Friday, January 3, 2020

4048. BKTP Veterinary Stories*****. The old Jack Russell limps as she cannot put her right hind foot down - hip dislocation

BE KIND TO PETS Veterinary Stories No. 1
Dr Sing Kong Yuen, BVMS (Glasgow)
Jan 10, 2020





The old Jack Russell limps as she cannot put her right hind foot down - hip dislocation


On Jan 2, 2020, a 12-year-old, female Jack Russell became lame suddenly. The lady owner consulted Vet 1 who took X-rays and diagnosed right hip dislocation. 

Vet 1 referred her to a practice saying: "The surgery would cost $4,000 - $5,000.". Her husband remarked: "Why pay $4,000? Just put your dog to sleep!"  

On Jan 3, 2020, the owner came to Toa Payoh Vets. "Now that Vet 1's clinic is near my house," she told me. "I usually consult him. I did consult Dr Daniel Sing recently."

In 2020, there are nearly 100 vet clinics in Singapore, I understand perfectly that many owners will prefer proximity to save time and transport expenses.


My physical examination showed right hip dislocation. I had two better quality X-rays taken as Vet 1's X-rays were not sharp enough to show any femoral fractures clearly.




"I work part-time and so I don't earn much," the owner was furious about her husband's suggestion of euthanasia of her beloved dog. "I will pay all my salary, but I will never put my dog to sleep! I want her to be able to walk normally, without limping in pain!"   

Dr Daniel Sing was her regular vet. He advised a non-surgical treatment using the Ehmer's Sling.  

The owner consented. Dr Daniel sedated the dog and put an Ehmer's sling which holds the femoral head into the socket as much as possible.

He repeated the Ehmer's Sling again as X-rays showed there was still hip dislocation. The Ehmer's Sling positioned the femoral head inside the hip joint to allow healing. The sling would be kept on for around 2-4 weeks. 

The Ehmer's Sling is a much less expensive treatment. It has around 50% chance of success. It is a safer approach since the 12-year-old dog may die under anaesthesia if she is operated. If it does not work, femoral head osteotomy (FHO), also known as femoral head excision can then be performed. 

FHO involves cutting off the femoral head and removing it. A false joint will be created and the dog can walk and run without obvious signs of limping. 

On Jan 9, 2020, the couple came to bring the dog home after 7 days of in-patient confinement. I keep my fingers crossed for the feisty Jack Russell and hope that she will walk and sprint normally in 2-4 weeks' time. 



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SCRIPT FOR VIDEO PRODUCTION

This is a story from the




The old Jack Russell limps as she cannot put her right hind foot down - hip dislocation


(Narrate as if speaking to a friend, varying your tone. Do not be monotonous) 

PART 1
On Jan 2, 2020, a 12-year-old, female Jack Russell became lame suddenly. The lady owner consulted Vet 1 who took X-rays and confirmed right hip dislocation. 





Vet 1 referred her to a practice saying: "The surgery would cost $4,000 - $5,000", Vet 1 told her. Her husband remarked: "Why pay $4,000? Just put your dog to sleep!"  

On Jan 3, 2020, the owner came to Toa Payoh Vets. "Now that Vet 1's clinic is near my house," she told me. "I usually consult him. I do consult Dr Daniel Sing recently."

In 2020, there are nearly 100 vet clinics in Singapore, I understand perfectly that many owners will prefer proximity to save time and transport expenses.


  

PART 2

My physical examination showed right hip dislocation.  (Edit and show physical examination video footage)  





"I need to take better quality X-rays," I said. "To see whether there are also femoral fractures." Vet 1's X-rays are as follows:






(Poor contrast. The femoral head area is not sharp. Also narrate the text in the 2 X-rays).

Toa Payoh Vet's X rays show no fractures in the surrounding right hip area.
(Narrate the text and "arrow" in the X-rays)     









Vet 1's diagnosis of right hip dislocation was confirmed.


"I work part-time and so I don't earn much," the owner was furious about her husband's remarks about euthanasia of her beloved dog. "I will never put my dog to sleep! I want her to be able to walk normally without limping in pain!"   

Dr Daniel Sing was her regular vet. He advised a non-surgical treatment using the Ehmer Sling. Although it has around 50% chance of success, it is a safer approach since the dog may die under anaesthesia during surgery. If it does not work, femoral head excision surgery can then be performed. It is much less expensive.  

The owner consented. Dr Daniel sedated the dog and put an Ehmer's sling which holds the femoral head into the socket as much as possible. (Narrate the X-ray text).   







He repeated the Ehmer's Sling again. It ensures that the femoral head is kept back into the hip joint to allow healing. The sling would be kept on for around 2-4 weeks. 




(Edit video shows the dog after treatment)

 


The Ehmer's Sling is a much less expensive treatment. It has around 50% chance of success. It is a safer approach since the 12-year-old dog may die under anaesthesia if she is operated. If it does not work, femoral head osteotomy (FHO) can then be performed. FHO involves cutting off the femoral head and removing it. A false joint will be created and the dog can walk and run without obvious signs of limping. 

PART 3

The common surgical treatment is femoral head osteotomy (FHO), also known as femoral head excision.












On Jan 9, 2020, I was on duty. The couple came to bring the dog home after 7 days of in-patient confinement. I keep my fingers crossed for the feisty Jack Russell and hope that she will walk and sprint normally in 2-4 weeks' time. 


CREDITS









This is a Be Kind To Pets Veterinary Educational Video sponsored by Toa Payoh Vets. (Show image below).










         

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