Hip dysplasia - it’s not just an old dog problem

Music.

Really, the goal is just to use our stories to bring veterinary medicine to life for the pet caretakers of the world. And we're doing it because we believe that educating these caretakers is the most powerful thing that we can do to improve the life quality of all of the pets that we love. Hello, Dr. Natalie Keith. Dr. Tracy Trussell. And this is Vet Tales. We are talking about hip dysplasia today. Hip dysplasia. Yeah. Yeah. I always like to bring you in when we're talking

about musculoskeletal problems. Right. Yeah. I definitely know a lot about hip dysplasia though, myself personally. Right. So, I mean, not my person, but my dog. Yeah. So. Yeah, because there's a few breeds that are pretty predisposed. Yeah. And you can expect that. Yeah. I mean, probably the poster child that most people will see is probably a German Shepherd. Yes. I have one of those, but I x-rayed his hips really early. Yes.

Because I was paranoid. Yes. And there are ways if we can find it early, we can help get some coverage on those hips. Because what happens in hip dysplasia is you got the, you know, everybody knows the ball and socket joint. Does everybody know the ball and socket joint? I mean, most everybody going through school, you would hear the ball and socket joint. Yeah, the leg bone is connected to the hip bone.

Yeah. Yeah, I got you. So it's a ball and socket. So you basically think of a ball and then something that covers the ball. Right. A hundred percent. Like a Barbie doll arm. Sorry. I mean, same. Popped in my head. Same concept. Okay. All right. Probably what happens is, though, you don't have, the ball isn't completely round. It's not completely round in a perfectly normal dog anyway. There are some little eccentricities. But for lack of a better term, the ball is not round like it should be.

And then the socket doesn't cover the ball as much as it should. That's where you get the hip dysplasia. Yeah, so because dysplasia meaning poor placement, dys meaning like out of, and plasia meaning place or formation, really, technically. So poor hip formation. Poor hip formation is what you have. Now, in some of these guys, and I've done it a few times, there is a test that you can do. Oh, good. I was hoping you were going to talk about this.

Well, I mean, let me back that up a little bit. There's a test that some people can do. Some people.

It's trained. pretty specific test yes it's called an ortolani test it's named after the dude it's dr ortolani i don't remember where he was maybe french i don't know french italian somewhere he was across the pond yeah years ago maybe in the 50s 60s all right i mean okay i didn't know this is that long yeah it's it might have been up in the 70s but it's been a while before i was okay yeah so it's been a while yeah yeah.

Anyway, you go through the test and you can feel, I mean, it's hard to describe without seeing it. The test is a manipulation of the leg. It is. It's just your hands on dog. Right. And it's just a manipulation of that hip joint in specific ways with the specific pressures to feel any inconsistencies, anything that's out of the ordinary. Instability. Yeah, instability. Stability, ordinarily, it's just tight and moves around, you know, it moves in its normal functions, but nothing abnormal.

The Ortolani test will put it in some abnormal positions that should, in a normal hip, not produce anything. Right. But if you have hip dysplasia, you know, everything isn't, it hasn't formed correctly, it will show differences there. Yeah. So with that, usually you can do that test at about, how about eight weeks old? Yeah. Eight to 12.

And we can go in, and there's actually a surgery we can go in and work on the pelvis, and what it does is it stops one of the growth plates on the bottom of the pelvis in there. We actually kind of scar that in so that growth plate at the bottom of the pelvis can't expand. The top of the pelvis can, so it comes out and covers, goes over that. The socket kind of moves over the ball, if you will. Okay. What's the name of that surgery? Do you know?

A, it's a, because what, it's a pubic symphysis that we go in and we, we scar in, scar it in with a laser or electrocautery. I don't know what the exact. Turn for that is. Turn of it is. Yeah. Maybe a pubic symphysis restriction, possibly. All right. I think at one time they were started, they started it doing bone plates. It actually put screws and plates in there, so it would restrict it, couldn't move. But that didn't allow for the folding of it some. Yeah.

