PETED01 Tuesday October 3, 2006
Hip Dysplasia: Diagnosis - Treatment - Prevention
Veterinary & Aquatic Services Department, Drs. Foster &
Smith, Inc.
Canine hip dysplasia is a very common degenerative joint
disease seen in dogs. There are many misconceptions
surrounding it. There are many things that we know about
hip dysplasia in dogs, there are also many things we
suspect about this common cause of limping, and there
are some things that we just do not know about the
disease. We will cover all of those here and hope to
separate out fact, theory, hypothesis, and opinion.
What is hip dysplasia?
To understand what hip dysplasia really is we must have
a basic understanding of the joint that is being
affected. The hip joint forms the attachment of the hind
leg to the body and is a ball and socket joint. The ball
portion is the head of the femur while the socket (acetabulum)
is located on the pelvis. In a normal joint the ball
rotates freely within the socket. To facilitate movement
the bones are shaped to perfectly match each other, with
the socket surrounding the ball. To strengthen the
joint, the two bones are held together by a ligament.
The ligament attaches the femoral head directly to the
acetabulum. Also, the joint capsule, which is a very
strong band of connective tissue, encircles the two
bones adding further stability. The area where the bones
actually touch each other is called the articular
surface. It is perfectly smooth and cushioned with a
layer of spongy cartilage. In the normal dog, all of
these factors work together to cause the joint to
function smoothly and with stability.
Hip dysplasia results from the abnormal development of
the hip joint in the young dog. It may or may not be
bilateral, affecting both right and left sides. It is
brought about by the laxity of the muscles, connective
tissue, and ligaments that should support the joint.
Most dysplastic dogs are born with normal hips but due
to genetic and possibly other factors, the soft tissues
that surround the joint start to develop abnormally as
the puppy grows. The most important part of these
changes is that the bones are not held in place but
actually move apart. The joint capsule and the ligament
between the two bones stretch, adding further
instability to the joint. As this happens, the articular
surfaces of the two bones lose contact with each other.
This separation of the two bones within a joint is
called subluxation and this, and this alone, causes all
of the resulting problems we associate with the disease.
What are the symptoms of hip dysplasia?
Dogs of all ages are subject to the symptoms of hip
dysplasia and the resultant osteoarthritis. In severe
cases, puppies as young as five months will begin to
show pain and discomfort during and after vigorous
exercise. The condition will worsen until even normal
daily activities are painful. Without intervention,
these dogs may be unable to walk at all by a couple
years of age. In most cases, however, the symptoms do
not begin to show until the middle or later years in the
dog's life.
The symptoms are typical for those seen with other
causes of osteoarthritis. Dogs may walk or run with an
altered gait, often resisting movements that require
full extension or flexion of the rear legs. Many times,
they run with a 'bunny hopping' gait. They will show
stiffness and pain in the rear legs after exercise or
first thing in the morning. Most dogs will warm up out
of the muscle stiffness with movement and exercise. Some
dogs will limp and many will decrease their level of
activity. As the condition progresses, the dogs will
lose muscle tone and may even need assistance in getting
up. Many owners attribute the changes to normal aging
but after treatment is initiated, they are shocked to
see much more normal and pain-free movement return.
Who gets hip dysplasia?
Hip dysplasia can be found in dogs, cats, and humans,
but for this article we are concentrating only on dogs.
In dogs, it is primarily a disease of large and giant
breeds. The disease can occur in medium-sized breeds and
rarely even in small breeds. It is primarily a disease
of purebreds although it can happen in mixed breeds,
particularly if it is a cross of two dogs that are prone
to developing the disease. German Shepherds, Labrador
Retrievers, Rottweilers, Great Danes, Golden Retrievers,
and Saint Bernards appear to have a higher incidence,
however, these are all very popular breeds and may be
over represented because of their popularity. On the
other hand, Greyhounds and Borzois have a very low
incidence of the disease.
What are the risk factors for the development of hip
dysplasia?
Hip dysplasia is caused by looseness in the hip joint.
The looseness creates abnormal wear and erosion of the
joint and as a result pain and arthritis develops. The
disease process is fairly straightforward; the
controversy starts when we try to determine what
predisposes animals to contract the disease. Almost all
researchers agree that there is a genetic link involved.
