0What are the first signs of Legg-Calve-Perthes?
The first sign is usually a gradually worsening limp on one back leg in a young small-breed dog. Your puppy may start favoring one leg, holding it up during walks, or becoming less willing to play and jump. As the femoral head deteriorates, the limp gets worse over weeks to months. You may notice the muscles on the affected leg getting thinner compared to the other side. Most cases are diagnosed between 4-12 months of age.
1How much does Legg-Calve-Perthes surgery cost?
Femoral head ostectomy (FHO) — the standard surgery — costs $1,500-$3,000 including anesthesia, surgery, and initial follow-up. Add diagnosis costs ($200-$400) and post-operative physical therapy ($200-$500). Total cost is typically $1,700-$3,400. Total hip replacement is an alternative at $4,000-$7,000 but is rarely necessary for small breeds, as they do exceptionally well with FHO.
2What is FHO surgery?
Femoral head ostectomy removes the damaged ball of the hip joint. The body forms a 'false joint' from scar tissue and muscle, which functions well enough for pain-free movement. Small dogs (under 20 pounds) have excellent outcomes because their light body weight puts minimal stress on the new joint. Most dogs return to normal activity within 6-8 weeks. It sounds dramatic but the results are consistently good.
3Can Legg-Calve-Perthes heal without surgery?
Very rarely. Conservative management with pain medications, rest, and physical therapy is sometimes attempted for very mild cases, but the deteriorating femoral head continues to cause pain and dysfunction. The vast majority of dogs need surgery for a good quality of life. Delaying surgery often makes things worse — the dog compensates by shifting weight, causing muscle loss and potentially affecting other joints.
4How long does recovery from FHO take?
Most dogs start bearing weight on the leg within days to a week after surgery. Physical therapy should begin 1-2 weeks post-op to build muscle and range of motion. Controlled exercise increases gradually over 6-8 weeks. Full recovery to normal activity typically takes 6-8 weeks. Swimming and gentle walks are excellent rehabilitation exercises. The long-term outlook is excellent — most dogs live pain-free, active lives.
5Which breeds get Legg-Calve-Perthes?
It's almost exclusively a small and toy breed condition. Yorkshire Terriers are the most commonly affected breed. Miniature and Toy Poodles, West Highland White Terriers, Chihuahuas, Manchester Terriers, and Miniature Pinschers are also frequently diagnosed. The condition is extremely rare in medium and large breed dogs. If your small-breed puppy develops a hind leg limp, Legg-Calve-Perthes should be on the differential list.
6Can Legg-Calve-Perthes affect both hips?
Yes, but it's uncommon. About 10-15% of cases are bilateral (both hips). When both sides are affected, surgery may be performed on both hips — either simultaneously or staged weeks apart. Bilateral cases cost more but still have good outcomes with FHO surgery. Your vet will X-ray both hips to check even if symptoms are only on one side.
7Does pet insurance cover Legg-Calve-Perthes surgery?
If your policy covers hereditary conditions and you enrolled before symptoms appeared, yes. The main risk is the orthopedic waiting period — many policies have a 6-month wait for orthopedic claims. Since symptoms often appear at 4-12 months, timing is tight. Enroll your small-breed puppy as soon as possible. At $1,500-$3,000 for surgery, insurance coverage makes a significant difference.
