Junior's Growing Pains ...

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Junior's Growing Pains ...

Post by dBs™ » Thu Jul 21, 2011 6:05 pm

Growing Pains …

Junior, like Happy, started limping at around 10 months old.

It begins with a slight hopping action when Junior runs, like when we play hopscotch.
We were not even sure if it’s the left or the right hind leg. Few days later, Junior waking up one morning refusing to walk!
We rushed him over to the vet and an X-ray confirmed a luxated patella on both his hind legs. It’s a grade 1 on his left and a grade 2 on his right.
Vet ruled out Hip Dysplasia. He was given anti-inflammatory drugs and we were advised to put him on long term Glucosamine.

Junior limping went away following a course of anti-inflammatory medication.

He was good for a couple of weeks until we notice he started limping again …
It was only a slight limp and happens mostly when he is running.
Believing the limp was due to a luxating patella, we decided to observed further.
We noticed his left hind leg is not limping anymore but his right hind leg seems to be limping more each day.
It got from bad to worse, limping even from walking.
Took him in for another review on his condition and diagnosis with physical examination was still a luxated patella.

We decided to go for surgery taking into account he is only 1 ½ yrs old …
chances of a full recovery is positive.
What more worrying is the condition might get so bad that he might lost the mobility of both hind legs later in age.
He was put on 4 weekly catrophen injection prior to surgery.

We requested to meet the vet surgeon and that’s the beginning of a shocking truth …

Dr Kim, the veterinary surgeon from The Animal Doctors, did a physical examination on Junior and
we were told the limping was not caused by the luxated patella !
It came as a big blow to us as that means Junior has another health issue which was not known to us.
Dr Kim elaborated that he might have a tear or worse case, a ruptured ligament as well …
An X-ray is required and GA is necessary.

We were kind of at a lost as more and more problems surfaced for this poor little fella.
Not wanting him to go through more “torture” … we asked for all procedures to be done in a day.
We were kept worrying till the scheduled X-ray and surgery for the next 5 days. Not knowing what hip problem is affecting Junior.
He was given another course of anti-inflammatory medication. His condition improved on the 3rd day after taking the anti-inflammatory meds …

We begin to trust Dr Kim has hit the nail at the head.

It’s a hip problem for Junior !


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Re: Junior's Growing Pains ...

Post by dBs™ » Thu Jul 21, 2011 6:07 pm

Surgery Day

Junior was fasted, no food no water by 12 midnight.

Next morning, he was taken to the vet place by 10am.
The moment he was carried in … the frightened look on his face was enough to break my heart.

We waited for the X-ray result.
Dr Kim showed us the X-ray which clearly showed a “square shaped” ball of the hip joint.

It’s a Legg Perthes Disease !


Legg-Perthes disease

A disease of the hip joint that results in abnormal deformity of the ball of the hip joint.

Dr Kim explained that it is this deformity at the hip joint that caused Junior to limped.
She further explained that Junior does have luxated patella on both his hind legs and it is also this problem that has shadowed the actual cause of pain.
I asked to see the initial X-ray which Dr Kim promptly retrieved.
The signs were not present then …
It has developed so fast and bad that surgery is necessary.

Now we are faced with another tough decision making …

Dr Kim advised to perform only a Femoral head excision for Junior and not touch the patella as it involves the operation at two different locations.
Longer surgery hours and heavier dosage of GA. Longer recovery time for Junior.
She is worried it might cause the other “good” leg problems if he refuses to use the bad leg for a prolong period of time.
Further ensuring us that Junior only has a tear at the ligament and it’s due to the deformity at the hip joint bone …
there is a chance it will heal naturally and surgery is not necessary at this moment.

As paw-parents, we are worried Junior have to go through another round of surgery to fix his luxated patella.

After a tense discussion between us and much assurance from Dr Kim … we decided to proceed with surgery to treat the “A” problem only.


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Re: Junior's Growing Pains ...

Post by dBs™ » Thu Jul 21, 2011 6:12 pm

Further reading about Legg Disease :


What is it ?

