Bionic Barry; Lab's injured elbow surgically replaced.
GRAFTON - Just call him Barry the Bionic Dog.
It's not a moniker the 7-year-old yellow Labrador retriever really wanted when he became the second canine to have an elbow replaced with a steel and plastic joint at Foster Hospital for Small Animals.
Cutting-edge biomedical technology and a team of veterinary surgeons at Cummings School of Veterinary Medicine at Tufts University restored Barry's quality of life when there wasn't a whole lot left to try, said Dr. Robert J. McCarthy, Barry's orthopedic vet.
A full elbow replacement was the only option that offered substantial relief from the pain and lameness of elbow dysplasia that had affected Barry much of his life.
Elbow dysplasia is a hereditary, degenerative disease believed to be caused by abnormal growth and development of bones that make up the elbow, resulting in a malformed and weakened joint subject to arthritis, according to the website DogTime.
Barbara Drury of Westminster, Barry's owner, said he's made steady progress since the surgery two weeks ago.
"They took out his staples Wednesday and he'll be starting physical therapy soon.
"Right now he's pretty much using three legs, testing the right once in awhile to see how it feels," Ms. Drury said.
Barry was 3 months old when she brought him home, and by the time he was a year old he was showing signs of lameness in both front legs.
Ms. Drury, owner of Manilow's Canine Playground in Leominster, a dog daycare, said Barry was eventually diagnosed with elbow dysplasia by her vet at Fallon Animal Clinic in Lunenburg.
"He was given pain medication, but as his condition worsened, I called the folks at Tufts. From the X-rays it was pretty clear that Barry's elbows were not in good shape," she said.
Barry's arthroscopic surgery in 2005 was not as effective as she and his vet had hoped, said Ms. Drury, and surgery was repeated the following year.
"After that, he was pretty good for awhile, but the dysplasia was always there in the background. Barry's had a variety of pain medications for arthritis, as well as a number of injections into the elbow. It wasn't until he had shockwave therapy that he really seemed to improve," she said.
In addition to treatment with pain medications for his arthritis, the dog had injections and just the past year had shockwave therapy that really seemed to make a difference. That's to say it improved his left elbow, but not so much his right elbow, Ms. Drury said.
Taking him to North Andover once a week for water therapy seemed to help as well, but the deciding moment came this summer, she said, when he was playing in the backyard, fell and re-injured the right elbow.
"The X-rays at Tufts showed his right elbow was completely surrounded by arthritis," she said.
Dr. McCarthy told her they had done about everything they could, suggesting the two options left for Barry were elbow replacement surgery or fusing the joint altogether, which would reduce his pain but limit his mobility.
"I decided to go for the full elbow replacement," Ms. Drury said.
As for the $5,000 cost, Ms. Drury said because Foster is a teaching hospital and this was its second surgery, she felt the price was more than fair.
"I don't have any children, but Barry is like a child to me, so I don't mind spending whatever it takes," she said.
"It came down to a choice of fusing the joint or replacing it," Dr. McCarthy said.
"Barry was our second elbow replacement and I imagine once we've done 10 or 20 it will be easier to tell people that this is something they should consider. It's a little more difficult to be convincing when you have to tell someone that their dog will be just the second to have this particular operation," Dr. McCarthy said.
"Because there are so many dogs out there with elbow dysplasia, it's becoming a problem we're seeing more frequently. And as the dogs get older and we have fewer and fewer options, replacement surgery becomes one alternative for an otherwise healthy dog," Dr. McCarthy said.
Foster's first elbow replacement was on a dog owned by an anesthesia technician at the hospital and the cost was "deeply discounted," he said.
"We decided to cap Barry's procedure at $5,000. We flew in a team from Michigan State because of their prior experience with elbow replacement, and, at that, I think they've only done this a dozen times or so," Dr. McCarthy said.
The replacement joint is made of cobalt chrome steel with a high-density polyethylene "gliding" surface. The prosthesis alone costs $1,600 to $1,800.
There's been a steady improvement in the quality of joint implant systems, Dr. McCarthy said. The first used cement to hold the joint in place. That was replaced with a system held in place by screws and was less likely to cause complications.
"When we contacted them, the folks at Michigan State told us that typically the elbow replacement surgery should take between three and four hours. Barry's surgery took longer, more than five hours, but that's because we're still new to this procedure," he said. "We're also very compulsive about doing this right."
Orthopedic vets at Foster would not recommend elbow replacement surgery for very young dogs when other things can be tried first, said Dr. McCarthy.
"We have arthroscopy, injections, painkillers, shockwave therapy. Discussion of elbow replacement doesn't come into play until we've tried and failed to improve a dog's lameness and pain level with more common practices, and that's especially true of a growing dog," he said. "I would think the best candidates for this surgery would be middle-aged dogs."
"Dysplasia is most commonly diagnosed in Labrador retrievers, golden retrievers, Rottweilers, Bernese mountain dogs and Newfoundlands. We see it in many large breeds, but it's most common in these five," Dr. McCarthy said.
As for Barry's left elbow, Ms. Drury wants to see how he's doing after physical therapy and the healing period before deciding whether to up Barry's bionic ante.
"We'll have to see how things go. The left isn't healthy either, but at the moment it's less of an issue because of the success of the shockwave therapy," she said.
ART: PHOTOS; ILLUSTRATION
PHOTOG: (P) T&G Staff/JIM COLLINS; (I) T&G Staff/DON LANDGREN JR.
CUTLINE: (P) Barbara Drury's yellow Labrador retriever emerges from Foster Hospital for Small Animals, where he underwent surgery to replace his right elbow. The bandage on his left leg is where intravenous therapy was inserted. (I) Canine elbow