HIP DYSPLASIA IN DOGS

ELBOW DYSPLASIA IN DOGS

One of the most common causes of hind leg lameness in the dog is developmental problems of the hip joint. This disease leads to degenerative changes (osteoarthritis) in the joint including cartilage damage, bone spur (osteophyte) production, and loose bone fragments.

HIP JOINT FUNCTION

The hip joint of the dog is formed by two bones (the femur and pelvic bones (Figure 1)) that must fit together correctly for the joint to function normally. The top of the femur has a ball that fits to the socket of the pelvis. The muscles surrounding the joint help to maintain a tight joint. The ball should glide smoothly around the socket without excessive looseness.

CAUSES OF HIP DYSPLASIA

Hip dysplasia is typically a developmental, inherited disease of young large-breed dogs. Several factors have been found to play a role in the abnormal development of the hip joint. In these dogs, during growth, excessive looseness develops in the hip due to an imbalance between the muscles and the mechanical forces acting on the joint (Figure 2). This imbalance causes extra stress to be placed on the cartilage and the prominent parts of the joint (the rim of the socket and the edges of the ball) during normal activity. The joint cartilage is damaged in this process leading to pain, inflammation, and further joint looseness. Arthritis develops as a result of loss of cartilage and subsequent bone damage (Figure 3).
Whilst hip dysplasia in dogs is predominantly a genetic condition, diet and excessive exercise contribute to the severity of symptoms seen. Limiting the intake of calories in young, growing dogs and avoiding sustained activity are helpful in reducing the signs of hip dysplasia.
For a number of years, hip scoring schemes (e.g. PennHIP) have been used to assess breeding dogs for signs of hip dysplasia. X-rays of the hips are taken under anaesthesia or heavy sedation and sent away to be graded by trained veterinarians. These schemes are helping to eradicate this condition but because even normal dogs can produce puppies with hip dysplasia the rate of hip improvement has been slow.   

SYMPTOMS

Typically, affected dogs show hind leg lameness that can start as young as 5 months of age. The lameness may be intermittent and tends to improve with rest and get worse with exercise Affected dogs are often reluctant to jump or rise and may resist climbing stairs. Not all dogs with hip dysplasia show symptoms.

DIAGNOSIS

A thorough orthopaedic and neurologic examination is performed evaluating the dog when walking and by manipulating all four limbs and the spine. Pain and joint looseness can frequently be felt in the affected joint. Sedation or anaesthesia and x-rays are necessary to show signs of joint looseness and arthritis. A CT scan will often be more effective in showing any bony changes.

MEDICAL TREATMENT

Some dogs with confirmed hip dysplasia will improve without surgery. The object of medical treatment is to control the symptoms. allowed to The dog should not be to get overweight and exercise should be controlled. Cartilage protecting agents (omega fatty acids. glucosamine, green-lipped mussel, fish oil) may help lubricate the joint and keep cartilage healthy, Generally, lifelong supplementation is necessary. Anti-inflammatory medication (aspirin like drugs) can be helpful in reducing pain but should only be necessary occasionally. Medical treatment does not stop arthritis from continuing to develop.

SURGERY

Surgical treatment benefits dogs that do not adequately respond to medical treatment. The type of surgery differs between dogs depending on age, degree of arthritis, and hip looseness.
The triple pelvic osteotomy (TPO) can be performed in young dogs without arthritis. This procedure involves cutting the pelvis to rotate the socket thereby tightening the joint.
A total hip replacement (THR) can be performed to remove the arthritic hip joint and implant an artificial joint that is functional and pain-free.
If either of these procedures is not possible then a femoral head ostectomy (FHO) can be performed to remove the ball and reduce the arthritic pain.

RESULTS

Dogs that have had surgery generally show excellent results and can return to full activity 3-4 months after surgery.

DISK FUNCTION

The intervertebral disk of the dog acts as a cushion between the spinal bones (vertebrae) to absorb the shocks and movements of normal activity. The normal disk is like a “jelly doughnut” with a gelatinous centre and an outer ring of stronger fibrous tissue. In certain breeds of dog (Dachshund, Poodle, Beagle, Spaniel, Corgi), the disk degenerates at a very early age. As the dog ages, the jelly like component of the disk becomes more gritty and less resistant to pressure. The disk is then no longer able to cushion the spine and the contents of the centre may forcibly squirt out and bruise the spinal cord. Alternatively, the outer part of the disk may bulge up putting pressure on the spinal cord.

