DPO or TPO for the Puppy Who Missed the JPS Window: What the 8-to-10-Month Deadline Buys, and What It Does Not

If your puppy's hips were found loose after about 18 weeks, the age by which the ACVS says JPS must be done, the operation on the table is a pelvic osteotomy: a triple (TPO), which cuts the pelvis in three places and rotates the hip socket over the ball, or a double (DPO), which makes the same rotation with one cut fewer. The ACVS describes both for immature dogs, ideally under 8 to 10 months, with no arthritis on the films.^[1] Which of the two your dog gets is mostly the surgeon's technique, and no trial has compared them head to head. The question that deserves your evening is the one underneath: the only study to follow TPO against JPS for two years found that neither operation eliminated the laxity or stopped the arthritis. What an osteotomy reliably buys is a better-covered hip. Whether it also buys a sound adult dog has been measured far less well than the consult may make it sound.

You probably have two tabs open. One says DPO, one says TPO, and the consult is on Friday. The honest news is that the tab you should close is the one comparing them. The difference between the two is one cut in the pelvis, and the published evidence cannot tell you which cut your dog is better off without. What it can tell you, and what this page is for, is what either operation is likely to do to a hip like your dog's, what it has never been shown to do, and which questions will actually change the answer.

What is the difference between a DPO and a TPO?#

A dysplastic hip is a ball sitting too loosely in a socket that is too shallow and tilted the wrong way. Both operations fix the tilt rather than the looseness directly: they cut the pelvis so the piece carrying the socket can be rotated down and outward over the ball, then hold it there with a plate bent to a set angle while it heals. The ACVS describes them as "cutting the pelvic bone in two (DPO) to three places (TPO) and rotating the segments to improve coverage of the ball by the socket and decrease hip laxity."^[1]

The table's middle rows come from two places. The DPO's developers, in the first large series, wrote that "elimination of the ischiatic osteotomy allowed for increased stability of the pelvis," that the ability to sit without discomfort after DPO "was attributed to the stability of the ischium," and, in the discussion, that DPO "was a more difficult technique than TPO because mobility of the distal iliac segment was limited"; the paper's conclusion calls it "a little more demanding than TPO" and says that difficulty "is offset by elimination of ischial osteotomy."^[2] The equivalence comes from eight cadaver pelves, in which a 25-degree DPO produced acetabular rotation most similar to a 20-degree TPO.^[3] A 2026 CT study of 27 dogs adds that the rotation actually achieved by DPO "is less than the predetermined plate angle."^[4] So a plate's number is a nominal figure, not a promise.

More rotation is not better past a point. In a retrospective study of 56 dogs, 20 degrees of TPO rotation gave the same improvement in coverage as 30.^[5] If you are told your dog needs an unusually steep plate, ask why. Some authors hold that more rotation worsens pelvic canal narrowing and that dogs needing extreme rotation "are not likely good candidates"; a 2021 case series used 60-degree plates in seven dogs with high reduction angles, and all regained full function. Seven dogs settle nothing in either direction.^[6]

Which one has fewer complications?#

This is the question the two tabs are really asking, and the answer is that the numbers exist but cannot be put side by side. Every series below is one centre, one era and one kind of plate, followed for a different length of time and counting complications in its own way. Read them as the range your surgeon's own figures should fall inside, not as a league table.

Three things are worth taking from the table, and none of them is "DPO wins."

First, the more recent series, using locking or purpose-made plates, report far lower screw-loosening rates than the older conventional-plate series, so a figure from the 1990s says little about a surgeon operating today. These are different centres, so the comparison is suggestive rather than proof. Second, the two largest DPO series both carry the operation's developer among their authors, which is where you would expect the best results; the independent DPO studies are much smaller. Third, the loosening screw is the characteristic failure of both. One study found loose screws in 12 of 21 TPOs at ten days and recommends a film at that point to catch them;^[12] in dogs operated on both sides, the first side operated loosened more often than the second.^[7]

On the pelvic canal, which is the worry you will read most about: the DPO series reported "no narrowing of the pelvic cavity, except in a few cases with implant failure," in contrast, its authors say, to TPO, "which usually results in narrowing."^[2] Case reports exist of difficulty urinating after single-session bilateral TPO, from compression of the urethra where the canal narrowed.^[24] What we could not find is any canine study of whelping after either operation, so the birth-canal worry you will read about has not been measured in dogs.