If a parent has hip dysplasia, then the offspring are at
greater risk for developing hip dysplasia. Some
researchers feel that genetics are the only factor
involved, where others feel that genetics contribute
less than 25% to the development of the disease. The
truth probably lies in the middle. If there are no
carriers of hip dysplasia in a dog's lineage, then it
will not contract the disease. If there are genetic
carriers, then it may contract the disease. We can
greatly reduce the incidence of hip dysplasia through
selective breeding. We can also increase the incidence
through selectively breeding. We cannot, however,
completely reproduce the disease through selective
breeding. In other words, if you breed two dysplastic
dogs, the offspring are much more likely to develop the
disease but will not all have the same level of symptoms
or even necessarily show any symptoms. The offspring
from these dogs will, however, be carriers and the
disease may show up in their offspring in later
generations. This is why it can be difficult to
eradicate the disease from a breed or specific line.
Nutrition: Experimentally, we can increase the severity
of the disease in genetically susceptible animals in a
number of ways. One of them is through obesity. It
stands to reason that carrying around extra weight will
exacerbate degeneration of the joint in a dog with a
loose hip. Overweight dogs are therefore at a much
higher risk. Another factor that may increase the
incidence is rapid growth in a puppy during the ages
from three to ten months. Experimentally, the incidence
has been increased in genetically susceptible dogs when
they are given free choice high protein and high calorie
diets. In a large study done in 1997, Labrador Retriever
puppies fed a high protein, high calorie diet free
choice for three years had a much higher incidence of
hip dysplasia than their littermates who were fed the
same high calorie, high protein diet but in an amount
that was 25% less than that fed to the dysplastic group.
As might be expected, however, the free choice group was
significantly heavier at maturity and averaged 22 pounds
heavier than the control group. Because obesity is also
a risk factor, this study may be difficult to interpret.
We have yet to see a study that links an increased
incidence of hip dysplasia in dogs fed a normal diet of
commercial puppy food versus a specialty diet formulated
for just large breed dogs.
There have also been studies looking into protein and
calcium levels and their relationship to hip dysplasia.
Both of these studies were able to increase the level of
hip dysplasia by feeding increased amounts of calcium
and protein. But once again, the studies of puppies fed
greatly increased amounts over normal recommended values
and compared them to animals fed decreased amounts. They
failed to compare puppies fed a normal amount of food
that had the recommended amount of protein, fat, and
calcium to those fed a diet with slightly less protein,
fat, and calcium (similar to those 'large breed puppy
foods' that are now flooding the market). We have yet to
see a study that links an increased incidence in hip
dysplasia in dogs fed a normal diet of commercial puppy
food versus a specialty diet formulated just for large
breed puppies.
Exercise: Exercise may be another risk factor. It
appears that dogs that are genetically susceptible to
the disease may have an increased incidence of disease
if they over-exercised at a young age. But at the same
time, we know that dogs with large and prominent leg
muscle mass are less likely to contract the disease than
dogs with small muscle mass. So exercising and
maintaining good muscle mass may actually decrease the
incidence of the disease. Moderate exercise that
strengthens the gluteal muscles, such as running and
swimming, is probably a good idea. Whereas, activities
that apply a lot of force to the joint are
contraindicated. An example would be jumping activities
such as playing Frisbee.
How is hip dysplasia diagnosed?
Diagnosis of hip dysplasia in dogs that are showing
clinical signs of arthritis and pain is usually made
through the combination of a physical exam and
radiographs (x-rays). If a dog is showing outward signs
of arthritis, there are usually easily recognized
changes in the joint that can be seen on radiographs. In
addition, the veterinarian may even be able to feel
looseness in the joint or may be able to elicit pain
through extension and flexion. Regardless, the results
are straightforward and usually not difficult to
interpret.
However, about half of the animals that come in for a
determination on the health of their hip joints are not
showing physical signs, but are intended to be used for
breeding. The breeder wants to ensure that the animal is
not at great risk for transmitting the disease to his or
her offspring. There are two different testing methods
that can be performed. The traditional and still most
common is OFA testing. The other newer technique is the
PennHip method.
