgery getting him to use the leg and build that muscle back up. 

He had no issues with the surgery or recovery and went on to live to be 12 when cancer took him. His leg held up the whole time with no issues.


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## rubymac (May 4, 2013)

Thank you that's very reassuring


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## 2Hounds (Jun 24, 2009)

If can't afford hip op & can't really leave as is without further deterioration, then FHO op seems best option.

Have seen couple FHO come through hydrotherapy centre I work at, from what I gather they aren't on such restricted exercise after that op but need to be using leg properly to keep muscle on, given they can tend to lift affected leg. Our Physio said walking slower helps if start to hop along, but little & often tends to be more effective in recovery generally. 

They start on underwater treadmill to work the leg (easier without buoyancy advantage). The FHO case i saw most regularly was a young labradoodle, she went from carrying leg to moving more normally. She was bit hampered by her family tbh who weren't great at remembering still recovering, from silly zoomies at home & once let off lead at park to play with dogs for hour (sigh) which would make her sore again & if remembers leg hurting is less likely to want to use it. 

If you can afford it hydrotherapy is very good at building/maintaining muscle some dogs come pre-op to get in shape or referral by vets after op as less/non weight baring so can exercise earlier & more effectively than land based


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## Dani s (Dec 6, 2017)

Hi rubymac, what happened in the end. We are currently in the same position.


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## Burrowzig (Feb 18, 2009)

Dani s said:


> Hi rubymac, what happened in the end. We are currently in the same position.


I don't think they've been back.


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## Vashworth (Feb 2, 2018)

We have just found out our 9 month old border collie has severe hip dysplasia too in both hips! We've been quoted £5900 (replacement) and £1600 (FHO) per hip. Even with £7000 insurance can't afford the double replacement. Any information on the FHO would be greatly appreciated.


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## Our Pets Health (Dec 28, 2017)

Although I consider a FHO a "salvage" procedure, in those young dogs where hip pain is a daily presence then it most often gives a fantastic result. It is better in smaller breeds but in my experience large breed dogs generally do very well, certainly better than they would have been without it. I wouldn't say hip dysplasia alone is a reason to do it, only if a dog is actually in pain because of the disease if that makes sense. I'm sure your vet would have discussed this with you.
Afterwards you need to be hyper-aware of the need to keep your dog lean and a post op rehab program is really important to maintain muscle and a full range of motion in the new "joint". You should ask your vet about this before the op as if you can schedule any physio/hydrotherapy that would be really helpful and may be less stressful to sort it all before the op. Hope that helps


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## Burrowzig (Feb 18, 2009)

Vashworth said:


> We have just found out our 9 month old border collie has severe hip dysplasia too in both hips! We've been quoted £5900 (replacement) and £1600 (FHO) per hip. Even with £7000 insurance can't afford the double replacement. Any information on the FHO would be greatly appreciated.


You could have one side replaced though, and FHO on the other.


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## tabelmabel (Oct 18, 2013)

With an active dog like a border collie, this news is especially devastating and it's always worth seeking a second opinion especially as your dog is below the age of getting a properly graded hip score exam.

Many dogs who have mild to moderate dysplasia can do well on a conservative management programme of weight management and exercise to build strong muscle. Weight management to keep weight low and joint supplements.

When seeking a second opinion, I would keep the fact that you have insurance under wraps initially - that way you are more likely to hear the more cost effective options first.

Was it an orthopaedic specialist that made this diagnosis? That is essential for a proper evaluation and well worth the additional cost to see a specialist.

It is possible for dysplastic dogs to work depending on their comfort levels. Dysplasia is a funny one - some dogs have the most horrendous hips on x ray but don't display signs of great pain, and vice versa.

If the dysplasia is severe as you say, an orthopaedic specialist should outline the procedure in detail for you and answer all your questions.

I would seek a second opinion though before considering this major surgery.


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## Vashworth (Feb 2, 2018)

Thanks, it was an orthopedic specialist who made the diagnosis - our vet sent the x-rays to him, we are due to go and see him to discuss our options. She doesn't appear to be in much pain or discomfort with it at the minute, although she has been given pain relief medication. I just want to do what is best for her! We are devastated, we've only had her 3 months, she was a rescue dog, do you think they should've picked this up as she was spade before she came to us? I'm not blaming them but don't they have a responsibility to ensure any dog they put up for adoption us fit and healthy? Would it be worth contacting them??


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## Vashworth (Feb 2, 2018)

rubymac said:


> Very sadly I have just found out that my 10 month old Border terrier, Sonny, has very severe hip dysplasia. The X Rays clearly show that the ball joints have not formed and what is there is unstable and crumbling.
> I have been told that there are basically two options - hip replacement or femoral head ostectomy. The cost is approx £8000 for the replacement or £3000 for the other option.
> If we bring it down to money, the fact is I can afford option 2 but I can't afford option 1. My insurance, I think, will cover £2000. Having said that i really feel I need to know as much as I can about the two operations in order to make a decision.
> From what i read Femoral Head Ostectomy can be very successful in smaller dogs and should give him a pain free and relatively easy recovery. He may very likely be left with an altered gait and perhaps a bit of a funny walk but pain is my main concern.
> Have any of you any thoughts, ideas or experience you can offer me to help me get my head together on this? It's been such a shock to find this out.


