Elvis and His Ceramic Hips

Posted on by

Meet Elvis, a 2 year old domestic long hair cat that is now the proud owner of 2 ceramic hips.

At the start of the year, he started to have some pain in his back right leg. He had been limping, reluctant to jump onto furniture and seemed painful when picked up. After a visit to see one of our vets, he was trialled with pain relief as there was some discomfort when extending his right hip. Unfortunately, he didn’t improve so he was referred to see Rob, our in- house orthopaedic specialist, who agreed the issue was with his hip.

Elvis underwent sedation and radiography to ascertain what was wrong with his hip and he was diagnosed with bilateral (both sides) metaphyseal osteopathy. This is a fancy way of describing his growth plates not closing and being at risk of slipping (fracture). On his right side this had already happened so poor Elvis was walking around with a broken hip joint. At this point his left hip joint was stable and hadn’t fractured but the worry was that this could happen soon!

There were 2 options for Elvis’ owners to choose from. He could either undergo a procedure to remove the hip joint and allow his muscles to form a pseudo joint rendering him pain free although potentially resulting in reduced strength in that leg. This is called a femoral head and neck excision. Or he could be referred to have a total hip replacement (THR). THR is considered to be the optimal outcome as once healing is complete it is entirely pain free and offers full range of motion for our patients.

As Elvis would potentially require both hips to be operated on, THR would likely allow the best long term quality of life. Elvis’s owners decided to have his right hip replaced first with a view to assess how his left side was after the procedure.

Three days after his surgery he was sent home with strict instructions to be rested and pain relief to keep him comfortable. During his post operative period, Elvis struggled with pain management and was not following the expected recovery arc as he couldn’t achieve the levels of movement expected in the time frame. At his post op check he was now more painful over his left hip (the leg not operated on) and there was an obvious crunching (crepitus) coming from that side.

Rob re-examined Elvis and confirmed that the left side had now fractured and would need treatment. The same two options were offered to Elvis’s owners, and they were very dedicated and decided to give him a matching set of new artificial hip joints! Surgery was scheduled and performed with great success. The second recovery period was much smoother now that both of his hips had been fixed and were pain free.

Elvis is now well on the road to recovery and is back to being a young happy cat again. Within four months, Elvis has had both of his hip joints replaced and has gone from a sore cat who doesn’t enjoy exercise to a confident happy cat who is able to do all of the usual things for him. Despite all of his trauma and the pain of having his hips palpated and manipulated he still loves to come in and show off his scars for regular post op checks.

Inhouse Specialists-Canine Cruciate Ligament Disease

Posted on by

What is the canine Cruciate ligament and what does it mean to have a rupture?

The canine cruciate ligament is similar to the anterior cruciate ligament (ACL) in people. It stops the shin bone (tibia) moving forwards relative to the thigh bone (femur) and prevents internal rotation of the knee. It has two components which work together to stop the tibia moving when the knee (stifle) is both flexed (bent) and extended (straight). In dogs it is generally considered to be a degenerative condition due to the angle of the joint being too steep. It can also be traumatic as it is in sportspeople however this is less common for dogs.

As there are two components to the cruciate ligament in dogs, they can have either a partial or complete rupture of their cruciate ligaments. Unfortunately a partial tear is almost certain to become a full tear in the future as the remaining band will face more inappropriate forces and the knee will become unstable when flexed.

Dogs that have suffered a cruciate rupture are typically very sore at the point of the injury or immediately afterwards but the pain may lessen with time and rest. They may be reluctant to put their foot down on the affected leg, or in some cases they will be toe-touching (putting the foot on the ground but not actively weight bearing). Although some very stoic dogs will also be able to walk/run around with some lameness.

Some unlucky dogs also tear their meniscus (a pad of cartilage in the joint), as the knee is now unstable and moves in ways it wasn’t intended to. This is generally much more painful.

Treatment options for cruciate disease

When your pet is diagnosed with a cruciate ligament rupture the initial therapy is anti-inflammatories, pain relief and rest. The immediate goal is to reduce ongoing trauma to the joint due to inflammation and instability. With time the inflammation and swelling within the joint will reduce and the knee will fibrose (scar) to provide more stability. For some dogs this method of conservative management is a good option, however for dogs larger than 15kg this rarely results in a return to function for that leg.

Surgical intervention is the preferred option and there are a variety of procedures available that work. With advancements in veterinary medicine the techniques that attempt to replicate the function of the ruptured ligament are considered less favourable compared to procedures that eliminate the need for the ligament. The procedure performed here at Hollybank Vets by our resident Professor in orthopaedics Rob Pettitt is called a tibial plateau levelling osteotomy (TPLO).

The TPLO means we change the angle that the tibia sits at relative to the femur which prevents the forward movement of the tibia when the leg is loaded. This requires radiographic (x-ray) measurements of the knee and proper planning of the intended bone cuts. Once the angles have been measured we are ready for surgery.

The first part involves opening the joint and inspecting the cartilage, ligaments and menisci. This enables any meniscal tears to be removed and confirms there isn’t any other underlying disease process. Then a semi-circular bone cut is performed through the top of the tibia, rotating the fragment before fixing it with a locking/compression plate as we would for a fracture. This may sound excessive or unpredictable however the benefits of this procedure are very repeatable and predictable outcomes. Whilst the bone cut is healing the pet must be rested to allow the bone to heal however after 8 weeks they will graudally start to increase their exercise and by 16 weeks we expect a normal return to function.

