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Hip Displasia

Winger & LisaMy Golden Retriever, Winger, had hip displasia. I have read a lot to deal with his condition. Here is some important information worth sharing.

What is Hip Displasia?
Hip displasia can be a terrible, painful, degenerative disease. A dog can be affected in one hip or both. Basically, hip displasia means a disfigurement of the hip joint. A displastic hip socket is too shallow. Because the head of the femur isn’t held in place securely by the hip socket, there is continuous movement of the head of the femur against the edges of the hip socket.

This movement causes the cartilage to wear down, eventually causes bone on bone friction, which is obviously very painful for the dog. The joint will continue to degrade – which is known as degenerative joint disease. The word sublexation refers to the painful dislocation of hip in the malformed sockets.

The severity of the displasia is often not correlated to the degree of lameness. Some dog’s hip x-rays can show very deformed hip sockets, if one is present at all, but the dog is still able to run and play, leading an active life.

The Orthopedic Foundation of Animals (OFA) grades hip x-rays in the United States. They rate displastic hips by one of three grades: mild, moderate, or severe. To see sketches of the hips for these three grades, as well as excellent, good, fair, and borderline displastic hips, please click here.

Signs of Hip Displasia?
If you are wondering that your dog might have hip displasia, some of the signs include: bunny-hopping (holding their back legs together when running), difficulty going up stairs, faint popping sound coming from the back legs with each step, painful or violent reaction to an extension of their back legs, reluctance to walk, jump and play, whining for no reason, and slowness/difficulty getting up from lying or sitting position. Lameness will often be worse after exercising. Overall, you’ll notice your dogs symptoms come and go and not be consistent at all times.

After time, a displastic dog will have developed a front end – especially shoulders, where their back end will look much weaker, maybe even atrophied. Older dogs will hip displasia will usually develop degenerative joint disease

If you are worried your dog might have hip displasia, please take your dog to the vet for full examination, which will probably include a set of hip x-rays (often done under a light sedation). Some other diseases can have similar symptoms as hip displasia, such as spinal problems, metabolic diseases (hypothyroidism), immune mediated diseases (rheumatoid arthritis, lupus), bone diseases (panosteitis, OCD), stifle diseases, and multiple joint disease.

How to treat Hip Displasia?
When a dog is young, and degenerative joint disease has not yet set into the joint, the goal of treatment is to prevent cartilage damage, whereby preventing further joint degeneration.

For an older dog with secondary degenerative joint disease, the goal of treatment is to control the pain associated with the joint degeneration.

For both old and young dogs, exercise is so very important. Good muscle tone will help hold the hips together, and help the dog remain mobile. Swimming is a good exercise that is easy on the hips, yet helps maintain excellent muscle tone. Exercise is also important to keep your dog thin. Every extra pound on your dog is extra stress on their weakened hips, which could quicken the development of degenerative joint disease.

Additionally, your dog will benefit from a warmer place to sleep. Provide your dog with a dog bed instead of the cold floor. Cold seems to magnify their pain and stiffness.

NSAIDs – Non-Steroidal Anti-Inflammatory Drugs: Aspirin is a quick and easy way to ease your dogs pain. You do not want to use NSAIDs everyday, but for occasional pain relief, aspirin may be your first line of attack. The side effect of NSAIDS includes stomach irritation (can develop into ulcers). I prefer the Bufferin brand which is easier on the stomach.

 Corticosteroids are sometimes used as a drastic measure to reduce pain and inflammation. Their severe side effect is that they actually speed up the destruction of a dog’s joints. They can also produce systemic side effects, such as increased thirst, increased urination, liver disease, and adrenal gland disease.

 I treated Winger with liquid glucosamine (we used Syn-Flex). While most glucosamine products available today are in capsule or pill form, liquid glucosamine formulas provide maximum glucosamine absorption and complete treatment of osteoarthritis and articular joint pain. It drastically improved Winger’s recovery time after an afternoon running or swimming.

