Animal Clinic of Billings and Animal Surgery Clinic surgical suite

Veterinary orthopedic surgery deals with bones, joints, muscles, and ligaments. At the Animal Clinic of Billings and Animal Surgery Clinic, we see dogs and cats with a variety of orthopedic conditions almost every day. If your pet is favoring a leg either constantly or intermittently, is having difficulty getting up, or seems to be slowing down, there may be a problem with his or her joints. Sudden limping or pain accompanied by swelling or the abnormal appearance of a leg could indicate a bone or joint injury. This could be a broken bone or torn ligament. Some dogs and cats require orthopedic surgery to correct congenital (genetic or hereditary) problems they are born with, not caused by injury. However, many of these problems can be solved with surgery.

If your dog or cat has a broken leg, a broken back or some other severely broken bone or fracture, our orthopedic surgeons at the Animal Clinic of Billings and Animal Surgery Clinic are here to help! Many of the surgical procedures performed by Dr. Brown and Dr. Sherburne at the Animal Clinic of Billings and Animal Surgery Clinic on any given day can be among the most advanced and cutting-edge veterinary surgical procedures. Certification to perform many of these operations requires specialized training after veterinary school and specialized equipment.

Many pets will have to undergo surgery at some point in their lives. As a pet owner, you want your companion to receive the best possible surgical care in a safe, comfortable environment. The Animal Surgery Clinic of Billings understands these concerns. Our facility features a state-of-the-art modern surgical suite, where we perform surgeries with the safety and comfort of our patients in mind. We use cutting-edge instruments and technology, including anesthetic monitoring equipment and body temperature regulation during surgery.

Fractures in dogs and cats are most often caused by trauma, such as being hit by a car or jumping or falling from a height. Fractures can also be caused by aggressive cancer that destroys the bone or by certain metabolic conditions that leach calcium from bone. Broken bones need support during healing so that a callus is able to bridge the gap across the fracture site. Our doctors have years of experience in veterinary surgery and offer their expertise with precision and compassion.

ADVANCED ORTHOPEDIC AND SPINE SURGERY

Veterinarians Dr. Sherburne and Dr. Brown perform advanced orthopedic procedures and spine surgery at The Animal Clinic of Billings and Animal Surgery Clinic in Billings Montana.

Doctors Brown and Sherburne have more than 65 years combined veterinary practice experience and have successfully managed thousands of complex orthopedic injuries.

Drs. Brown and Sherburne provide arthroscopic joint surgery, advanced ACL and CrCL injury procedures in Billings, including TPLO and TTA, partial and complete joint fusions, elbow dysplasia surgeries including PAUL, and CUE, total hip replacements, advanced limb straightening procedures in addition to many other advanced forms of spine surgery, knee surgery, shoulder surgery, pelvic fracture surgery, bone grafting, and torn or ruptured ligament repair procedures on dogs and cats at the Animal Clinic of Billings and Animal Surgery Clinic in Billings Montana.

What is Veterinary Orthopedic Surgery?

Orthopedic surgery is a broad term for surgical repair of the bone or joint. The objective of every orthopedic surgery procedure is to bring the pieces of bone into the correct alignment and to hold them firmly in place (ie, no movement) so that healing can occur.

A canine that has broken or fractured a bone due to trauma, or one that is suffering from a congenital condition that affects the joint, may require orthopedic surgery. Orthopedic Surgery is the most effective procedure for correcting an affected bone or joint and returning the patient to a normal state of health.

Orthopedic surgery, in general, uses surgical procedures to bring damaged or dysfunctional limbs, joints, ligaments and tendons back to a normal or near normal state when operable. The orthopedic veterinary surgeon may require the use of bone plates, pins or screws, nylon, casts or an artificial joint to achieve such a goal in orthopedic surgery.

What to expect during your dog or cats orthopedic surgery

A dog that is scheduled to undergo orthopedic surgery will require heavy sedation and supplementary oxygen, as the procedure may take several hours for completion. With that being said, it is crucial for pre-surgical blood work and an overall analysis of the canine to take place.

Prior to surgery, radiographs (X-Rays) are taken both of the fracture site, and of the opposite limb for comparison. Your veterinary surgeon will use the X-Rays to decide the best course of action, surgical procedure, and if necessary, implant type(s) to repair the fracture, including the size of plates, pins, or screws required.

