FHO In Dogs
What is Femoral Head Osteotomy (FHO) Surgery?

A femoral head osteotomy also referred to as a femoral head osteotomy or FHO, is the surgical removal of the head and neck of the femur. In simpler terms, it is the removal of the “ball” part of the ball-and-socket that makes up the hip joint. This way, the bones of the joint are no longer in contact, which eliminates the pain that is caused by the abnormal contact of the bones in a dog with hip dysplasia or severe osteoarthritis. This procedure is usually used as a last resort or salvage procedure in dogs with severe hip dysplasia that are not candidates for a total hip replacement. It is also used to treat dogs with Legg Calve Perthes Disease. Once the femoral head and neck are removed, the surrounding muscles and developing scar tissue work to support the area, and act as a false joint. This means that now when the limb is moved, the forces are transferred to the pelvis rather than the leg itself. FHO surgery is a fairly simple procedure in that minimal equipment is required, and no implants are needed. The procedure causes the leg to be slightly shorter than the unaffected leg, although amazingly, most dogs return close to normal activity after the surgery.
In many cases, the goal of the FHO procedure is to relieve pain associated with hip dysplasia, rather than create a joint with completely normal function. Therefore, while there are no specific weight guidelines for the use of an FHO, smaller dogs typically have a better outcome since less stress and force are carried on the false joint than would be in a large breed dog. That being said, this procedure may be indicated in large and giant-breed dogs in which other treatments have been ineffective or are not feasible, and can dramatically improve the quality of life in dogs with painful arthritic hips. Additionally, the best results are usually attained when done after the animal is skeletally mature and has finished growing.
FHO surgery will relieve the pain that is caused by hip dysplasia, and you may notice that your dog seems to feel better rather quickly. But it is important to note that following FHO surgery, your dog may always have some degree of lameness, even when proper rehabilitation is done. This does not mean the surgery has failed but is due to the fact that your dog is no longer working with a correctly formed joint, but rather with a false joint and a slightly shortened leg, and so the dynamics of the hip have completely changed. Although some degree of lameness may still be present, it will most likely be a huge improvement over the dog’s gait prior to the surgery.
Cost of an FHO in Dogs
The cost of an FHO ranges from $1,200 to $2,500. The exact cost will depend on the area you live, as well as the hospital in which the surgery is performed. Typically, the cost includes not only the surgery, but also pre-surgical bloodwork, anesthesia, post-surgical care, and medications. Some hospitals may even include post-surgical physical therapy.
Alternatives to FHO
As previously mentioned, FHO surgery is often considered in cases when a Total Hip Replacement is not feasible. FHO as a treatment for hip dysplasia is generally performed in mature dogs. In younger dogs with hip dysplasia, other surgical options include Triple Pelvic Osteotomy or Juvenile Pubic Symphysiodesis (JPS). However, JPS surgery is only performed in puppies less than 20 weeks old. When it comes to hip surgery, the size, weight, and age of the dog are very important factors in deciding how to proceed. Most general practitioners can perform an FHO, meaning that referral to an orthopedic surgeon may be unnecessary. Therefore, FHO is a viable option for the treatment of hip dysplasia when finances are a major concern.

Recovery after an FHO in Dogs
Despite the lack of a normal hip joint following FHO surgery, most dogs do surprisingly well after the procedure, but results can vary depending on the patient’s size, and post-operative rehabilitation. Unlike many other orthopedic surgeries, with an FHO, the dog should be encouraged to use the leg immediately post-op in a controlled manner. This is important because the dog now relies on the surrounding musculature to support the hip; if the dog is not weight-bearing, resulting in muscle atrophy and shortening will greatly increase the time of recovery and decrease the chances of a desirable return to function. According to Michigan State University, dogs having FHO surgery will usually toe-touch in about 10-14 days, and are partially bearing weight in 3 weeks. Usually, they are actively using the limb in one month, but it can take up to 6 months before complete using healing and function are evident.
How Can Hydrotherapy Help after FHO?