DIAGNOSIS

A thorough neurologic examination is performed evaluating the head, all four limbs, and the spine. Pain can frequently be felt at the site of the affected disk. Anaesthesia and X-rays can help to show signs of narrowed disk spaces and degenerative disks. To confirm the diagnosis, a CT scan is recommended as this provides us with the best information on the spine. A special X-ray test called a myelogram can be helpful, in addition to a CT scan. Some dogs have an associated instability of the vertebrae that has contributed to the disk degenerating.

SURGERY

Dogs that have severe neck pain.or significant spinal cord damage are also candidates for surgery. The most common procedure is a ventral slot, which involves drilling a slot in the base of the vertebrae to relieve the spinal cord pressure and allow the delicate extraction of the disk material. Sometimes, the central portion of adjacent degenerative disks is removed to reduce the chance of further disk

SYMPTOMS

Syleptoms typically develop, in order of severity, from neck pain to weakness and wobbliness then finally to unwillingness to stand depending on the speed or the amount of the disk rupture. In the most severe cases, dogs lose the ability to walk and become quadriplegic.

MEDICAL TREATMENT

Some dogs with only mild symptoms will respond to medical treatment. Generally this involves three or four weeks of strict confinement to a cage with the dog only allowed out to go to the toilet. Pain relief (cortisone or aspirin-like medication) is given at the same time but this does not mean the dog can be more active. Dogs that do not improve or get worse with medical treatment are candidates for surgery.

RESULTS

Dogs that have retained the ability to walk prior to surgery have a 95% chance of complete recovery following surgery. Complete healing of the spinal cord can take up to six months to occur. Regular progress in spinal cord recovery is seen during this time. Dogs with unstable vertebrae have an increased risk of further instability developing later in life.

Rupture

For dogs with instability of the vertebrae, additional surgical stabilisation may be performed. This is done using metal plates and screws or bone cement.

PROGNOSIS

The prognosis for recovery is mostly dependent on the severity of the damage to the spinal cord. The ability to walk before treatment is the key indicator for prognosis in dogs with a slipped disk in the neck.

POSTOPERATIVE CARE

EXERCISE CONTROL

To allow the bone to heal following the surgery. complete restriction of exercise is absolutely necessary for the first 6 weeks. Your dog can be walked on a lead for toileting. Light (515) minutes) lead walks can begin after 4 weeks.

SUTURE REMOVAL

The skin stitches need to be removed 10-14 days following surgery. This can be done by your regular veterinarian Please call our hospital if there is any swelling, discharge or redness around the stitches.

MEDICATION

Most dogs are sent home with medication for additional pain relief Sometimes, antibiotics are also dispensed Give the medications as 4 prescribed. Further pain relief can be prescribed if necessary. Please let us know two days before suture removal if you think more medication is required or you may be charged an urgent fee.

PHYSIOTHERAPY

Physiotherapy is an important part of your dog's recovery We strongly recommend a consultation with a recognised animal physotherapt Home-based physiotherapy should consist of a wants compress applied to the region of the stitches for 15 minutes followed by gende massage of the muscles The can be followed by gentle lexing and extending of the leg.

After the bone has healed, your dog can begin more active physiotherapy with regular controlled exercise Running without leash control is recommended for only short periods. Regular swimming is an excellent way of providing active exercise without joint stress.

FURTHER X-RAYS

Your dog should return to our clinic for further x-rays about six weeks after surgery to evaluate the bone healing. The dog will require sedation to get good x-rays. Do not feed your dog on the morning of this visit. This assessment will incur an additional cost.

LONG TERM TREATMENT

Some dogs will need long-term medication to control the arthritis already present in the elbow prior to the surgery. Cartilage protecting agents (omega fatty acids, glucosamine, green-lipped mussel, fish oil) may help lubricate the joint and keep cartilage healthy Generally, lifelong supplementation is necessary.

Dogs with hip dysplassa may benefit from feeding with Hill's Prescription Diet j/d Canine Mobility. This diet can improve your dog's signs of arthritis with a clinically proven combination of nutrients.

Antiinflammatory medication (aspirin-like drugs) can be helpful in reducing pain but should only be necessary occasionally.

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