OFA: The method used by the Orthopedic Foundation for
Animals (OFA) has been the standard for many years. The
OFA was established in 1966, and has become the world's
largest all-breed registry. The OFA maintains a database
of hip evaluations for more than 475,000 dogs.
Radiographs are taken by a local veterinarian under
specific guidelines and are then submitted to the OFA
for evaluation of hip dysplasia and certification of hip
status. Since the accuracy of radiological diagnosis of
hip dysplasia using the OFA technique increases after 24
months of age, the OFA requires that the dog be at least
two years of age at the time the radiographs are taken.
They also recommend that the evaluation should not be
performed while the female is in heat. To get the
correct presentation and ensure that the muscles are
relaxed, the OFA recommends that the dog be anesthetized
for the radiographs. OFA radiologists evaluate the hip
joints for congruity, subluxation, the condition of the
acetabular margins and acetabular notch, and the size,
shape, and architecture of the femoral head and neck.
The radiographs are reviewed by three radiologists and a
consensus score is assigned based on the animal's hip
conformation relative to other individuals of the same
breed and age. Using a seven point scoring system, hips
are scored as normal (excellent, good, fair), borderline
dysplastic, or dysplastic (mild, moderate, severe). Dogs
with hips scored as borderline or dysplastic are not
eligible to receive OFA breeding numbers.
When dogs born in 1972 to 1980 were compared with dogs
born in 1989 and 1990, 60% of the breeds demonstrated a
statistically significant decrease in hip dysplasia. At
the same time, 68% of breeds had a statistically
significant increase in the number of hips scored as
excellent.
The OFA will also provide preliminary evaluations
(performed by one OFA radiologist) of dogs younger than
24 months of age to help breeders choose breeding stock.
Reliability of the preliminary evaluation is between 70
and 100% depending on the breed. Results published by
the OFA suggest that the incidence of hip dysplasia in
certain breeds has decreased as a result of selective
breeding programs. When dogs born in 1972 to 1980 were
compared with dogs born in 1989 and 1990, 60% of the
breeds demonstrated a statistically significant decrease
in hip dysplasia. At the same time, 68% of breeds had a
statistically significant increase in the number of hips
scored as excellent. This information may suggest
progress is being made to decrease the frequency of hip
dysplasia, but it may simply be that only radiographs
from dogs thought to have normal hips are being
submitted to the OFA, while those with dysplasia are
being screened out by referring veterinarians.
PennHIP: The diagnostic method used by the University of
Pennsylvania Hip Improvement Program (PennHIP) uses
distraction/compression radiographic views to more
accurately identify and quantify joint laxity.
Radiographs of the hip joints are taken with the dog
under heavy sedation. Two views are obtained with the
hind limbs in neutral position to maximize joint laxity.
Weights and an external device are used to help push the
head of the femur further into or away from the
acetabulum. The amount of femoral head displacement
(joint laxity) is quantified using a distraction index
(DI). The DI ranges from 0 to 1 and is calculated by
measuring the distance the center of the femoral head
moves laterally from the center of the acetabulum and
dividing it by the radius of the femoral head. A DI of 0
indicates a very tight joint. A DI of 1 indicates
complete luxation with little or no coverage of the
femoral head. A hip with a distraction index of .6 is
60% luxated and is twice as lax as a hip with a DI of
.3. When the DI was compared to the OFA scores for 65
dogs, all dogs scored as mildly, moderately, or severely
dysplastic by the OFA method had a DI above .3.
Hip joint laxity as measured by the DI is strongly
correlated with the future development of
osteoarthritis. Hips with a low DI are less likely to
develop osteoarthritis. Hips with a DI below .3 rarely
develop osteoarthritis visible on radiographs. Although
hips with a DI above .3 are considered "degenerative
joint disease susceptible" not all hips with a DI
greater than .3 eventually develop osteoarthritis. It is
known that some hips with radiographically apparent
laxity do not develop osteoarthritis. A means of
differentiating lax hips that develop osteoarthritis
from those that will not is important in developing a
prognosis and making treatment recommendations. In one
study, the DI obtained from dogs at four months of age
was a good predictor of later osteoarthritis, though the
6 and 12-month indices were more accurate.
