A Tale of Two Clients

Dr. Phil Zeltzman is a mobile, board-certified surgeon in Allentown, PA. Find him online at www.DrPhilZeltzman.com. He is the co-author of “Walk a Hound, Lose a Pound” (www.WalkaHound.com).

Katie Kegerise, a Certified Veterinary Technician in Reading, PA, contributed to this article.

Daisy, a fluffy 8 month old Shih Tzu, and Pip, a cute 3 month old Jack Russell terrier, had one thing in common: they had a hip condition that required surgery on the same day. Their owners also had one thing in common: they clearly loved their pups. The unfortunate difference between them? One followed directions, and the other didn't.

It was a fascinating experience for me. Two weeks prior, on the same day, we performed surgery on the puppies’ hips. The surgery is a salvage procedure called a Femoral Head Ostectomy (FHO) which entails removing the ball of the hip joint. The reason for the procedure was different: Daisy had a congenital defect called Legg-Perthes disease, where the hip basically crumbles. Pip had a fracture of the hip after a bad fall. But although the reason behind their injuries was different, we had the same discussion during the consultation, performed the same surgery in the same joint, and provided the same physical therapy protocol explained during similar discharge instructions. Are you starting to see the picture?

Daisy's owner followed our instructions to the letter. She kept Daisy confined, kept the plastic cone (E-collar) on, around the clock, to protect the stitches, she prevented Daisy from jumping up onto people or furniture by confining her strictly, and she stuck to the physical therapy guidelines. She was able to stretch the hip 20 times 3 times daily. Two weeks after surgery, Daisy had a very nice incision, a surprisingly good and pain free range of motion…and a happy owner.

Pip's recovery, however, did not go quite as smoothly. His owner felt bad keeping him confined after surgery because "he looked so sad". So she let him have free range of the house. He constantly jumped on and off the couch or the bed. He was allowed to run freely (but on 3 legs) in the yard with his canine “sister.” The owner also didn't keep the E-collar on Pip because “he was constantly running into walls, ankles and furniture.” Physical therapy didn't go well either. Pip's owner gave up easily when her 3 month old puppy squirmed one or two times too many. So she reported doing “1 or 2 stretches every once in a while.” Remember, Daisy could do 20 reps 3 times daily!

Two weeks after surgery, Pip had an irritated incision missing its stitches, a severe limp, a painful hip, and a poor range of motion that might cause problems for the rest of his life.

So we had a little talk. I felt bad because I was wondering if we should have used a different approach to better explain things to Pip’s owner. Yet at the time, she looks like she understood everything we explained, and she implied that she would follow our instructions.

She also felt bad because she realized the negative consequences of her behavior. She promised that she would get back on track. I hope she does, for Pip’s sake…

It all boils down to compliance. When a vet gives specific instructions about your pet’s care, it's really in your best interest to follow them. You may feel bad about confining your pet, or keeping an E-collar on, or holding them still for physical therapy when they try to wiggle away, but the long-term benefits far outweigh the short-term inconvenience.

The best way to help your pet, is to work with your vet as a team.

 

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