Question 1

What is Canine Hip Dysplasia?

Accepted Answer

Canine Hip Dysplasia (CHD) is a condition where the ‘ball’ and ‘socket’ of the hip joint don’t fit together as they should, causing looseness and instability in the joint that results in a progressive loss of cartilage, the development of scar tissue and bone spurs, and the eventual onset of osteoarthritis.
Radiograph of a typical canine surgical candidate for total hip replacement showing degenerative changes in both hips. These changes include a shallow acetabular cup with boney production on the edges of the joint and flattened heads of the femurs, again with boney production at the margins.

Several surgical methods exist for treating hip dysplasia in dogs, including:
Juvenile Pubic Symphysiodesis (JPS) is a relatively minor, minimally invasive surgical procedure performed on puppies under 18 weeks of age. JPS closes a growth plate at the bottom of the pelvis to stop the growth of the pubis, which results in the ‘socket’ reshaping to cover the ‘ball’ as the puppy continues to grow post-surgery. Research has shown that the JPS procedure has consistently provided normal, pain-free hip function.

Double or Triple Pelvic Osteotomy (DPO/TPO) has been used successfully in both dogs and children for decades. The DPO/TPO procedure cuts the pelvic bone in two (DPO) or three (TPO) places. The segments are rotated in order to improve the coverage of the ball by the socket.

Total Hip Replacement (THR) is an option for dogs who are at least one year old. Just as in humans, both ball and socket are replaced with implants. Evidence-based studies show this surgery consistently results in normal, pain-free function.

Femoral Head Ostectomy (FHO) Unlike the previous surgeries, the goal of FHO is pain reduction, not normal hip function. In an FHO, the ‘ball’ of the joint is completely removed. Without the ball, the muscles of the hip take over during limb movement. Dogs that undergo FHO are required to stick to a limited exercise program and stay slim. Still, the surgery can provide enough comfort to negate the need for anti-inflammatory pain medication.
It is important to note that the  Orthopedic Foundation for Animals  (OFA) exam often used by breeders to certify that a dog is free of CHD cannot be performed until a dog is at least 24 months, at which time it is too late in the progression of the disease for some of the most effective surgical options. Because of this, we recommend the  PennHIP test  be used. PennHIP is a well-researched, peer-reviewed, and objective method that can successfully diagnose puppies as early as 16 weeks.

Question 2

Why would my pet need CHD surgery?

Accepted Answer

Left alone, CHD will get progressively worse until your dog can no longer comfortably rise or walk and is in frequent pain. Sadly, in some dogs, this can be as early as a few months old. Medical management can provide some relief for dogs with a sedentary lifestyle, but surgery is the only option for a dog with CHD to live an active, pain-free life.
Symptoms of CHD include:
Lameness or stiffness of one or both hind legs
Trouble getting up or going up or downstairs
Bunny hopping gait
“Froggy” sit
Loss of muscle mass on the pelvis and rear limbs
Although there are various factors that contribute to the development of CHD, such as improper nutrition or too little or too much exercise, genetic predisposition is the single most significant risk factor. While smaller dog breeds, such as pugs and French bulldogs, can be affected, the highest risk appears in large and giant breed dogs such as Rottweilers, German Shepherds, Golden and Labrador Retrievers, Great Danes, and Mastiffs as well as others.

Question 3

What is included with my investment for my pet’s hip surgery at VSS?

Accepted Answer

Our all-inclusive fee provides:
Pre-op
We include a consultation with one of our  board-certified veterinary surgeons  to discuss options, determine candidacy for total hip replacement, and all aspects of the procedure, and the owner’s investment required for post-op at-home care. At the initial consultation, our staff will provide an estimate for pre-operation, the procedure, and post-operation, which includes all exams, medications (not refills), recheck appointments, and X-rays for up to one year from date of surgery.

A separate appointment needs to be scheduled for pre-op diagnostic workup within two weeks of the date of surgery. The appointment includes pre-op bloodwork, pre-op urinalysis, and detailed X-rays for surgical planning.
During Surgery
At VSS, your pet’s surgery is performed in a sterile, dedicated surgical environment by the same surgeon you meet with during your initial consult. Medications and anesthesia required by your pet during surgery are included, as well as anesthesia monitoring both during surgery and through recovery by a registered veterinary technician (RVT) who has extensive experience with anesthesia. Our staff will keep you updated on the progress throughout the procedure.
Post-op
Overnight hospitalization is required for most surgeries, although total hip replacement requires three – four nights. You can rest easy knowing that your pet will be monitored 24/7 by a veterinarian and receive necessary antibiotics and pain medication. Additionally, patients are offered a meal when they are alert and will be walked in the afternoon for elimination. While we don’t usually allow visitors due to patient anxiety, we are happy to send photos as requested by the pet parents.