You know, they used, some of them went with string of pearls, so they couldn't spread out, but they could, that string of pearls would fold a little bit. So that, that kind of helped. Then we found if we can just kind of kill some of the physis so it can't grow, it does it on its own.

Interesting. So made it a whole. Yeah. So my first tale of the day is I remember that we had that little puppy that came in a sky that one of the nicest people I know had just adopted this little Frenchie puppy and it walked really, really weird. And he was like, that was the first thing he said. He's like, I don't think, I don't think she walks right.

And sure enough, very odd gate. So I take her back to you and you you do the ordinaline test and you're like yes this is not normal because the reason why we can't take x-rays at that age is because that they're they're like they look like puppets on a string on an x-ray because there's so much growth play and cartilage and like it literally x-rays on puppies look like they're held together by strings yeah i mean it looks like the bones are connected yeah it does it looks like

giant gaps it's like very very weird to x-ray a puppy so you can't use an x-ray to determine it at that young of an age and so you're like yeah we're really concerned And so the, the guy like contacted the breeder and then the breeder like called screaming at us. Yeah. Yeah. It was really interesting clients.

Yeah. Uh, sometimes, but, but that puppy actually did turn out that it did have hip dysplasia as it went on, which the owner ended up keeping her and was fine, but they were intending to breed and just decided not to based off of that. So that was that, that forever scarred that test into my brain. Yeah. Yeah, and it's, like I said, not everybody, I think we all heard about the test going through vet school. Did we? I think I zoned out. But I think that was about it. I was like,

that sounds like it's about bones. Yeah. I do medicine. I mean, honestly, I think that's the introduction that we had to it, and that was it. But because you do so much CE about orthopedics, like you were looped back in on that. Looped back in on that. And so, I mean, I think most all of our veterans have heard it, but did it stick in the memory? Probably not. Nope. Not this one. And it's, yeah, because it's not something that you do every day.

Yeah. And if you're not in tune to the orthopedics, you're, I mean, that's going to kind of fly out the window. Yep. In there. So, yeah, there's not a whole lot of people that do it. Or do it properly. Properly, yeah. And do it properly. So, yeah, I mean, if you have a dog and you're like, doc, can you do the Ordwani test? Because the dog's not walking that. And then he's like, I'm not sure what you're talking about. Don't be surprised. Yeah, yeah. Yeah, definitely.

For sure. If I didn't work with Dr. Trussell, I would not know what that test was. Right. So, wait, and I might have forgotten again if I hadn't had such a traumatic incident around that one. But anyway, okay, so we talked a little bit about what hip dysplasia is. And we talked a teensy bit about who gets it. Jevron Shepherds are, of course, supposed to be a child, but we see it in a lot of large breed dogs. Goldens, Doeys, Rotties. Labs. Labs. And then, of course, you know, my dog.

Max. Max makes almost every episode for some reason or another. Yeah, Max has an issue or two. Yeah, so we'll get a little bit more into that and how we go about it. But let's just, so we, we had this, this dog, let's say that we did not do an Ortolani test on as a young dog and it comes in and it's like maybe two-ish and the owners have, I had a dog, actually the same dog type as Max, actually reminded me a lot of Max, just his confirmation. He was a bully type dog.

And the way this dog sits and moves, I was like, oh, these dogs, his hips are trash like they are even though he's only he was literally not very i think he's maybe like three or four but max was lame by two yeah with it that being said some of them aren't some of them will be completely asymptomatic because hip dysplasia is not the same thing as arthritis in the hips that happens far later so the dysplasia happens first then you start to have have lesions associated

with that on the bones and then the arthritis. Yeah. And I know of one, you know, as well. Really, really nice cattle working dog. Work cows, work sheep. And saw him when he was seven or eight. Eight.

In there and he's just a little bit off yeah back in and been working his whole life right, and just he's just a little off slowing down just just a touch mind you i mean he's seven right you're a working dog i mean it's time for them yeah he's been yeah i mean he's had a rough life and take x-rays of hips and like oh wow how's the dog walking in that wild sometimes and yeah and like so sometimes it's about pain tolerance sometimes it's the x-rays don't necessarily indicate level of pain.

