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Due to the number of possible complications, it is hard to make predictions
about how
elbow dysplasia will affect a dog. If it can be identified at a
young age before changes are
severe, surgical correction has a reasonably good success rate.
Once severe changes set
in, it is much harder to prevent subsequent arthritic changes. Most
dogs with this condition
eventually become lame and the lameness can be very severe in some
dogs, even to the
point of disuse of one leg or severe difficult getting up and walking
even short distances.
Treatment consists of surgical correction of whatever complications
are present, if
possible. Medical management using aspirin or other anti-inflammatory
medications is
helpful. Weight control is very important over the long term for
success of either surgical
or medical management of this condition.
Hip Dysplasia
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Dogs with hip dysplasia appear to be born with normal hips and then
to develop the disease later. This has led to a lot of speculation
as to the contributing factors which may be
involved with this disease. This is an inherited condition, but
not all dogs with the genetic
tendency will develop clinical signs and the degree of hip dysplasia
which develops does not always seem to correlate well with expectations
based on the parent's condition. Multiple
genetic factors are involved and environmental factors also play
a role in determining the
degree of hip dysplasia. Dogs with no genetic predisposition do
not develop hip dysplasia.
At present, the strongest link to contributing factors other than
genetic predisposition
appears to be to rapid growth and weight gain. In a recent study
done in Labrador
retrievers a significant reduction in the development of clinical
hip dysplasia occurred in a
group of puppies fed 25% less than a control group which was allowed
to eat free choice. It
is likely that the laxity in the hip joints is aggravated by the
rapid weight gain.
If feeding practices are altered to reduce hip dysplasia in a litter
of puppies, it is probably
best to use a puppy food and feed smaller quantities than to switch
to an adult dog food.
The calcium/phosphorous to calorie ratios in adult dog food are
such that the puppy will
usually end up with higher than desired total calcium or phosphorous
intake by eating an
adult food. This occurs because more of these foods are necessary
to meet the caloric
needs of puppies, even when feeding to keep the puppy thin.
If clinical signs of hip dysplasia occur in young dogs, such as lameness,
difficulty standing
or walking after getting up, decreased activity or a bunny-hop gait,
it is often possible to
help them medically or surgically. X-ray confirmation of the presence
of hip dysplasia prior
to treatment is necessary. There are two techniques currently used
to detect hip dysplasia,
the standard view used in Orthopedic Foundation for Animals (OFA)
testing and X-rays
(radiographs) utilizing a device to exaggerate joint laxity developed
by the University of
Pennsylvania Hip Improvement Program (PennHIP). The Penn
Hip radiographs appear to be a better method for judging hip dysplasia
early in puppies,
with one study showing good predictability for hip dysplasia in
puppies exhibiting joint
laxity at 4 months of age, based on PennHIP radiographs.
Once a determination is made that hip dysplasia is present, a treatment
plan is necessary.
For dogs that exhibit clinical signs at less than a year of age,
aggressive treatment may
help alleviate later suffering. In the past a surgery known as a
pectineal myotomy was
advocated but more recent evidence suggests that it is an ineffective
surgical procedure.
However, administration of glycosaminoglycans (Adequan Rx) may help
to decrease the
severity of arthritis that develops later in life. Surgical reconstruction
of the hip joint (triple pelvic osteotomy) is helpful if done during
the growth stages. For puppies with clinical signs at a young age,
this surgery should be strongly considered. It has a high success rate
when
done at the proper time.
Dogs that exhibit clinical signs after the growth phase require a
different approach to
treatment. It is necessary to determine if the disorder can be managed
by medical
treatment enough to keep the dog comfortable. If so, aspirin is
probably the best choice for initial medical treatment. Aspirin/codeine
combinations, phenylbutazone,
glycosaminoglycosans and corticosteroids may be more beneficial
or necessary for some
dogs. It is important to use appropriate dosages and to monitor
the progress of any dog on
non-steroidal or steroidal anti-inflammatory medications due to
the increased risk of side
effects to these medications in dogs. If medical treatment is insufficient
then surgical repair is possible.
The best surgical treatment for hip dypslasia is total hip replacement.
By removing the
damaged acetabulum and femoral head and replacing them with artificial
joint components,
pain is nearly eliminated. This procedure is expensive but it is
very effective and should be
the first choice for treatment of severe hip dyplasia whenever possible.
In some cases, this
surgery may be beyond a pet owner's financial resources. An alternative
surgery is femoral head ostectomy. In this procedure, the femoral
head (ball part of the hip joint) is simply
removed. This eliminates most of the bone to bone contact and can
reduce the pain
substantially. Not all dogs do well following FHO surgery and it
should be considered a
clear "second choice".
Hip dysplasia may not ever be eliminated by programs designed to
detect it early unless
some effort is made to publish the results of diagnostic tests such
as the OFA evaluation or Penn HIP evaluations, openly. This is the
only way that breeders will be able to tell for
certain what the problems have been with hip dysplasia in a dog's
ancestry.
When an older dog is exhibiting signs of pain associated with this
condition it is often
possible to help them dramatically through medication and simple
steps like providing a
warm bed or warm spot to rest during the day. There is no advantage
to pain and steps
should be taken to ensure that the older dog is not in pain. Regular
exercise can be very
helpful and weight loss can have dramatic effects on the amount
of discomfort a dog
experiences.
Working with your vet to come to the best solution for your dog and
your situation will
enable you and your dog to enjoy life to its fullest, despite the
presence of hip dysplasia.
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