The staff at VSS are available for you to call for updates on your pet any time during their stay with us, 24 hours a day, 7 days a week.
Pain Management
The surgery fee includes all the medications (antibiotics, anti-inflammatory, and pain) your pet needs to come home and be comfortable during their recovery.
Recovery
We will provide a sling to help your furry loved one during their recovery at home. After his or her surgery, your dog will need to be confined to a small rest area for two weeks, with limited walks only while on a leash with support from the sling. For two to six weeks, we recommend all patients go on short walks on a leash and continue to be confined indoors when unattended. These types of measures at home will ensure a successful and speedy recovery.
Follow-up
Post-surgery appointments to check on the status of your pet are also included and vary depending on the surgery. Total hip replacement follow-up appointments include a suture removal at two weeks and then a round of recheck X-rays at six weeks, three months, and nine months. All of the above routine recheck appointments are included with the surgery.
Post-op radiograph showing the placement of both acetabular and femoral components.

Question 4

Why choose VSS for your pet’s procedure?

Accepted Answer

At VSS, all we do is perform advanced, technical surgeries every day our state-of-the-art facility. Our  board-certified veterinary surgeons  have trained at some of the most prestigious veterinary teaching hospitals in the country, and are leaders in the field of orthopedic surgery, with over 70 years of combined surgical experience. Additionally,  VSS is Southern California’s premier animal surgical hospital  and one of the first specialty hospitals to receive an Accredited Referral Practice designation, which means over 900 quality standards of our practice are consistently evaluated by the  American Animal Hospital Association (AAHA).  Unlike human hospitals, accreditation for a veterinary hospital is voluntary. Rest assured, we hold ourselves to that higher standard every day. But all that means nothing without the compassion and dedication to service from our highly trained and experienced team members. In short, you can expect the best from VSS from the very start.

Question 5

Why would my pet need TPLO surgery?

Accepted Answer

A torn CrCL is painful! Dogs with this injury cannot walk normally, and the instability caused by the tear damages the surrounding bone and cartilage. Surgery can stabilize the joint, relieve pain, help avoid irreversible joint damage and the onset of osteoarthritis, and allow your dog to live a normal, active, pain-free life.
Symptoms of a torn CrCL include:
Decrease in activity level and unwillingness to play
Limping/lameness
Difficultly rising or jumping
Pain and stiffness in the hindquarters
Decreased range of motion
Muscle atrophy in the affected leg
Popping noise or swelling on the inside of the shin bone

Risk factors for CrCLD include age, obesity, poor conformation (structure), breed, and lack of fitness. While the disease can affect any size, breed, or age of dog, Newfoundlands and Labrador Retrievers have been found to have a genetic component to developing CrCLD. Other breeds that have a higher risk of developing CrCLD include Chesapeake Bay Retrievers, Akitas, Mastiffs, Rottweilers, Saint Bernards, and Staffordshire Terriers. Cats are rarely affected.

Question 6

When does my dog need TPLO surgery?

Accepted Answer

What is TPLO?
Tibial Plateau Leveling Osteotomy (TPLO) is a surgical treatment used to stabilize the stifle joint when the Cranial Cruciate Ligament (CrCL) has ruptured. The CrCL is similar to the ACL in a human knee, but unlike in humans, the CrCL rarely ruptures from sudden trauma in an otherwise healthy ligament. Rather, a rupture is usually the result of a slow degeneration that has taken place over months or years due to the presence of Cranial Cruciate Ligament Disease (CrCLD).

The CrCL cannot heal on its own once it starts to tear, nor can it be replaced with a graft, so the surgical techniques used on dogs focus on changing the biomechanics of the knee joint itself in order to attain the goal of pain-free, stable movement. Surgery is the only option to permanently “fix” the instability and relieve pain created by the rupture.

The TPLO procedure consists of cutting the top of the tibia (bone below the knee), rotating it, and stabilizing it in a new position with a bone plate and screws. These changes affect the dynamic movement between the bones of the knee and counter the loss of the CrCL. The TPLO procedure has been proven to have consistent positive outcomes even in large, athletic dogs, and dogs that undergo TPLO are highly likely to be capable of a full and active life.
Pre-op radiograph of the stifle joint (knee) in a canine patient.

Question 7

What is included with my investment for TPLO at VSS?

