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Old 10-20-2008, 09:32 AM   #1
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Default Logan has Ischemic Necrosis of Femoral Head

Logan was just diagnosed with this. My first vet thought it was hip dysplasia. After much research on hip dysplasia I decided that that diagnosis didn't make sense so I took Logan for a second opinion. The vet told me he has Ischemic Necrosis of Femoral Head (Legg-calves Perthes) disease. We don't have to do anything at this time, but we're supposed to watch him closely for signs he's in pain & muscle atropy in that leg. We don't want the muscles to get weak & then do it. My vet said there is a guy in Fort wayne that does the head replacement, but he recommends that I go to Michigan State & have the whole joint replaced.

Does anyone have any experience with either of these surgeries? I will probably do it either way, but I would like it to be something that would make him feel better forever. He's 3.5 years old & it just showed up in the last couple months. His x-ray in January showed no signs of it, but the densisity difference in the 2 hips is very apparent in the x-ray that was taken a week ago. So my vet feels it's rather aggressive.
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Old 10-20-2008, 09:36 AM   #2
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Oh poor Logan. I don't have any experience but if you search YT for legg-calves perthes....you'll find several threads.

Good luck
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Old 10-20-2008, 10:35 AM   #3
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I searched the archive & didn't find much help. All the dogs in there were puppies & Logan is older. Is it weird that he's older & not a puppy? My vet said I could wait to do the surgery, but to make sure he's not in pain & he's using his leg. Which he is right now. Once the replacement is done, is that it, will it last forever? My vet recommends getting a full hip replacement, but most people on her seem to be getting just the femoral head replacement. Does anyone know the benefits of one over the other. I plan to have a long chat with my vet to decide the best course of action.
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Old 10-20-2008, 10:41 AM   #4
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Didn't Logan have a liver issue too? Or am I confused?

I know "replacements" such as knee or hips...in humans are generally thought to last about 10 years. If the same holds true for dogs...I would tend to believe it would last his lifetime.
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Old 10-20-2008, 11:30 AM   #5
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Hi. I am so sorry that you and Logan are going through this. Roxy had surgery on her hip a couple of months ago because of Legg-Perthes. I feel like we had an amazing specialist for her - I would (and have already) recommend him in a heartbeat. I had 3 vets recommend the femural head removal before I mad the appointment w/ the specialist. Before the surgery we talked about the removal vs. a total hip replacement. He said that they do make hips small enough for yorkies and he could definitely do that if that was what we chose. However, they "glue" them in. Larger dogs have a shorter life expectancy, so they last their lifetime. Smaller dogs often outlast the "glue," so they need more surgery when they are older. The cost for hip replacement was more than 4 times as much, and not recommended even if they had been cost equivalent, so our decision seemed pretty easy.

Looking back, I am so glad that we made the choices that we made. From the Dr. to the procedure - everything.

One regret is that I didn't move quicker. She definitely lost a lot of muscle mass. Our little friend Tucker (mxkids) had the same surgery a week ago today - same hip, same Dr., same everything. We had an Idaho playdate Sat. and I could not believe how well Tucker was doing. I really think his speedier recovery is due largely in part to Robin recognizing there was a problem and getting it handled so quickly. Roxy never cried, and didn't even always favor her leg, but just from that short time of favoring it part time, she really lost alot.

I have a tendency to go in circles, but if you want to talk, PM me and I can send you my phone number.

Good luck!
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Old 10-20-2008, 11:55 AM   #6
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I don't get to post much but I wanted to let you know that my Hannah had the femural head removal surgery about 6 years ago and hasn't had any problems at all. After a while the cartilidge will build up to form a false femural head and as long as the dog has not lost to much muscle mass they will get full use! She spent a few days in the vet hospital but within a week she was up and back to herself again. She is almost 11 now and has no problems with it at all!

Angie
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Old 10-20-2008, 01:20 PM   #7
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Default for what's it's worth...

I just want to start with saying, I understand Legg-Calve-Perthes disease better in people. I am sure there are some vets that visit this site, and who might have some advice, but I know how uneasy it can be not knowing stuff immediately. From what I understand, not enough blood flow is getting to the top of Logan's femur - so it's not growing as well as the rest of him, and if the blood supply gets cut off too much for too long, it becomes necrotic - a fancy way of saying the top part of his thigh bone dies. What could potentially happen then is that the head of the femur could collapse (picture an ice cream cone with a scoop on top - think of that scoop kinda falling in) - causing pain, and decreased movement. Sometimes the treatment can be pretty conservative, but if your vet is considering surgery, it is probably a little more advanced, or aggressive.

I don't know about the better treatment options for this situation specifically, but my brother has a Rhodesian Ridgeback (somewhere around 90 lbs) that had to have the head of his femur removed after he was hit by a car when he was younger. And we were very lucky, in that he is still very active, even with some muscle loss (atrophy). Dogs muscles are different from ppl's in that they twist around the bone, so even with removal there is enough structual support so the dog can still move. Recovery, from what I remember, took a while - but our Samson is very happy and active now. And I believe the surgery is easier on smaller dogs...