Leading into surgery, your dog will be given a general anesthetic and the area surrounding the fracture is shaved and sterilized. Under strict aseptic conditions, your surgeon incises over the fracture site and dissects down to visualize the broken bones. Different techniques are required for different procedure types, but the general rule is to put all of the broken bones back in place where they’re supposed to be and immobilize the fractured pieces of bone so that they cannot move against each other. This includes preventing any slippage of the fracture ends and also stopping any rotation around an implant.

The fracture site is lavaged with sterile saline prior to closure, and local anesthetic may be instilled to reduce postoperative pain. Follow-up x-rays are taken to establish the repair is good, the operation site closed with skin sutures, and the patient woken.

Orthopedic surgery includes a number of bone and joint correction surgery types, such as:

DOG AND CAT BONES

Bones provide a rigid structure to the body and act as the levers that turn muscle movement into motion. The term “bone” makes most people think of the bones in the limbs, such as the femur (thigh), tibia (shin), radius (forearm), and humerus (upper arm). However, the ribs, spinal vertebrae, hips, shoulder, and skull are also made of bone. In dogs and cats, the spinal vertebrae extend all the way down into the tip of the tail. Male dogs also have a bone in the penis.

Bones consist of an outer, hard portion known as the cortex and an inner, spongy portion known as the marrow. The outside surface of the cortex is surrounded by a fibrous capsule called the periosteum, which contains blood vessels and nerves. The periosteum also contains immature cells that grow into the osteoblasts, which are the cells involved in bone growth and fracture repair.

COMMON TYPES OF DOG AND CAT BONE FRACTURES

Bones contain large amounts of calcium, which makes them hard and resilient, but unfortunately also breakable. The complexity and severity of a fracture depends on the force of the impact, the location of the injury, and the general age and health of the individual dog or cat.

  • HAIRLINE FRACTURES – The simplest types of fractures produce fine cracks near the middle of long bones, such as those in the legs. These hairline fractures cause little or no displacement of the bone, much like cracks in a windshield.
  • MULTIPLE-PIECE FRACTURES AND FRACTURES THAT INVOLVE A JOINT – Stronger impacts can cause the edges of the fractured pieces of the bone to separate, or the bone may shatter into multiple pieces, making repair more difficult. Fractures that involve a joint are even more serious. These types of fractures can interfere with movement and lead to arthritis long after the bone has healed.
  • OPEN OR COMPOUND FRACTURES – Fractures in which the bone is exposed are called “open” or “compound” fractures. In these serious fractures, jagged edges of the bone can pierce surrounding tissues and damage muscles, blood vessels, and nerves. In addition, because the bone is exposed to the outside environment, these types of fractures are often contaminated and serious infections that are difficult to resolve can develop.

Common orthopedic conditions we manage regularly

Almost all fractures and other orthopedic injuries have a surgical and /or management solution and most have several possible acceptable treatments, no matter how bad it might appear. Drs. Brown and Sherburne at the Animal Clinic of Billings and Animal Surgery Clinic are skilled in a number of different fracture repair modalities and will employ the most practical, safe and effective techniques for your dog or cat. Frequently, these may involve what are called minimally invasive techniques, which require less aggressive surgical approaches that lessen the discomfort your pet experiences and quicken the rate of healing.

We offer a wide array of fracture stabilization and management options including but not limited to:

TPLO Surgery

We offer TPLO Surgery (Tibial Plateau Leveling Osteotomy), TTA (Tibial Tuberosity Advancement),  and extracapsular repair for all breeds of dogs. The TPLO procedure stabilizes the knee by leveling the tibial plateau. The TPLO technique is designed to alter the biomechanics of the knee such that the dog no longer requires the damaged CrCL (ACL or CCL) to provide stability to the knee. This is accomplished by reorienting the surface of the tibia, which is the bone that makes up the bottom of the knee joint. Dogs possess a sloped proximal tibia, which can result in the femur sliding off the back of the tibia when they bear weight on their limb if the CrCL is damaged. The TPLO technique levels this slope, thereby preventing the dynamic instability of the joint.

Cruciate Ligament Repair (ACL, CrCL, CCL)

The diagnosis, treatment and repair of damaged or ruptured Cranial Cruciate Ligaments (ACL, CrCL, CCL) and Cruciate ligament disease in dogs is by far the most common orthopedic injury we treat at the Animal Clinic of Billings and Animal Surgery Clinic. We offer ACL, CrCL or CCL extracapsular repair for all breeds of dogs and cats.