So you can have a really painful dog with minimal changes if it just happens to be at the wrong spot or, you know, it's impacting a nerve or whatever. Yeah, because his hip dysplasia was pretty, pretty significant. Best of my memory, it's been six, seven years since I looked at the x-rays. The hip dysplasia was fairly significant, but his arthritis wasn't bad. It was just kind of starting at that point. Yeah.

If you can catch these dogs before they're painful, you know, if you're doing, like, Like, let's just say you have, again, like my dog, I have two, but my other one's a German shepherd. And whenever he was getting neutered, which was just shy of his year birthday, he was like 11 and a half months old. I was like, let's take x-rays while he's asleep. And his growth plates are nearly closed at this stage. And we were able to see he has actually really good hips, luckily.

But if he had not had good hips at that point, we would have started a bunch of prevention type measures. It's because there's a lot of things you can do to help slow down the progression of clinical disease. So do you want to touch on those? Yeah, there's a number of things if you find it before they become clinical, which is when you want to find it because, I mean, everybody knows prevention is better than a cure. Oh, yeah. I mean, any time.

So if you can find them and see some radiographic signs that we know typically are going, how they're going to develop, then yeah, we can, we can start doing some joint supplements, do some, there's some different exercises that can help in there. One of the big things, which sounds kind of odd, is strengthening their back muscles.

And they're, and a lot of people don't, don't put that all together.

And it works the same way with us. but you know if you can get them going up and down heels strengthen those back muscles that helps their hips a lot yeah it protects them yeah and then there's also things like adequate injections which is a polysulfate glycosamine a glycan which is really fun to say but really essentially what we're doing is in injecting a type of like falls into the type of category i guess but because it's going into the body and not through the.

Through the digestive tract, it's much more effective at getting into the joints and actually repairing cartilage. Because that's the first thing that happens in these dogs is the cartilage gets worn down. And then once you don't have cartilage, you don't have cartilage. And then you get bone on bone and that hurts. Bone on bone hurts. So we want to try to preserve that cartilage for as long as possible.

And the problem is that adequate works best when the dog, before before it's ever showing symptoms. So nobody wants to do that. Nobody wants to put their dog on, uh, you know, these, these medications, if you will. Um, although it's not technically medicine, uh, it's like a nutraceutical, but we don't want to spend the money or do the things on a dog that doesn't have any symptoms. In fact, the dog I was telling you about that reminded me of Max.

I was like, Hey, so like his hips and she's like, no, they're fine. And I was like, Like, well, no, they're not. Yeah. I was like, can we please take x-rays? Like just sometime in the next 12 months, I beg of you, because if we can get the x-rays, then I can start preventing because he's already exhibiting odd gait behaviors. And so we'll see. We'll see. Hopefully she comes around to my recommendation because I want to get that dog in the best position now.

But it is hard. It's hard to want to do things to prevent a disease you can't see and or detect that there's any ill effect of, if that makes sense. And I've got a question for you because it just popped into my mind. Talking about preventative, Labrella, because I haven't looked at the Labrella a lot, mechanism of actions, all that. Would it be, would Labrella be beneficial? You know, I say no, because all it's really doing is blocking pain receptors.

So it's really great for dogs that have pain, but it doesn't prevent disease progression. Now, Labrella people might tell you some other reason why they think it's better, but I personally, I think the early indications for Labrella is more as follows.

Follows people think sometimes that if their dog isn't lame that it isn't in pain and that's not true right just like going back to your dog the working dog it's not like he was carrying a leg or crying out every time he you know jumped into the vehicle or whatever the thing is he was just slowing down and a lot of times that's your first indicator of pain and chronic pain very very rarely.