Hydrotherapy helps with dogs who have FHO surgery by using the controlled aquatic exercise to build weakened muscle in the hind without having to put any pressure on them. It encourages joint mobility, endurance and cardiovascular fitness that maintains the health of the cartilage around the joints. Consistent, gentle and regular swimming is key in managing a healthy physical structure along with natural supplements if needed. Water therapy has been proven to be the most successful therapy in helping dogs rehabilitate after surgery, especially those that occur in the hips, joints, and legs. Some benefits include:
- Increased muscle mass
- Increased muscle strength
- Increased range of joint movement
- Improved quality of life and fitness
- Decreased pain
- Decreased inflammation
- Relaxed muscles
- Reduced frustration in dogs who cannot exercise
- Slowed progression in disease
- Overall feeling of well-being and comfort
Possible Complications of an FHO in Dogs
Every surgery comes with a risk of complications. With FHO surgery, the most common complications encountered are decreased range of motion and mobility in the leg, muscle atrophy, loss of function, and infection. However, with aggressive post-operative rehabilitation under the guidance of your veterinarian and/or rehabilitation therapist, the chance of these complications is greatly reduced, and most owners are happy with the outcome of the surgery.
About Dip’ n Dogs Hydrotherapy – Orlando, FL
At Dip’n Dogs Hydrotherapy, we are certified and caring professionals devoted to restoring and enhancing the health and happiness of your beloved pup. Encompassing a pool, as well as a certified hydrotherapist, this can provide effective and long lasting results for your pet’s injury or illness. We are conveniently located in Winter Park, FL. Contact us today at (407) 227-0030. Our Services include the following: Outdoor Hydrotherapy and In-Home Mobile Therapy for dogs. We look forward to hearing from you!

What Our Clients Are Saying
Rachel is extremely kind, gentle and motivational towards animals. She provides quality individual attention.
What a great way to help your animal!Chase Milner March 20, 2018
"My Lab mix Tucker, is a new client of Dip'n Dogs. After just a few assisted swims with Rachel, we have seen great results with his weight loss and overall behavior. Rachel is fun and motivating when in the water and Tucker really loves his weekly swim session!"
Patrick Haggerty March 22, 2018
"Rachel is amazing! The changes in Blu’s overall physical health have been worth every effort. I recommend hydrotherapy for any dog’s overall fitness health."
Jennifer Corso Leonard April 29, 2018
"Rachel is wonderful with our fur baby Bella. We were told by Bella’s vet that she needed to lose some weight and we are already seeing results! Bella may not be the easiest client (very much a diva) but Rachel is so patient and gentle with her. Bella is a mix of husky and German Shepherd so we want to keep her fit to prevent conditions that are common with those breeds."
Kaela Rebecca April 30, 2018
"Our little Yorkie Jack has arthritis and our vet recommended trying hydrotherapy. Jack is a yipper but remains calm with Rachel! After his sessions, we do see Jack go up the two steps he usually avoids, with less hesitation and his walking seems easier! Thank you Rachel!"
Joni Browder April 30, 2018
"Our 11 year-old Yorkie just started hydrotherapy for his arthritis. Since starting, he’s a little more agile, and goes upstairs with more ease! Thanks Rachel for all you do and your extra TLC with our little Jack!"
Caitlin Browder May 5, 2018
My beagle, Badger, is overweight (like many beagles are) but I wasn’t too worried because we would go for long walk/runs to keep him healthy. BUT, his hips began to hurt and he wouldn’t walk for more than just a few minutes. I was worried he would become obese! I found Dip’n Dogs online and signed Badger up for hydrotherapy with Rachel. Not only is he almost back to normal with our walks but he has lost a bit of weight! The swims have definitely benefited him. Rachel is kind, patient and very flexible with scheduling appointments. Plus, her package deals help with the cost. I highly recommend her services. Both Badger and I are much happier than we were a month or so ago!”
Camille King July 12, 2018
“Jack’s mobility has benefited from the swimming sessions in a short time. I appreciate the patience and care Rachel has shown with our 17 year old Jack Russell. He needs special attention and she always gives him terrific assistance. I wish we had known about hydrotherapy earlier in his life. I know he would be in even better shape than he is now.”
Seth Miller July 12, 2018
"Hope is getting her second session of water therapy to help with her arthritis in her spine and legs and build her leg muscles back up! Maria and I love her trainer Rachel!"
Andrea Ruiz-Hays July 17, 2018
"Rachel has been awesome and I would most definitely recommend her!! My 12 year old beagle recently had knee surgery and she reached out to me through social media to let me know about her services. When it came time for him to start hydrotherapy as part of his recovery I contacted Rachel and set up an appointment. She was very responsive to messages and easy to get a hold of to set up our first appointment. After our first session my beagle started walking better and showing improvement in his healing process. I decided to buy a 4 session pack from her and taking him to see her weekly. Since we have started, his mobility has improved after each session and he gets around better than ever."