Accepted Answer

Our all-inclusive fee provides:
Pre-op
Before surgery, you and your dog will have a consultation with a VSS board-certified veterinary surgeon, which includes a physical exam, discussion of the causes of a cruciate ligament tear, an explanation of options (TPLO vs. lateral suture vs.TightRope), a viewing of an animation of the TPLO procedure, and of course, answering any questions from you.
At the initial consultation, our staff will provide an estimate for pre-operation, the procedure, and post-operation, and also includes all exams, medications (not refills), post-op X-rays, and day-of-surgery bloodwork.
During Surgery
At VSS, your pet’s surgery is performed in a sterile, dedicated surgical environment by the same surgeon you meet with during your initial consult. Medications and anesthesia required by your pet during surgery are included, as well as anesthesia monitoring both during surgery and through recovery by a registered veterinary technician (RVT) who has extensive experience with anesthesia. Your dog’s leg will be bandaged and he or she will recover in a bed with supplemental heat.
Post-op
Overnight hospitalization is required for most surgeries, although for TPLO, possibly two to three nights if bilateral, depending on whether the patient is able to walk with two bandages. You can rest easy knowing that your pet will be monitored 24/7 by a veterinarian and will receive necessary antibiotics and pain medication. Additionally, patients are offered a meal when they are alert and will be walked in the afternoon for elimination. While we don’t usually allow visitors due to patient anxiety, our veterinary technicians are happy to send photos as requested by pet parents.

The staff at VSS are available for you to call for updates on your pet any time during their stay with us, 24 hours a day, 7 days a week.

Pain Management
The surgery fee includes all the medications (antibiotic, anti-inflammatory, and pain) your pet needs to come home and be comfortable during their recovery. For TPLO patients, we often use long-acting regional anesthesia, which has greatly decreased the need for narcotics.
Recovery
After your dog returns home, he or she will need to be confined to a small rest area for two weeks with limited walks only while on a leash. For two to six weeks, we recommend all patients go on short walks only while on a leash and continue confinement indoors when unattended. These types of measures at home will ensure a successful and speedy recovery.
Follow-up
Post-surgical appointments to check on the status of your pet are also included in the surgery package. Post-op follow-up appointments include bandage removal at three to five days, suture removal at two weeks, then post-op X-rays at six weeks. All of the above routine recheck appointments are included with the surgery.

Orthopedic Surgery

At Veterinary Surgical Specialists

Veterinary Surgical Specialists

Veterinary Surgical Specialists

You've come to the right place

Highest standard of care

Unmatched expertise

State-of-the-art facility

Open 7 days a week

What is orthopedic surgery?

Types of surgery

Cruciate ligament disease

Diseases of the hip

Elbow dysplasia

Fracture fixation

Patella luxation

Reconstructive surgery

We’re here for you (and them)

Schedule a visit. We’re here to help.

Prepare for your visit

During your visit

After your visit

Our surgery team

Diane Craig, DVM, Diplomate, American College of Veterinary Surgeons

Thomas Keeshen, DVM, Diplomate, American College of Veterinary Surgeons (Small Animal)

Peter Sebestyen, DVM, Diplomate, American College of Veterinary Surgeons

Kyle Walker, DVM, Diplomate, American College of Veterinary Surgeons (Small Animal)

Frequently asked questions

What is Canine Hip Dysplasia?

Why would my pet need CHD surgery?

What is included with my investment for my pet’s hip surgery at VSS?

Why choose VSS for your pet’s procedure?

Why would my pet need TPLO surgery?

When does my dog need TPLO surgery?

What is included with my investment for TPLO at VSS?

New patients

Fast track your visit

Our partner hospital

AVSG Internal Medicine Emergency & Critical Care

You've come to the right place

Highest standard of care

Unmatched expertise

State-of-the-art facility

Open 7 days a week

What is orthopedic surgery?

Types of surgery

Cruciate ligament disease

Diseases of the hip

Elbow dysplasia

Fracture fixation

Patella luxation

Reconstructive surgery

We’re here for you (and them)

Schedule a visit. We’re here to help.

Prepare for your visit

During your visit

After your visit

Our surgery team

Diane Craig, DVM, Diplomate, American College of Veterinary Surgeons

Thomas Keeshen, DVM, Diplomate, American College of Veterinary Surgeons (Small Animal)

Peter Sebestyen, DVM, Diplomate, American College of Veterinary Surgeons

Kyle Walker, DVM, Diplomate, American College of Veterinary Surgeons (Small Animal)

Frequently asked questions

What is Canine Hip Dysplasia?

Why would my pet need CHD surgery?

What is included with my investment for my pet’s hip surgery at VSS?

Why choose VSS for your pet’s procedure?

Why would my pet need TPLO surgery?

When does my dog need TPLO surgery?

What is included with my investment for TPLO at VSS?

New patients

Fast track your visit

Our partner hospital

AVSG Internal Medicine Emergency & Critical Care