Capers: Juvenile Pubic Symphysiodesis

Capers is a super happy 5 months young Labradoodle puppy. Recently, his family noticed he was bunny hopping (taking short, hopping steps) more frequently, especially during faster gaits. There was also stiffness in his hind limbs.

X-rays were taken and Capers was diagnosed with mild hip dysplasia. A surgical procedure called Juvenile Pubic Symphysiodesis (JPS) is recommended to prevent the development of painful arthritic hip degeneration. Treated early, Capers can continue to live an active and full life!

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“It was mixed emotions for us. Our perfect little puppy being unwell so early. The decision to proceed with surgery was easy. I was open to whatever was needed to give Capers many many great years ahead.”

what is hip dysplasia?

In a normal hip joint, the femoral head (ball) fits snugly into the acetabulum (socket). In dogs with hip dysplasia, there is abnormal looseness between the ball and socket. When these two structures do not fit smoothly, the femoral head slips in and out of the joint (subluxation). Over time, the bones become deformed, resulting in inflammation, lameness, stiffness and pain.

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Ref: vetsurgerycentral.com

how is hip dysplasia diagnosed?

A puppy’s hip dysplasia is usually detected during the second or third vaccination appointment when the vet performs a physical examination and gait evaluation. X-rays are necessary. In order to get the best diagnostic view, the dog is sedated or anaesthetised for proper positioning with the hips distracted (femoral heads “distracted” or pulled out of the acetabula as far as they will go) so that any looseness between the ball and socket can be seen.

Symptoms of hip dysplasia 

  • Bunny hopping
  • Stiffness
  • Limping
  • Swaying gait
  • Difficulty getting up and lying down
  • Reluctance to run, jump or climb stairs/slopes
  • Shifting of weight to forelimbs

DID MY PUPPY GET HIP DYSPLASIA FROM HIS PARENTS?

Genetics do play a part. Puppies diagnosed with hip dysplasia should be neutered or spayed to prevent the breeding of dogs who carry the gene for hip dysplasia. Dogs used for breeding should have their hips evaluated by vets.

Although there is a genetic influence, hip dysplasia can be caused by other factors:

  • Body weight – Overweight puppies and larger breeds who grow rapidly are at greater risk of developing hip dysplasia.
  • Nutrition – Puppies must receive good nutrition to grow but they should not be overweight. Speak with your vet about proper nutrition and supplements.
  • Exercise – Avoid over exercising your puppy and high impact activities like jumping, leaping for balls, running up and down the stairs. Take your pup for a few short walks daily instead of one long walk/run. 
  • Environment – Puppies who frequently walk on slippery surfaces or have access to stairs at a very young age have a higher risk of hip dysplasia.

What can be done?

* Early intervention is critical. If the diagnosis is made at an early age, a minimally invasive surgery known as Juvenile Pubic Symphysiodesis (JPS) is recommended.

If the diagnosis is made at a later stage, Triple Pelvic Osteotomy (cutting the pelvic bone in three places and rotating the segments to improve coverage of the ball) or total hip replacement surgery is required. These are major surgical procedures. If surgery is not an option, the dog may need lifelong pain relief medication.

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Puppies with hip dysplasia may have weak upper thighs that lack muscle mass.  They may also take short, hopping steps especially when running fast.

WHAT IS JPS surgery?

In JPS surgery, the goal is to achieve a better congruency (fit) of ball and socket. This is done by “fusing” the growth plate of the pubic bone to limit the growth. The hip socket is forced to rotate over the ball (femoral head) as it grows.

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A small incision is made between the hind limbs to expose the pubic bone of the pelvis.

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Image 1: The growth plate is cauterised (burn with electrocautery) to stop this part of the pelvis from growing. Image 2: As the remaining parts of the pelvis continue to grow, the hip sockets rotate over the balls (femoral head) resulting in a more stable hip & less chance of future arthritis. (Ref: vetsurgerycentral.com)

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Dr Patrick Maguire, Veterinary Specialist in Small Animal Surgery, Mount Pleasant Vet Centre (Gelenggang) performed the surgery on Capers. JPS is more successful when there is significant potential for growth & thus, the opportunity to alter the hip growth. It is ideally performed at 16 weeks & no later than 20 weeks of age.

should my puppy be neutered at the same time?

