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HIP DYSPLASIA IN DOGS, PART 3

Posted Aug 07 2009 12:12pm
Wow, now that I have your attention with this photo of a full moon, how many of you remember where you were 40 years ago tomorrow, 20 July 1969? Desperado and Helpful Buckeye were sitting in our tiny apartment, in married student housing, in graduate school at Florida State University, and not quite certain of the importance of what we were about to see on the TV. It's impossible to forget the transmitted pictures of Neil Armstrong as he took the first step on the moon.

As the many turns of events that occur in our lives bring us to unexpected destinations, Desperado and Helpful Buckeye find ourselves in Flagstaff, AZ, where those early astronauts came for part of their training before the attempted lunar landing. Tomorrow evening, we'll be attending a 40th anniversary of that first lunar landing, being held at Lowell Observatory, in downtown Flagstaff. Lowell Observatory is also where the planet Pluto was discovered in 1930.

Except for those of you who still believe the lunar landing was filmed on the back lot of a movie studio, I'm sure the rest of us consider the event one of the most striking accomplishments in our lifetime. Believe it or not, there actually is a connection between this event and Questions On Dogs and Cats...and this picture proves it:
Special recognition to anyone who knows the name of the painting and the artist. More on this next week.

Apparently,not very many of our readers have faith in the pet horoscopes we discussed last week. Only 20% of you said you'd be likely to follow them for your pet, while the other 80% said either "not at all" or "you didn't care, one way or the other." Be sure to answer this week's poll questions in the column to the left.

CURRENT NEWS OF INTEREST

1)To help reduce the estimated 500,000 pets affected by home fires each year, The American Kennel Club and ADT Security Services today (16 July 2009) launched the inaugural "National Pet Fire Safety Day." This nationwide awareness day educates pet owners about potential risks when pets are left home alone and provides them with proven prevention measures to ensure their safety. For the rest of the story and a list of tips on keeping your pets safe from house fires, go to: http://www.akc.org/news/index.cfm?article_id=3907

As an extra benefit, you can obtain a free pet alert window cling by going to: https://www.adt.com/resi/programs/pets/

2) The American Veterinary Medical Association has released this information about a new vaccine for dogs:



USDA approves canine flu virus vaccine
The Department of Agriculture announced in June that it had issued a conditional license for the first canine influenza virus vaccine.


For therest of the press release, go to: http://www.avma.org/onlnews/javma/aug09/090801c.asp



So far, this recently-recognized disease of dogs seems to be associated with kennels and with dogs living in close-quarters. If you have any questions about the incidence of canine flu virus in your area or advice about the vaccine, check with your regular veterinarian.



DISEASES, AILMENTS, AND MEDICAL CONDITIONS




Much to the credit of our readers, many of you have sent e-mails stating that, even though you've never had a dog with Hip Dysplasia, you were very interested in learning about the painful arthritis associated with this disease. A lot of the lessons learned about Hip Dysplasia can be applied to other forms of arthritis as well. After giving a preliminary review of medical and surgical treatment last week, Helpful Buckeye is presenting a more detailed description of those options in this week's issue of Questions On Dogs and Cats.



General Guidelines For Medical Treatment


Once evidence of osteoarthritis is detected on an X-ray, dysplastic changes are irreversible and usually continue to progress over time. If a dysplastic dog has secondary arthritis and pain, most owners elect to first treat their dog with medical management. The two main keys to medical management of arthritis are weight control and exercise management. Studies have shown that up to 76% of severely dysplastic dogs with arthritis secondary to HD are able to function and live comfortable quality lives with conservative medical management.

With weight control, the goal is to prevent the dog from becoming overweight to reduce mechanical stresses applied to the hip joints. In general terms, the ribs should be easily palpated and there should be an indentation in front of the pelvic wings (waist line).

Controlled exercise is indicated to prevent or relieve the inflammatory process that leads to the pain associated with arthritis. The amount and difficulty of the activity is determined on a trial and error basis. Exercise should start with short leash walks and be gradually increased until the dog reaches the desired level of activity. If clinical signs start to reappear, the amount of exercise is scaled back to a level that will not cause clinical signs. Overall, exercise should fit to an individual dog's maximum intensity level with the goal to maintain muscle tone and cardiovascular function without causing pain, stiffness, and inflammation to the joint. The right amount of exercise helps to maintain muscle tone and strength which can help make the unstable dysplastic joint stronger. Exercise also improves joint range of motion which in turn, keeps the dog more comfortable. Swimming, because it is a non-weight bearing exercise, can be a very useful means of maintaining muscle tone and range of motion without placing concussive forces on the joint.