Manifest as vocalization and or non-weight bearing right it's just they're slower to get up they sit down weird they're more reluctant to do the things they used to like to do and so on and so forth so okay yeah it was just something while we were actually going through the podcast i thought about i was like yeah because i don't remember the mechanism of action how it goes yeah it's a monoclonal antibody that blocks pain receptors so it's just telling the body that it isn't in pain,

which is great when you have chronic pain, because chronic pain isn't useful anymore. Acute pain is useful because it says, don't put weight on this leg. It hurts right now. But chronic pain just keeps you from using something that needs to be, again, like your muscles to keep them built up or whatever. So that, and there's this windup pain associated with it.

And a windup pain, the way I describe that to clients is like, if you, like, let's just say you stick your arm out and you, and you rub your hand down your arm, that does not hurt at at all, right? And you go back up, so does it hurt. But if you do that back and forth motion for like about 20 minutes, you're going to start to feel like it's burning.

You haven't done really anything traumatic, but you're starting to get this wind up of this over-stimulation of those nerves over the course of time. So that's what Librella will undo and help with so we don't have unnecessary pain, as I understand. Good. Yeah. Like I said, it was just a thought. I was like, I don't know. I didn't know that it would. I wasn't sure. Yeah. It sounds like that. That's not a good. No, you're better off with like,

like fish oils are amazing. So I think all big dogs should be on fish oils. Just do it. There's no reason not to. It's good for their immune system. It's good for their skin and coat and hair. It's good for their joints and the whole thing. So fish oils for everybody. And then, you know, Max is the poster child for all the other things that follow after that.

So. right checked one one other thing just to kind of throw in there if the dogs like to swim yeah swimming is a wonderful exercise yeah low impact muscle building yeah low impact you get the muscle built so you have the muscle that's protecting that kind of helping protect the hip we're not changing the bony structure of the hip joint but we're getting the soft tissues the muscles muscles, tendons, ligaments, everything kind of strengthened up to help make what we have as far as a joint

the best it possibly can be. Yeah, for sure. For sure. Yes. They have underwater treadmills. You just don't see them. They're high maintenance. Yeah. God love you if you're a veterinarian out there trying to keep one of those going. So anyway. Okay. So let's say, so ideal scene is you figure out a puppy has hip dysplasia right off the bat. So we can try to, you know, fix the way that that bone is going to develop and protect the dog.

Then the next thing that would be great is if we didn't do that, is to check the dog at about two years of age with. Good radiographs, which like I mentioned, I did it at the neuter for my dog because sedated is a much, much, much better x-ray for this because of the position you have to put them in. Their legs have to be really relaxed in order to get them at the right angle. And that's very hard to do on an awake dog.

You have to rotate them to a certain angle and da-da-da-da. So it's great if you can do them sedated. If you're wanting to get your dogs hip checked, I guess we could even go back farther and say, ideally, like if you're going to purchase a dog, like a shepherd, make sure that they've been hip certified, OFA certified. OFA certified. And OFA is the Orthopedic Foundation for Animals. They have a database that not everybody's in it, but most all of your breeds that have,

that are prone to hip dysplasia. You know, your German chapters, your labs, all those guys. They have a database for them and it's, I think it all goes off of their AKC registration or one of the registration numbers. Anyway, they've got the database. Yeah. They will not certify a dog until they're two years old. Yeah. You cannot certify them until they're two.

And if you're taking OFA radiographs to send to their radiologist, because they've got their own radiologist, they make the determination on the hips. They have to be sedated. They have to be sedated. And it is very particular x-rays that they want. Yeah, or they'll reject the image and you have to do it again. And like Dr. Schoessl said, we don't make that decision.

It's these veterinarians, literally a radiologist, that that's what they do, is look at these x-rays to determine the status of the dog's hips. So anyways, it'd be great if we had a hip-certified puppy. But even if you have hip-certified parents, it doesn't mean that your puppy can't have dysplasia. So that's why I checked mine.