Long term outcomes for surgical repair are more favourable than conservative management, however as the joint has sustained an injury it will suffer from osteoarthritis. Unfortunately as this is largely a degenerative condition if a dog suffers one cruciate injury they are likely to suffer another in the other leg. Ongoing weight management and exercise management often help mitigate this risk and by maintaining a good weight in a well muscled dog we are more likely to see better outcomes.

Professor Rob Pettitt

We are very fortunate to have Rob here at Hollybank, he works at our Winnington surgery on a Friday and is open to reviewing all dogs (and cats) with cruciate ligament disease or any other orthopaedic disease.

Rob started his career as a sailor in the royal navy before jumping ship to become a veterinary surgeon.

Rob graduated from the University of Liverpool in 2002 and spent three years in general practice. He returned to the University as a Clinician Teacher in Small Animal Orthopaedics and in 2010, passed the RCVS Diploma in Small Animal Orthopaedics. Rob is now an RCVS recognised specialist in orthopaedics, has published widely in his field, is the current chair of AOVET principles course and has presented at numerous conferences both nationally and internationally.

Rob continues to work as Professor of Small Animal Orthopaedics at the University of Liverpool but joined the Hollybank team in addition to this in 2024. Rob provides specialist orthopaedic consultations and surgeries at our Winnington practice . Our Orthopaedic service is supported by our own vets and RVNs whom Rob also provides additional support and teaching to.

Outside of work Rob is a keen cyclist and enjoys exploring the local area.

If you think your pet may be showing signs of joint disease or you wish to know more about this condition please contact the practice on 01606 880890 or 01606 717969

Rabbit Awareness Week

Posted on by

The Rabbit Awareness Action Group (RAAG) is the trusted voice for rabbit welfare, each year they run Rabbit Awareness Week (RAW) to improve the lives of pet rabbits. This year is their 20th anniversary campaign and the theme is Feeding Bunnies Better!

This is to educate and inform about the ideal diet and feeding requirements we should provide for our bunnies. Rabbits are the UK’s third most popular pet, after dogs and cats, however they are still often neglected with the wrong diet, no companionship or unsuitable housing.

Hay should make up 85–90% of your rabbit’s diet! The rest should include a small portion of high-fibre nuggets, rabbit-safe greens and fresh water daily. Too many treats or muesli-style foods can lead to selective feeding and serious health issues, so getting the balance right matters. A rabbit’s diet is very important as this is the main way to ensure their dental health. If rabbits are not fed correctly then they can be prone to overgrown teeth, which will cause pain and discomfort. Rabbit teeth grow continuously throughout their life so they require plenty of fibre to help wear them down. Incorrect diets can also lead to gut stasis and obesity.

Rabbits need plenty of space to hop, stretch, explore and forage naturally. A cramped setup limits movement, impacting their health, wellbeing and make it harder to encourage natural feeding behaviours like grazing on hay throughout the day. You should provide a rabbit-friendly space with room to scatter feed, forage and roam, because happy homes help create healthy appetites.

Rabbits love to forage, dig, chew and explore, and food can be a great way to encourage these natural behaviours. Try scattering nuggets through hay, hiding treats in enrichment toys or offering safe forage to keep mealtimes fun and stimulating. Feeding shouldn’t just fill tummies, it should keep rabbits mentally and physically active too.

Rabbits are social animals and should live in compatible pairs or groups. A lonely rabbit can become stressed, withdrawn and may even lose interest in food. Eating together is a natural rabbit behaviour, bonded bunnies often graze side-by-side, forage together and help each other feel safe and secure. Friendship really can help keep rabbits happier, healthier and eating well.


A rabbit that stops eating is often a rabbit that needs urgent veterinary attention. Changes in appetite can be an early sign of dental problems, stress, illness or gut stasis — which can quickly become serious.

Keep an eye on eating habits, droppings and behaviour, and always contact your vet if something feels wrong. Healthy rabbits start with prevention, proper nutrition and regular care.

Ensuring your rabbit is fed correctly is one of the ways you can ensure they are the happiest and healthiest they can be. Other important aspects of their lives include providing adequate space and housing, grooming, neutering and vaccinations.

A hutch is not enough! Hutches should never be used as the main enclosure for a rabbit as they do not provide enough space. As a minimum, a pair of average sized rabbits would need space measuring at least 3m x 2m all on one level with a height of 1m. Having a 3m length of space is important for them to be able to run. Other components of a good enclosure include a multi level home with ramps and platforms, places to dig, such as a foraging box. or a play tunnel to run through. Hiding spaces are important, as are cosy areas to sleep – a hutch could make a good hiding or sleeping place.

Rabbits love going free range and having a wide lawn they can be let out to explore and run. 

As rabbits should live in groups it is also important to ensure they are neutered to prevent any unwanted litters. Neutering also has the further benefit of preventing uterine cancers in females and can reduce aggressive behaviour. 

All rabbits should be vaccinated against Myxomatosis and Rabbit Viral Haemorrhagic Disease (RVHD), which can both be fatal. Vaccinating them is a simple way to help prevent spread of the disease.

If you have any questions about looking after your rabbits or if you are thinking about getting rabbits as a pet, then we are here to help.

Contact us on 01606 880 890 or 01606 717969 or visit https://rabbitawarenessactiongroup.co.uk for more information