To assure quality and repeatability among diagnostic
centers using the PennHip technique, veterinarians must
take a special training course to become certified. As
this technique gains popularity more and more
veterinarians are becoming certified.
How is hip dysplasia treated surgically?
There are several surgical procedures available
depending on the age and the severity of the joint
degeneration.
Triple Pelvic Osteotomy (TPO): TPO is a procedure used
in young dogs usually less than 10 months of age that
have radiographs that show severe hip laxity, but have
not developed severe damage to the joints. The procedure
involves a surgical breaking of the pelvic bones and a
realignment of the femoral head and acetabulum restoring
the coxofemoral weight-bearing surface area and
correcting femoral head subluxation. This is a major
surgery and is very expensive, but the surgery has been
very successful on animals that meet the requirements.
Total Hip Replacement: may be the best surgical option
for dogs that have degenerative joint disease as a
result of chronic hip dysplasia. Total hip replacement
is a salvage procedure that can produce a functionally
normal joint, eliminate degenerative changes, and
alleviate joint pain. The procedure involves the removal
of the existing joint and replacing it with a
prosthesis. To be a candidate for this procedure, the
animal must be skeletally mature and is usually
performed on dogs weighing at least 20 pounds. There is
no maximum size limit. If both hips need to be replaced,
there is a three-month period of rest recommended
between the surgeries. As with the TPO surgery, this is
a very expensive procedure but has had some very good
results.
Femoral Head and Neck Excision: Femoral head and neck
excision is a procedure in which the head of the femur
is surgically removed and a fibrous pseudo-joint forms.
This procedure is considered a salvage procedure and is
used in cases where degenerative joint disease has
occurred and total hip replacement is not feasible. The
resulting pseudo-joint will be free from pain and allow
the animal to increase its activity, however, full range
of motion and joint stability are decreased. For best
results, the patient should weigh less than 45 pounds,
however, the procedure may be performed on larger dogs.
Juvenile Pubic Symphysiodesis: A new, less invasive
surgery for treating hip dysplasia, called Juvenile
Pubic Symphysiodesis, is currently being evaluated. This
surgery prematurely fuses two pelvic bones together,
allowing the other pelvic bones to develop normally.
This changes the angle of the hips, lessening the
likelihood of arthritis. Early diagnosis is critical,
since the procedure must be done before 20 weeks of age,
preferably 16 weeks.
Pectineal Myectomy: This is a somewhat controversial
treatment for patients with chronic hip dysplasia. The
pectineus is one of the muscles attaching the femur to
the pelvis. By cutting and removing this muscle, the
tension on the joint and joint capsule are reduced. This
offers some pain relief for some patients, but does not
slow the progression of the disease. There are possible
complications with this procedure and with the
introduction of the newer, better procedures. This
surgery is rarely performed anymore.
How is hip dysplasia treated medically?
Because hip dysplasia is primarily an inherited
condition, there are no products on the market that
prevent the development of hip dysplasia.
Medical treatment of hip dysplasia and osteoarthritis
has greatly improved in the last several years thanks to
the introduction and approval of several new supplements
and drugs. Because hip dysplasia (and other types of
dysplasias) are primarily inherited conditions, there
are no products on the market that prevent their
development. Through proper diet, exercise, supplements,
anti-inflammatories, and pain relief, you may be able to
decrease the progression of degenerative joint disease,
but the looseness in the joint or bony changes will not
change significantly.
Medical management is indicated for both young dogs with
clinical signs and for older dogs with chronic
osteoarthritis. Because of the high cost involved with
many surgeries, medical management is many times the
only realistic option for many pet owners. Medical
management is multifaceted. For the best results,
several of the following modalities should be
instituted. For most animals, veterinarians begin with
the first recommendations and work their way down this
list as needed to control the pain and inflammation
associated with degenerative joint disease.
Weight Management
Weight management is the first thing that must be
addressed. All surgical and medical procedures will be
more beneficial if the animal is not overweight.
Considering that up to half of the pets in the U.S. are
overweight, there is a fair chance that many of the dogs
with hip dysplasia/osteoarthritis are also overweight.
Helping a dog lose pounds until he reaches his
recommended weight, and keeping it there, may be the
most important thing an owner can do for a pet. However,
this may be the hardest part of the treatment, but it is
worth it. You, as the owner, have control over what your
dog eats. If you feed an appropriate food at an
appropriate level and keep treats to a minimum, your dog
will lose weight.