So the fair answer to "which is safer" is: the difference in the literature points one way, and it is small in the modern series. We found no study comparing surgeons, but the DPO's own developers wrote that skilful rotation of the segment "required a certain amount of training",^[2] and that is true of both operations. That makes the most useful question at the consult not "which is better" but "which do you do, how many a year, and what happened to the last fifty?"

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What Manley 2007 says the operation does not do#

The only prospective study to follow a pelvic osteotomy against another operation for two years is small, and its conclusion is the sentence most consults leave out. Manley and colleagues at Wisconsin operated 18 dysplastic dogs with a distraction index of 0.5 or more in at least one hip, JPS at 4 to 5.5 months or TPO at 5 to 12 months, and found no significant difference at two years in lameness, laxity, force-plate loading, arthritis score or owner-scored function. TPO did change the shape of the socket: after it, the dorsal acetabular rim angle was significantly lower and the acetabular angle significantly higher at two years. And then: "neither procedure eliminates the hip joint laxity characteristic of hip dysplasia or the progression of degenerative changes."^[13]

The other long-term evidence says much the same in more words. A prospective series of 34 TPO dogs found about 40% had progression of arthritis on film, while 87% scored excellent or good on physical examination and 76% on owners' reports of activity at home; its authors concluded TPO "may slow, rather than stop, radiographic progression," and that the risk of arthritis on film rose with age at surgery, though age was not associated with how well the hips functioned.^[14] In the first DPO series, the hip had stopped clunking back into place on examination at two months in only 17 of 53 hips, and the authors wrote that further studies were required "to evaluate the long-term efficacy of DPO for the elimination of excessive joint laxity and for the prevention of osteoarthritis."^[2]

You will also find sources that say the opposite, and it is worth knowing why they disagree rather than picking the one you prefer. Cornell's canine health centre says JPS and TPO "often have good success if performed at the appropriate age in eliminating joint laxity as the puppy grows."^[15] A 2020 study of DPO concluded that the operation "prevented radiographically confirmed progression of osteoarthritis in the medium- to long-term": 34 of 38 operated hips had BVA hip scores of 10 or less at follow-up, a median of 49 months after surgery. Its untreated comparison group was four dogs.^[16] A 2014 systematic review of every surgical treatment for canine hip dysplasia published from 1948 to 2012 screened 477 papers, kept 17, and found that "few provided strong evidence to allow an adequate assessment of therapeutic efficacy"; pelvic osteotomy was not among the treatments it found consistently returning dogs to normal function.^[17]

The reconciliation is in what each one measured. The sources that sound confident measured the shape of the hip on a film, at a point in time, usually without an untreated comparison. The source that sounds cautious put a force plate and an owner questionnaire on the dogs, two years later, beside a comparison group, and found the looseness still there. Both are telling the truth about what they measured. A pelvic osteotomy changes the shape of the hip. It has not been shown to change what the hip becomes.

Does operating beat not operating?#

This is the comparison the whole decision rests on, and it is the thinnest evidence on the page.

The oldest long-term study of doing nothing surgical followed 68 immature dogs with hip dysplasia, clinical signs and radiographic changes, and found that 76% had minimal gait abnormalities at long-term follow-up "despite radiological evidence of moderate or severe osteoarthrosis."^[18] A later study of 74 dogs managed without surgery found that by the owners' assessment between 41.9% and 66.2% remained clinically affected, depending on the measure, and 41 of the 74 had been prescribed long-term medication.^[19] The closest thing to a head-to-head, a 1997 study of dogs under 12 months treated the same way on both sides, found TPO superior to conservative treatment on locomotion, examination, owner assessment and films. It had 16 TPO hips and 14 conservatively managed ones.^[20]

So there is a signal in favour of the operation, it comes from small groups, and the careful conservative option is not the same as doing nothing. Most dogs in the oldest series walked well on hips that looked bad. That is not an argument against surgery. It is an argument that declining surgery is a real choice with an outcome, and it should get a plan of its own: a weight target, an exercise prescription, a recheck date, and the same scrutiny the operation got. Without those, "we decided to wait and see" is simply what happened.

Who is a candidate, and what the 8-to-10-month deadline is really about#

The published criteria are more specific than "under ten months." The ACVS says DPO/TPO suits immature dogs with hip dysplasia "but no visible radiographic arthritic changes," and that dogs "with lameness and early evidence of hip arthritis are not ideal candidates."^[1] The first DPO series selected dogs of 4.5 to 9 months with subluxation and laxity, "no or minimal signs of osteoarthritis," a preserved rim on the dorsal acetabular view, an angle of subluxation not above 25 degrees and a distraction index up to 1; it named an angle of subluxation above 20 degrees as the mark of a poor candidate.^[2] The angles of reduction and subluxation come from the surgeon's hands on the sedated dog, the same palpation as the Ortolani test with a measurement attached, and they are numbers your surgeon should be willing to tell you.

