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Boss’s owner, through tears, agreed to relinquish ownership. She could not find any other financial avenues to continue to provide care and, unfortunately, the reality of owning and caring for Boss became all to evident.
As soon as I had time, we anesthetized Boss again and prepped for the pinning I wished to do. Dissecting down to the hip I found significant muscle damage, much more than I expected. Finding the fracture end was easy but I was now able to see the true damage to the femoral head. I found a growth plate fracture but a large section of the femoral head luxated from the pelvis with the rest of the femur. This type of fracture was not evident on initial x-ray and complicated the entire surgery.
I spent 2 hours attempting to place “trangular” pins and feel comfortable that that fixation would hold for healing. After multiple attempts, I finally decided that setting pins was not going work; the damage was too extensive. I proceeded with a salvage procedure called an FHO. This removes the entire femoral head and neck, eliminating pain but reducing the function of the hip joint. The final result of an FHO is the formation of a fibrous false joint, which has an unpredictable result. Small dogs can do quite well with an FHO due to limited weight on the area; large breed dogs, however, have more loss of function and potential debilitation. We can only wait to see how big Boss will get and how he can handle the situation. This procedure was not ideal, but should at the least make him more comfortable in the short term.
Boss is recovering well from the procedure and is even starting to get around on the surgical leg and feeling very well. I continue to be amazed how quickly most dogs and cats recover from these procedures. Today is a good day. Tommorrow is uncertain for Boss, but hopes are high and we will know soon enough how good his leg will be.
If all goes well, I hope to find Boss a new home soon.
Boss awoke from his anesthesia well (remember I had to anesthetize him just to get xrays) . Were keeping his pain contolled and he is resting for the moment. I called his owner and inform her of his fracture and set a time to discuss options from this point
When she arrived, I start in on the xrays and types of stabilization needed and give a fairly good prognosis barring any rare complications. I then recommend that they see an orthopedic surgeon and give an estimate for the service. Needless to say, the price of $2500-$3500 was overwhelming and, per the owner, completely unatainable.
I tried unsuccessfully to help find some financing to spread out the cost. Since no sources of help were available and we’re at a significant impasse. She simply does not have the finances to care for Boss at this time of need.
I offered to attempt the surgery myself. Not an board certified ortho surgeon, but this surgery I have done with success and the principles are basic. This will cut the costs in half at least and the prognosis is still good.
This compromise is still unacceptable to the owner. Boss is in a lot of pain and waiting on surgery will compromise healing. I can feel the decision inching towards euthanasia. He can’t just go home on pain meds. He can’t live in this current state and I just cannot put this dog to sleep.
I offered one last alternative. The practice will accept relinquisment of Boss from his current owner. I will take on his care and his surgery and his life. The owner will no longer have a say in his care, but no longer will have the financial burden either. This sounds harsh, but is done to benefit the pet and get his urgent medical needs met. This of course is difficult for the current owner to consider, but she knows that Boss’s pain needs to be fixed. She asks for the evening to consider her options, and decide tomorrow morning.
1:11 a.m. glared at me from the light on my phone. When I answered, a frantic young voice explained how her 5 month old puppy just got away from her and returned holding one leg up and in a lot of pain. I explained that a significant trauma had probably occured and he should be looked at ASAP at a emergency facility. She questioned the cost and I told her if she felt he could make it till morning I would see him first thing and determine how bad it could be. She decided that it was the only way she was able to financially provide the first steps in handling this accident.
Boss, a happy aussie/ husky mix was still wagging his tail while laying on the exam table, but I could tell he was in a lot of pain. Any movement of his leg illicted a yelp; a serious dislocation or fracture was an imminent diagnosis. My hope was dislocation of the hip joint — probably no surgery required, something this client could afford to manage if things went well. Pop it back in place. Sling the leg and a dog this young should heal well.
We sedated and anesthetized and got our survey xrays. The hip was not dislocated, but fractured–specifically, a growth plate fracture of the head of the femur. This has to be stabilized surgically. Usually pins are placed through the neck of the femur and driven across the fracture into the remaining head to stabilize and allow healing.
Growth plate fractures are special fractures that can lead to more complications, but overall we expect a good outcome from surgery and in the orthopedic world puppies are known as “healing machines.”
I call a couple of ortho surgeons and get estimates. $2500 -$3500 is where we’re falling for this 5 minute midnight escape. I have a distinct feeling that this whole situation is about to turn on money… and the lack there of. I cross my fingers hoping for a rich uncle or a pet insurance policy I don’t know about!
