Important Considerations 

An FHO is considered a salvage procedure, meaning the head and the neck of the femur are not replaced as they are in a total hip replacement.  FHO is best suited to small and medium sized dogs and cats and post-operative rehabilitative therapy is crucial for the best outcome.  There are people who specialize in physical therapy and rehab for dogs and cats. In addition, there are many exercises that you can do at home with your pet after surgery. 

What is recovery like?

All high-impact activity should be eliminated until your veterinary clears your pet to resume normal activity, and at a minimum for 10-14 days. This means no running, jumping (including on or off couches), or unassisted stairs.

Proper activity restriction often requires a crate, pen or small room with no furniture. If you have a high-energy pet, you should inquire with your veterinarian on strategies to avoid injuries during recovery. Activity should be limited to short leash walks (10-15 minutes) for bathroom breaks only.

A sling is strongly advised for dogs to help them get up and walk around as they recover. An e-collar should be kept on to prevent licking or chewing the incision site to prevent dehiscence and infection. Pain medications will be prescribed to assist with their recovery.

Immediately post-surgery, your pet may be drowsy, uncoordinated or nauseous. Unless otherwise instructed, we normally recommend the following for food and water:

• Water Reintroduction: Offer a small amount of water 30 minutes to 1 hour after arriving. If there are no signs of nausea and water is kept down, more can be offered in small amounts. You may resume normal water access the following day,

• Food Reintroduction: Offer 1/2 their normal feed 2 hours after arriving home. If there are no signs of nausea and food is kept down, you may resume normal feedings the following day.

Detailed postoperative instructions will be provided to you after the surgery that outline medications, and incision care. Bandages on the IV catheter site can be removed once you get home. Local bandages applied to the surgical site can be removed in 72 hours unless otherwise instructed. It is normal for some bruising and swelling to occur. If there is no pain or discharge associated with the swelling, continue to monitor at home. Please notify us or your veterinarian if you observe:

• Increased redness/bruising over time

• Odorous or pus-like discharge

• Opening of the incision site

• Increased swelling

• Signs of acute pain.

  • CSU Canine Pain Scale

  • CSU Feline Pain Scale

The incision will typically be closed with all absorbable sutures so you do not need to bring them back for suture removal but it is recommended that you at a minimum email a photo of the incision site and a short walking video at 2 weeks. If the incision is healed as expected at 14 days, you will not need to take additional precautions to keep it dry.

If tolerated, you can assist your pet recover with the following care (don’t hesitate to ask for demonstration):

Cold Therapy

Upon returning home for the first 3 days:

• Prepare a cold compress (ice pack, ziplock with ice cubes, frozen bag of vegetables).

• Wrap in a towel and place against incision.

• Continue contact for 10-15 minutes every 4-8 hours as tolerated by your pet.

Heat Therapy

After 3 days, switch to warm compresses.

• Dry, microwavable heating reusable heating pads are best.

• Make sure after heating you can place on your own skin without pain. If it’s too hot for you, it’s too hot for them.

• After warming and testing, place against the incision.

• Continue contact for 10-15 minutes every 4-8 hours as tolerated by your pet.

Passive Range of Motion

The day after surgery for up to two weeks:

• Place your pet in a standing position or laying down on their non-surgical side.

• Holding the knee, slowly move the femur (portion of the leg above the knee) that was operated forward, mimicking the natural movement of the leg toward the chest.

• Then, gently move the leg backward, extending the hip joint, simulating the leg moving away from the body. Repeat for 5-10 minutes, two to three times a day as tolerated.

• IMPORTANT: DO NOT FORCE ANY MOTION YOUR PET IS RESISTANT TO PERFORM.

After the first two weeks: 

The involvement of a veterinary physical therapist is highly recommended, but we want to encourage movement at this stage to help the new scar tissue joint develop and maintain adequate range of motion as well as strengthen the muscle regardless. 

For dogs, begin leash walks.  Start with 5-minute leash walks 2-3 times a day for one week, increase the duration of the walks by 5 minutes each week until your dog is taking 20-minute leash walks without issue.   

Encourage use of the leg by walking slowly, walk through water if possible, walk uphill or upstairs, and “dance” (hold your pet up by the front legs and walk them on their back legs).  You can also stand next to your pet and hold up their opposite back leg to encourage them to put more weight on the operated leg. 

Cats often like to follow the beam of a laser pointer or play with feathers attached by string to a stick.  These are good ways to increase their activity levels during recovery. You do not need to get them going fast, just walking and bearing weight on their leg. Some cats will tolerate “dancing” as well, but use your best judgement knowing your cat.

Prognosis 

Healing is general complete after 4-6 weeks.  If at any time your dog or cat is not progressing as expected, please contact us.  

With proper post op care and rehabilitation, many dogs and cats experience significant pain relief and a good quality of life.  A slight alteration in gait (the way they walk) is expected but should not be painful or limiting.