Accupuncture: The theory is that acupuncture stimulates nerves, relieves muscles spasms, increases blood circulation, and releases endorphins and cortisol. Endorphins decrease pain and cortisol helps reduce inflammation.

Polysulfated Glycosaminoglycans: Polysulfated glycosaminoglycans are a new class of drugs that come in an injectable or oral form. They inhibit the formation of enzymes known to be involved in the destruction of joint cartilage.

Vitamin C: Some people treat their dog’s pain by supplementing with Vitamin C.

Surgery: There are several different surgeries used for dogs with hip displasia. The kind of surgerical intervention used depends on the age of the dog, and whether or not degenerative joint disease has set in.

Pectineus Tenotomy: Used on young dogs, the pectineal tenotomy procedure is used to release tension on the joint capsule by cutting a section of the pectineus tendon or muscle. This leads to increased joint mobility for the dog with a reduction in pain. Unfortunately this procedure does nothing to stabilize the joint and therefore does not slow the inevitable onset of degenerative joint disease. This procedure is mostly obsolete now.Femoral Head Excisions: This procedure involves the removal of the ball portion of the socket. This helps ward off arthritis because with the ball removed from the socket, there will be no rubbing of the two. In actuality, a piece of muscle or joint tissue is placed between the thigh bone and the socket, which causes scar tissue to form which helps support the leg. This procedure normally recommended for dogs weighing less than 45 pounds. Larger dogs, like Golden Retrievers, don’t respond as well to the surgery, as the scar tissue can not support the weight of the dog well enough. The recovery time for this procedure is also very long (4-6 months) and is uncomfortable for the dog, but on the plus side, exercise does not need to be restricted during the recovery time and is encouraged for recovery. Both hips are usually done at the same time, forcing the dog to use both legs immediately.Triple Osteotomy of the Pelvis: This surgery is used on any dog that is over 7 months of age who has partial dislocation of at least one hip, with no signs of arthritis. This surgery is used to prevent the development of arthritis, which is the most painful part of hip displasia. By cutting the bone in three places, the surgeon is able to insert the femoral head into the socket. The bone is held together with a stainless steel plate and screws, or a combination of screws and wire. This hardware will remain in place for the lifetime of the dog. Unlike the femoral head excisions, the triple osteotomy of the pelvis surgery can only be preformed on one hip at a time. This surgery is the hardest and most difficult of all four surgerical procedures. Because only screws are holding the pelvis together, the dog should not walk using the affected leg right away. The opposite leg is usually scheduled for surgery 6 weeks after the first. Recovery time is 6-9 weeks with strict exercise restriction (ie. no stairs, no running, no wrestling, no slippery floors – dogs should only go outside on a leash). Controlled walks are allowed 2-3 weeks after surgery. Success rates with this procedure are very high.

Total Hip Replacement: Total hip replacement surgeries are the only surgerical option for an older dog who already has degenerative joint disease. This surgery is only done on dogs that are truly suffering and are lame. This surgery involved the complete removal of the hip, replacing it with a stainless steel ball with a high density plastic socket. Dogs normally remain in the vet hospital for 2 days. The recovery care instructions are similar to the triple osteotomy of the pelvis surgery mentioned above. If both hips are affected, a surgery will be preformed on the worst hip first. Sometimes just operating on one will reduce the lameless so that the 2nd hip will not require the surgery. There is a high success rate with total hip replacement surgeries with some dogs walking out of the vet hospital after the surgery, better than they walked in.

Is Hip Displasia preventable?
Hip displasia is considered a hereditary condition. All breeding stock must be screened and cleared of hip displasia before breeding. Dogs that are genetically predisposed to hip displasia will benefit from a lean diet in their first 2 years, allowing them to grow slowly. Slowing the growth rate during the early months of life, some veterinary nutritionists now believe, can lessen the severity of hip dysplasia and even prevent it.

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