CANINE HIP DYSPLASIA Overview
Canine Hip Dysplasia is a condition which begins in immature dogs with instability or a loose fit of the hip joint. The hip joint laxity is responsible for early clinical signs and joint changes. The abnormal motion of the hip stretches the fibrous joint capsule and ligament connecting the head of the femur to the pelvis, producing pain and lameness. The acetabulum (the hip socket) is easily deformed by continual movement of the femoral head. Causes
Causes of hip dysplasia are considered to be multifactorial; including both hereditary and environmental factors. Rapid weight gain and growth through excessive nutritional intake may encourage the development of hip dysplasia. Mild repeated trauma causing synovial (joint lining) inflammation may also be important. Incidence and Prevalence
The incidence of hip dysplasia is greatest in large breed dogs. Two populations of animals show clinical signs of lameness: (1) patients 5 to 10 months of age, and (2) patients with chronic degenerative joint disease. Signs and Symptoms
The clinical signs of hip dysplasia are lameness, reluctance to rise or jump, shifting the weight to the forelimbs, loss of muscle mass on the rear limbs, and pain when the hips are manipulated. Dogs may show clinical signs at any stage of development of the disease, although many dogs with hip dysplasia do not show overt clinical signs. Some dogs are painful at 6 to 8 months of age but recover as they mature. As the osteoarthritis progresses with age, some dogs may show clinical signs similar to people with arthritis such as lameness after unaccustomed exercise, lameness after prolonged confinement, and worse problems if they are overweight. Risk Factors
Risk factors for CHD include breed (genetic), rapid growth and nutrient excesses. When to Seek Veterinary Advice
Some veterinarians recommend radiographing the hips at 6 months of age to help identify dogs with hip dysplasia early enough to perform a triple pelvic osteotomy. For many dogs, the owners seek veterinary surgery advice when the dog has been consistently lame, and has not responded to medical therapy. Many of the surgical treatments for hip dysplasia are performed by surgical specialists. Treatment Options
Treatment depends on the dog’s age and degree of discomfort, physical and radiographic findings, and owner’s expectations and finances. Conservative and surgical options are available for juvenile and mature animals with hip pain secondary to hip dysplasia. Most immature animals are best treated with conservative or medical management. Although early surgical intervention with juvenile pubic symphysiodesis or triple pelvic osteotomy may increase the prognosis for long-term acceptable clinical function, approximately 75% of young patients treated conservatively return to acceptable clinical function with maturity. The remaining 25 % require further medical or surgical management at some point in life. In puppies less than 20 weeks of age, juvenile pubic symphysiodesis (JPS), a technique for stopping the growth of the pubis (part of the pelvis) may be performed to alter the growth of the pelvis and increase the degree of coverage of the acetabulum over the femoral head. Most puppies of this age do not show clinical signs of hip dysplasia, so diagnosis depends upon use of a screening technique for documenting hip laxity, such as Penn Hip, to determine which animals may be candidates for the procedure. Although specific criteria for application of JPS have not been developed, puppies under 20 weeks of age that have palpable and radiographic evidence of laxity on a hip distracted view can be considered for the procedure. Immature dogs (less than one year) with loose fitting hips, but no arthritic changes can be treated with a pelvic osteotomy (also sometimes called a triple pelvic osteotomy). This procedure involves cutting the pelvic bone in three places and rotating it to stabilize the hip joint and in many cases slow the progression of osteoarthritis.
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