Monika Wisniewska / stock.adobe.com
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Hip dysplasia is a deformity of the hip that occurs when the ball (head of the femur or femur) and the socket of the pelvis (acetabulum) do not develop in unison during childhood, leading to laxity of the hip. joint then degenerative joint disease or osteoarthritis. (OA).1 Canine hip dysplasia is an inherited disease, but there are also environmental risk factors, according to Selena Tinga, DVM, PhD, DACVS-SA, assistant professor in the section of small animal surgery at Cornell University College of Veterinary Medicine , in a dvm360® interview.
“The heredity (of hip dysplasia) is very complex, there are… very many genes involved in the predisposition, and just being genetically predisposed does not necessarily mean that an animal has the phenotype or the clinical signs associated with it,” explained Tinga.
Some other risk factors for canine hip dysplasia include obesity and lack of sufficient exercise, said Matthew Brunke, DVM, DACVSMR, CCRP, CVPP, CVA, medical director of Veterinary Surgical Centers Rehabilitation in Vienna, Virginia. , in a study. dvm360® interview. Tinga added that overfeeding, growing too quickly and, potentially, calcium supplementation or early sterilization can also promote the development of clinical disease.
Why some breeds may be more at risk
Hip dysplasia is often associated with large and giant, fast-growing breeds (e.g., German Shepherds, Newfoundlands, Labradors, Golden Retrievers, and Bernese Mountain Dogs), which have genes linked to the disease . However, this condition is not exclusive to larger dogs. In fact, Tinga suggested that hip dysplasia might not even be more prevalent in larger breeds, although they show clinical signs more frequently.
“I wouldn’t say that large breed and giant dogs are the only ones to be affected, or even necessarily more affected; it probably is, (but) we just don’t have the numbers to say,” she said. “I think (smaller breeds) are more tolerant of instability and osteoarthritis, and so we don’t diagnose it as a clinical problem very often.”
Another reason why giant and large breed dogs are known to suffer from hip dysplasia could be that surgical treatment, such as a femoral head ostectomy (FHO), is more complicated in these dogs than in smaller. They require much more postoperative care to achieve a moderate or good result, Tinga added, “because large breed and giant dogs are very clinically affected by them and because we don’t have easy surgery to give them comfort.” ; that’s why we invest and focus more on them.
Early detection is essential
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Early screening is important for detecting hip dysplasia in young dogs, especially because a dog may not show any signs of this disease. Brunke said: “When a dog’s hip hurts, he keeps walking. But he just doesn’t want to walk that much, so he lays down (and) we think he’s lazy… It can be very subtle, trying to (hide his discomfort) from the start. He recommends veterinarians perform a PennHIP X-ray, especially in at-risk dogs, which measures the degree of looseness in a dog’s hips. “This is through a series of distracted, compressed x-rays that have to be done under sedation,” Brunke continued.
If veterinarians notice hip laxity in puppies under 5 months of age, there are surgical procedures where the hip does not need to be replaced, including juvenile pubic symphysiodesis (JPS). “(JPS) is where we fuse the pubic growth plate together. This allows us to get better coverage (over the femoral head) which promotes the growth of those hips,” Brunke explained. Tinga said JPS helps slow the development of osteoarthritis and can even prevent dogs from needing more complex surgeries later in life.
For juvenile dogs just over 5 months old, additional surgical options include double pelvic osteotomy (DPO) and triple pelvic osteotomy (TPO). These procedures consist of pelvic osteotomies to promote rotation of the acetabulum and better acetabular coverage of the femoral head.2 Dogs with hip dysplasia that are good candidates for DPO or TPO are ideally those aged 8 at 10 months and who do not have visible radiographic arthritic changes.3
Management and treatment options
For dogs diagnosed with hip dysplasia later in life, medical management is the most common modality. This can be done through a balanced diet and exercise to maintain a healthy weight. Tinga noted, “(For) any dog with an orthopedic condition, getting them back to good physical condition and then doing controlled, regular, that is, daily, low-impact activities is really good for the dog. strengthening, but not having concussive forces on the joints with orthopedic diseases. disease.”
After total hip replacement
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For temporary relief, dogs can also take nonsteroidal anti-inflammatories (e.g., carprofen and meloxicam), joint supplements (e.g., those containing omega-3 fatty acids, undenatured type II collagen, etc. .) or joint injections. Rehabilitation therapy is another great way to help patients manage hip dysplasia. “This can be things like phytoceuticals, laser therapy, shock wave therapy and good exercise, (like) with underwater treadmills,” Brunke said.
If, after using all of these modalities for pain relief, dogs still show clinical signs of hip dysplasia, Tinga said that’s when you can consider advanced surgical options, such as a total hip replacement or FHO. According to Brunke, hip dysplasia is “one of the few diseases that we can absolutely cure in veterinary medicine” through total hip replacement. “Then there is no painful arthritis. It is a perfectly watertight seal. It has implants that will last the life of the animal, and they can be much more comfortable because they use the leg the way it was designed to be used,” he added.
On the other hand, an FHO, Tinga said, “is more difficult to retrieve for large breed dogs. So it is usually not our first choice for treating hip dysplasia. Because it’s such a final thing once you’ve done it, it’s the dog’s paw.
Takeaways
Tinga noted that it is important to become familiar with the treatments offered by local veterinarians and their general intervention guidelines, so that you can easily refer patients with canine hip dysplasia. She also reemphasized determining a nutrition and weight loss program for an affected patient. Brunke and Tinga agreed that dogs with hip dysplasia should be removed from the breeding pool to prevent future dogs from inheriting the condition.
Brunke concluded by encouraging veterinary professionals to be good patient advocates. You can catch hip dysplasia in the early stages, but also when the pet is older and there are still great options, he noted. “Age is not a disease, so we must not give up on it; we still have a lot of good ways (in which) we can help,” Brunke said.
The references
- Hunter T, Ward E. Hip dysplasia in dogs. VCA Veterinary Hospitals. Accessed September 26, 2022. https://vcahospitals.com/know-your-pet/hip-dysplasia-in-dogs
- Double pelvic osteotomy (DPO): for the treatment of canine hip dysplasia. DePuy Synthes Veterinarian. Accessed September 27, 2022. https://jjmdanimalhealth. com/sites/default/files/2020-12/DSUSVET09140027_DPO_TPO_brochure.pdf
- Canine hip dysplasia. American College of Veterinary Surgeons. Accessed September 27, 2022. https://www.acvs.org/small-animal/canine-hip-dysplasia