Caitlyn Canada July 17, 2018
"Rachel became certified in canine hydrotherapy through the certification program we offer through The Canine Fitness Institute. Since then, she has been working with dogs daily and I've seen her skills and competence grow by leaps and bounds. She opened her own business in 2018 - Dip N Dogs Canine Hydrotherapy and is doing a great job helping a wide variety of dogs regain strength after surgery, lose weight, become more mobile even though they have arthritis, and more. To further her knowledge, she continues to study and research a variety of orthopedic conditions that routinely affect dogs. She is very personable and her clients love her and the care she gives their dogs. If your dog can benefit from the incredible healing effects of hydrotherapy, I recommend you give Rachel a call."
Sherri Cappabianca July 17, 2018
"Jack was always extremely active throughout his life. Now at 17 plus years, he isn’t able to walk as well as we would like, due to arthritis and atrophy from age a medications he has taken. The hydrotherapy treatments with Rachel have made such a difference. They have helped him maintain his mobility and gain additional strength. Jack swims twice a week with Rachel. He swims very hard and I think he enjoys the mobility in the water that he no longer has on land. I wish we had known about hydrotherapy and Rachel earlier. I don’t think it is ever to early to start your dog swimming. I know would be in even better shape now than he is, if we had started him sooner. I highly recommend Rachel to work with your pet. She always has Jack’s best interest in mind and we certainly appreciate that."
Carrie Miller September 10, 2018
"Rachel is a pro when it comes to helping our dog Ellie feel comfortable during her swimming session. She has a kind nature towards animals and is really good at what she does. I'm glad we found out about her business. I highly recommend her services for your pet's well being."
Andy Schifaro September 10, 2018
"Rachel's calm, confident approach had our dog very comfortable."
Tracy Robinson September 10, 2018
"We are absolutely thrilled and happy to have Rachel swim with our dog Griffin. The exercise really has helped calm Griffin and his weight is right where it should be. Our vet was very happy with Griffins weight at his last check up this past week. They were happy that he had not gained any as many dogs do after being neutered. Griffin really loves his time with Rachel! she is a true dog lover."
Sara Palmer September 10, 2018
"Rachel was wonderful with my Dusty who had an FHO done on his right hip but his left hip is not so good either. As of right now his right has healed wonderfully and his left hip is holding strong! I believe it is because of hydrotherapy with Rachel. Dusty had his surgery in March and I can’t go fast enough for him on his walks! I might need some hydrotherapy myself!"
Terrie Sandefur October 3, 2018
"Rachel seems to see and love my Hannah's Spirit. Hannah recently said goodbye, for now, to Hazel, her litter mate and twin. Needing some fun new experiences and with a recent arthritis diagnosis, Dip'n Dogs was a nice adventure. Hannah enjoys the pool. Seems a natural swimmer. And Rachel has a good positive energy!"
Gwen Hartmann October 4, 2018
"Rachel is a caring and experienced dog guardian and is one of my dog, Maisie’s, favorite people. I highly recommend Dip'n Dogs!"
Marcia Caton February 18, 2019
"Sophie doesn't love the pool but Rachel was so great with her that Sophie was giving her kisses by the end! I'm so excited about Sophie continuing her hydrotherapy!"
Katlyn Billue February 18, 2019
"We are absolutely thrilled and happy to have Rachel swim with our dog Griffin. The exercise really has helped calm Griffin and his weight is right where it should be. Our vet was very happy with Griffins weight at his last check up this past week. They were happy that he had not gained any as many dogs do after being neutered. Griffin really loves his time with Rachel! she is a true dog lover."
Sara Palmer February 18, 2019
"Guinness and I are so happy that we met Rachel. She is super nice, gentle, patient and knows how to make Guinness comfortable in the pool, because he gets soo nervous. She is helping Guiness get back on his leg after a luxating patella injury. Right now he is doing great and starting to put his leg down when walking. I would definitely recommend Rachel- best hydrotherapy
:) and she does a great job in the pool. Thank you Rachel!"
Noelia Cocco February 18, 2019
"From the instant that I met Rachel, I felt comfortable with her and would have trusted her with any of my dogs. She came and worked with my senior, blind Shih Tzu this summer. My Millicent has arthritis, bad skin, allergies and had recently developed a heart murmur. Rachel made sure to go over Millie’s health history with me and was very aware of how Millie was doing the whole time she worked with her. It is great exercise for an old, lazy dog!"
Kristi Klein February 18, 2019