A third and lesser factor in the conservative medical management of hip dysplasia is keeping the dog in a warm environment. Warmth tends to help control the pain of arthritis from hip dysplasia. As in people, arthritic pain in dogs tends to be worse in the damp and cold of winter. Providing a well-padded and warm bed will help alleviate some of the pain associated with osteoarthritis. An egg-crate foam bed for dogs is commercially available. Applying superficial heat in the form of heating pads may also relieve pain. Care must be taken not to burn the skin especially with an electric heating pad. Heat works best for chronically inflamed joints from arthritis while cold works better to treat acute (sudden) types of joint injury.

Because of the high cost involved with corrective surgeries, medical management is many times the only realistic option for pet owners. Medical management is multifaceted. For the best results, several of the following approaches should be instituted:


  • Weight Management: Helping a dog maintain his recommended weight may be the single most important thing owners can do for their pets. Surgical procedures and medical therapies will be far more successful if the animal is not overweight. You, as the owner, have control over what your dog eats. If you feed a quality food in an amount appropriate for your dog's size, breed and activity level and keep treats to a minimum, your dog should be able to maintain an ideal weight. Considering that more than half of the pets in the U.S. are overweight, there is a fair chance that many of the dogs with hip dysplasia and osteoarthritis are also overweight. If your dog is overweight, seek the advice of your veterinarian concerning a lower calorie dog food and an exercise program.

  • Exercise: Exercise is equally important in losing and/or maintaining the appropriate weight. Exercise that provides good range of motion and muscle building as well as limiting wear and tear on the joints is best. Leash walks, swimming, walking on treadmills, and slow jogging are excellent low-impact exercises. Bear in mind that an exercise program needs to be individualized for each dog based on the severity of the osteoarthritis, his weight, age, and physical condition. In general, too little exercise can be more detrimental than too much, however the wrong type of exercise can actually cause harm. While playing Frisbee can be very enjoyable and fun for the dog, it is extremely hard on his joints. Remember, it is important to exercise daily; only exercising on weekends, for example, may cause more harm than good. Regular exercise in shorter sessions is always better than long work-outs on weekends. Warming the muscles prior to exercise and following exercise with a "warm-down" period are beneficial. Consult with your veterinarian regarding an exercise program appropriate for your dog.

  • Warmth and good sleeping areas: Most people with arthritis find that the symptoms tend to worsen in cold, damp weather. Keeping your pet warm, may help him be more comfortable. A pet sweater will help keep joints warmer. In addition, you may want to consider keeping the temperature in your home a little warmer. Providing an orthopedic foam bed helps many dogs with arthritis. Beds with dome-shaped, orthopedic foam distribute weight evenly and reduce pressure on joints. They are also much easier for the pet to get out of. Place the bed in a warm spot away from drafts.

  • Massage and physical therapy: Your veterinarian or the veterinary staff can show you how to perform physical therapy and massage on your dog to help relax stiff muscles and promote a good range of motion in the joints. Remember, your dog is in pain, so start slowly and build trust. Begin by petting the area and work up to gently kneading the muscles around the joint with your fingertips using small, circular motions. Gradually work your way out to the surrounding muscles. Moist heat may also be beneficial.

  • Making daily activities less painful: Going up and down stairs is often difficult for arthritic dogs; it can make going outside to urinate and defecate very difficult. Many people build or buy ramps, especially on stairs leading to their yard, to make it easier for their dogs to go outside. Ramps also make car travel easier for arthritic dogs.


Medical management of hip dysplasia and osteoarthritis has greatly improved thanks to the introduction and approval of several new drugs. Because hip dysplasia is primarily an inherited condition, there are no products on the market that prevent its development. Through proper diet, exercise, supplements, anti-inflammatories, and pain relief, you may be able to decrease the progression of degenerative joint disease, but the looseness in the joint or bony changes will not change significantly.

Anti-inflammatory Drugs



  • Carprofen (Rimadyl), etodolac (EtoGesic), deracoxib (Deramaxx), firocoxib (Previcox), tepoxalin (Zubrin), meloxicam (Metacam): These are non-steroidal anti-inflammatory drugs (NSAIDs) developed for use in dogs with osteoarthritis. They are very effective painkillers that also reduce inflammation. They are prescription products and because of potential side effects, careful adherence to dosing quantity and frequency must be followed. The manufacturers recommend that patients taking these medications have a thorough physical examination along with appropriate blood-work (especially tests for liver health) performed before starting these medications. In addition, patients taking these products should be periodically monitored to make sure that they are tolerating the medication. These products are often used initially with glucosamine therapy and then as the glucosamine product begins to work, the NSAID dose may be reduced or even eliminated. NSAID's (including aspirin) should never be combined unless directed by your veterinarian.