So then let's say we find some disease there. we started prevention methods which we've talked about but sometimes that's still not enough so with max i i don't i did first of all he's 12 so 10 years ago we didn't know as much as we know now plus he was a rescue plus he's not a breed really like the you think of for this i mean kind of but it's usually it's their knees that they have more trouble with which you know he definitely has arthritis in his knees too

but anyway so what happened was he was lame and so we took x-rays and it was horrible, like at two, at two years old. And so arthritis already develops like so bad. And so I actually sent those to a board certified surgeon and he was like, well, you could do a total hip replacement, but with his overall confirmation. You won't have any additional additional benefit of a total hip versus doing what's called an FHO, which is a femoral head osteectomy.

And so that is the way we chose to go because we do those here. And so I was like, I'm not going to refer into another hospital and have implants that might go wrong and spend literally 5,000 times more dollars on that surgery than what I would spend here. And so we decided to do the FHO, which he received when he was two. Yeah, he got that when he was two.

And what that is, just a quick explanation, you know, like I said earlier, talking about the ball and socket joint, basically we cut the ball off of the femur, the leg bone, and just take it out of play. It comes out of the body. Yep. So they just have like kind of a truncated femur that doesn't go to the joint, and those muscles are creating what's called a false joint. So the dog's like, I mean, you could look at Max and never have any idea. Sometimes I forget. No.

No. No, I mean, you can see he walks a little bit different. Yeah, and he's post-legged. But he was post-legged before. He was post-legged before. But these guys will walk a little bit different because that leg, functionally, is shorter than the other leg. Just because you don't have that bone stopping it going up. Now on Max, what was Max's weight? He's about 60, yeah, 58 to 62. Yeah, his leg is probably half inch, three quarters of an inch shorter functionally than the non-surgical leg.

If you don't know the dogs, you know, once they get all healed up and going back to normal, which is about a four-month process, you wouldn't know it. But, you know, now a Great Dane, that's different because, you know, Great Danes are three and a half foot tall. So you're losing an inch and a half of leg. You can tell that. Yeah, you can tell them that more. And then, of course, Max is so front heavy being kind of a bully. It's like his back legs, I mean,

they're helpful, but they're not really what's doing all the work. No. So he's shoulder heavy in a big way. But anyway, so then we still went ahead and did all the things with the fish oil. He's on a joint diet. He occasionally gets a non-steroidal anti-inflammatory, but he also has diabetes insipidus, probably, that causes his urine to not concentrate. So we're really careful with his kidneys. And so he gets labrella. And he's been on adequate for a while. A while. I don't even know.

So he does all the things. Probably six years? That feels right-ish. Yeah, because he's 12 now. Yeah, probably six. Yeah. Yeah. The other thing I think maybe is we're talking about a little bit is right after surgery, we had a really hard time getting him to use his leg. He just wanted to carry it because he didn't really, again, he didn't really care because he had like his, all of his weights on his front end. Yeah. 90% of his weight he carries on his front end. I mean, honestly.

And so we ended up bringing in the laser. That's when we fell in love with the laser. So he started doing laser therapy on his leg and he started using it again because we just couldn't make him do it. Like he just would carry it. Yeah. He's just like, I don't need it. He's like, I'm fine. That's fine. And so his muscle was wasting, but we brought in the laser and started doing some physical therapy with him, like range of motion and blah, blah, blah.

And then like a month later, he was solid. Like you couldn't hardly tell that it ever happened. Yeah.

And then he broke a front toe. But that was a different story. Different story, different day. That is dog. Anyway, so, okay. So that's kind of the nuts and bolts of hip dysplasia. Yeah. I think, yeah. There is, there is, we just touched on it a little bit, Dr. Keith did. There is a total hip replacement now. Yeah, which we've had a couple patients. We have. They've made great strides in that in the last 10 years. Mm-hmm.

Now, that is a very specialized surgery. Oh, yeah. There's just a few places in the country that will do that. Mm-hmm. I know one place down by Houston that will. I know there's a place, and these are just places that I know personally. One down by Houston's in Katy, Texas, and then one in Park City, Utah, and one in Baltimore, Maryland. We used to have somebody that did them in the city, but I don't know if he's still doing them.