Exercise
Exercise is the next important step. Exercise that
provides for good range of motion and muscle building
and limits wear and tear on the joints is the best.
Leash walking, swimming, walking on treadmills, slow
jogging, and going up and down stairs are excellent
low-impact exercises. An exercise program should be
individualized for each dog based on the severity of the
osteoarthritis, weight, and condition of the dog. In
general, too little exercise can be more detrimental
than too much, however the wrong type of exercise can
cause harm. While watching a dog play Frisbee is very
enjoyable and fun for the dog, it is very hard on a
dog's joints. Remember, it is important to exercise
daily; only exercising on weekends, for instance, may
cause more harm than good if the animal is sore for the
rest of the week and reluctant to move at all. Warming
the muscles prior to exercise and following exercise
with a "warm-down" period are beneficial. Consult with
your veterinarian regarding an exercise program
appropriate for your dog.
Warmth and good sleeping areas
Most people with arthritis find that the signs tend to
worsen in cold, damp weather. Keeping your pet warm, may
help him be more comfortable. A pet sweater will help
keep joints warmer. You may want to consider keeping the
temperature in your home a little warmer, too.
Providing a firm, orthopedic foam bed helps many dogs
with arthritis. Beds with dome-shaped, orthopedic foam
distribute weight evenly and reduce pressure on joints.
They are also much easier for the pet to get out of.
Place the bed in a warm spot away from drafts.
Massage and physical therapy
Your veterinarian or the veterinary staff can show you
how to perform physical therapy and massage on your dog
to help relax stiff muscles and promote a good range of
motion in the joints. Remember, your dog is in pain, so
start slowly and build trust. Start by petting the area
and work up to gently kneading the muscles around the
joint with your fingertips using a small, circular
motion. Gradually work your way out to the surrounding
muscles. Moist heat is also beneficial.
Making daily activities less painful
Going up and down stairs is often difficult for
arthritic pets, and for dogs, it can make going outside
to urinate and defecate very difficult. Many people
build or buy ramps, especially on stairs leading to the
outside, to make it easier for the dogs to go outside.
Larger breed dogs can especially benefit from elevating
their food and water bowls. Elevated feeders make eating
and drinking more comfortable for arthritic pets,
particularly if there is stiffness in the neck or back.
Oral Disease-Modifying Osteoarthritis Agents
Glucosamine and Chondroitin: Glucosamine and chondroitin
are two ingredients of supplements that have become
widely used in treating both animals and humans for
osteoarthritis. Due to the overwhelming success in
treating patients with osteoarthritis, these products
have come to the forefront of therapy and are becoming
the most popular products for managing arthritis today.
Glucosamine is the major sugar found in
glycosaminoglycans and hyaluronate, which are important
building blocks in the synthesis and maintenance of
cartilage in the joint. Chondroitin enhances the
synthesis of glycosaminoglycans and inhibits damaging
enzymes in the joint.
When a dog has hip dysplasia or other osteoarthritis,
the joint wears abnormally and the protective cartilage
on the surface of the joint gets worn away and the
resultant bone-to-bone contact creates pain. Glucosamine
and chondroitin give the cartilage-forming cells (chondrocytes)
the building blocks they need to synthesize new
cartilage and to repair the existing damaged cartilage.
These products are not painkillers; they work by
actually healing the damage that has been done. These
products generally take at least six weeks to begin to
heal the cartilage and most animals need to be
maintained on these products the rest of their lives to
prevent further cartilage breakdown. These products are
very safe and show very few side effects. There are many
different glucosamine/chondroitin products on the
market, but they are not all created equal. We have seen
the best results from products that contain pure
ingredients that are human grade in quality. Products
such as Drs. Foster and Smith Joint Care and Gluco-C, or
the veterinary-sold product Cosequin are several that
fit this category.
S-Adenosyl-L-methionine (SAMe, Denosyl SD4): A recent
product, Denosyl SD4, has been advocated for the
management of osteoarthritis in people. The efficacy of
this product for the management of osteoarthritis in
animals has not been fully determined, however it is
being used as a treatment for liver disease in dogs and
cats. It has both anti-inflammatory and pain relieving
properties.
