This is Part 2 of two blogs on Hip Dysplasia in dogs, in this blog we go through the diagnosis and treatment of hip dysplasia.
DIAGNOSIS
The only definitive way to diagnose hip dysplasia is XRAY. If your dog shows any of the signs mentioned in Part 1, a veterinary examination should be carried out immediately. The vet’s examination may reveal some clues as to the problem but xrays will be needed. Xrays enable an assessment of the severity of the hip dysplasia, whether arthritis is present and helps in the decision of what is the most appropriate cause of treatment. It is interesting to note that the severity of the pain and lameness the dog shows and the severity of the xray changes do not always correlate i.e. some dogs with mild radiographic changes can have a lot of pain and vice versa. There are a number of conditions that can mimic hip dysplasia. Once xrays have confirmed the diagnosis a treatment plan is devised.
TREATMENT FOR HIP DYSPLASIA
There are two types of treatment medical or surgical. Which of these options is taken depends on age of patient, level of pain and disability, physical and Xray findings and financial constraints. Your vet will advise you on the best course of action. 1.Medical Treatment is also known as conservative treatment. When hip dysplasia is diagnosed in young dogs (5-10 months) the aim of treatment is to reduce the stresses on the developing joints in an attempt to minimise the progress of the hip dysplasia. Therefore, weight control and sensible exercise are vital. Lead exercise should be used wherever possible up to 12 months of age. Swimming is an excellent form of exercise for dogs with hip dysplasia, as it is non weight bearing and so does not traumatise the susceptible joint. It also maximises muscle development which helps joint stability. As the affected dog approaches maturity at 12 months of age the dysplastic joint capsule becomes thicker and stronger. This helps to stabilise the joint and helps reduce the pain and lameness the young dog has suffered from. During this period and beyond the joint can be painful and sensible use of painkillers is often needed. The commonest drugs used are Non Steroidal Anti-Inflammatories (NSAIDS) and chondroprotective drugs (drugs that may help to reduce the progression of arthritis.) Young dogs with hip dysplasia often have sudden flare ups of pain in the joints. When older dogs are diagnosed with hip dysplasia treatment is directed at the arthritis 2. Surgical Treatment. There are a number of complex surgical procedures that can be undertaken to treat hip dysplasia. They vary in difficulty and most of them need to be carried out by specialist orthopaedic surgeons.:
a) Triple Pelvic Ostetotomy (TPO) is carried out on young dogs before any osteoarthritis has developed. The aim of the operation is to alter the shape of the hip joint to reduce the instability of the joint and increase the fit of the head of the femur (ball ) in the acetabulum (socket). It is a complex procedure and must be done by a very competent surgeon.
b) Juvenile pubic symphysiodesis. There have been no clinical studies proving this procedure works and is basically an experimental operation. It may prove to be an alternative to TPO but long term studies are needed.
c) Femoral Head and Neck Excision (Excision Arthroplasty) can be used when conservative treatment fails and is a relatively simple and economic procedure to carry out. In larger dogs it must be used only as a salvage procedure when the hip joints are very painful and there are no other options available. The operation involves cutting off the head and neck of the femur. As a result there is no bony contact between the femur and the pelvis thereby reducing pain. A fibrous false joint forms in the place of the hip joint. Unfortunately, post operative function of the leg can be unpredictable and disappointing in large dogs. This procedure should only be done in mature dogs.
d) Total Hip Replacement is the gold standard of surgical treatment. The acetabulum and head of femur are replaced by prosthetic (false) implants. Mainly used in older dogs with untreatable arthritis. It is a very technically demanding procedure and there are many potential complications. Selection criteria is tough. However, in the hands of specialist surgeons the results can be excellent.
Summary
Hip dysplasia is a common and distressing condition. One day via gene mapping the condition may be eliminated, but until then careful selection of breeding stock is vital. Treatment options are complicated and decision making for the owner of an affected animal can be difficult and stressful. If you have any concerns over your pet’s well-being, please consult your vet.