I'm not sure if any of this helped, or just added to what you already knew...but after having gone through something like this with my brother's Samson, I thought it might be reassuring to hear from people. It sounds like you are taking control of this problem, but if you are discussing something with your vet and he/she says something you don't fully understand - Please, stop him and ask him to explain!!! And ask questions if you have them... When you leave the office, you should have a clear understanding of what's going on because this stuff is overwhelming, esp if you are worried about your little guy...

I don't know if this was of any use...but it sure did turn out longer than expected - sorry!
Logan sure is a cute one, and he's lucky to have you
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Old 10-20-2008, 01:26 PM   #8
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I"m sorry that Logan has a bad hip. If i were you i'd get a femoral head ostectomy (FHO). this is the removal of the femoral head. Its easier on them if their muscles haven't atrophied so much. its a simple procedure that takes 1/2 an hour for a good specialist. the recovery is easy and exercise is encouraged (not crazy exercise but walking).
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Old 10-20-2008, 01:33 PM   #9
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My vet was pretty adament about the Total hip replacement over the femoral head extrasion. I didn't realize they just completely remove the head and don't replace it with anything that freaks me out. Logan is a much bigger yorkie. He is 15lbs solid muscle. Michigan state, which is where we would take him, does do cementless replacements. Logan is 3.5 years old, not a puppy, I don't know if that makes a difference. I'm going to have a more indepth talk with my vet now that I've done research & have a lot more questions. My husband & I have also decided to take him to Michigan State & have him evaluted & see what they recommend. My vet said the Total hip replacement at Michigan state will cost me around $3500, which is more than I heard the FHO is, but we want to do what's best.

The comment about how dogs muscles wrap around was very helpful. As was the dog that had this done 6 years ago & is still doing well. Thank you so much for the information so far.

To Bchgirl (i think). Logan had tummy issues back in January. They turned out to be nothing, at the very most a mild case of pancreatis. Both my vets think it was because I was very stressed out & not eating or sleeping at the time for personal reasons. Logan is very sensitive to me & it stressed him out causing tummy upset; we've had no problems since January with his tummy.
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Old 10-20-2008, 02:28 PM   #10
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Quote:
Originally Posted by Ponyup View Post

To Bchgirl (i think). Logan had tummy issues back in January. They turned out to be nothing, at the very most a mild case of pancreatis. Both my vets think it was because I was very stressed out & not eating or sleeping at the time for personal reasons. Logan is very sensitive to me & it stressed him out causing tummy upset; we've had no problems since January with his tummy.
I just kinda recalled something....I'm glad he's fine and wish him well from whatever treatment you decide on the Legg-Calve-Perthes. I do think the sooner you come to a conclusion and he gets help....the better.
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Old 10-21-2008, 03:18 AM   #11
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we don't do total hip replacements where i work. from what i hear it is a very hard and long and expensive procedure (much more then $3500 over here). i can't tell you how they recover or what the likely hood of problems could be.

what i can tell you is that in an FHO, the femoral head (ball that fits in the socket) is cut off. Exercise is recommended after this surgery to build up any muscle lose that might have happened before the surgery and to build up even more muscles. the muscles and scar tissue are what keeps the femur in place. I've seen this done of very young dogs and very old dogs, small dogs and large dogs. We've even done bilateral ones on severe cases. Of all the cases i've seen they've all turned out very well...unless the owner didn't keep up their part of the bargain with the phycial therapy.
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Old 10-21-2008, 04:57 AM   #12
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Quote:
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I just kinda recalled something....I'm glad he's fine and wish him well from whatever treatment you decide on the Legg-Calve-Perthes. I do think the sooner you come to a conclusion and he gets help....the better.
My husband & I discussed it last night & we are going to move forward with some kind of treatment very quickly. We're going to the AQHA congress this weekend & when we get back from that I'm going to discuss more indepth with my vet what are options are. I'm also going to talk to a friend that has had both hips replaced on her corgie & then we'll probably make an appointment at michigan state to have him evaluated. I'm thinking over winter would be the best time to get it done since he'll want to be inside & he gets a little lazier in the winter.
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Old 10-21-2008, 07:15 AM   #13
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Chloe is a year old and just yesterday had an xray and has legg calve-perthes. She has been limping,holding up her leg,and cries if you pick her up with pressure on her hip.I am waiting for the vet to call me and get the surgery date.She is already losing muscle,and I want to move on it as quickly as possible.I live in Ohio,and the surgery here is 780.00 to 900.00.Good luck with Logan I hope all goes well........Lisa
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Old 10-21-2008, 10:10 AM   #14
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I'm so sorry your Chloe is dealing with this as well. Logan's pain is not that severe. He limped for a few days, but not constantly. and he never wimpered or anything. Right now he's on anti-inflammatories & doesn't seem to be in a lot of pain, but we are going to move forward rather quickly.
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Old 10-21-2008, 08:16 PM   #15
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I am so sorry to hear about Logan's problem. Over 5 years ago, I bought an adorable male to use in my breeding program. I noticed he was limping one day on the deck while playing with the bunch. His little leg muscles had barely started to atrophy but my vet got him in and surgery to remove the femur head. I gave him to one of the vet techs who took care of him during his post-op stay. He is doing fine and is a reg. therapy dog.
Can you imagine a better outcome? Your baby will do fine and once recovered, will be back to his lil self.
Keep us updated and we are sending prayers for all of you..
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