Perna Mussels: Perna canaliculus, or green-lipped
mussel, is an edible shellfish found off the shores of
New Zealand. The soft tissue is separated from the
shell, washed several times, frozen, and freeze-dried.
It is then processed into a fine powder and added to
products. It is made up of 61% protein, 13%
carbohydrates, 12% glycosaminoglycans (GAGs), 5% lipids
(including eicosatetraenoic acids, or ETAs), 5%
minerals, and 4% water. It also contains glucosamine, a
GAG precursor and one of the building blocks of
cartilage. Glucosamine, GAGs (unbranched chains of
complex sugars) and ETAs (a type of Omega-3 fatty acids)
are the compounds in the mussel believed to contribute
to its beneficial effects. ETAs are the key ingredients
that help in the anti-inflammatory activity and thereby
the reduction of joint pain. GAGs are the main
components of cartilage and the synovial fluid found in
joints.
Tetracyclines: Some tetracyclines such as doxycycline
and minocycline have been shown to inhibit enzymes that
break down cartilage. The results of one research study
suggested that doxycycline reduced the degeneration of
cartilage in dogs with ruptured cruciate ligaments.
Further studies need to be done to evaluate the benefit
of these tetracyclines in the treatment of
osteoarthritis in dogs.
Polysulfated Glycosaminoglycan (Adequan): Adequan is a
product that is administered as an injection. A series
of shots are given over weeks and very often have
favorable results. The cost and the inconvenience of
weekly injections are a deterrent to some owners,
especially since the oral glucosamine products are so
effective. This product helps prevent the breakdown of
cartilage and may help with the synthesis of new
cartilage. The complete mechanism of action of this
product is not completely understood, but appears to
work on several different areas in cartilage protection
and synthesis.
Hyaluronic Acid (Legend): Hyaluronic acid is an
important component of joint fluid. Including it in the
management of osteoarthritis may protect the joint by
increasing the viscosity of the joint fluid, reducing
inflammation and scavenging free radicals. Most of the
research on hyaluronic acid has been done in people and
horses, but it may also be effective in dogs. This is an
injectable product which is administered directly into
the joint.
Other Oral Supplements
Methyl-sulfonyl-methane (MSM): MSM is a natural, sulfur-containing
compound produced by kelp in the ocean. MSM is reported
to enhance the structural integrity of connective
tissue, and help reduce scar tissue by altering
cross-linkages which contribute to scar formation. MSM
has been promoted as having powerful anti-inflammatory
and pain reducing properties.
Creatine: Creatine is an amino acid derivative formed in
the liver, kidneys, and pancreas from the amino acids
arginine, glycine, and methionine. It is found in red
meat and fish. Creatine is not a muscle builder, but
aids in the body production of adenosine triphosphate
(ATP), a fuel, for short, intense bursts of energy. In
humans, it builds lean body mass by helping the muscle
work longer, allowing one to train harder, lift more
weight, and have more repetitions. It is the increase in
exercise which results in building muscle, not creatine
alone. Creatine may be helpful in dogs with muscle
atrophy associated with osteoarthritis.
Vitamin C: Vitamin C acts as an antioxidant and is an
important nutrient in the synthesis of collagen and
cartilage. Because dogs and cats can manufacture their
own Vitamin C and do not require it in their diet like
humans do, the efficacy of using Vitamin C in the
management of osteoarthritis in dogs remains unclear.
Supplementing with Vitamin C at a reasonable level will
not result in a toxicity and may prove to have a
beneficial effect.
Omega-3 Fatty Acids: Omega-3 fatty acids are often used
for the management of the signs of atopy in dogs.
Because of their anti-inflammatory properties, some have
advocated their use in dogs with osteoarthritis.
Research studies are under way to determine their
effectiveness in the management of osteoarthritis.
Duralactin: Recently, a patented ingredient obtained
from the milk of grass-fed cows has been studied and
marketed for the management of musculoskeletal disorders
in dogs. It is called Duralactin, has anti-inflammatory
properties, and is a non-prescription product. It may be
used as a primary supportive nutritional aid to help
manage inflammation or in conjunction with non-steroidal
anti-inflammatory drugs (NSAIDs) or corticosteroids.