Read the list and the deadline stops looking like a birthday. Cornell phrases it as "before orthopedic maturity, which for a Labrador Retriever-sized dog is eight months of age,"^[15] and the age is a stand-in for the things that actually disqualify a hip: a rim that has started to wear, cartilage that has started to fail, a socket too shallow for any rotation to cover. A nine-month-old whose hip still meets the criteria is a better candidate than a seven-month-old whose rim is gone.

And here is the finding that should change how you read your own dog's films. In 52 young dogs booked for TPO, all with clinical signs, 30 of 70 hips showed no arthritis on the X-rays, yet at arthroscopy 60 of 70 had cartilage lesions of grade 2 or worse and 14 had full-thickness lesions. Of the 46 hips with moderate lesions, only 23 showed anything on film. The authors' conclusion: "radiography is not a sensitive method for identifying moderate cartilage lesions in juvenile dogs with hip dysplasia."^[22] A 2019 study of 20 dogs scoped before DPO found the distraction index only weakly related to joint inflammation, and concluded that arthroscopy "can allow detection of joint pathology that might not be appreciated by using traditional radiographic screening criteria."^[23]

A puppy of seven months with loose hips may be limping a little or not at all. He runs, he sleeps, he eats, and his films come back with the words "no degenerative changes." Those words mean the X-ray could not see arthritis. They do not mean the cartilage is untouched: in that study, 24 of the 30 hips with clean films had moderate or worse cartilage damage when someone looked inside. The damage the operation is supposed to prevent may already have begun, quietly, in a dog showing nothing at all.

“Because your dog can't tell you how much pain he or she is in.”

If your surgeon offers arthroscopy before the osteotomy, that is not an upsell. It is the only way to see whether the joint you are about to spend the money on is still the joint the operation is designed for. Ask whether it is offered, and what finding would change the plan.

What recovery looks like#

This is a much bigger operation than JPS. It involves a bone cut, a plate and screws, and weeks of healing, so the aftercare looks more like a fracture repair than a puppy procedure. The early part is quicker than owners expect.

Both hips are often dysplastic, and surgeons differ on doing them together or weeks apart. The 95-dog series operated both sides in one session; the DPO developers do the same and operate first on the side needing more rotation;^[2] other surgeons stage them several weeks apart. We found no study establishing one interval as better. What changes for you is the shape of the next two or three months: one recovery, or two in a row. Ask which, and plan leave around it.

Two things to watch at home that a discharge sheet may mention only in passing. A dog who strains to urinate or produces little: difficulty urinating from urethral compression has been reported after single-session bilateral TPO, rarely, and it is a same-day call. And a dog who was improving and then stops using the leg, or cries when sitting: those are the signs a screw or plate may have moved, and the ten-day film exists to catch it.

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What you need to buy, and what you already own#

Less than you think. A puppy of this age almost certainly already has a crate, and because these dogs are walking within a day or two, the crate he already knows is usually the right confinement. It is the paralysed dog after spinal surgery who needs to be lifted from above rather than dragged through a door. Before you buy a pen, look at the one on this site we recommend for that dog: the 30-inch MidWest pen is the wrong object here. Its own Amazon listing names French Bulldogs, terriers and Dachshunds and suggests a mesh top "for pets that jump or climb,"^[26] and MidWest's 42-inch listing names Australian Shepherds and Boxers instead.^[27] If you need a pen for a big adolescent, it has to be a taller one, and a crate is cheaper still.

The free thing that matters is a bath towel. Rolled lengthwise and passed under the belly just in front of the hind legs, it steadies the back end on a slippery floor or the two steps into the garden for the first days. Many dogs after a single-side DPO will not need anything more.

The case for a sling is narrower and specific: both hips done in one session, a big dog, hard floors, and steps you cannot avoid. In the 95-dog bilateral series, the dogs were walking unaided by day four,^[9] so what you are buying is support for the days before that and for the floors where one slip could load a freshly cut pelvis sideways. That is where the GingerLead earns its place: a single padded strap under the belly with handles, quick on and off at 6am, washable.

