D. E. Larsen, DVM
Dr. Jensen carefully placed Blue on the exam table. Blue was a growing Bluetick Coonhound. He was about 5 months old. Dr. Jensen had acquired him to replace one of his border collies that he had lost a few months ago.
“Good morning, Mark,” I said as I entered the exam room. “What’s up with Blue this morning?”
“I was driving out to the cows in the far pasture with the dogs in the back of the pickup,” Mark said. “I wasn’t going very fast, and this damn little cottontail darts across the road and into the grass. Blue makes a dive for the bunny and does about three cartwheels when he hits the ground. So he comes up carrying a hind leg. My guess is he either blew out a knee or injured his hip.”
“Did you get any x-rays?” I asked with a smile.
“I know. All you need is someone coming in with all the answers before you even get a look at the patient.”
“Let’s get at this guy. It looks like he has been growing since his last visit,” I said. Which leg is he carrying?”
“It’s his right hind leg,” Mark said. “I haven’t seen him touch it down, so it must hurt.”
“You have to watch it with those observations,” I said. “Someone might think you are a real doctor.”
Starting at Blue’s toes, I went over every bone in his foot and hock. Then, after palpating the lower leg bones, I came to his stifle.
I carefully slipped my left hand under Blue’s stifle and elevated it slightly. Blue didn’t say anything, but he lifted his head off the table and looked at me. I took his stifle in both hands and tested for a ligament tear.
“His knee is pretty stable,” I said. “It must be his hip.”
With my left hand on his hip, I moved his leg forward and back. I could feel some grinding deep in the hip joint.
“There is some crepitus in his hip,” I said. “We need to get an x-ray, but my guess is he fractured his femoral head. Most likely at the growth plate.”
“Let’s get a picture, then there will be something concrete we can discuss. I need to sedate to get a good x-ray. Do you have something to do in town, or do you want to just check back later?”
“I will run over to Mollie’s and get a cup of coffee and read the newspaper,” Mark said. “How much time do you need?”
“A half an hour should be fine,” I said. “In the off chance that you get lucky, and this is just a luxated hip, I will go ahead and replace the hip while he is sedated.”
“But you seem pretty sure this is a fracture,” Mark said.
“Blue is five months old. The growth plate in the femoral head doesn’t close until 6 months. It takes less force to fracture the grown plate than to luxate the hip. So at this age, it is almost always a fracture.”
“Well, that is quite a picture, and it makes it pretty obvious,” Mark said as I put the x-ray on the viewer. “What are my options?”
“Some will say that a surgical repair is the best option, but I am not sure that I agree with that opinion,” I said. “Actually, it is a simple repair. You just reduce the misalignment and place a couple of small pins to hold in place.”
“Why the hesitancy then?” Mark asked.
“That little piece of bone that is knocked off the femoral head has a precarious blood supply. It is an easy repair, and it heals well, then in a year or two, you end up with avascular necrosis. Sort of like Bo Jackson.”
“That doesn’t sound good. Then you are looking at a new hip, I guess.”
“At this point in time, nobody that I am aware of is hip replacements in the dog,” I said. “What you end up with is a femoral head ostectomy. So I am beginning to think that we should just be doing the ostectomy from the get-go.”
“An ostectomy! You just take the femoral head off and throw it away? That sounds pretty drastic.”
“The dog has four legs. The ostectomy removes the bone to bone contact and actually works pretty good. Not perfect, but pretty good. You will always see a difference, but your neighbor never will notice.”
“What about a duck cast?” Mark asked. “That is what they do with kids.”
I gave some thought to that possibility. However, I had no idea if it would work, and I had no idea how the pup would tolerate it.
“To be honest, I doubt that it is written up anywhere,” I said.
“I don’t want to get a lot of money into this pup,” Mark said. “He might not work out well for me on the ranch. I would like to try a duck cast.”
“One problem is Blue is his rapid growth phase. Six weeks might not be a big deal in growth in a five-year-old kid, but it is a big deal in a five-month-old hound, and a cast will become constrictive. But with a little thought, I could probably fashion a spica splint that holds that right hind leg up. We might be able to make it work. And the good thing is that if it fails, we can always resort to the ostectomy.”
“Do you want me to leave Blue here now?” Mark asked.
“Yes, I should be able to get this done and have ready to go home this afternoon,” I said. “You can plan to pick him up around four or five.”
It took a couple of tries, but I could get the hip in place and fashion a splint to hold his right hind leg up at a near ninety-degree angle and still be able to poop and pee. He looked a little funny, but I think it might just work.
Dr. Jensen was in the office right at four to pick up Blue.
“He looks a little funny, but this might just work,” I said. “You need to keep him restricted, and this splint needs to be clean and dry at all times.”
“I think his buddies are going to laugh at him,” Mark said.
“I want to check him every week to make sure we don’t have to adjust this for his growth,” I said. “I am really interested to see what kind of results we get.”
Six weeks passed rapidly, and Blue was on the x-ray table with the splint removed. The hip had healed beautifully, and Blue was happy to have four legs under him as I lead him out front to see Mark, who was waiting anxiously.
“The x-ray looks great,” I said. “Blue should be good to go. Just take it easy for a few weeks until he has all the strength back in that leg.”
“My only problem will be keeping him in the back of the pickup when the rabbits are scurrying around in the pasture,” Mark said.
“I can tell you the real problem that you have,” I said. “You can’t make a cow dog out of a hound dog. These dogs have memories from their grandfathers buried deep in their DNA, and when that rabbit ran across the road in front of him, Blue knew he was a hound, and he gave chase.”
“Well, you might right, Doc,” Mark said. “But he is just going to have to learn his place. And thanks, Doc. Blue thanks you also.”
I followed Blue’s status for a couple of years before Dr. Jensen decided to change his status and concentrate more on his doctoring and less on the cattle market. Blue was perfectly normal on his hip as long I knew him.
Photo by Cynthia Smith on Unsplash