Puppies should be spayed or neutered at the same time as JPS surgery, to prevent the breeding of dogs that carry the genes for hip dysplasia.

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Capers waking up from surgery. Exercise is restricted & we will see him in 2 weeks’ time for review & suture removal.

Snag The 3-Legged Singapore Special

Look for the good in people and you will surely find it.

Snag was rescued by the folks of Mount Pleasant Animal Clinic (East). He was limping along a street, dragging a snare caught tightly around his leg.

Snag may have lost a limb. But gained a big family at Mount Pleasant East!

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When Snag was brought back to Mount Pleasant Animal Clinic (East), he was very thin, forlorn & didn’t want any human interaction. But he would allow the team to treat his wound. Just a gentle ol’ soul, lost & scared in his new environment.

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Snag managed to get away only because he gnawed off the other end of the snare. The authorities have been informed.

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The wire had cut right through the flesh & muscle in Snag’s leg.

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The team tried to save Snag’s leg by managing the wound but it was already badly infected. Gangrene had set in. Snag also has heartworms & is currently on medication for a “slow kill” treatment.

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Snag’s badly infected leg had to be amputated. Amputation may also be recommended for dogs with cancer (e.g. osteosarcoma), severe trauma (e.g. multiple fractures) or birth defects.

“We amputated Snag’s leg at the proximal humerus (just below the shoulder joint). If he goes to an animal sanctuary or somewhere outdoors, there is the scapula bone to protect his chest from trauma.” ~ Dr Audrey Loi

As in humans, dogs can be fitted with a prosthetic leg following an amputation. An adequate stump is needed to fit the prosthesis. However, this procedure is not suitable for all pets. It also requires diligent care to ensure the remaining stump is not traumatised during daily activities or subjected to pressure sores.

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A few weeks later, Snag (with Maya) is looking happier & healthier!

Dogs bear more than 50% of body weight on their front legs. Snag may need more time to adjust, balance & move around, as compared to rear limb amputees. Keeping him trim will put less stress on the joints of his remaining three limbs. We will follow up on Snag’s progress and update on his future plans!

We took the opportunity to speak with Lillian Wang from Three Legs Good about her experience with disabled dogs. Three Legs Good is an animal welfare group that focuses on raising awareness, education, fund-raising for medical needs and finding homes for injured and disabled dogs. 

“From my experience, dogs who have gone through an amputation are up on their feet remarkably quickly. Of course, it would be easier for younger and healthy dogs. Usually it is the humans who have a problem accepting the amputation. The dogs are happy they are no longer in pain and can get on with their lives!” ~ Lillian

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Snag with Toby. Toby & Maya were rescued as puppies 2 years ago. Maya has seizures which makes it tough for her to find a home. Both of them are happy residents at Mount Pleasant Animal Clinic (East)!

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Snag with Marc the Dachshund who was given up by a breeder because he was oversized & not ideal for sale. When you are ready for a pet, do consider adoption.

Poppy is another Singapore Special tripawd who lost her forelimb to osteosarcoma (bone cancer).

Poppy is another Singapore Special tripawd who lost her forelimb to osteosarcoma (bone cancer).

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Haloumi, Dr Cheryl Ho’s (Mount Pleasant Central Veterinary Clinic, Whitley) adopted Greyhound, lost her hind limb to osteosarcoma.

Meet some of the lovely rescued dogs from Three Legs Good: Mochi, Dinah, Grady & Zora! Contact Three Legs Good to adopt or support their work!

Some of the tripawds & disabled dogs from Three Legs Good: Mochi, Dinah, Grady & Zora! Contact Three Legs Good to adopt or support their work! (Photo credits: Mochi – Nicholas Koh, Dinah – Furry Photos)

“The best thing we can do for a dog who has had an amputation is not to feel sorry for it! Treat the dog perfectly normally. A 3-legged dog is really no less able than a 4-legged one. Dogs adapt amazingly well. They don’t worry about having 3 legs. They don’t look back!” ~ Lillian


meet the big family at Mount Pleasant Animal Clinic (East)!
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The team at Mount Pleasant Animal Clinic (East): Moe, Gladys, Jonna, Nelli (Gelenggang), Andy, Dr Sarah Wong, Dr Ng Yi Lin & Andy Jr!