Yeah, I don't know if he is or not. I don't even know if he's still practicing. Yeah, I don't know. That's been so long ago. It's been a while. Anyway, so yeah, so it's very specialized, but it does exist. I think the last one we had went to Texas. Yeah. I sent them to Gulf Coast. Yeah. And it's a good surgery. Yeah. I mean, and these are, I mean, those three places are guys I would recommend without any hesitation. Yeah. I mean, they're also the guys that are teaching me all of my orthopedics.

Yeah, for sure. So. Brilliant, brilliant surgeons. You know, so they do a really good job. Oh, that was Tracy's ringtone. Yeah. I'm not editing that out. No, that's fine. Okay, cool. So. So, yeah, that is an option. Most of the time, I can't say it is not the best option for a lot of dogs. It's not cheap, though. It's not. It's not cheap. I mean, honestly. Ten years ago, it was $5,000. Yeah. And it hasn't gone up tremendously since then. It's probably about $6,500 now.

So, not horribly for inflation. But, I mean, it's still not cheap. Yeah. Where your FHOs will be probably more like 1,500. Well, granted, that's here. I mean, who knows? Yeah, I mean, we're probably 1,000 to 1,500 depending on all the medication and stuff. Well, with your medicine and the size of the dog and all that. But yeah, so definitely. And you don't have to go to Houston because then you've got hotel rooms and all sorts of stuff going on. Yeah, because they get to stay

there for a little while. They do. They do. But yeah, we've done some FHOs on even really big dogs like Great Pyrenees. I remember that one. It was one of the worst hip displages I've ever seen. It's on that great parent. It's bilateral. It's bilateral. And they feel so much better. Yeah, they do. And a lot of those bigger dogs, they will be walking better the day after surgery than they were walking in for surgery. Yeah, because that bone was so painful. Because that pain is gone.

Yeah. I mean, and you can just imagine. So, yeah, my mom had a total hip, and that was her experience. Like, she literally felt better right after surgery than she had for years before. And you got to think, you know, we got a lot of muscle and stuff we got to cut through to get there. Oh, yeah. And the pain of that surgery is less than the pain that they were dealing with. Yep. You know, I mean, run that through your mind for me.

Yeah. Yeah. So, you know, hopefully, hopefully we can jump in before then, you know, but there's still options as you move down that dog's life that we can still greatly improve their mobility, their comfort level and, you know, just how they're going to progress over time. Yeah, I mean, we've got pretty much, I mean, until we're getting close to kind of end-of-life stuff where the joint just doesn't move anymore. Yeah.

We've got options. Yep, yep. We can help them. We may not make them back to where they used to be, you know, at a year old. You know, you have a 12-year-old giant shepherd. You're not going to make him a year old dog again. No. It's just not going to happen. No. But we can make him more comfortable and more functional for the most part. You know, like I said, there's cases like, no, there's not really anything else we can do.

But that's pretty rare. And typically we've been talking, you know, been talking to people and know that that day is coming at some point. And it's just, yeah, it doesn't usually, yeah, it doesn't usually catch you off guard. Like, you know, it's coming. But anyway, but there's so much that can be done before then. And I think early detection is, with all of these diseases we talk about, early detection is paramount. Yes. Yeah. I mean, the only one that.

Written was when we did the fractures. I think we did fracture. We did. I mean, you really don't have early detection of that. I mean, it just happens. Yep. Yeah. And sometimes I've, I've seen them need FHOs because of trauma. Like they get hit by car, kicked by a horse or whatever and had to have an FHO. So, but in general, I think the big thing is just like, don't wait until your dog can't get up to, to ask the question, could they have hip dysplasia?

It's much better to just look into that. It doesn't cost that much to sedate him and get good x-rays early on. You You will save yourself so much down the road. Yeah. I mean, it's, I mean, probably financially, probably not. If they do have, you know, at two years old, you find they do have some hip dysplasia. Probably in the end, you're going to spend about the same money. But your end, instead of at eight years, is going to be at 12 years.

