Happy's Journey with IOHC
Happy has always been an aggressive chaser of any kind of prey. So it didn’t surprise us when, in February of 2020, he hurt his right forelimb while pursuing a lure on hard winter ground.
He had just taken a very tight turn and dropped his head to grab the lure when he yelped loudly and came up limping. We had never heard him yelp before, but it appeared to be a soft tissue injury so we put him on rest. Happy was a two months shy of three years old at that time.
The Covid lockdowns started shortly afterward, and I moved into a condo in town to take care of my dad. Happy came with me, so he got lots and lots of rest for a few of months.
In late spring 2020 when we started resuming normal activities, Happy’s limp was long gone, but his gait when he ran had changed. He was short-striding in the front, meaning he didn’t extend his front legs fully as he had before. I had seen this type of gait several times at Boykin events, so I chalked it up to a change that comes with maturity. Happy had also become much cautious about jumping down off an object, whereas his upward jumps remained high and powerful.
Twice that Summer, Happy appeared to perhaps exhibit some discomfort during a bumper retrieve, and his gait would be slightly unusual afterward. But it would always resolve quickly.
Fast-forward to November of that year, when we were out in the back yard. When I casually tossed a Chuck-it ball for Happy, he ran about 20 feet, reached down to grab the ball, and then shrieked. He came up holding his right paw way off the ground and would not bear any weight on it at all.
X-rays done at our local vet later that day reveal no cause for the limping, but the vet recommended a CT scan if the lameness did not resolve within 2 weeks. It did not resolve, in fact, he continued hold up the right forelimb for nearly two weeks. In addition, he appeared uncomfortable when he lowered himself into the "down" position.
In December I took Happy to see a specialist in Virginia. He found asymmetrical musculature of the forelimbs, with Happy's right side 2 cm smaller than the left, an indication that he had been favoring the right leg for a while. He was also clearly uncomfortable with flexion and extension of the right forelimb.
Happy received platelet-rich plasma (PRP) and hyaluronic acid in the right elbow that day, which significantly improved his clinical symptoms. When the CT report came back, it revealed a condition I had never heard of: IOHC/HIF. (Incidentally, Happy's OFA elbow results at age 2 were found to be normal.)
He had just taken a very tight turn and dropped his head to grab the lure when he yelped loudly and came up limping. We had never heard him yelp before, but it appeared to be a soft tissue injury so we put him on rest. Happy was a two months shy of three years old at that time.
The Covid lockdowns started shortly afterward, and I moved into a condo in town to take care of my dad. Happy came with me, so he got lots and lots of rest for a few of months.
In late spring 2020 when we started resuming normal activities, Happy’s limp was long gone, but his gait when he ran had changed. He was short-striding in the front, meaning he didn’t extend his front legs fully as he had before. I had seen this type of gait several times at Boykin events, so I chalked it up to a change that comes with maturity. Happy had also become much cautious about jumping down off an object, whereas his upward jumps remained high and powerful.
Twice that Summer, Happy appeared to perhaps exhibit some discomfort during a bumper retrieve, and his gait would be slightly unusual afterward. But it would always resolve quickly.
Fast-forward to November of that year, when we were out in the back yard. When I casually tossed a Chuck-it ball for Happy, he ran about 20 feet, reached down to grab the ball, and then shrieked. He came up holding his right paw way off the ground and would not bear any weight on it at all.
X-rays done at our local vet later that day reveal no cause for the limping, but the vet recommended a CT scan if the lameness did not resolve within 2 weeks. It did not resolve, in fact, he continued hold up the right forelimb for nearly two weeks. In addition, he appeared uncomfortable when he lowered himself into the "down" position.
In December I took Happy to see a specialist in Virginia. He found asymmetrical musculature of the forelimbs, with Happy's right side 2 cm smaller than the left, an indication that he had been favoring the right leg for a while. He was also clearly uncomfortable with flexion and extension of the right forelimb.
Happy received platelet-rich plasma (PRP) and hyaluronic acid in the right elbow that day, which significantly improved his clinical symptoms. When the CT report came back, it revealed a condition I had never heard of: IOHC/HIF. (Incidentally, Happy's OFA elbow results at age 2 were found to be normal.)
|
|
Before surgery: fissures in the humeral condyles appear as vertical “lines” just above the arrows
Our next stop was Dr. David Dycus, an orthopedic surgeon in Baltimore. (I had come to have significant confidence in Dr. Dycus after he diagnosed another Boykin's condition that had eluded several other veterinarians.) At that visit, Happy showed no overt lameness, but he did short-stride slightly on the right. (These Boykins can conceal a major injury well!) He also appeared to have some external rotation of both elbows during a walk. {Link to view video of limp Nov 2020: https://www.youtube.com/watch?v=8kcr6YpvgCw} To my surprise, Dr. Dycus was just as concerned about the left elbow - despite it not being symptomatic - as the right; Happy had a complete fissure on the right elbow and an incomplete fissure on the left. Dr. Dycus explained the risks of further injury of / fracture to the left elbow as well as the right, especially as Happy favored that right leg.