It comes with a caution nobody puts on the box. A sling takes weight off the hind legs, and how much weight your dog puts on the operated leg is the one thing you are watching for six weeks. If he walks every outing in the sling, you are measuring your own arm, not his hip. Use it on the floors and steps that frighten you, and take it off on grass for a few metres each day so you can see him load the leg on his own. When he stops needing it on the hard floors, put it in the cupboard; given that the dogs in the published series were walking unaided within one to four days, expect that to be a matter of days, not weeks. It is also sized by sex and pad width, not weight, so a 50 lb male adolescent may fit the Small Male rather than the Medium/Large our link goes to. Do the maker's towel test before you order, because the direct return window is ten days.

The other thing that works has no deadline. Whatever you decide about the surgery, a lean dog is the one intervention in the hip literature that does not close at 18 weeks, as JPS does,^[1] or at 10 months, and the kitchen scale page sets out the lifelong feeding trial behind it. An osteotomy changes the socket; the ration decides how much load goes through it for the next ten years.

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What it costs#

We could not find a veterinary teaching hospital that publishes a fee for TPO or DPO. The ranges on insurer and blog pages disagree with each other by thousands of dollars and cite nothing, so we do not repeat them. Ask for a written estimate that states: one hip or both; one session or two; preoperative films, sedated angle measurements and any CT or arthroscopy; the ten-day and six-week radiographs; and what happens to the bill if a screw loosens and the plate has to be revised. If the puppy is insured, read the hip dysplasia insurance page before the films are taken, because the screening record is dated and it follows the dog.

The questions that change the answer#

Most of these are in our questions for an orthopedic surgeon. These five are specific to this operation:

1. Which do you do, DPO or TPO, and how many a year? The answer you want is a number, not a technique debate.
2. What are my dog's angles of reduction and subluxation, the rim view and the distraction index, and where do they sit against your own cut-offs? If the answer is "borderline," ask what the borderline dogs in your practice went on to do.
3. Would you scope the joint first? And what would you do differently if the cartilage is already damaged?
4. Both sides together or staged, and why?
5. What does success look like in writing, and when do we measure it? A film at two months showing coverage is the operation working mechanically. Ask what the practice measures at one and two years, and whether it has ever compared its dogs against ones managed without surgery.

What to do this week#

Your puppy is 18 weeks to 8 months, with loose hips on film. You are inside the window, and it is narrower than the calendar suggests, because what closes it is the rim and the cartilage, not the date. Get the surgical consult booked this week, go in with the five questions above, and ask for the angles on paper. If JPS was never discussed and your puppy is only just past 18 weeks, ask about it anyway: the JPS page sets out the age results honestly.

8 to 10 months. Still within the ACVS range. The films and the rim view matter more than the birthday; ask whether the surgeon would scope first.

Past 10 months, or arthritis already on the film. The criteria have mostly closed, and the choices become the long management and, later, the operations built for a hip that is already arthritic, laid out on our page comparing hip replacement with other surgery. The one DPO series in older dogs was eight dogs. If a surgeon offers it, ask for the practice's own results in dogs of that age.

You have decided against surgery. Then make it a decision rather than a drift: a target weight with your vet, an exercise plan with a number on it, and a recheck on the calendar. The hip dysplasia guide is where that plan starts.

The one-letter difference between DPO and TPO is the question you will spend the evening on, and it is the one the evidence settles least and matters least. The questions that decide how this dog walks at eight years old are about the joint, the surgeon and the ration, and they can all be asked this week.

