Kirk's Hips =( **8/26 GOOD update!**"

[Kater]

Kirk did not end up having surgery on Thursday. Upon viewing the x-rays they discovered that he had bent his plate, thus narrowing his pelvis significantly. I can't say this came completely unexpectedly-- we did not follow post op instructions to the letter and I know that. However, I did not have complete control over that and what my father did; he did it with the best of intentions. But the surgeon told me he put in the LARGEST plate he could (thus the strongest) and he has had 60 lbs. dogs (twice Kirk's size) not bend this plate. This little dog has atrophied tiny back legs and is only 32 lbs, so I'm still not totally sure how the bending happened. Perhaps I should have expected as much from a border collie. I don't know...

At any rate, the plate is bent and one screw is slightly loosened, however at this point, 6 weeks out, the bone has healed around this. Thankfully it is not something that should cause him pain (and there is no reason to go back in and 'fix' anything), but it does affect the likely success of operating on the second hip in the same way.

The narrowing that has happened will leave only a TINY margin of error (for bending and thus greater narrowing) and this all GREATLY increases the chance for complications that could affect his ability to urinate/defecate in the future. This is a no-brainer for me; there is no reason to risk that IMO. They called me post x-rays and asked me to decide, TPO today or do we call it off (and maybe do a FHO later). I said wake him up, we're not doing the TPO! I felt some ambivalence just because I do not like to make decisions under time pressure, but after calling home and bawling to my Mom my reasoning kicked in and I realized that I made the right decision, no question.

One sad thing was of course they had shaved him already. He looks soo pitiful and skinny. He has been licking his butt area as a result of a close shave and now has some hot spots back there, so I had to put the cone on him. Little dork!! I'm washing the area with Hibiclens twice a day, and I will ask the doctor today if there is any reason to bring him in or if I can continue treating at home.

Well, there is GOOD news...
He can start walking now and we have been doing 10 mins. of leash walking (on flat ground only) twice a day for this first week. Then we will increase the time by 5-10 minutes each week. This may sound extreme, but if you could see his completely atrophied back legs, you would understand. We want to build up the muscle slowly and carefully. Oh wow, he loves being back to his walkies again. I love to see him so happy!!

Now if we can just get his butt healed and his poopies back to normal.... I have him on acidophilus and gave rice with his first couple meals home, but I may pick up some stronger antidiarrheals from the clinic. I would try pumpkin, but he has been picky about it in the past, finicky eater that he is...

So, the long term plan? Build up muscle first. See how well he does with one 'good' hip. Consider an FHO for the left side in the future. This procedure is not age sensitive and so we are free of the 'deadlines' of the TPO at this point. Thankfully he is a small dog, so the FHO is a feasible option. I am not sure how I feel about it yet, because I really spent all my time researching the TPO. The descriptor "salvage procedure" attached to it is certainly an unattractive term. Again, thankfully, there is no time pressure to make the decision, except in the case that he were in pain that we could not control with other methods. This is not the case as he seems very happy and mostly pain-free at this point (as far as I can tell).

I am trying to do my best to see the positive and not dwell on the negatives or the mistakes we may have made. We love him and we're doing the best we can by him.

Sorry I took so long to update, it has been a crazy and emotional week for many reasons. Thank you for thinking of us!!

{{{HUGS}}}

Kate & lost-his-breeches Kirk

[ramanth]

Poor little Kirky. You made the right decision! I hope his muscle and hair come back quickly.

[Cataholic]

Kate,
Praying for ALL of you guys.
Johanna

[Ginger's Mom]

Kate, I am sure that you are doing the best you can for Kirk, and I will continue to keep that little man and you in my prayers. {{{Hugs}}}

[lizbud]

I am so sorry to hear of the complications. Please give Kirk a big
smooch from me. (((HUGS))) to you.

[cloverfdx]

Ohh no Kate i am sorry you had to much such a quick decision . You are doing all you can to keep Kirkie happy & pain free, you will all be in my thoughts {{Hugs}}.

[cloverfdx]

Good thoughts are often sent your way Kate and of course Kirk. Cmon mate get better for your big 1st Birthday {{Hugs}}.

[pitc9]

many hugs to you both!!

[Kater]

Hello PT. I wanted to post an update on Kirkie.

On January 12th I took Kirk into the vet because I had noticed he was showing signs of increased pain. That week he had started lifting his left foot off the ground for short periods, something which I had never seen him do before that-- prior to that he was weight-bearing on his left leg, but obviously still favoring it while walking. (FYI --He had the TPO on his right side, and the left had not been operated on at all.)

At that point I did not have him on pain meds and was relying on supplementation with Hyaflex daily and Adequan injections weekly. Both of these are chondroprotective agents and the Adequan especially was providing obvious relief. However, that week I took him in I did not notice any marked improvement in the beginning of the week after his Adequan shot.

Anyway, we performed x-rays because we knew that dislocation of the hip was a real possibility. X-rays clearly showed that his left hip was completely popped out of the socket (the femoral head popped completely out of the acetabulum). This is incredibly painful and it is a testament to the absolute stoicism of dogs that he was continuing to weight bear on the leg. Crazy boy!! Anyway, this has always been something we knew was likely to happen to him after seeing his initial x-rays, but we certainly hoped that he would be older before this happened.

At this point we called the board-certified surgeon (who performed his TPO) and asked him how to proceed. His first recommendation was to wait until he was a year old (2-3 months) before operating and in the mean time keep him on high doses of pain meds and work on building up his hindquarter musculature. Then later, after sending the surgeon the x-rays, he informed us that the hip had been dislocated longer than a week. Hearing that made me feel like the most terrible Mommy ever. I swear, dogs are just so stoic!! He also amended his recommendation and felt that we should try to work on building his muscle for just a month before operating, unless he became any more painful and then we could operate sooner.

Well, Kirkie lasted two weeks on the high pain meds routine before things got really bad. Around the middle of last week he started hop on his back leg alone about 80% of the time and slowly all but ceased weight bearing on that left leg. I was afraid he had blown his left knee, or would be in danger of blowing the right knee if he continued the full on bunny hop. I upped his pain meds a bit more, but when I saw no improvement I notified my vet to let her know that I wanted to schedule the surgery.

He had the FHO (femoral head osteotomy) on his left side this Friday and the whole operation went VERY smoothly. I actually watched most of the procedure...which proved a bit difficult at times. I watched through a window outside of the operating room--- I couldn't be *in* the OR.

He came home Saturday night. He has lots of pain meds on board and I'm sedating him to keep him calm. In about 2 weeks he should be back to walking. I cannot wait!

The leg is hardly swollen. The sutures/staples are very neat and not looking red or inflamed in the least. He is much easier to look at than he was after the TPO. He is not whining or crying much at all, which is so much easier on everyone.

Here he is looking pathetic in his cone:



Thank you for reading. Please send us good thoughts for his recovery! I hope after recovery he can run, hike and play like a normal pup. He has been through so much already and he's JUST 10 months old.