And that's going to be a better, you know, say we started at two. You know, you get to the end at eight years. That's kind of a rough six years. You get to the end at, you know, 10 or 12 years.

Years well now we've had eight or ten good years in there yeah it's you know with big dogs like because typically it is a really big dog that has this issue we can't be any dog but big dogs if they can't get up and get around on their own it is a you know it's a quality of life issue that sometimes leads to euthanasia people just can't help them because they're you know too big and so so early intervention

really can increase not only their quality of life but the length of their life Yeah, the longevity. Yeah, for sure. So anyway, so much to be done.

If you have a big dog, I would encourage you, even if we're not your veterinarian, reach out to your veterinarian and see what you can do about getting aware of their hip status and starting early prevention measures to give yourself the best time with your furry friend possible. Yes. And now, and one little caveat in there on German Shepherds.

I just got to deal with a lot of those in the military. You can see a German Shepherd in, you know, to the regular person, you're looking like, oh, his hips are bad. So if you're thinking that, you go to your vet and they take x-rays and they're like, no, the hips are great. That's quite possible. We've had a fair number of those because some dogs, German Shepherds especially, will have lower back issues, sacroiliac specifically issues.

Yeah. That will mimic the look of hip dysplasia, hip issues.

Issues so that's why x-rays are important you can't just assume that it is their hips because, there's so many other things that are going on back there i actually had one case two weeks ago probably german shepherd mix i believe i remember right eight year old dog ten year old dog i think he was eight i don't think he'd get to the double digits yet and like yeah he's got hip dysplasia just i don't know if we can do anything blah blah in there take x-rays this dog's yet they are very pristine.

Yeah. I mean, it looks like the hip of a two-year-old dog. So then we took him for more x-rays. It was a lower back issue. Which is a whole different treatment plan. Yeah. But it mimicked the way he was walking. It mimics a hip issue. Yep. And there. So that's why one of the x-rays are imperative. Yep. Absolutely. Yeah. We don't just guess. No. So, okay, cool. One extra fun thing. First of all, if you're still listening,

you're a rock star. Thanks for being with us. We appreciate you being engaged with this.

But for the first time since we started the podcast, we are going to take a break for four weeks. Yes. Do you want to tell them why? Well, I don't know. Have we gotten the podcast about what's going on, what happened about a year ago? We occasionally will touch on it. We'll be like, sorry about the construction in the background. Well, about exactly 11 months ago yesterday. Yeah. Not that we're counting. Yeah. Mother Nature came by with a little windstorm. We call them tornadoes.

Yes. And kind of ravaged our building. Yeah. Sucked her off the planet. Yeah. Yeah. We were missing like a third of it. Yeah. Just gone. Don't know where. Somewhere between here and Kansas. Yeah. And so now we have a new building. You know, we got through all the insurance stuff. Insurance did us well in there. So we were able to get a new building coming up. and we have the open house in that building in one month. Yeah. Currently in that building, we don't have doors hung.

We don't have blinds. We don't have countertop. We don't have electricity. We don't have electricity. But it's going to be ready. It'll be ready. It will be. But. April 20th. I mean, it's going to be kind of all out. Everybody all out. Yeah, it's going to be. So we're going to be focusing heavily on not compromising the amount of patients we can see and also getting this building done. So we're trimming the fat, so to speak, of everything optional for the next month.

But then we'll be back. Yep, we'll be back. With new good stuff and fun times. So in the meantime, if you got friends that haven't listened to the podcast, we would love for you to share it. There's plenty of episodes. I think we're getting close to 40 of them now, 35, 40. It should be somewhere in there. By the time this one launches, I think maybe like 38. I don't know. Anyway, plenty of catching up for them to do to keep them entertained until

we get back in a month. But yeah, I think that's the big thing we wanted to tell you. Don't worry, we're coming back, but we just need a minute. Yeah, we need a minute. So, okay, cool. And otherwise, call us if you're having any concerns with your pet hips or anything else, and we'll be here to help. Sounds good. Music.