Sources#

1. American College of Veterinary Surgeons. "Canine Hip Dysplasia." acvs.org — read 23 September 2026: DPO/TPO "for immature dogs (ideally less than 8–10 months old) with CHD but no visible radiographic arthritic changes"; "Immature dogs with lameness and early evidence of hip arthritis are not ideal candidates"; leash exercise and confinement to a small area until healed, "generally six and eight weeks respectively" for DPO/TPO and total hip replacement.
2. Vezzoni A, Boiocchi S, Vezzoni L, Vanelli AB, Bronzo V. "Double pelvic osteotomy for the treatment of hip dysplasia in young dogs." Veterinary and Comparative Orthopaedics and Traumatology. 2010;23(6):444-452. doi:10.3415/VCOT-10-03-0034 — retrospective, single surgeon; 53 DPOs in 34 dogs aged 4.5–9 months; selection criteria quoted above; implant failure 3.5% (12 loose and 1 broken of 371 screws), partial plate pull-out 9.4%, incomplete fracture of the ischial table 7.5%; 19 complications in 11 of 53; canal narrowing 11.3%, all after implant failure; Ortolani negative at two months in 17 of 53 hips; walking at 8–18 hours; four to six weeks of confinement; no control group. Full text read.
3. Punke JP, Fox DB, Tomlinson JL, Davis JW, Mann FA. "Acetabular ventroversion with double pelvic osteotomy versus triple pelvic osteotomy: a cadaveric study in dogs." Veterinary Surgery. 2011;40(5):555-562. doi:10.1111/j.1532-950x.2011.00802.x — eight cadaver pelves; 25° DPO most similar to 20° TPO.
4. Trommelmans I, Jenkins PL. "Effect of Double Pelvic Osteotomy on Dorsal Acetabular Rim Angle Using Computed Tomography in 27 Dogs." Veterinary and Comparative Orthopaedics and Traumatology. 2026;39(1):38-46. doi:10.1055/a-2648-3251 — achieved rotation less than the plate angle.
5. Tomlinson JL, Cook JL. "Effects of degree of acetabular rotation after triple pelvic osteotomy on the position of the femoral head in relationship to the acetabulum." Veterinary Surgery. 2002;31(4):398-403. doi:10.1053/jvet.2002.33598 — 56 dogs; 20° TPO rotation gave the same coverage improvement as 30°.
6. Elefterescu H, Ober C, Timen A, Yiapanis C, McCartney W, Milgram J. "The Use of Sixty Degree Rotation of the Acetabulum for Treatment of Dogs With Canine Hip Dysplasia. A Short Case Series." Frontiers in Veterinary Science. 2021;8:669680. doi:10.3389/fvets.2021.669680 — 60° TPO plates in seven dogs; indicated in skeletally immature dogs without secondary arthritis; summarises other authors' view that dogs needing extreme rotation are "not likely good candidates," and concludes that 60° rotation can be used successfully when reduction angles exceed 40°; all seven dogs regained full function.
7. Doornink MT, Nieves MA, Evans R. "Evaluation of ilial screw loosening after triple pelvic osteotomy in dogs: 227 cases (1991-1999)." JAVMA. 2006;229(4):535-541. doi:10.2460/javma.229.4.535 — complications in 96 of 332 procedures (29%); first-operated side loosened more often.
8. Whelan MF, McCarthy RJ, Boudrieau RJ, Kraus KH. "Increased sacral screw purchase minimizes screw loosening in canine triple pelvic osteotomy." Veterinary Surgery. 2004;33(6):609-614. doi:10.1111/j.1532-950x.2004.04091.x — 69 TPOs in 46 dogs; 6% of screws loosened; pelvic diameter fell a mean 7.79%.
9. Borostyankoi F, et al. "Results of single-session bilateral triple pelvic osteotomy with an eight-hole iliac bone plate in dogs: 95 cases (1996-1999)." JAVMA. 2003;222(1):54-59. doi:10.2460/javma.2003.222.54 — all but one dog walking by day four; mean stay 7.5 days; mean iliac healing 8 weeks; 0.5% of screws loosened; all complications minor.
10. Rose SA, Peck JN, Tano CA, Uddin N, de Haan JJ. Veterinary Surgery. 2012;41(1):156-162. doi:10.1111/j.1532-950x.2011.00930.x — locking plates, DPO and TPO, 26 dogs and 38 hips; 1 of 266 screws loosened; no clinically significant change in canal dimensions.
11. Tavola F, Drudi D, Vezzoni L, Vezzoni A. "Postoperative Complications of Double Pelvic Osteotomy Using Specific Plates in 305 Dogs." Veterinary and Comparative Orthopaedics and Traumatology. 2022;35(1):47-56. doi:10.1055/s-0041-1735288 — 458 DPOs; complications 8.2% (major 0.6%); one-to-two-month follow-up.
12. Bogoni P, Rovesti GL. "Early detection and treatment of screw loosening in triple pelvic osteotomy." Veterinary Surgery. 2005;34(3):190-195. doi:10.1111/j.1532-950x.2005.00030.x — loose screws in 12 of 21 TPOs at ten days; recommends a ten-day radiograph.
