Frequently asked questions
Does my dog need orthopedic surgery?
With the exception of rare cases, it is unlikely that I will say “yes” to this question. Instead, I will re-phrase the question, “Will my dog benefit from surgery?” We will then discuss the pros and cons of surgical versus non-surgical management. In some situations, this leads to a clear decision to either pursue surgery or not, and in other cases it is not entirely clear which is the “better” choice for an individual patient.
Why do you refer to physical therapy with dogs as “physical rehabilitation”?
Technically it is illegal to perform physical therapy for animals. This seems to be a matter of semantics because it is highly improbable that anyone will be prosecuted for saying they perform physical therapy for dogs, but the appropriate terminology for animals is physical rehabilitation.
Do I need to do physical rehabilitation for my dog following surgery?
Most dogs, like people, have improved function and outcomes if they perform physical rehabilitation. The primary goals of such rehabilitation are to improve range of motion, muscle mass, strength, and comfort. The single most important modality to achieve this objective is controlled, therapeutic exercise that meets the objectives of improving range of motion, strength, coordination, and comfort. As in people, exercise is most beneficial when performed routinely. Accordingly, many dogs can do very well if their owner performs controlled, therapeutic exercise with them routinely. Often, having dedicated physical rehabilitation sessions are valuable in showing owners what exercise to do with their animals at home. With that said, and as an analogy, many people don’t need a gym membership to be fit, flexible, and strong. Similarly, if a dog is exercised routinely and appropriately at home, performing dedicated physical rehabilitation at a rehabilitation center is not always necessary to obtaining a good outcome. However, other people greatly benefit from having a designated space, time, and instruction for exercise. In summary, the need for physical rehabilitation is often dependent on the individual dog, their medical condition, and the owner’s ability to perform rehabilitation exercises with them.
“I just don’t want my dog to be in pain.”
Understandably, the single most common statement made by dog owners is “I just don’t want my dog to be in pain.” Unfortunately, pain is difficult to interpret in dogs because they don’t complain, which is one of the reasons we love them as companions. As a result, many owners presume that their dogs are not in pain if they “don’t whine” or “seem happy”. However, because dogs do not often express pain or discomfort in ways that people are attune to, many owners falsely interpret them as being pain-free even when they are limping or sore. I typically encourage owners to focus on what they can evaluate more easily: function. If a dog is lame or limps it is likely the dog has pain. It is rare that limping, lameness, or stiffness are entirely mechanical in nature and unrelated to pain. In turn, if we improve or resolve the limping or lameness then it is highly probable that we have greatly alleviated or remedied the pain the dog feels.
What is the difference between sedation and anesthesia?
Sedation involves providing your dog with medication(s) that calms the dog and alleviates pain. When we perform sedation in the hospital, we frequently provide one injection that is a an opioid similar to morphine and that alleviates pain, and another medication that functions as a sedative. Often times the use of such protocol is highly beneficial when performing brief procedures in a patient that is either stressed/anxious or painful. As one example, if a patient has terribly painful hips attributable to osteoarthritis of the hips, sometimes it can be uncomfortable positioning the dog for X-rays. Providing this sedation protocol can alleviate their pain and relax them, making the experience less stressful for them and facilitating the acquisition of better images.
Importantly, dogs that are sedated are not anesthetized and they are typically reversed from their sedation and are ready to leave the hospital shortly (less than 20 minutes) following their sedation. Risk of serious complications or adverse outcomes associated with sedation are extremely unlikely in healthy dogs.
General anesthesia is more involved than sedation. Patients are anesthetized for surgical procedures and the anticipated period of general anesthesia is longer than the aforementioned use of sedation for minor tasks such as obtaining radiographs (x-rays). Fortunately, the risk of complications in healthy dogs undergoing elective orthopedic procedures is very low.
Will my dog need to be sedated for it’s diagnostics or procedure?
This depends upon your dog’s particular situation and the procedure being discussed. In most cases we acquire radiographs (x-rays) without sedating the patient. However, if a patient is particularly painful or anxious we may advise using the aforementioned sedation protocol to alleviate their pain and anxiety and make the process easier on them.
I typically sedate patients briefly for CT scan, arthrocentesis (collection of joint fluid for diagnostic purposes), or injecting medications into joints.
Do I need to be concerned about anesthesia?
This is a very reasonable question that is individual-specific and certainly there is always some risk associated with general anesthesia. However, risk of anesthetic-related complications or adverse events associated with general anesthesia for elective orthopedic surgery in healthy dogs and cats is very low. This includes if the dogs are somewhat older. For example, if a dog is 11 years old, but healthy, with no other medical problems, no heart murmur or arrhythmia, and no abnormalities on routine pre-anesthetic bloodwork, then it is highly likely this patient will do well with general anesthesia.