I have just had the same diagnosis for my 9month old border collie. It is shocking! Can I ask - the quote you've been given is that per hip or both? I only ask as my puppy has it severely in both hips and we've been quoted £5900 for the full and £1600 for the FHO. I hope your doggy gets sorted!


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## Vashworth (Feb 2, 2018)

This is the x-ray taken by the vet. She's only 9months


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## Vashworth (Feb 2, 2018)

Vashworth said:


> This is the x-ray taken by the vet. She's only 9months


Here's the other image.


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## Blitz (Feb 12, 2009)

That does look quite dire. Going back to when I was vet nursing there was not such a thing as hip replacement and femoral head removal was the only option for severe HD. It was usually with large breeds as it was fairly unheard of with small breeds and border collies were not sufferers of it at all. It seemed to be very successful in the dogs I saw done. Even more successful was when it was caught with young dogs and the pectineal muscle was cut which seems to relieve pain and discourage later arthritis. Not sure that would be an option with hips as bad as your dog though.


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## tabelmabel (Oct 18, 2013)

Oh my goodness. Poor soul. That does look severe indeed. Presumably she had some symptoms to cause you to have her x rayed in the first place?
Do you know why she was placed in rescue? 

I'm not sure that the rescue could have picked this up earlier as the only way to know for sure is by x ray so unless she was showing abnormal gait, resistance to exercise etc, they could not have known.

However, it might be worth contacting them to see if they are able to help with the financial cost of an op at all.

It would be interesting to find if she was originally placed in rescue due to the original owner suspecting some problem.


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## tabelmabel (Oct 18, 2013)

Ps the OP on this thread hasn't been around since May last year so you might not get a reply to your questions there.


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## Vashworth (Feb 2, 2018)

tabelmabel said:


> Oh my goodness. Poor soul. That does look severe indeed. Presumably she had some symptoms to cause you to have her x rayed in the first place?
> Do you know why she was placed in rescue?
> 
> I'm not sure that the rescue could have picked this up earlier as the only way to know for sure is by x ray so unless she was showing abnormal gait, resistance to exercise etc, they could not have known.
> ...


Do you know she had been fine until she slipped last week and started limping on her left leg. The vet was very surprised she hadn't displayed any symptoms before this though. We were told she went into the rescue centre as she didn't get along with other dogs but who knows? I'm going to get in touch with them to see if they can help! It's so unfair, she is the best dog!


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## Vashworth (Feb 2, 2018)

tabelmabel said:


> Ps the OP on this thread hasn't been around since May last year so you might not get a reply to your questions there.


Thanks! I didn't look at the date! This forum has been really helpful!


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## tabelmabel (Oct 18, 2013)

Yes I think that would definitely be worth doing.


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## Mishkas mum (Feb 9, 2018)

Hi HD is mind blowing when you find your dog has it. We are in the same position with mishka what to have done and can you afford it . We live in Leicester have found Westmidland referrals in Lichfield,they do fixed price opps . Took Mishka last week they were very good gave us three options FHO FHR or neurectomy a scraping away of the sensory nerve supply to joint. The hip replacement fixed price is £4,000 one hip £1,400 for neurectomy on both hips . I have researched them they have very good reviews. We know he has to have an opp but which one? He too is rescue .


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## Vashworth (Feb 2, 2018)

Mishkas mum said:


> Hi HD is mind blowing when you find your dog has it. We are in the same position with mishka what to have done and can you afford it . We live in Leicester have found Westmidland referrals in Lichfield,they do fixed price opps . Took Mishka last week they were very good gave us three options FHO FHR or neurectomy a scraping away of the sensory nerve supply to joint. The hip replacement fixed price is £4,000 one hip £1,400 for neurectomy on both hips . I have researched them they have very good reviews. We know he has to have an opp but which one? He too is rescue .


It is awful isn't it!!! You just done know what to do for the best!!! We've been given just 2 options, either the FHR or FHO - I'd love to give her 2 new hips but even with the insurance we'd have to find £5000 and with my husband fighting cancer at the moment I don't think I can justify such a big expense! Is it wrong to go for the cheaper option??? It's so confusing!!!! How old is your dog? Its so hard though isn't it - we've been in touch with the rescue place to see if they can help and have been told they will taker her back but that's all. Descions, descions!!!!


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## Mishkas mum (Feb 9, 2018)

Mishka is 4yrs about,we were told he was 5months old when we first had him ,in July 2014 . Always thought there was something wrong with his hips as they sometimes clicked, had to do a little dance before jumping into the car and he has never cocked a leg to pee . How bad are her hips ? Would scraping the nerve supply work!! I had not heard of it before going to WMR it’s so much cheaper . If the rescue took her back what would they do!! Pass her onto someone else knowing what she has, or ??. The surgeon said he had done quite a few scrapings and nobody had been back to have a FHR . I feel so sorry for you everything happens all at the same time


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## tabelmabel (Oct 18, 2013)

I'm quite surprised the rescue won't offer any more assistance than offering to take her back tbh - surely they will then have to have her operated on anyway before re homing her for a second time? I would have thought they would have had funding set aside for this sort of thing.