13. Manley PA, Adams WM, Danielson KC, Dueland RT, Linn KA. "Long-term outcome of juvenile pubic symphysiodesis and triple pelvic osteotomy in dogs with hip dysplasia." JAVMA. 2007;230(2):206-210. doi:10.2460/javma.230.2.206 — 18 dogs with DI ≥0.5, allocated by age rather than randomised; no significant differences at two years; "neither procedure eliminates the hip joint laxity characteristic of hip dysplasia or the progression of degenerative changes."
14. Rasmussen LM, Kramek BA, Lipowitz AJ. "Preoperative variables affecting long-term outcome of triple pelvic osteotomy for treatment of naturally developing hip dysplasia in dogs." JAVMA. 1998;213(1):80-85. doi:10.2460/javma.1998.213.01.80 — 34 dogs; about 40% had progression of arthritis; 87% excellent or good on examination, 76% at home; "may slow, rather than stop."
15. Cornell University College of Veterinary Medicine, Riney Canine Health Center. "Canine Hip Dysplasia." vet.cornell.edu — updated 31 August 2026, read 23 September 2026.
16. Jenkins PL, James DR, White JD, et al. "Assessment of the medium- to long-term radiographically confirmed outcome for juvenile dogs with hip dysplasia treated with double pelvic osteotomy." Veterinary Surgery. 2020;49:685-693. doi:10.1111/vsu.13404 — 22 DPO dogs (38 hips) against four non-surgical dogs (8 hips); median follow-up 49 months; 34 of 38 operated hips BVA ≤10.
17. Bergh MS, Budsberg SC. Veterinary Surgery. 2014;43(5):501-506. doi:10.1111/j.1532-950x.2014.12208.x — systematic review, 477 papers screened, 17 included.
18. Barr ARS, Denny HR, Gibbs C. Journal of Small Animal Practice. 1987;28(4):243-252. doi:10.1111/j.1748-5827.1987.tb03879.x — 68 immature dogs managed conservatively; 76% minimal gait abnormalities despite moderate or severe osteoarthrosis on film.
19. Farrell M, Clements DN, Mellor D, et al. Veterinary Record. 2007;160(15):506-511. doi:10.1136/vr.160.15.506 — 74 dogs, not limited to juveniles; 41.9–66.2% remained clinically affected by owner assessment.
20. Planté J, Dupuis J, Beauregard G, Bonneau NH, Breton L. Veterinary and Comparative Orthopaedics and Traumatology. 1997;10(2):101-110. doi:10.1055/s-0038-1632578 — dogs under 12 months; 16 TPO, 14 conservative and 10 excision hips; TPO superior on function and films.
21. Petazzoni M, Tamburro R. Veterinary Surgery. 2022;51:320-329. doi:10.1111/vsu.13737 — DPO in eight dogs aged 10–28 months; all free of lameness at eight weeks; no change in canal width.
22. Holsworth IG, Schulz KS, Kass PH, Scherrer WE, Beale BS, Cook JL, et al. "Comparison of arthroscopic and radiographic abnormalities in the hip joints of juvenile dogs with hip dysplasia." JAVMA. 2005;227(7):1091-1094. doi:10.2460/javma.2005.227.1091 — 52 TPO candidates, 70 hips; dogs with clinical signs; 30 hips without radiographic arthritis; grade 2 or worse cartilage lesions in 60 of 70 at arthroscopy; radiographic abnormalities in only 23 of 46 hips with grade 2–3 lesions.
23. Ulfelder EH, Hudson CC, Beale BS. "Correlation of distraction index with arthroscopic findings in juvenile dogs with hip dysplasia." Veterinary Surgery. 2019;48(6):1050-1057. doi:10.1111/vsu.13265 — 20 dogs, 36 hips, scoped before DPO.
24. Papadopoulos G, Tommasini Degna M. "Two cases of dysuria as a complication of single-session bilateral triple pelvic osteotomy." Journal of Small Animal Practice. 2006;47(12):741-743. doi:10.1111/j.1748-5827.2006.00112.x — two dogs, urethral compression from pelvic canal narrowing, both resolved.
25. Janssens LAA, Daems R, Pillin Y, Vandekerckhove P, Van Dongen S. "Triple pelvic osteotomy with a 12.5° and a 20° Slocum-type plate: a short-term prospective clinical pilot study in 38 dogs." Veterinary Surgery. 2020;49(7):1449-1457. doi:10.1111/vsu.13471
26. MidWest 30-inch exercise pen with door, Amazon listing B002908DX0, read via the Amazon Creators API 23 September 2026.
27. MidWest 42-inch exercise pen with door, Amazon listing B005OCWML4, read via the Amazon Creators API 23 September 2026.

Where we could not obtain a paper's full text, its figures above come from the published abstract; source 2 was read in full.

This article is educational and does not replace veterinary advice. Whether a dog is a candidate for a pelvic osteotomy, which one, and when, is a decision for your own vet and a board-certified surgeon with your dog's films and examination findings in front of them. We have no veterinary reviewer on this page yet and say so in the badge above.