The repair choice is tailored to that which best suits the individual dog or cat. We provide comprehensive case management from start to finish and offer many additional services, including laser therapy and physiotherapy (PRT) consultation to reduce recovery time and assist with pain management.

Elbow Dysplasia

Elbow dysplasia is the most common cause of forelimb lameness in dogs. Like hip dysplasia, it is a multifactorial complex condition that will first affect the dog as a puppy. Over time, elbow dysplasia may result in loss of cartilage and remodeling of the joint surfaces with secondary osteoarthritic changes. The term elbow dysplasia actually describes a disease that comprises a number of different conditions. Through orthopedic examination and X-rays, one of our surgeons at the Animal Clinic of Billings and Animal Surgery Clinic will be able to discern what, if any, components of elbow dysplasia your dog possesses to help guide treatment decisions. Treatment will vary depending on which of these contributing conditions is present and can consist of medical management, arthroscopic examination (via a very small incision and the insertion of a tiny camera) of the joint, removal of cartilage and bone fragments or corrective osteotomies (cuts in the bone) to correct alignment. The recommended treatment will be tailored specifically to the needs of your dog.

Shoulder OCD

OCD stands for osteochondritis dissecans and describes a condition whereby a portion of the cartilage of the joint doesn’t form normally and can become dislodged, resulting in inflammation and pain. Much like elbow dysplasia, this condition will affect puppies and present as a forelimb lameness. The diagnosis is made upon orthopedic examination and taking X-rays of the shoulder joints. This condition is usually successfully treated via arthroscopic removal of the fragment. This is a minimally invasive procedure as it only requires two tiny incisions: one for the camera and one for a small instrument to retrieve the cartilage fragment and to clean up the joint. The prognosis for return to function and alleviation of pain is excellent.

Hip Dislocations and Fractures

There are a number of problems affecting the hip that may require surgical intervention. They include fractures, dislocation and hip dysplasia. The repair depends on the nature of the problem and in many circumstances may be dictated by conditions during surgery. Toggle pin fixation surgery can be performed to replace a dislocated hip joint. Femoral head and neck osteotomy (FHO) is recommended for disease of femur head and as an alternative procedure for hip dislocations in small cats and dogs.

Total Hip Replacements (THR)

Considered the gold standard in treatment of severe hip dysplasia that is no longer manageable with medical treatments, the total hip replacement involves the replacement of the affected femoral head and acetabular socket of the hip joint with artificial replacement components fashioned from medical cobalt-chrome and polyethylene. Advantages of this technique are the expected return of full function and resolution of pain for the dog for the rest of its life. Although more expensive and requiring a longer post-operative recovery time than FHNE or FHO, medium and large breed dogs typically have far superior function with this technique.

Limb Deformities (ALD)

Limb deformities can affect both dogs and cats, causing shortening or angulation of a limb, resulting in disability and pain. Frequently, deformities are first detected in the young animal, as the proper growth of the bone is affected. Therefore, surgical intervention in juvenile patients is often indicated. However, many times the deformities are not fully realized until adulthood, in which case different techniques are employed.

Patellar Luxation

Patellar luxation occurs when the knee cap dislocates and is both painful and a cause of chronic lameness and arthritis. It can be traumatic and associated with cruciate ligament rupture or is seen as an inherited defect in certain small breeds of dogs like Yorkshire terriers. It is often bilateral (both legs affected) and is occasionally also seen in cats. Correction of patellar luxation is a routine and relatively basic orthopedic procedure.

Biceps Tenosynovitis

In very active and working dogs, the large tendon that spans the shoulder joint, called the biceps tendon, can become injured, resulting in an intermittent forelimb lameness. Once injured, it can be a source of inflammation and discomfort if not treated. The diagnosis of this injury is completed on orthopedic examination and diagnostic imaging, including X-rays and ultrasound. Depending on the chronicity, severity and type of injury, different treatment protocols can be employed, ranging from medical management to minimally invasive surgical intervention.

Shoulder Instability

The shoulder joint is considered a “ball-and-socket” joint and is stabilized by a number of different tendons, ligaments and the joint capsule. Occasionally, in middle-aged and older dogs, some of these tissues can become stretched or damaged resulting in instability of the joint. The diagnosis of this condition can be challenging and requires a thorough orthopedic examination and usually some kind of diagnostic imaging like ultrasound. Treatment will vary depending on the severity and chronicity of the condition, as well as the kinds of activities your dog partakes in. A treatment plan will be developed specifically for your dog based on these factors and may include physical rehabilitation, surgery or a combination of the two.