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## Vashworth (Feb 2, 2018)

tabelmabel said:


> I'm quite surprised the rescue won't offer any more assistance than offering to take her back tbh - surely they will then have to have her operated on anyway before re homing her for a second time? I would have thought they would have had funding set aside for this sort of thing.


I know! I was quite surprised they weren't able to offer further assistance! Especially as they are still the legal owners and we have only adopted her! You're right if the took her back they would have to have her operated on or put her to sleep as she wouldn't be deemed as a healthy dog and noone else would want to adopt her knowing she has this problem! I've been in touch with them again and am awaiting a response but I'm not holding out any hope! It's such a shame she really is the best dog and has settled in to our family so well!!!


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## Vashworth (Feb 2, 2018)

Mishkas mum said:


> Mishka is 4yrs about,we were told he was 5months old when we first had him ,in July 2014 . Always thought there was something wrong with his hips as they sometimes clicked, had to do a little dance before jumping into the car and he has never cocked a leg to pee . How bad are her hips ? Would scraping the nerve supply work!! I had not heard of it before going to WMR it's so much cheaper . If the rescue took her back what would they do!! Pass her onto someone else knowing what she has, or ??. The surgeon said he had done quite a few scrapings and nobody had been back to have a FHR . I feel so sorry for you everything happens all at the same time


Were going to see a specialist in Manchester next week to discuss options - I will suggest the scraping and see if that is an option for Kiera! Her Hip Dysplasia is severe though! I've attached her x-ray. It's awful though isn't it! This is our first dog and we've only hard her 3 months


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## tabelmabel (Oct 18, 2013)

It will be interesting to see what the orthopaedic specialist has to say. Especially as you did mention that she isn't showing any/many outward signs of pain yet.

I just wonder if she could manage for any length of time on a conservative management plan. 

My dog has moderate dysplasia, not nearly as severe as your xrays show but he already had some arthritic change when x rayed at 8 months of age and his hip is popping in and out every single time his leg moves.

In his favour is the fact he is a little dog. I try to keep his weight down to 12kg.

He is now 5 yrs and most of the time you wouldn't know there was anything the matter. He runs fast and is very mobile. No sign of a limp though he does moan and groan a bit when it's damp weather and an hour and a half is about the maximum he can sustain activity. And he is on no painkillers, just a nutraceutical.

Have you a date in to chat this over with the orthopaedist?


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## Mishkas mum (Feb 9, 2018)

I wonder what the rescue would do with Kiera if you took her back? It will be interesting to see their reply . The surgeon we said that all dogs are different , some dogs that have HD don’t show any signs of pain but X-ray show bad HD and some dogs display a lot of pain but X-ray are not too bad . There are these different options but which is the best for your dog ? If only we had a crystal ball. Mishka has been on metacam for about a year but is once again showing signs of pain. Mainly when he first gets up he can’t put his leg down . I am keeping my fingers crossed for you that the rescue may help in some way . It is so heart breaking to se them in pain . with this being your first dog I can’t imagine how you feel. Especially as you also have your husband to worry and care about. My heart goes out to you


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## Mishkas mum (Feb 9, 2018)

Have never seen Mishkas X-rays !!!! Our vet referred us to frizpatricks in Surrey. We were told that his hips would never be a problem, that was 2yrs ago we never have seen the X-rays or scans , so can’t say how bad they are.


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## Kaizen (Mar 25, 2018)

Mishkas mum said:


> Have never seen Mishkas X-rays !!!! Our vet referred us to frizpatricks in Surrey. We were told that his hips would never be a problem, that was 2yrs ago we never have seen the X-rays or scans , so can't say how bad they are.


Hi,

I've just found your post whilst searching online for THR costs and noticed you were referred to NF in Surrey. My GSD has just been diagnosed with HD and is in the process of being referred to NF. Do you mind me asking what the procedure is once they receive the referral forms and X-ray? And were you given any idea of costs involved?

His X-ray looks quite severe but he's not terribly symptomatic at the moment. He went lame last summer but I gave him tramadol and turmeric golden paste and it seemed to resolve itself within a couple of months. This is his X-ray ....


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## Mishkas mum (Feb 9, 2018)

Hi just found your post.our vet just referred him to frizpatricks we never had any X-rays done before we took him. We just made an appointment for a consultation. Where he had X-rays , scans and fluid taken from every joint in his body including his spine. We were told that his hips would never be a problem. We did tell them that he had a problem going to the loo at times. But they did find that he had a mass up his botton and a thickening of his bowl lineing so we were then referred to their soft tissue and oncology hospital. Going back to our vet he couldn’t believe what they said about his hips. Although he has been on metacam they are once again giving him pain. So now not sure which path to go down for him 
The initial cost for the consultation was£200 the whole bill was just under £3,000 . But that was 2yrs ago so most probably gone up . I believe a hip replacement was about £ 6.500 for one hip .
It is such a horrible thing for them just wish they could tell you how bad it is


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