Hips and elbows

Clodagh

Clodagh

Rage, rage, against the dying of the light.
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GA or sedation? The price difference is negligible. My vets say GA safer for the dog as there’s so much placing and they have to be roped or weighted to hold their legs in position.
I’m leaning towards just going with the GA as it’s much closer for me and I like and trust my vets. But, although they do quite a lot of these apparently, they are not specialists like the sedation people.
 
Pearlsasinger said:
I think the difference is probably that your local vet prefers GA because they are not so experienced in the procedure, while the experts are comfortable with sedation. Not sure which I would choose tbh. How far away is the specialist?
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I’m not sure it’s so straightforward. I spoke to someone else that has all their dogs done and she would only ever use GA. Sedation seems a bigger plus to people as it’s cheaper. But only £50 cheaper and the sedation place is an hour and a half away. I hoped people on here who have had it done might be able to help.
 
We had our Lab’s hips x-rayed recently prior to an FHO op. Our vets said they’d probably try with sedation initially, as they know her well and she’s super calm and compliant, but that it would probably end up as a GA because a lot of the positions they need to get them in are pretty uncomfortable. We told them to go with whatever they thought was best, and she ended up being done under GA.
 
I've always had them done under sedation in recent years, but my vet was an expert who people travelled to from all over the country. He could predict a score within a couple of the actual BVA scores, very quick, dog sedated, I had a cup of tea while x rayed , we discussed plates then dog woken up and we went home, maximum of an hour But for me it is more important to have a vet who is experienced regardless of GA or sedation. My vet has now retired but luckily there is another leading ortho guy local and my girl is booked in there for June, again he uses sedation and predicts score. Reasonable too, £400 inclusive of submission to bva for hips and elbows.

Edited to add, when I say sedation, the dog isn't awake, it is just a very light dose, so only out for a short time. Not like the sedation you give a horse for say a dentist.
 
Look at it more long term, if it’s uncomfortable/painful for the dog and they’re aware of it it may affect their relationship with the vet. If they’re knocked out they won’t know what’s going on. Doddi was sedated, she went to Ipplepen (I think) to whoever out vets recommended.
 
GA gives you the best chance for good positioning as you tend to get better muscle relaxation & your dog is much less likely to wake up if you overstimulate them by moving them (certain sedation protocols will also give good muscle relaxation but if they fight it then it makes it difficult to get them in the right position). It’s also considered very poor practice within the profession to use ties on a sedated patient as there is a much higher risk of them suddenly starting to wake up whilst you’re out of the room taking the image. If they do that whilst their hips are tied out & they panic and can’t get free then they’re at risk of serious injury. (Yes even if tied to sandbags rather than a solid object like the table) GA is also considered safer in some ways than deep sedation as you’ve got a secure airway which you should be able to maintain even if the patient vomits (if they vomit under sedation and someone doesn’t immediately notice it’s much higher risk in terms of aspiration or airway occlusion… still not a good thing to happen under GA) I can understand in theory how someone very experienced may be able to get the views quick enough to do under sedation (& for sure someone who does a lot of scoring is going to do the job faster than someone who doesn’t) but I’d have my concerns about what drug doses they may be having to use to achieve this, how they achieve this in terms of positioning aids / whether they’re following best practice in terms of what is safest for the patient (or if they’re one of the few who compromise their own safety instead by staying in the room & holding the patient themselves. From a patient safety POV this is not unsafe for the dog in any way as obviously a human is able to loosen their grip / let go if required but from a human safety POV not so much & again it’s frowned upon outside of life & death type situations & may even result in disciplinary action in some places)
 
Pretty much as Boulty said but to reiterate most practices I worked for that offered X-rays for hip and elbow scoring would only do them under GA. The patient is more manoeuvrable, you can use ties and you have more time. It’s considered safer in some respects and tends to yield better radiographs in general.

As for hip and elbow scoring yes it can be difficult to get the correct angles. But IME radiographs that were not good enough to be scored were rejected rather than the dog being scored poorly.
 
Ty
SOS said:
As for hip and elbow scoring yes it can be difficult to get the correct angles. But IME radiographs that were not good enough to be scored were rejected rather than the dog being scored poorly.
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Thank you, and Boulty too. My vets said that about rejections.
 
I do see the point about GA, but I would say that majority of experienced breeders/exhibitors (of all breeds that are x rayed) use sedation, and in fact go to only a handful of practices throughout the UK who are highly experienced in scoring. These practices are usually booked up well in advance, the earliest you can get an appointment with the vet I am using is August I believe at the moment.
 
Ga unless your at a practice that scores constantly.
The hip score straight legged position is uncomfortable even when the hips are perfect, under sedation with somewhere that doesn't do them often can sometimes mean lots of takes to get it right...if the dogs fights at all it's hard to do and more likely they will end up sore. They may be semiaware of what's going on under sedation so it can be hit and miss on compliance depending on the dog.
The practices that do it daily are a bit different as they are better at getting the line up first go simply due to the experience level.

Under ga theres no pain,everything's relaxed and the dog doesn't fight and end up more uncomfortable and it's usually easier to get better images.

Both carry risk of course. But a ga at least the airway is secured and there's usually an iv in if there's any adverse reactions.
If it's a brachy dog where I work we straight up won't do sedation anymore for elective procedures due to the risks involved.
It's not inherently safer then a ga. It's quicker and cheaper.
 
I had Zak's hips x rayed but the vet was clueless, overexposed the plates. I wasn't planning on using him for breeding, just wanted a decent x ray to assess the situation and see what to do next when we realised he had HD. I wish I'd gone to a specialist.
 
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