Orthopedic Disorders – Hip Disorders
Orthopedic Disorders – Hip Disorders
*The following was originally printed in the Metropolitan Dog Club’s 2010 Blue Book.
Charlie, a 5 year old mixed breed was Sharon’s best pal and exercise buddy. Together the two would jog a couple of miles a day and on weekends hike the nearby hills. But recently, Charlie was not as enthusiastic about their workouts as he had been. In fact, he was even having difficulty standing from a lying down position. Sharon took Charlie to the vet, who considered orthopedic disorders of the hip, forelimb and knee as part of the dog’s reluctance to run.
The following blog post is part one of a three-part series about orthopedic disorders found in our pets — how they are manifested, potential methods of diagnosis and treatments. The decision to pursue these treatments would typically be made in concert with a canine orthopedic specialist and a canine rehabilitation specialist.
Canine hip dysplasia (CHD) is an abnormality of the hip joint. CHD occurs most commonly in rapidly growing, large breed dogs but also occurs in small breeds. Joint laxity results in cartilage degeneration, osteoarthritis (OA) and loss of muscle mass, range of motion and limb function. CHD occurs due to a combination of genetic and environmental factors.
CHD may manifest itself in either young (less than one year) or older (skeletally mature) dogs. In young dogs, lameness associated with CHD is attributable to joint laxity; as a dog ages, lameness is attributable to OA. Clinical signs include abnormal or bunny-hopping gait in young dogs, and difficulty rising, exercise intolerance, or hip pain in any age dog. CHD typically affects both hips and is diagnosed by localizing pain to the hip on exam and x-ray evidence of laxity and/or OA.
Veterinarians tailor treatment to the dog’s age and the amount of OA. In dogs less than 1 year of age and before the onset of OA, surgery may be performed to improve biomechanics and help prevent or slow the progression of arthritis. In dogs that are skeletally immature, either a juvenile pubic symphysiodesis (16 to 20 weeks of age) or a triple pelvic osteotomy (6 to 12 months of age) may be performed. These procedures are surgeries that decrease the laxity of the hip joint by rotating the pelvis (acetabulum) over the femoral head.
In dogs older than one year of age, those who have severe hip laxity or those that already have evidence of OA, CHD may be treated either medically or surgically. There are many dogs with CHD that are asymptomatic and may not require treatment. Weight loss, dietary management, medications and activity modification are recommended in all patients before surgery. Acupuncture may also benefit some dogs. For those that do not respond favorably to medical therapy, surgery may be of benefit. A total hip replacement is the “gold standard” to normalize comfort and function in dogs with CHD. A femoral head and neck ostectomy (FHO) is an alternative procedure that can alleviate pain and improve function. FHO is a surgical procedure to remove the arthritic femoral head and neck, creating a comfortable and functional pseudoarthrosis or false joint; however, the rear limb gait and limb carriage typically remain slightly abnormal.
Veterinarians do not recommend breeding dogs with CHD. For dog owners considering breeding their dog, hip evaluations can be performed by Penn Hip® or the Orthopedic Foundation for Animals.
Legg-Calve Perthes Disease is also known as avascular, aseptic or ischemic necrosis of the femoral head. While the cause is unknown, the loss of the blood supply to the bone just below the hip joint results bone loss and lameness. This condition affects young, small and toy breed dogs between four and 12 months of age. There is an increased incidence in Manchester terriers, miniature pinschers, poodles, Lakeland terriers, West Highland white terriers and Cairn terriers but there is no sex predilection. Although occasionally both hips are affected, the condition typically affects only one hip and is manifested as lameness in one of the rear limbs. Diagnosis is made by localizing pain to the hip on examination and by having an x-ray that demonstrates bone loss. While there is no cure for this condition, one of the procedures used to treat CHD, FHO often alleviates pain and improves function in dogs with Legg-Calve Perthes Disease.
Rehabilitation therapy plays a role in the management of all these diseases as an adjunct to surgery or in cases not requiring surgery. Low impact exercise, including work on an underwater treadmill to provide buoyancy to the limbs as the pet works to regain strength and stamina, can be very beneficial to recovery. Deep tissue ultrasound and electrostimulation are also gaining in popularity for the treatment of canine musculo-skeletal disorders. Acupuncture also benefits many dogs with orthopedic diseases.
If your pet appears to be having trouble standing, walking or running, please consider consulting an orthopedic specialist at The Animal Medical Center. The AMC also provides rehabilitation therapy and acupuncture for dogs with orthopedic disorders. To make an appointment, call 212.838.8100 today.
About the Authors:
Dr. Marc Havig, DACVS is currently a staff surgeon at The Animal Medical Center, and the interim Chair of the Department of Surgery. Dr. Havig specializes in orthopedic surgery and has a special interest in canine sports-related injuries.
Dr. Ann E. Hohenhaus is a Diplomate of the American College of Veterinary Internal Medicine, certified in both Oncology and Small Animal Internal Medicine. She has over 20 years of experience as a practicing veterinary oncologist in New York City.
For nearly a century, The Animal Medical Center has been a national leader in animal health care, known for its expertise, innovation and success in providing routine, specialty and emergency medical care for companion animals. Thanks in part to the enduring generosity of donors, The AMC is also known for its outstanding teaching, research and compassionate community funds. Please help us to continue these efforts. Send your contribution to: The Animal Medical Center, 510 East 62nd Street, New York, NY 10065. For more information, visit www.amcny.org. To make an appointment, please call 212.838.7053.