Post Surgical Care of Luxated Hip Toggle Pin Repair 

Home patient care after orthopedic surgery is critical to the success of the surgery. Allowing your pet too much activity may alter the anticipated outcome of the surgery. A normal hip joint is held together by a large “round ligament” and the joint capsule, which is a tough fibrous tissue. When a hip becomes dislocated, both of these tissues are torn and damaged. The round ligament is replaced with a heavy nylon suture during this surgery and the joint capsule is sutured back together, if possible. Over time, this artificial ligament will break but the scar tissue that forms during the healing process will hold the joint in a normal position. If you allow your dog too much activity in the first few weeks, the suture will break prematurely before enough scar tissue forms allowing the joint to dislocate again. At that point, a second surgery will be needed to remove the end of the femur and allow a false joint to form. To avoid the added expense of a second surgery, it is imperative that you follow these instructions very carefully. 

The following instructions will be your guide to home care: 

Week 1 & 2: 

  • Provide pain management with NSAID’s the first ten to fourteen days and Tramadol for three days if available
  • Apply an ice-pack to the hip for 10 to 15 minutes two to four times a day for the first 24 to 36 hours after surgery
  • If inflammation has resolved after 72 hours, apply a hot-pack to the hip for 10 to 15 minutes two or three times a day
  • Keep your pet confined to a bathroom or small kennel with just enough room to lay down and have a bowl of food and water
  • If your pet does not have an Ehmer sling bandage around the limb, put a towel or leash around your pets abdomen just in front of the back legs so you can support their weight while taking them outside two or three times daily to go to the bathroom. Do not allow them to walk on the affected limp(s) with full weight for the first week.
  • No running, jumping, playing, free roaming of the house or yard, and no stairs.
  • Schedule a recheck with your doctor 10 days after surgery to remove any sutures and evaluate range of motion and percent weight bearing.
  • Most patients begin to bear some weight by week 2, but every pet is different and some may take longer

Weeks 3 & 4: 

  • Apply a hot pack to the hip for 10 to 15 minutes two or three times a day until the swelling has resolved
  • If you notice your pet’s pain level getting worse after the last pain medication, please call and ask for a refill
  • Continue house and leash restriction for weeks 3 and 4 but the abdominal sling is no longer necessary if your pet’s limp is slight

Week 5 & 6 

  • Start slow leash walks for 10 minutes two or three times daily
  • If available, swimming exercises for one to three minutes twice a day is helpful
  • Schedule another recheck with your doctor six weeks after surgery to evaluate your pet’s progress

Weeks 7& 8: 

  • Slow return to function from this point forward by slowly increasing activity levels over these two weeks
  • Start allowing some light off leash activity in a confined yard
  • Continue swimming if possible

Weeks 9: 

At this point, your pet’s healing should be complete and should gradually return to full activity by the end of 9 weeks. 

Additional Instructions: 

  • Licking at the incision should be discouraged because it may lead to chewing at the sutures or staples causing a wound infection. It may be necessary to use an Elizabethan collar to prevent licking.
  • Feed your pet its regular diet but reduce it by 10% to allow for reduced activity.

Complications 

As with any surgical procedure, complications can occur. Unlike human patients who can use a sling or crutches, our patients do not know enough to stay off a healing leg so restricted activity is a major responsibility of you, the pet owner. Failure to follow these instructions carefully can lead to delayed healing. 

The most common complication is re-luxation of the hip, where, despite our best efforts, the hip just will not stay in place. Rarely, infections can develop and will need to be treated with antibiotics. Notify your veterinarian if you notice any discharge from the incision. Lastly, some pets will develop significant arthritis in the hip that may necessitate further surgery. If you have any questions, please feel free to ask your veterinarian or call us at 406-252-9499. 

Follow Up Instructions: 

  • Remove Ehmer sling in 7, 10, or 14 days. Ask your veterinarian. 
  • Please monitor your pet’s ability to urinate over the next 1-2 days. Rarely, patients that had an epidural will have transient urinary retention, straining to urinate but no stream is observed. This can lead to a ruptured bladder after several days and kidney failure if you do not seek immediate treatment. 
  • Re-check in ten days: Sutures / Staples removal / Dissolving sutures and first radiograph to make sure hip has not re-luxated 
  • Feed your pet its regular diet but reduce it by 10% to allow for reduced activity. 
  • Any swelling or redness near the incision should be checked immediately. 
  • Re-check every 2 weeks after suture removal to evaluate progress 
  • Please use an Elizabethan Collar on your pet after bandage removal to prevent licking of the incision as this can cause infections 
  • Tegaderm clear bandage can be left on until it falls off or at suture removal 
  • Start Keflex Clindamycin Baytril Ciprofloxin tonight and give for 14 days 
  • Start Rimadyl Metacam Previcox pain medication tonight and give for 14 days (refill if limp worsens after running out for as long as it is helping) 
  • Start Tramadol pain medication tonight and give for 3-5 days (refill if limp worsens after running out for as long as it is helping) 
  • Start Dasuquin, Cosequin, or Glycoflex (joint supplement) and cold water Omega 3 Fish Oils (Wellactin) ASAP and use for 3 months to minimize osteoarthritis during healing for life due to underlying osteoarthritis go slow the progression over time 
  • Weight loss is very important for healing and to minimize risk of injuring the repaired hip joint.