By Dr.

Heather Kovac

The Patient
Bella, a 1 year old intact female English Bulldog, came to see me as an

emergency. She had been placed in an upstairs bedroom with a sliding glass

door while a lawn maintenance company was working at the home. She

somehow managed to open the slider, go out onto the balcony, squeeze

through the railing, and jumped off the second story balcony landing on the

concrete in the backyard. Her owner was home at the time and heard her land

with a thud on the ground. She immediately scooped her up and brought her

to the hospital.

The Case
On examination, she was bright and alert, was not bleeding anywhere, was

breathing normally, but was unable to place any weight on her back right leg.

She was holding it under her body in a strange way and was refusing to stand
or walk. She could stand with help and was using the left rear leg just fine, but

not the right. There was no obvious external injury to the limb and she was

not even acting painful when I palpated her leg. But, she was unwilling to

bend it properly. I recommended taking some xrays of her hips and rear legs

to determine the cause of her lameness. The xray showed that her right hip

was dislocated, or luxated out of joint.

As you can see on the xray, the left hip is in the proper position with the head

of the femur sitting in the acetabular cup but the right one is located in a

craniodorsal position outside the acetabular cup. The hip joint is a ball and
socket joint and swings freely forward and back in the joint. If out of socket,

the muscles prevent the leg from moving properly. I recommended that we

sedate Bella heavily in order for me to replace the leg into its proper position.

This is called a "closed reduction" of a luxation. This means, there is no true

surgery needed; no incision is made. The sedation is necessary to relieve pain

but also to relax the muscles to allow the manipulation of the joint. The owner

authorized the procedure.

The Treatment Plan

I administered an injectable sedative as well as an opioid analgesic. Once

Bella was fully relaxed, I was able to carefully manipulate the leg and "pop" it

back into place. I took another xray to confirm proper positioning and then

took the leg through a passive range of motion for about 10 minutes to fully

ensure a good connection of the ball and socket and to further relax the

muscles that had been out of alignment. If a joint is out of place for more

than 12 hours, it is nearly impossible to replace the joint in this fashion. The

longer it is out of place, the more chance that the muscles will contract in that

new position and not allow for reduction. This is when an "open reduction"

becomes necessary. This involves general anesthesia, a deep incision into

the joint, manual replacement of the bones, or even a surgery to remove the

head of the femur altogether (called an FHO). Luckily, Bella's owner had

rushed her to the hospital within a matter of minutes so her leg cooperated
with me. Once I was confident her leg was once again in the right place, I

reversed the sedation and woke her up.

The Outcome
I instructed the owner to keep Bella confined and not allow for any running,

jumping, rough housing, or stair climbing for several weeks. Once a joint is

out of place, it takes time for all the soft tissues in the area to heal and there is

a chance it could reluxate if she became too active. I prescribed a pain

medication as well as a sedative to use as needed if she was being too

rambunctious. I tried to explain to Bella that dogs don't have wings and she
shouldn't be jumping off of second story balconies. I'm not sure she

understood me but her owner now knows the bedroom is not a safe place for

Bella, the flying dog.

The Drake Center for Veterinary Care is an AAHA-accredited animal hospital

located in Encinitas, CA. The Drake Center loves being a source of information

for all pet owners across the country; however, if you have any questions

regarding pet care and do not live in Encinitas, CA or surrounding cities, we

encourage you to contact your local veterinarian.