• A disease of the hip joint that results in abnormal deformity of the ball of the hip joint


Causes :

• Legg-Perthes disease in domestic dogs is considered to be “idiopathic” – which means that it has no known cause.
• It tends to occur in young, small or miniature-breed dogs of either gender and is thought to have a strong genetic component.
• For some reason, the normal blood supply to the upper part of the femur bone becomes disrupted, without any recognizable precipitating traumatic event.
• Interruption of the blood supply causes the affected bone and surrounding cartilage to degenerate, deform, fracture and die.
• The entire area around the affected hip joint becomes irritated, inflamed and increasingly painful.
• Once the cells of the upper part of the femur die, they start to be replaced by fibrous and granulation tissues that are not as strong as bone.
• The body tries to revascularize the area and remodel the dead and dying bone and cartilage as it is reabsorbed by the body, but these attempts are not successful.
• This degenerative process causes the hip joint to become disfigured, lose its structural integrity and become non-weight-bearing.
• Eventually, the hip collapses.
• Legg-Perthes disease can show up bilaterally (in both hip joints) or unilaterally (in just one).


Symptoms :

Typically, the owner of an animal with Legg-Perthes disease notices her dog gradually developing varying degrees of lameness in one or both hind legs over the course of several months.
The symptoms usually begin when the dog is less than one year of age. In particular, the owner may see one or more of the following signs in their dog:

• Hind limb lameness; gradual onset; one or both rear legs
• Limping
• Pain upon flexion, extension and/or physical manipulation of the affected hip joints and hind legs
• Reluctance to rise, run, jump or play
• Weakness
• Exercise intolerance
• Wasting of the thigh muscles (atrophy)
• Irritability
• Chewing, licking, bothering the affected hip joint
• Audible clicking or snapping coming from the hip joint during movement or when rising (crepitus); unusual early in the disease; becomes more common later in untreated dogs.


Treatment Options for Legg-Perthes Disease

In mild or very early cases of Legg-Perthes disease, non-surgical medical management may be sufficient to alleviate the dog’s pain and lameness.
This might involve enforced activity restriction and strict cage rest, together with intermittent or chronic administration of oral pain-relief medications (analgesics)
and/or no steroidal anti-inflammatory drugs. Physical therapy may also be very helpful.

Surgical treatment has a much higher rate of success than medical management alone.
In most cases, surgery ultimately will be necessary as the disease progresses, even if non-surgical approaches are tried first.

The most common surgical procedure is a femoral head and neck osteotomy (FHO), also sometimes called a femoral head and neck excision (FHNE).
This involves surgically removing the head and usually the neck of the long upper thigh bone (the femur) that, together with the pelvis and surrounding cartilage, forms the hip joint.
The procedure basically allows a “false joint” to form from fibrous tissue, granulation tissue and other scar tissues that fill in and replace the removed ball-and-socket joint of the affected dog’s hip.
A total hip replacement is another surgical option. This procedure in dogs, as in people, involves removing the entire damaged joint and replacing it with an artificial femoral head and pelvic hip joint socket.
This is usually reserved for the uncommon large dog that is affected by Legg-Perthes disease.


Prognosis

The prognosis for dogs treated surgically for Legg-Perthes disease is very good to excellent, as long as owners are diligent about post-operative physical rehabilitation and supportive care.
After treatment and rehabilitation, most dogs regain pain-free function of the affected hind leg and hip and are able to enjoy normal canine activities such as running, jumping, walking
and playing throughout the course of a normal life span.


* Legg-Perthes disease is not particularly difficult for a veterinarian to diagnose.
However, the symptoms of Legg-Perthes disease can mimic those resulting from other causes of hind limb lameness, such as patellar luxation and hip dysplasia.



Dogs At Increased Risk

Legg-Perthes disease occurs most commonly in young miniature, toy and small-breed dogs between 5 and 12 months of age.

Predisposed breeds include the Yorkshire Terrier, Manchester Terrier, Miniature Pinscher, Poodle (toy and miniature), Lakeland Terrier,
West Highland White Terrier, Cairn Terrier, Australian Shepherd, Chihuahua, Dachshund, Lhasa Apso and Pug.


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Re: Junior's Growing Pains ...

Post by dBs™ » Thu Jul 21, 2011 6:14 pm

Junior's road to recovery …

A long 8 hours wait ... we finally can see our little furry boy Junior,
after going through a 1.75 hrs hip surgery.

I remembered clearly the moment Junior set sight on me … he whined out loudly like a crying baby.
I was shock coz I was making payments and not expecting him yet …

Totally heartbroken to see quarter of his body shaven and has a 5cm long scar in horrible stitches.
He was still drowsy from the GA but I can tell he was very very frightened.
A small body which had gone through so much in just a few hours.
Thank god we made the decision to just operate on the deformed hip joint.
I cannot imagine him with two scars on a tiny leg.