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Clara, Yimin, Syahidah, Dr Ng Yilin & Zen’s rescuers.

Andy, Dr Sarah Wong, Moe, Dr Iin with Tilala!

Andy, Dr Sarah Wong, Moe, Dr Iin with Kilala!

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Dr Audrey Loi (top L) with her team at work.

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The fur kids of MP East’s staff: Club Jr the Singapore Special who is going to his new home soon, Ellie the Poodle, Momo the Chihuahua, Marley & Xena the Miniature Schnauzers!

Miss B’s Fractured Forearm

Note: The following images may be unpleasant for some readers.

A dog’s forearm is made up of 2 bones – the radius and the ulna – spanning the distance from the elbow to the carpal or wrist joint.

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5-year-old Miss B the mongrel was hit by a car. The impact fractured her ulna.

Ref: petemergency.com.au

Red coloured areas highlight the radius & ulna bones that make up a dog’s forearm. Ref: petemergency.com.au

Fractures are usually caused by trauma, such as being hit by a car or falling from a height. Splints, casts, pins, steel plates and screws can be used to realign the bone. Treatment will depend on the type of fracture and the age of the dog. 

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For a small young dog, a fracture can be treated with a cast. For a bigger dog like Miss B, plates & screws are needed to secure the fractured bone.

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Surgical correction of a radius or ulna fracture is a specialised surgery performed by Dr Dennis Choi of Mount Pleasant Veterinary Centre (Gelenggang).

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The broken bones are exposed to allow for visual reduction (alignment) & placement of the plate.

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After the plate is aligned, a hole is drilled in the bone where a screw will be placed.

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The process of drilling, measuring & placing the screws is repeated until the bone is securely held in place.

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Internal implants like these plate & screws will remain in the leg; they do not need to be removed.

After surgery, it is important to limit activity (no running or jumping) so that the bones stay aligned and heal properly. X-rays will be recommended at various time intervals to monitor Miss B’s progress and make sure it is safe to increase her activity level.

We wish Miss B speedy recovery. Her guardian say she can’t wait to resume her favourite pastimes – going to the beach, swimming and chasing squirrels!

Poodle Gets Surgery For Torn Knee Ligament

The cranial cruciate ligament (CCL) is one of the main stabilising structures of the stifle joint (knee). CCL rupture (torn knee ligament) is the most common orthopaedic conditions in dogs which causes hind limb pain, lameness and subsequent arthritis

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The cranial cruciate ligament is a fibrous tissue that connects the femur (thigh bone) with the tibia (lower leg bone). (ref: michiganveterinarysurgeons.com)

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Once the ligament ruptures, the dog will become acutely lame due to severe inflammation that occurs within the joint. (ref: highdesertvet.com)


extracapsular suture repair is the most common 
orthopaedic procedure performed for small dogs (below 20kg) with CCL disease.
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Dr Dennis Choi, Mount Pleasant Veterinary Centre (Gelenggang), performed an extracapsular repair on a poodle’s right hind limb to stabilise the stifle. An incision is made to open the joint capsule for examination.

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The cranial cruciate ligament & meniscus are examined. Any torn or damaged portion is removed & the joint capsule sutured closed.

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A tiny hole is drilled in the tibia.

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A strong sterile suture is passed around the fabella behind the knee & through the hole drilled in the tibia. The suture is tightened to stabilise the knee by mimicking the action of the cranial cruciate ligament. Over time, the suture will induce scar tissue formation which also helps to stabilise the joint.

Post-operative care at home is critical.  Premature or excessive activities must be prevented. Physical rehabilitation (such as range-of-motion exercises and massage) and weight control would also help to speed up recovery and improve the outcome of surgery.

For larger or more active dogs, other surgical techniques like cranial tibial wedge osteotomy has better outcome. Read about 50kg Dandelion’s surgery here.