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To Cut or Not to Cut: Apparent Pain & Lameness in a Puppy

Jean K. Reichle, DVM, MS, DACVR, Animal Specialty & Emergency Center, West Los Angeles, California


|June 2013|Web-Exclusive

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10-month-old, 28-kg, castrated golden retriever. 


Injured 3 weeks prior while playing with another dog; lameness worsened 3 days ago.

Related Article: To Cut or Not to Cut: Tarsal Injury in a Dog

Physical Examination

Grade 3/4 lameness in the left pelvic limb; apparent pain on extension of left hip.

Clinician's Brief

Pelvic Radiographs

Patient was sedated with IV ketamine at 150 mg and diazepam at 7.5 mg to obtain high-quality radiographic images. A traditional VD extended hip view (Figure 1) showed moderate subluxation of the left coxofemoral joint. The left femoral capital physis is not clearly seen in comparison to the right.

Related Article: To Cut or Not to Cut: Foreign Body in a Dog

Would you send this dog to surgery based on this information?

The history of trauma and acute onset of severe lameness, with radiographic asymmetry between the left and right femoral capital physes, prompted the veterinarian to request an additional VD flexed hip (“frog-legged”) view (Figure 2), which showed separation and abnormal alignment of the left femoral neck (arrowhead) relative to the respective femoral head (arrow).

Clinician's Brief

Radiographic Diagnosis

Left femoral capital physeal fracture.  


This patient needs surgery; femoral head and neck ostectomy (FHO) or total hip replacement (THR) were discussed with the owner.

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