On February 8, 2021, Happy had bilateral transcondylar screw placement. The surgery involved placing one 3.5 mm screw across each of his humeral condyles (elbows) to stabilize them and help prevent catastrophic fracture of the humerus. He stayed overnight and came home with a pile of meds.
The prognosis was for full functional recovery with expected periods of stiffness. Progression of osteoarthritis of the joints was also a possibility.
On February 8, 2021, Happy had bilateral transcondylar screw placement. The surgery involved placing one 3.5 mm screw across each of his humeral condyles (elbows) to stabilize them and help prevent catastrophic fracture of the humerus. He stayed overnight and came home with a pile of meds.
The prognosis was for full functional recovery with expected periods of stiffness. Progression of osteoarthritis of the joints was also a possibility.
|
|
After surgery: radiographs show placement of the screws across the elbow.
The day after elbow surgery: Home from the hospital and ready for dinner
Recovery to pet function (not sporting activity) took about 12 weeks. Happy was on strict crate rest for 4 weeks followed by crate rest or full supervision for 8 additional weeks. We started at-home range-of-motion exercises 3 days post-op. Once the sutures were removed about 2 weeks post-op, formal rehabilitation commenced to include laser, water therapy, and various movement patterns. We had a walking schedule that started 2 weeks post-op and began with 2 @ 5-minute walks daily, increasing in duration by 5 minutes each week. By week 6, we resumed stairs on-lead, and shortly afterward started walking different environments such as hills, woodlands, and higher grass, all on-lead.
Post-op radiographs were required at both 4 weeks and 8 weeks post-op to verify the hardware was still placed properly and to check healing. At the 8 week mark, Happy was still short-striding in the front, but he was approved for gradual return to normal activity over another 4 week period.
For ongoing joint support, it was recommended we give Happy Dasuquin Advanced with ESM, Antinol, and an Omega-3 fatty acid supplement with EPA and DHA, which he remains on to this day.
By Summer 2021, Happy was clearly more comfortable, and by November, he was running through the woods and jumping over logs as though nothing had ever happened.
He did very well for several years, although I did have to restrict his activity somewhat. It seems that the action of reaching down to pick up something with his mouth while on the is the perfect angle to aggravate his condition. On several occasions after picking up a bumper, he would start short striding or walking gimpy again. So, no more marks for Happy in open grass. He still tolerates running in tall grass and in the woods well, though.
In Summer 2024, when Happy was 7 1/2, he began walking with an uneven gait again and then ran after a squirrel and started limping on the left. An X-ray did not show any significant change, any fractures, or any movement of the screw, so he was back on crate rest again for several weeks.
In February 2025, it became obvious that he was uncomfortable again, so he was put on carprofen and his symptoms improved.
At the time of this writing, Happy is nearly 8 1/2 years old and it has been about 4-1/2 years since surgery. As all of us age, we start breaking down bone more rapidly than we replace it, and Happy's extended use of NSAIDs contributes to bone loss. We are just starting the process of how to best manage this little man’s condition as he ages.
IOHC/HIF is not a condition that can be fully rectified by surgery and you simply return to how things were prior. Lifelong monitoring, restrictions, and other medical interventions are needed on an ongoing basis.
Debra Jones
Post-op radiographs were required at both 4 weeks and 8 weeks post-op to verify the hardware was still placed properly and to check healing. At the 8 week mark, Happy was still short-striding in the front, but he was approved for gradual return to normal activity over another 4 week period.
For ongoing joint support, it was recommended we give Happy Dasuquin Advanced with ESM, Antinol, and an Omega-3 fatty acid supplement with EPA and DHA, which he remains on to this day.
By Summer 2021, Happy was clearly more comfortable, and by November, he was running through the woods and jumping over logs as though nothing had ever happened.
He did very well for several years, although I did have to restrict his activity somewhat. It seems that the action of reaching down to pick up something with his mouth while on the is the perfect angle to aggravate his condition. On several occasions after picking up a bumper, he would start short striding or walking gimpy again. So, no more marks for Happy in open grass. He still tolerates running in tall grass and in the woods well, though.
In Summer 2024, when Happy was 7 1/2, he began walking with an uneven gait again and then ran after a squirrel and started limping on the left. An X-ray did not show any significant change, any fractures, or any movement of the screw, so he was back on crate rest again for several weeks.
In February 2025, it became obvious that he was uncomfortable again, so he was put on carprofen and his symptoms improved.
At the time of this writing, Happy is nearly 8 1/2 years old and it has been about 4-1/2 years since surgery. As all of us age, we start breaking down bone more rapidly than we replace it, and Happy's extended use of NSAIDs contributes to bone loss. We are just starting the process of how to best manage this little man’s condition as he ages.
IOHC/HIF is not a condition that can be fully rectified by surgery and you simply return to how things were prior. Lifelong monitoring, restrictions, and other medical interventions are needed on an ongoing basis.
Debra Jones
|
|
|
Happy lost his battle with IOHC in November 2025, a disease that quietly but profoundly impacts affected dogs and their families. His story remains close to our hearts and continues to shape the work we do - in hopes of sparing other dogs and families the same path. |
|