Intervertebral Disk Disease (IVDD)

Extrusion, protrusion and bulge can all cause the disc to put pressure onto the spinal cord and nearby nerve roots. This causes the neurological signs (e.g. weak or paralysed legs, changes in skin sensation) and contributes to the pain. In severe cases of extrusion, the centre of the disc may explode out and hit the spinal cord so suddenly that this section of the cord is left concussed (damaged after being knocked), contused (bruised), or oedematous (swollen).

If we determine your dog has IVDD, then how badly he or she is affected makes a big difference to his prognosis (how likely your dog is to feel better and to walk again after treatment). Our veterinarians at the Animal Clinic of Billings and Animal Surgery Clinic are here to help guide you though all of your options and figure out the best coarse of action for you and your canine companion.

Advanced Spine and Neck Procedures

In a spinal fracture, the bones (vertebrae) of the spine break (fracture) or come apart from each other (dislocate or luxate). Fracture of the spine usually occurs as a result of a significant injury, such as being hit by a car, although occasionally the bones in the spine may fracture with minimal, if any, trauma because they are already weakened by a condition such as a tumor (referred to as a ‘pathological fracture’). When the vertebrae of the spine fracture or dislocate (luxate) the associated vertebral displacement often injures the nerves of the spinal cord. The concussion and compression of the spinal nerves affects nerve function, and the signs that develop may vary from only mild weakness through to paralysis (inability to voluntarily move the limbs). Surgery aims to re-align and stabilise the affected vertebrae. The procedure most often involves placing screws or pins in the bones on either side of the fracture (or luxation) and securing them with either a plate or cement.

Advanced Bone Plating Techniques

Bone plates are one of the strongest and most effective methods of fixing a fracture. Fractures are common in pets and are caused by a variety of reasons.

Anesthesia, anesthetic safety and monitoring

Fear of anesthesia is one of the most common reasons owners decline necessary dental cleanings or other procedures for their pet. At the Animal Clinic of Billings, you can be assured that your pet will be well cared for before, during and after anesthesia.

Precision anesthesia and cardiovascular monitoring are essential, integral aspects of every surgery we perform. Anesthesia is individualized for your pet based on a number of factors, which includes the type of procedure, his or her preexisting conditions, blood test values, age, breed, and prior anesthetic experience. The more precise the anesthesia, the fewer side effects and the faster the recovery.

Before a patient is completely anesthetized, he/she is given pre-medications to help sedate him/her and provide pain control before the procedure is started. Pre-medication is important because it aids in a smooth induction and recovery from anesthesia, as well as reduces the amount of drugs needed during the actual procedure.

After the pre-medication is given, an IV catheter is placed into the patient’s vein. This allows us to use fluids during the procedure. These fluids help us to control the patient’s blood pressure and support organ function while under anesthesia. In addition, IV catheters provide rapid access to the circulatory system. This enables us to administer supportive medications as well as prevent or treat any complications that may arise.

During anesthesia and surgery, your dog or cat is constantly monitored by a trained veterinary technician, using our advanced monitoring system. This system continuously monitors your pet’s arterial oxygen level, blood pressure, heart rate, respiratory rate, and core body temperature. The result of all our efforts is the best and safest outcome for your dog or cat. You can rest assured that we are able to provide the highest and most compassionate surgical care to our clients and their pets.

Efficacy of veterinary orthopedic surgery on dogs and cats

Orthopedic surgery is the most effective form of surgery to correct a canine with a bone injury or joint condition. Completed by an experienced veterinary orthopedic surgeon, a canine’s limb, spine, hip or joint can often return to a near normal state.

Causes for badly broken bones and fractures in dogs and cats

Bone fractures in dogs are commonly the result of external trauma that occurs in otherwise healthy pets. Their injuries are obviously painful and stressful and often require the expenditure of time and resources to successfully manage.