Day One :

Junior was weak on all four legs. In a drowsy and disorientated state but he recognized Scott who jumped in joy on seeing him home.
He stayed laid down in bed whining. I fed him water with a small tea spoon which he happily took a few licks.
His continuous whining has us all panic, thinking he was in great pain and not knowing what to do. It is only later that we realized he was hungry.
He was fed some steamed carrots and diced beef which he finished.
The whining did not stop till almost morning when I realised he wanted to sleep on our bed like he always do.

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Re: Junior's Growing Pains ...

Post by dBs™ » Fri Jul 22, 2011 6:03 pm

Day Two:

Junior was still weak on his limps and seems sleepy most of the time.
This is due to the anti-pain stripe on his back as told by the vet.
As long as he eats well, we should not disturb it till we bring him in for a review on Friday.
Appetite was good, two healthy meals of steam carrot, pumpkin and fish/beef.
I notice he drinks very little water. Very unusual for him coz he loves to drink water just like how much he loves duck jerky.

No bowel movement yet but I can sense he is having difficulties to poo …


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Re: Junior's Growing Pains ...

Post by dBs™ » Fri Jul 22, 2011 6:04 pm

Day Three:

Junior had a good night’s sleep.
No more whining in the middle of the night.
No more waking up in shock.
He was able to walk on three to the bathroom on his own without assistance.

Bowel movement still zero which we begin to worry.

Started wanting to play with Scott after meal. Something they always do every day.

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Re: Junior's Growing Pains ...

Post by dBs™ » Fri Jul 22, 2011 6:04 pm

Day Four :

Junior finally poo-ed !

Bowel movements came three days after surgery.
We were so happy when he did his biz immediate after breakfast.

E-collar taken off as it is causing much discomfort and preventing him into his favorite hiding places.
He is not licking at his stitches so I would think he is not feeling much pain by now.

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Re: Junior's Growing Pains ...

Post by dBs™ » Fri Jul 22, 2011 6:05 pm

Day Five :

Junior went for a post-op check-up.
Dr Kim is happy with his progress, wounds is healing nicely.
Body temperature is normal. Eating well and bowel movements back to normal.
She is positive about Junior’s condition.
Junior might not need any surgery to correct his luxated patella.

We were concerned if the “bones” will grow back and leads to another surgery procedure.
Dr Kim assures us it will never happen and Junior will not have arthritis on his right hind leg.

Junior can have his stitches removed on next Friday.

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Re: Junior's Growing Pains ...

Post by gohyuheng » Fri Jul 22, 2011 6:56 pm

so cute!
I wanna catch a big fish~~~~

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Re: Junior's Growing Pains ...

Post by patrick2405 » Sun Jul 24, 2011 12:59 am

hope he gets well and be able to run around with scott again!

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Re: Junior's Growing Pains ...

Post by dBs™ » Mon Jul 25, 2011 12:02 pm


One week after surgery ...

Image

Junior's wounds recovering very well ...
I apply two drips of therapeutic Lavender oil onto it twice a day, morning and night.
It is healing nicely. :grin:

Dr Kim told us that he should be using his right hind leg by this week.
And he did it this morning.
It's breakfast time and he walk a few steps towards me on four !

Will be checking out with Dr Kim when he can start swimming again.
Need to boost up his right leg muscles.

Thanks all for well wishes and concern. :heart:


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Re: Junior's Growing Pains ...

Post by sgpu » Tue Jul 26, 2011 6:41 am

i feel for junior . . . . from fasting to walking on 4 limbs again . . . showering junior with lots of love will certainly help. have you chosen a tattoo for his scar? :lol: 'miami ink' get some inspirations . . .
若要人不知, 除非己莫为

'tio bo'???

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Re: Junior's Growing Pains ...

Post by Peace » Tue Jul 26, 2011 6:57 am

Poor Junior, glad he'll be alright. If it makes him any better, tell him that chicks dig scars. ;)

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Re: Junior's Growing Pains ...

Post by patrick2405 » Tue Jul 26, 2011 10:04 pm

Peace wrote:Poor Junior, glad he'll be alright. If it makes him any better, tell him that chicks dig scars. ;)
hahas that scars are a sign of manhood? :mischieve:

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Re: Junior's Growing Pains ...

Post by POOH » Wed Jul 27, 2011 1:43 am

Oh dear! the moment i saw the first photo taken on 18jul, i was :cry: ... Junior looks so vulnerable... as i read on... i am so relieved.
Junior get well soon :rose: :kiss: :kiss: :kiss:

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