  • Corticosteroids: Corticosteroids have been used for many years to treat the pain and inflammation associated with osteoarthritis, however, their use is controversial. Corticosteroids act as a potent anti-inflammatory, but unfortunately, they have many undesirable short and long-term side effects. Because of these side effects and the advent of newer, more specific drugs, corticosteroids are generally only used in older animals with flare-ups where all other pain control products have failed. Corticosteroids are a prescription product and come in both a pill and injectable form.


Surgical Interventions

In younger dogs usually less than 10 months old with only partial looseness of the hip joint caused by dysplasia, a triple pelvic osteotomy (TPO), a surgical procedure involving three cuts through the pelvic bone, can be performed to re-establish joint stability, encourage normal joint development, and minimize abnormal biomechanical forces on the joint before osteoarthritis occurs. This procedure is not advised if osteoarthitis is already present. Recovery time is about 6 weeks and a good success rate has been reported with return of normal hip function.

For older dogs (over 10 months) that already have established osteoarthritis and can no longer be medically managed, a total hip replacement is the treatment of choice for re-establishing normal, pain-free limb function and joint mechanics. A high degree of success has been reported with this surgery and like the TPO, post-op recovery is about 4-6 weeks. The main disadvantage to this surgery is the high cost.

An alternative surgery, which is more of a salvage procedure when there is significant osteoarthritis and a total hip replacement is cost prohibitive, would be a femoral head and neck excision (removing the ball of the ball-and-socket joint). This eliminates hip pain by removing the femoral head and neck and initiating the development of a false joint that permits mobility. The false joint is less stable with a reduced range of motion than the normal joint which in turn, can cause an abnormal gait. Nevertheless, pain relief with adequate function can be achieved. The procedure can be performed in all dogs of all sizes, but there are usually better long-term success rates in smaller dogs less than 20 kg (about 44 pounds). Preoperative muscle mass and early postoperative physical therapy are two important factors in determining a successful outcome. This surgery is usually not as successful if there is severe muscle wasting (atrophy) present and/or the animal is obese. Heavier dogs usually require more extensive postoperative rehabilitation to help promote an ambulatory pain-free false joint. Rehabilitation is aimed at preserving and promoting the leg's muscle mass, strength and range of motion through early (3-5 days) postoperative weight bearing ambulation and passive range-of-motion exercises. Early mobility can be achieved by assisting the dog in getting up and walking. A towel can be placed under the abdomen to make assistance easier to perform in heavy dogs. Leash walks and/or swimming beginning the day of discharge from the hospital should be performed until near normal use of the leg returns. Passive range of motion physical therapy is also necessary to increase muscle strength and flexibility. Dogs that are obese, inactive or have substantial muscle atrophy and have poor owner compliance with physical therapy recommendations are poor candidates for this surgery. Of course, any dog being treated medically or surgically for hip dysplasia should be removed from the breeding chain and the surest way of doing that is to have the dog neutered or spayed. The prognosis, or outlook, is highly variable and depends on the overall health and environment of the animal. In general, if surgery is indicated and performed correctly, it is beneficial. Animals on which surgery is not performed may require an alteration in lifestyle in order to lead a comfortable existence, as was discussed under medical treatments.

What can breeders do?



Hip dysplasia appears to be perpetuated by breeder-imposed breeding practices, but when breeders and their breed clubs recognize HD as a problem and establish reduction of HD as a priority, improvement of the hip status can be accomplished without jeopardizing other desirable traits. Prospective buyers should check pedigrees and/or verify health issues with the breeder. If suitable documentation is not available, assume the worst until proven otherwise.
Do not ignore the dog with a fair hip evaluation. The dog is still within normal limits. For example; a dog with fair hips but with a strong hip background and over 75% of its brothers and sisters being normal is a good breeding prospect. A dog with excellent hips, but with a weak family background and less than 75% of its brothers and sisters being normal is a poor breeding prospect.

OFA's Recommended Breeding Principles:


  • Breed normals to normals

  • Breed normals with normal ancestry

  • Breed normals from litters (brothers/sisters) with a low incidence of Hip Dysplasia

  • Select a sire that produces a low incidence of Hip Dysplasia

  • Replace dogs with dogs that are better than the breed average


The OFA accepts preliminary consultation radiographs on puppies as young as 4 months of age for evaluation of hip conformation. If the dog is found to be dysplastic at an early age, the economic loss from the cost of training, handling, showing and so forth can be minimized and the emotional loss reduced. These preliminary radiographs are read by the OFA veterinary radiologists and are not sent to outside radiologists. The same hip grades are given to preliminary cases.

How do we prevent hip dysplasia?

