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Date:   09 July, 2010  
Focus: Small animals - dogs, cats, hamsters, guinea pigs & rabbits.
 
HIP DISLOCATION IN A RABBIT
Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS
Saturday
09 July, 2010
toapayohvets.com 
Be Kind To Pets
Veterinary Education
Project 2010-0129
This 24-year-old veterinary student with bronze yellow hair and a left ear stud towered one head over Auntie Margaret who used to help his mum to change his diapers when he was an infant. He hugged her and said goodbye after the dinner. He would be going back to Perth for his second session of the year veterinary undergraduate studies in Murdoch University tomorrow Sunday, July 4, 2010.

Auntie Margaret had been feeling pain in her left leg for many years and had seen many doctors. She could not walk for long now.  She even went to the Chinese TCM doctors and took all sorts of multi-vitamins, herbal medicine and drugs. Yet her pain persisted over the years. One doctor diagnosed spinal problems. Another thought it was due to a nerve disorder. X-rays and scans were done over the last ten years. The pain persisted.

"What's the diagnosis?" I asked Auntie Margaret at the dinner. She could not put a name to it. "One doctor asked if I had fallen down when I was young," she told me. "But I don't remember any fall."  


"What did X-rays and scans show?" I asked Auntie Margaret who is in her late 50s. "Is it hip joint arthritis?" The joy of daily walks with her husband Uncle Francis was no more nowadays. She was advised not to squat nor jump. Drugs stop her pain for some time and then the pain would recur.  From her description that the X-rays show a normal right hip joint with "rounded (joint) space" compared to the left hip joint which had "rough" edges, I deduced that she had a left hip dislocation not diagnosed early. Now, the femoral head had rubbed against the acetabulum and had shown arthritic changes. I had not the chance to see her X-ray but from her description I could guess that she has a chronic left hip joint arthritis.  Has she got a shallow acetabulum and therefore had dislocated her right hip after some exertion?   


"What treatment did the doctors propose?" I asked. The student's mum, Julia had told me that Auntie Margaret's doctor had proposed sticking a metallic pin into the bone but that pin had to be removed after 10 years. Auntie Margaret did not fancy some metal sticking inside her bone. So I asked Auntie Margaret what was the doctor's advice during the farewell dinner yesterday, Friday, June 2, 2010 at a Toa Payoh Eating house selling steaks and fried chicken which would shoot Uncle Francis' and Julia's blood cholesterol through the roof. Both are not bothered with the Health Ministry's campaign to lead a healthy life-style by eating more vegetables and no fried food. Steaks and fried chicken are too good to resist. I did not order my steak as the others did.  I try to restrain myself and I can assure you that the temptation to eat steak once in a few months was just too much to resist. The spirit is willing but the flesh is weak as I see Uncle Francis finishing all his deep fried chicken wings and Julia enjoying her steak. 

Auntie Margaret had resigned to her fate of growing old with pain. Therefore getting joint pains was due to old age. She said: "The doctor says it is too late for laser treatment now. He wants me to rub a gel." To me, it seems that this not a treatment.  How would gel help?  Auntie Margaret can walk but with pain. I don't know whether there is a cure for her. What is the medical name of the diagnosis actually?  She could not tell me. Coincidentally, I had just treated a rabbit with an equivalent hip dislocation pain problem like Auntie Margaret.

rabbit 5 months, dislocated left hip, sling method to hold the hip in, toapayohvets, singaporeIn the rabbit with hip dislocations, the intense pain stopped the rabbit from eating or drinking normally. I put the rabbit under isoflurane gas anaesthesia to manipulate the left femoral head back into the hip joint. Without the anaesthesia, the rabbit just would be stressed out by pain and may just die of fright.  Under anaesthesia, the joint was clicked back. When the rabbit woke up after slinging the left leg up, the rabbit eats and drinks.

In this case, I had slung the rabbit's left leg up to put the right femur back into the hip joint as requested by the owner who must have had done lots of research in the internet. He did not want surgery (cut off the femoral head) and so came to me to get the sling conservative treatment.  His rabbit was prescribed painkillers for 4 days. "It even hops onto the grate to pee and poop too", the young man who is a student told me 4 days later That was great news.