We call the incidents that cause these injuries “accidents”, and they are. However, there are some common causes of these injuries that can be prevented:

Tips for preventing broken bones and fractures

  • Avoid placing untethered dogs in the backs of open pickups and don’t allow excitable dogs to ride in the cabs of vehicles with open windows. They will fall out. They will jump. They do get hurt.
  • Do not pick up dogs by their front legs. Their legs are not handles and bones can snap.
  • Let the puppies do the walking: Toddlers and small children should not carry puppies because, like young humans, puppies squirm and then they get dropped and their bones break. It’s safer to let the pups walk on their own and better for their physical development.
  • Blow the horn: Country dogs, especially ones who spend their lives outdoors, will seek out shade on hot days. Often, dogs nap under vehicles and trailers. Always check under and behind your vehicles for pets (and children). Honking your vehicle’s horn is an effective wake-up call and a good practice before driving off.

If your dog or cat breaks it’s leg or any other bone – Get Proper Help Immediately!

When accidents occur, and bone(s) are fractured see your veterinarian immediately. All bone fractures are not created equal nor is a good outcome assured no matter how well fracture patients are managed.

Follow the advice of your veterinarian – who always has your dog’s best interest in mind. Fracture-stabilization and xation surgery may be needed for proper healing instead of a simpler cast or splint. If your veterinarian advises a surgery he or she is unequipped to perform and suggests a referral to a veterinarian that is so equipped, follow that sound advice.

Decisions and planning during early care are most important when dealing with major injuries.

recovery for dogs and cats after orthopedic surgery

Animal Surgery Clinic of Billings patient with two broken and repaired femurs. We’re happy to report the patient is getting along great now.

Orthopedic surgery requires a lengthy recovery and rehabilitation period following surgery. A dog that has undergone orthopedic surgery will require at least two weeks of exercise restrictions. The canine will not be allowed to walk around or engage in any other types of physical activity, which requires constant monitoring from the pet owner. After the initial two weeks, activity limitation will continue for four months after that and physical therapy may be recommended for the canine.

How to prevent your dog or cat from breaking bones and orthopedic surgery

Preventing the need for orthopedic surgery can be challenging for pet owners, as many causes for bone surgery are related to unexpected injury or hereditary joint conditions. To prevent possible fracture or bone breaks, it is important to practice basic canine safety precautions such as providing a fenced-in yard and using a leash outside the home. Hereditary or congenital causes for a dog to need orthopedic surgery can only be prevented through halting all reproductive practices of canines known to have the condition(s). For canines that are diagnosed with hereditary joint complications, such as hip or elbow dysplasia, orthopedic surgery is the most effective form of treatment for that dog.

Animal Clinic of Billings fracture rehabilitation program

THE ANIMAL CLINIC OF BILLINGS UNDERWATER TREADMILL

When post-op x-rays confirm stable enough fixation, a rehabilitation program is started. During this period the dog’s activities are gradually increased in order to stretch the surgery scar tissue and rebuild muscles. The degree of activity should progress with the dog remaining comfortable. Since increasing duration, not intensity is the goal, explosive activities, such as running, jumping or playing are not allowed during this period.

If your dog or cat has just had a major orthopedic surgery procedure, ask your vet for post-op rehab instructions. We’ve laid out a typical fracture rehab guideline and time table HERE.

We highly recommend incorporating physical rehabilitation therapy and laser therapy to your dog or cats post-surgery rehabilitation program in addition to our recommended home care. We cannot emphasize enough how much of a difference it makes, both in recovery time and recovery outcome, when post-op patients are able to frequent our underwater treadmill and laser treatment center during the critical rehab months after surgery. Learn more about our PRT Underwater Treadmill and Laser Therapy Treatment Center in Billings HERE.

Orthopedic surgical procedures we offer:

The Animal Clinic of Billings and Animal Surgery Clinic is equipped with a state-of-the art surgical suite where our veterinary surgeons perform advanced orthopedic procedures, including but not limited to:

FORELIMB SURGERY


HIND LIMB AND PELVIC SURGERY


SPINE AND NECK SURGERY


GROWTH DEFORMITIES AND CROOKED LIMBS


REGENERATIVE THERAPY


OTHER ORTHOPEDIC PROCEDURES INCLUDE:


CLICK HERE FOR POST-OPERATIVE HOME CARE INSTRUCTIONS AND REHABILITATION AFTER SURGERY

Let our highly trained and experienced team of veterinarians and veterinary technicians help you keep your pet as happy and healthy as they can be.

Call the Animal Clinic of Billings to schedule your pets next wellness examination with us today!

406-252-9499

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ANIMAL CLINIC OF BILLINGS AND ANIMAL SURGERY CLINIC

providing our region’s companion animals and their families what they need and deserve since 1981

1414 10th St. West, Billings MT 59102

406-252-9499

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