When it comes to preventing hip dysplasia, there is only one thing that all researchers agree on; selective breeding is crucial. We know that through selectively breeding animals with certified hips, we can significantly reduce the incidence of hip dysplasia. We also know that we can increase the incidence of hip dysplasia if we choose to use dysplastic animals for breeding. Breeding two animals with excellent hips does not guarantee that all of the offspring will be free of hip dysplasia, but there will be a much lower incidence than if we breed two animals with fair or poor hips. If we only bred animals with excellent hips it would not take long to make hip dysplasia a rare occurrence. If owners insisted on only purchasing an animal that had parents and grandparents with certified good or excellent hips, or if breeders only bred these excellent animals, then the majority of the problems caused by hip dysplasia would be eliminated. For someone looking to purchase a dog, the best way to lower the possibility of getting an animal that develops hip dysplasia is to examine the incidence of hip dysplasia in the litter's lineage. It is best to examine the parents and grandparents out to three or four generations. There are many different theories on how to prevent the progression of hip dysplasia. As discussed earlier, poor nutrition, inadequate or improper exercise, and increased body weight may all contribute to the severity of osteoarthritis after the hip dysplasia has developed. Following solid recommendations for exercise and nutrition may help, but will never come close to controlling or eliminating the disease if stricter requirements for certified hips are not instituted or demanded.

Any comments, please send an e-mail to dogcatvethelp@gmail.com or click on the "Comment" at the end of this issue.

GENERAL INTEREST

1) For those of you who may have missed this story, pay attention!

"Smokey, a 12-week-old chihuahua puppy, ended up with a large barbecue fork in his brain after the utensil snapped in half on the grill, flew through the air, and impaled the poor puppy's head."

To read the whole account of this pup's ordeal, go to: http://www.pawnation.com/2009/07/14/chihuahua-survives-3-days-with-bbq-fork-in-b and be sure not to miss the actual photo of the impaled puppy.

2) Dan Vergano, a writer for the USA Today, has summarized an interesting article from the scientific journal, Current Biology. He reports that "Cats pull people's strings with hidden meows, as an acoustic analysis of feline purrs suggests. Mealtime purring from 10 cats was compared with normal purring. Even people without cats could tell these solicitation purrs apart from regular ones, and the study shows a high-pitched meow was hidden within the purrs, signaling urgency. Solicitation purring is probably more acceptable to humans than overt meowing, which is likely to get cats ejected from the bedroom, added researcher, and author of the study, Karen McComb."

3) It used to be that you couldn't do much to make a neighbor with a barking dog keep their dog quiet. Well, a woman in Phoenix has found out that there is something that can be done. "Renee Maurer was sentenced Wednesday to three years of probation and a $940 fine in Phoenix Municipal Court for allowing her dogs to disturb the peace of her northeast neighborhood."


For the rest of the story, go to the Arizona Republic at: http://www.azcentral.com/arizonarepublic/local/articles/2009/07/16/20090716phxdo


The only thing that surprised Helpful Buckeye was that this involved a Pomeranian and a miniature Poodle, when you might have expected a much larger and louder dog to be responsible.

4) On the lighter side, Helpful Buckeye found this web site that should appeal to our readers with dogs, who want to take their pooch to dinner with them. "Our database of dog friendly restaurants was started by Caleb, an Australian Shepherd, who loves to travel and eat out with his humans Dale and Marilyn. Over the years many of Caleb's canine and human friends have added to the database with their own comments about the food, service, ambiance and general dog-friendliness."

Go to their web site for restaurant reviews and remember to click on your state for dog-friendly restaurants near you: http://www.petfriendlytravel.com/pet_dog_friendly_restaurants

5) The ASPCA is sponsoring the 2009 Adopt-A-Shelter-Cat Month Photo Contest.All you have to is go to their web site and click on the cat that appeals to you the most: http://www.aspca.org/news/photo-contest/2009-adopt-a-shelter-cat.html


Helpful Buckeye likes Chloe....

SPORTS NEWS



The LA Dodgers still have the best record in baseball. Coming out of the All-Star break, we have split a 4-game series with Houston, a team we have always had trouble beating.


PERSONAL STUFF

Several of our readers wrote in about the photo on my profile last week and wondered if I had any other photos like that. Well, I do and here is one more:


I took this photo near Buellton, CA, on the road to Lompoc, CA.

Helpful Buckeye was fortunate to have been going UP a hill rather than DOWN the hill this past week, when the rear axle and sprocket assembly on my bike decide to fall apart!

I missed a day of riding while it was being repaired, but that gave me plenty of time to contemplate how much worse it could have been!

~~The goal of this blog is to provide general information and advice to help you be a better pet owner and to have a more rewarding relationship with your pet. This blog does not intend to replace the professional one-on-one care your pet receives from a practicing veterinarian. When in doubt about your pet's health, always visit a veterinarian.~~


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