Anti-inflammatory Drugs
Buffered Aspirin: Buffered aspirin is an excellent
anti-inflammatory and painkiller in dogs (Do NOT give
your cat aspirin unless prescribed by your
veterinarian.). It can be used along with glucosamine/chondroitin
products. With all aspirin products used in dogs, there
is a risk of intestinal upset or in rare cases, gastric
ulceration. Because of these problems, it is recommended
that if a dog develops signs of GI upset, the product be
discontinued until a veterinary exam can be performed.
(By giving aspirin with a meal, you may be able to
reduce the possibility of side effects.) Using buffered
aspirin formulated just for dogs makes dosage and
administration much easier.
Carprofen (Rimadyl), Etodolac (EtoGesic), Deracoxib (Deramaxx),
Ketoprofen, Meloxicam: These are non-steroidal
anti-inflammatory drugs (NSAIDs) developed for use in
dogs with osteoarthritis. They are strong and effective
painkillers and anti-inflammatory agents. They are
prescription products and because of potential side
effects, careful adherence to dosing quantity and
frequency must be followed. The manufacturers recommend
periodic bloodwork to be done on animals that are on
this product to monitor any developing liver or other
problems resulting from their use. These products are
often used initially with glucosamine therapy and then
as the glucosamine product begins to work, the NSAID
dose may be reduced or even eliminated. Any NSAID should
not be used with aspirin, corticosteroids, or other
NSAIDs. Acetaminophen (Tylenol), and ibuprofen have many
more potential side effects and are not recommended
without veterinary guidance.
Corticosteroids: Corticosteroids have been used for many
years to treat the pain and inflammation associated with
osteoarthritis, however, their use is controversial.
Corticosteroids act as a potent anti-inflammatory, but
unfortunately, have many undesirable short- and
long-term side effects. Because of these side effects
and the advent of newer, more specific drugs,
corticosteroids are generally only used in older animals
with flare-ups where all other pain control products
have failed. Corticosteroids are a prescription product
and come in both a pill and injectable form.
How do we prevent hip dysplasia?
When it comes to preventing the formation of hip
dysplasia, there is only one thing that all researchers
agree on, and that is selective breeding is crucial.
There are many different theories on how to prevent the
progression of hip dysplasia. As discussed earlier,
nutrition, exercise, and body weight may all contribute
to the severity of degenerative joint disease after the
hip dysplasia has developed. When it comes to preventing
the formation of hip dysplasia, there is only one thing
that all researchers agree on, and that is selective
breeding is crucial. There will be a lot of new
information coming forward in the future concerning
other factors that contribute to hip dysplasia, but for
right now, we have to stick to what we know for sure. We
know that through selectively breeding animals with good
hips, we can significantly reduce the incidence of hip
dysplasia. We also know that we can increase the
incidence of hip dysplasia if we choose to use
dysplastic animals for breeding. Breeding two animals
with excellent hips does not guarantee that all of the
offspring will be free of hip dysplasia, but there will
be a much lower incidence than if we breed two animals
with fair or poor hips. If we only bred animals with
excellent hips it would not take long to make hip
dysplasia a rare occurrence. If owners insisted on only
purchasing an animal that had parents and grandparents
with certified good or excellent hips, or if breeders
only bred these excellent animals, then the majority of
the problems would be eliminated. For the best results,
buyers should look at three or four generations of dogs
prior to theirs to ensure that there are no carriers in
the bloodline. Following the newer recommendations for
exercise and nutrition may help, but will never come
close to controlling or eliminating the disease if
stricter requirements for certified hips are not
instituted or demanded.
Summary
Hip Dysplasia is a widespread condition that primarily
affects large and giant breeds of dogs. There is a
strong genetic link between parents that have hip
dysplasia and the incidence in their offspring. There
are probably other factors too that contribute toward
the severity of the disease.
Osteoarthritis is the result of degeneration of the
joint due to hip dysplasia. Surgical and medical
treatments are targeted to prevent and treat the
resulting osteoarthritis. The best way to prevent hip
dysplasia is through selection of offspring whose
parents and grandparents have been certified to have
excellent hip conformation.