Rehabilitation and Conditioning for Animals

This page will be under construction for quite some time.  There is a lot to say and do about hips, and I have only put together a small amount thus far to publish online.

POST-FHO HOMEWORK FOR CANINES

(Femoral Head Ostectomy/Removing the Ball off the Femur at the Hip Joint)

First and foremost:  pay attention to the discharge instructions your veterinarian has given you.  During this surgery, there was disruption of muscle and other tissue that will require care and time to heal.  Please follow the icing instructions noted on a separate sheet and which are also available on my websites.  While other tissues are disrupted during an FHO, muscle requires a little over 6 wks. to achieve a normal collagen ratio and will take longer to heal more fully.  This should be considered when you think your dog is ready to chase squirrels @ 2 wks. after surgery. Don’t let them if you hope for the best outcome from the surgery.  On the other hand, the bone that was cut does not require the same care that a fracture repair or a TPLO would; there is no need to be concerned that you will cause further damage to the bone with exercise.

In light of this information, I believe the best outcome from surgery will be realized with a rehab consult from me to give instruction and homework specific to your pet.  In-person consultation will always be better than the generic homework that follows.  Otherwise, I recommend starting by following the rehab program below: 

Week 1 of active homework may begin the day after your pet returns home from surgery.  Week 1 consists of 2-4 five minute walks per day only.  These should be done very slowly so as to encourage more weight bearing.  When the dog goes too fast, he/she can “cheat” and not use the repaired leg much or well.  Too fast could also prolong the inflammation and pain as well as create damage to the area of the muscle at the end of the femur.  There should be at least two-hours’ rest in-between each walk session.  These walks are to be purposeful exercise and are separate from potty walks.  Potty walks during this time should be in and out with business getting done separately from the five-min. walks.  Outside sniffing for four minutes and walking for one minute does not constitute the weight-bearing, purposeful exercise we hope to accomplish.   We hope to create a slightly and increasingly calloused area at the end of the modified femur.  This will make the tissue feel the end of the bone less and less and will create a cushion of sorts.  You can do this with moderate & slowly increased exercise.  Running & rambunctious play during this time will upset the scar tissue we want to create.  On the other hand, not enough exercise, which is usually the problem, results in too much scar tissue all around the hip and your pet will experience decreased mobility and more continuous pain, especially when he is technically at a point that he may play and be wild.

Week 2 is just like week 1 but the walks are for ten minutes instead of five.    Continue with ice.

Week 3 consists of only two walks per day for a duration of fifteen minutes each.  Still no crazy running & jumping.  Do not begin unless your dog is able to do at least three ten min. walks per day without greater lameness.

Week 4 the walks are to be twenty minutes in length, two per day.  Still no running, jumping, or playing.

Weeks 5 & 6 should continue with 2x20 min walks and at this time hills may be introduced for at least half of each walk.  If no hills are available, then slow stair climbing may be used.  The idea with the stairs is to work in 3 sets of 5, for instance, on a typical set of outside stairs, or 2 sets of 8-10 on an indoor set.  Make your pet go slowly so that hind leg usage is optimal and beneficial.  Swimming is ok if your vet or rehab practitioner okays it.

If your pet is not using the operated leg after week 1, then I recommend calling your vet or me for rehab intervention and to get them started on beneficial exercise.  At this time it is possible that passive range of motion and other exercises may be demonstrated.  If you follow the exercise prescription well and after week 6 would like advanced exercises, then a rehab consult is necessary.  I have some separate recommendations for feline FHO’s, so feel free to contact me for a copy of that if you need it.

(This article has been faxed and/or e-mailed to all the vets and/or clinics in the Austin area.  Several vets previewed it at the monthly CAVMA meeting in November, 2007, and it has been well-received and condoned)