What is Hemipelvectomy?
Hemipelvectomy is a surgical procedure used in dogs to treat masses located on the pelvis by removing all or part of the pelvis and, in some cases, the attached limb. There are two main types of hemipelvectomy: partial and total. Partial involves removing only part of the hemipelvis, while total hemipelvectomy will result in the removal of the entire hemipelvis and the attached limb. This is an invasive and aggressive surgery and is not generally the first line of treatment for conditions affecting the pelvis. It is a highly complex and specialized procedure that requires extensive knowledge of the pelvic region.
Hemipelvectomy Procedure in Dogs
The approach to hemipelvectomy will vary based on the location of the tumor or mass. The attached limb and other parts of the pelvic region may or may not need to be removed. The general approach to total hemipelvectomy is detailed below.
- Blood work, x-rays, and other diagnostic testing will be conducted prior to surgery to ensure anesthetization is safe for the dog and to visualize the mass(es).
- The surgeon may decide to acquire blood from a veterinary blood bank prior to surgery in case of severe perioperative hemorrhage.
- The dog will be given general anesthesia and analgesics.
- The surgeon will shave, clean, and drape the operative area and place a urinary catheter.
- A stay suture is placed on the rectum so the dog does not empty bowel contents during surgery.
- The surgeon will incise the skin and separate the hip muscles along their natural seams.
- Surgical swabs soaked in a saline solution will be used to keep the muscle moist throughout surgery.
- The surgeon will ligate, or cut off blood supply to, the major arteries and veins of the hip to prevent hemorrhage.
- The abdominal muscles attached to the pubis are cut and separated. The external iliac artery and vein are then isolated and double ligated.
- The surgeon will repeat the previous step for the iliopsoas muscles.
- The sacrum is exposed, allowing for the elevation of the ilium.
- An oscillating saw is used to cut the pubic symphysis, and the attached limb is lifted so the muscle attachments can be incised.
- Certain nerves are then separated from the hemipelvis and amputated limb.
- A local anesthetic is administered to the nerve sheath.
- A saline solution is used to flush the surgical site.
- For dogs requiring radiation treatment, the surgeon may decide to place metal hemoclips.
- The surgeon will replace the muscles and close the wound.
- For sexually intact dogs, castration should be considered because hemipelvectomy will increase the likelihood of testicular injury.
- The dog will be hospitalized for up to ten days.
Efficacy of Hemipelvectomy in Dogs
The efficacy of hemipelvectomy will vary based on the expertise of the surgeon, the overall health of the dog, and the underlying condition it is used to treat. Given that the surgeon is highly skilled and the dog is relatively healthy prior to surgery, hemipelvectomy is typically effective. This procedure carries a recurrence rate of approximately 16%. Dogs tend to recover and adjust to the loss of the limb relatively quickly.
Hemipelvectomy Recovery in Dogs
The dog will need to be hospitalized after surgery. Most dogs will be discharged within seven days. Analgesics and anti-inflammatories will be administered throughout the hospitalization period. The veterinarian may attempt to help the dog walk within forty-eight hours after surgery.
Healing times depend on the size and health of the dog, the efficacy of surgery, and the underlying condition. Larger dogs may require supportive walking therapy for up to four days after surgery. Dogs may need to wear an Elizabethan cone to avoid irritating the surgery site. The surgery site should be checked daily to make sure no bleeding, drainage, or swelling has occurred. If owners observe any abnormalities in urination and defecation, they should consult their veterinarian immediately.
A follow-up appointment will be scheduled within fourteen days to remove sutures. The veterinarian may schedule additional follow-up appointments to administer other treatments, including chemotherapy and radiation.
Cost of Hemipelvectomy in Dogs
The cost of hemipelvectomy will vary based on standards of living and additional costs incurred. On average, the cost of hemipelvectomy in dogs ranges from $3,500 to $4,200.
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Dog Hemipelvectomy Considerations
Complications associated with hemipelvectomy may range from moderate to severe. These include, but may not be limited to:
- Rupture of the surgical site
- Incisional hernia
- Urethral or rectal trauma
- Pressure point sores
- Tumor recurrence
The recurrence rate of tumors in dogs treated with hemipelvectomy is approximately 16%. Severe hemorrhage is a significant risk of this surgery because of the large muscles involved. Approximately 80% of small animals that undergo this surgery do not experience any complications. The remaining 20% do not experience life-threatening complications.
Hemipelvectomy Prevention in Dogs
Cancer cannot be prevented in dogs. However, for cases of pelvic fracture, it is imperative that owners follow their veterinarian’s recovery instructions carefully. Delayed and improper healing may warrant hemipelvectomy, and will cause more pain for the dog.