As the left hip was fully dislocated, the chances of success are slim, I told the young man who really cared about the rabbit. I think somebody had sat on the rabbit and dislocated the hip.  I have successes in many cases of partial dislocation in dogs and cats. One I click the femoral head back into the hip joint and enforce cage rest for many days, the dog or cat will become normal. The same applies to rabbits too. But this rabbit had totally luxated the left hip. So, the owner will need to come for weekly review, if he ever does.     

In this rabbit's case, X-rays are useful and he had them done at another practice. Even without X-ray, the vet just extend the two hind feet backwards and compare the length of the hind legs. The badly dislocated left hip is considerably shorter. Also, the femoral head can be palpated with fingers. Of course, X-rays comfort the owner.

I hope this 5-month-old rabbit will recover back to normal unlike Auntie Margaret. If only she was diagnosed early as she had seen too many doctors over the years without a diagnosis.  For this rabbit, the dislocation was less than 7 days and if it recovers fully, it will be hopping on all 4 legs.
 
rabbit 5 months, dislocated left hip, sling method to hold the hip in, toapayohvets, singapore rabbit 5 months, dislocated left hip, sling method to hold the hip in, toapayohvets, singapore rabbit 5 months, dislocated left hip, sling method to hold the hip in, toapayohvets, singapore
Gas mask isoflurane anaesthesia prevents pain during the manipulation of the hip joint. The left hind leg is much shorter than the right hind leg Under anaesthesia, the left femoral head is clicked back into the hip joint and the sling is applied The rabbit was able to eat and drink after being given pain-killer and immobilising the left hip with the sling.

I hope that muscle inflammation around the left hip had not been too severe and that the femoral head would go back into the hip. I doubt that this rabbit would be fully cured as the femoral head had come out entirely. It would suffer a life-time of pain like Auntie Margaret but would not be able to talk about it. But there are miracles as the rabbit is young. When there is life, there is hope.
morning sunshine toa payoh vets singapore
For more information on rabbit's hip dislocation, see the following:
http://www.fuzzy-rabbit.com/fuzzyleg.htm
http://homepage.mac.com/mattocks/morfz/dislocated.html
http://www.rabbit.org/journal/2-7/hop.html

 

 
July 9, 2010. The following is from: http://www.fuzzy-rabbit.com/phpBB2/posting.php?mode=quote&p=111232

My 7 year old english angora, Tiffany, got a dislocated hip after taking her to a groomer. Of course the groomer denied anything happened. This happened 3 weeks ago, my vet tried but was unsuccessful to put her hip back in place. We did the bandage thing but she will not keep it on for more than a couple of days.

My vet said it may be doing more harm than good since the bandage comes loose then holds her leg in the wrong position, plus the bandage made her miserable as she tried to move. She tries to move around, by pushing her feet while she is laying on her side (she is getting quite good at it) but I know this is not a good way for her to live.

When she was at the vet a week ago we were hopeful she would recover on her own once her bones started to heal and would be able to move around with little discomfort, I have been working with her, trying to keep her leg underneath her in a natural position but it is getting harder and harder for her leg to bend. My vet said that surgery is probably going to be her only option at this point. Surgery to remove the tip of the femur to eliminate any pain.

I did some research on it and it looks to be highly successful. Unfortunately it is not cheap, US$700! I went ahead and scheduled her surgery for the 19th of July, but I am hoping to keep working with her and maybe she will be using her leg by then and we can cancel the surgery. I hope your little one can make it without the surgery. What kind of a bandage are you using? My vet called it a "sling" and was made of this stretchy bandage material, but it did not take long for my bunny to kick it off.

I can't reply to the above writer as the administrators of the forum says:
 
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A successful case of sling bandage is shown below:

rabbit 5 months, left dislocated hip reduced by Day 7 using sticky sling bandage, toapayohvets, singapore rabbit 5 months, left dislocated hip reduced by Day 7 using sticky sling bandage, toapayohvets, singapore rabbit 5 months, left dislocated hip reduced by Day 7 using sticky sling bandage, toapayohvets, singapore
rabbit 5 months, left dislocated hip reduced by Day 7 using sticky sling bandage, toapayohvets, singapore rabbit 5 months, left dislocated hip reduced by Day 7 using sticky sling bandage, toapayohvets, singapore Use a sticky sling bandage to prevent the rabbit biting it off. Use oral NSAID pain-killers for at least 7 days

More info at: Rabbits
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