considering surgery - Page 1

My five yo male has recently shown worsening of his pain upon walking and rising from lying down, favoring one leg.  He is on glucosamine, which helps a great deal, and Rimidyl, which also seems to help, but he is not running and playing the way he should.  The Rimidyl is OK short term, but clearly something needs to be done for his quality of life (and mine).

I will take him for a complete work-up (X-rays to start) before making any decisions about his treatment, it could be his hip, could be a disc, I am guessing.  Right now I am looking for recommendations (good and bad) in the greater NYC area.  Because of the dog's age, I am thinking of a surgical solution, since I think it would give the best long-term relief, but of course that depends on the diagnosis.  

A neighbor recommended the New York Veterinary Center in Farmingdale Long Island, where his GSD had a hip replacement. The surgeons on LI are specialists, and certainly have excellent credentials, and are Penn Hip certified, so I am inclined to go there.  Comments are welcome.

Phoebe

I don't have any advice to give you but surgery certainly sounds like something worth considering.  I just wanted to wish you and your friend well...been there.

Hip surgery has a very long recovery - 2 months of crate time and 3-6 months of PT..... it is very painful too.

I don't know any one in NY......

There is something called T-stem (i think)  that might be worth looking into.....it lasts from 1 to 4 years, is not as invasive and very little recovery time......

Basically

vet takes fat cells  and sends them for processing
stem cells are derived form the fat
they are injected into the joint sack
they regenerate the area
pain is gone


http://www.thestar.com/living/article/666233


"Here's how it works:

While the animal is under general anesthetic, several tablespoons of fat are extracted from the abdomen or behind the shoulder, which is shipped overnight to the San Diego lab. That's the worst part for the dog. On receipt of the fat, clinicians separate the stem cells from all other tissue, count the cells and divide them into proper doses within four hours, shipping one or two doses back to be injected into the joint the following day. The injection takes moments and is done under mild sedation.

Then magic seems to happen. The introduction of the stem cells to the injured joint signals anti-inflammatory cells and new blood cells to form.

It's expensive – about $3,500 – but cheaper than joint replacement, which costs up to $10,000. "

have you looked into stem cell treatment?  i think the company is called vet stem or something similar.  i've heard from a couple people that it has helped their dogs significantly with hips, and it may be cheaper than hip replacement.

good luck,
uvw

I don't have any recommendations on a NY vet.  I do recommend that you consider the stem cell treatment depending on the issue.  I wanted to have the stem cell work done on my old timer who was 14 at the time (1 1/2 ago).  The clinic said he was too old and would not do it. 

Best of luck.  I hope your dog gets better.

Thanks very much for your thoughts and suggestions.  He is clearly better on Rimidyl, and also I think maybe all the recent rain has made things worse.  Now that it is drier, he is clearly happier.  He will need blood work to keep him on Rimidyl past next week.  i will talk to the vet tomorrow to see if we should reduce the drug, or continue.

I have looked into the stem cell treatment.  It is certainly less invasive, and cheaper, but not cheap at all.  The problem is that it seems to give only temporary relief from what I have read.  Since my dog is only 5 years old, it makes sense to go for a permanent solution.  The new hip should last his lifetime.  Also, very few dogs have received the stem cell treatment, it does not have the track record that the surgery has after 20 years experience.  Frankly, as a scientist, the proceedure does not make much sense, it is not clear why fat should contain polypotent stem cells.  Remember this is a business.

I am afraid of the surgery, beause it does have a real chance of complications.  An infection is a real posibility, and can require removal of the hip.  To prevent slippage of the implant, he will need very careful care and restrictions on movement for several months, and I have three more or less adult kids.  I need to make sure they will all be 100% reliable.  From what I have read, the dog should feel much better soon after the surgery, and it may be hard to keep him quiet.  There is also a lifelong concern for infections, I have to make sure his teeth and skin are in good shape, and he does have allergies.  I am just worried.

Has anyone here had this surgery for their dog?

I work at a major medical center, and today one of my colleagues called his sister for me to get a referral.  She is a well trained orthopedic veterinarian living in LA.  I am hoping she knows someone near me that she can recommend.  In general, for major surgery, I want to go with the best, but the AMC is really expensive, and I do not have thousands of dollars just sitting around. This will be a big expense for me, but I feel the time is rapidly approaching.  Anyway, I have to consider how much I pay yearly for vet visits and meds to control his symptoms.  My husband is opposed to spending the money, but I feel I have a choice between surgery and putting him down.  Not only do I love him dearly, but I have put a lot of time and money into him over the years.

Hi,Have you had a look at Temoral Head Neck Excision.It is a lot cheeper then hip replacment.I had the op done on my boy,he had his right side done at 10 months.Then the left done at 18 months,i have had no problems with him since his operations.I can say he is in no pain and boy can he run know.He will be 5 in december.
Hope this helps.
Stacey

I would take him off the rimidyl and give him aspirin.  The rimidyl could be part of the problem.  I use rimidyl as a last resort.  The aspirin dosage needs to be low but frequent. 

I had a dog that show similar skin issues as your dog.  I am not advocating this but an old timer told me to bath him in motor oil.  My wife said I was nuts to even consider it.  Well, I bathed in motor oil.  The skin infections, rash, and weight loss went away after two bathings.  Of course, it is a messy process but for the dog in question it worked. 

I hear you on the cost of stem cell treatment.  That is a resource and personal decision.  If you can't afford the treatments or have lost faith in making your dog better you clearly have the option to put your dog down.  I have put two GSD's down in 5 years at age 11 and 14.  In both cases I had no further medical options or any options that made sense. 

A 5 year old dog in the GSD world has just fully matured.  You won't find a BSP champ that is younger than 5.  I would really think long and hard before giving up on your dog. 

I will discuss aspirin with the vet.  I am already tapering him off the Rimidyl.  I told the vet I wanted to reduce and stop it to see if he would be comfortable without.  I do not want to use the drug long-term.  There are other options, Aquedan injections, for example, but if he is a good cadidate for surgery, there is no point in starting that.  It is hard to know exactly which helped more, the drug, the cooler drier weather, restriction in movement (he has had only leash walks this week) or just time to heal a strain.  

Motor oil sounds like a weird idea, but I guess it can't hurt.  How much do I use?  Should I just rub massage it in the skin and leave on a while, rinse in warm water, or use shampoo to remove?  Did you cover the entire dog or just the underbelly and legs where he has skin problems?  Hey, I'll try anything once.

I am not giving up on the dog.  He is very valuable to me, not as a worker, just as a companion.  I need to 1) get a solid diagnosis, and 2) find the money for surgery if he needs it.  I already feel that conservative management will not be enough. He is not crippled, but he is not happy either, and this is really unfair to him.  I have already started to talk to my kids about what we will need to do for his rehabilitation.  I will try and do the surgery late in the fall after I have finished with some family obligations that take my time, and have had a chance to save some money.

Stacey, the neck excision is only recommended for young or small dogs, my boy is 95 pounds and way over the weight limit for that procedure.    

I'm not really sure what kind of skin problems your dog has but I would be slow to take the recommendation of motor oil. Tar based shampoos for humans and dogs are readily available and a whole lot safer and have been used for skin problems for centuries.
Plain old black tea (my favorite) also makes a good rinse for skin problems as does baking soda. Vets also have an oatmeal based shampoo which is helpful for skin problems.
Make sure you are supplementing with fish oil ( at least 1,000 -2,000 g a day) which will help not only the skin but the joint inflamation as well and reduce the pain.
For skin also supplement with CoQ10, zinc and selenium. The last two carefully because you can od with them.
EsterC and multivitamin B are also good support but not quite as crucial if cost is a concern.