At Upper Canada Animal Hospital we have seen innumerable cases of hip dysplasia or arthritis in dogs and cats. With this condition, the hip joint develops abnormally such that the bones within the joint do not form a secure, tight fit. It’s an extremely painful condition for pets, and often results in severe wear and tear of the hip joint.
Hip dysplasia is a condition affecting both dogs and cats. With this condition the hip joint develops abnormally such that the bones within the joint do not form a nice tight fit. The wear and tear that results from hip dysplasia leads to a flattened femoral head (top of the thigh bone that sits in the hip joint) that gradually slips out of a progressively more flattened joint socket. New bone may develop in the area, causing arthritic pain—this and the laxity (looseness) in the joint may lead to lameness and reduced function.
There are basically two categories of hip surgery when it comes to hip dysplasia. These differ in that one involves early surgical intervention as a preventive measure. This involves surgery on immature dogs in an attempt to improve hip stability to minimize future arthritis and pain. while the other focuses on treatment. The second focuses on treatment. This option involves dealing with a painful arthritic hip joint. While it may seem obvious that prevention be the better treatment, it can be difficult to explain that screening a puppy at a young age to see if they are prone to developing a problem if hips are mildly to moderately dysplastic. Unfortunately this means that the vast majority of hip surgeries are performed on mature dogs that have developed severe arthritis, are painful, and have not responded adequately to medical management.
How do you, as a pet owner, check your pet for hip dysplasia or arthritis?
- Pets with hips dysplasia will typically appear uncomfortable and stiff
- Your pet may develop an unsteady gait
- Often, they exhibit reluctance in running or climbing stairs
- You should be concerned if they have trouble sitting down or getting up
- In some cases, your pet may even show loss of muscle mass in the hind legs
- Enlargement of shoulder muscles – placing weight on forelimbs
- Overall decreased activity
- "Bunny Hop" when running
At the first sign of trouble, get your cat or dog to a professional animal hospital – the earlier the diagnosis, the faster the recovery. Upper Canada Animal Hospital is well equipped with the expertise and radiographic equipment required to diagnose hip dysplasia and the skills to treat it in a timely manner.
What Causes Hip Dysplasia/ Arthritis in Animals?
The two most important factors to consider when discussing hip dysplasia are environmental and genetic:
- Genetic susceptibility for hip looseness or laxity
- Rapid weight gain and obesity
- Pelvic-muscle mass
- Nutritional factors
- Trauma
How is Hip Dysplasia Diagnosed?
Hip dysplasia is diagnosed by radiographs (X-rays). Pennhip, which utilizes a special set of x-rays, provides an objective diagnostic service comparing the hips of dogs within a breed, however the degree of dysplasia does not always coincide with the severity of lameness. A dog with advanced changes on X-rays may not be showing the expected degree of discomfort and a dog with minimal changes on X-ray may be quite sore. Despite having abnormal radiographs a thorough examination of the entire backend must be performed to ensure that the pain is truly isolated to the hip joints since other conditions, especially torn Cranial Cruciate Ligaments, can mimic the signs associated with hip dysplasia.
Although surgery helps cats and dogs in many ways, it is not always the answer when it comes to hip dysplasia. There are several conservative recovery strategies used by vets to improve stability and strengthen the body, particularly in canines.
Can Hip Dysplasia be prevented?
As the old saying goes “an ounce of prevention is worth a pound of treatment”. Prevention starts by selecting a breeder that has made a genuine effort to minimize the likelihood of the condition developing in the dogs they produce. In breeds that are prone to hip dysplasia it is imperative that the breeding dogs have been certified free of the condition (no excuses that a breeder may offer are acceptable) as this condition has a genetic component and is therefore passes down from the parents to their offspring. It is also very important that puppies be fed well balanced diets and are kept in lean body condition and in good muscle mass as this will also reduce the strain on the hip joints during their development.
Is surgery always necessary?
Thankfully no. Even in severe cases of hip dysplasia surgery can often times be avoided if the pet is kept lean and in good muscle mass. Medications, laser therapy, physiotherapy, and supplements can also be of tremendous benefit as they can further decrease or even eliminate the pain associated with hip dysplasia. Young dogs (often between 4 and 18 months) may show severe signs of hip discomfort/pain then gradually improve over the course of months. For this reason Dr Turpel generally recommends against surgery in these young dogs unless medical management has been largely unsuccessful.
When is surgery indicated?
Surgery is typically indicated for pets that do not respond to medical management. Medical management is a large umbrella that covers many treatments. These include but are not limited to: anti-inflammatories, weight loss, laser therapy, physiotherapy, supplements, diet, acupuncture, stem cell therapy, etc.. Dr Turpel defines successful medical therapy as the pet is kept comfortable, has an excellent quality of life and is able to perform “normal” activities (walking, running, playing) in a pain free fashion.
What surgeries are available?
If surgery is deemed necessary there are two main surgical options for hip dysplasia or for any causes of severe arthritis associated with the hip jopint(s).
The first procedure is a Total Hip Replacement (THR). This has been considered the gold standard of hip surgery over the last 2 to 3 decades. Since its inception numerous improvements in both the implant materials and surgical technique now result in an 80 to 90% success rate for return to excellent pain free function of the leg(s). The surgery involves the creation of an artificial ball and socket joint by removing the natural components (head of femur- “ball”, and acetabulum of pelvis- “socket”) of the hip joint and inserting synthetic replacement parts that result in a smooth, stable, pain-free hip joint(s). Unlike people, the lifespan of our pets is such that a one-time prosthesis should do, and repeat surgery to replace worn implants is not typical. After surgery, one can expect a pet to use the limb well in a week or two, but exercise restriction usually lasts for 2-3 months. Physiotherapy is typically recommended during recovery to assist return to mobility, and for maintenance of muscle strength and joint flexibility. Despite the advancements in the THR surgery a 10% to 20% complication rate can still be expected. Unfortunately many of these complications can be extremely serious since they may involve the fracturing of bones, breakage or loosening of implants, dislocation of the artificial hip and severe infection. Despite the excellent outcome in the majority of cases these complications in conjunction with cost of the procedure often times limit its application.
The second surgical procedure is a Femoral Head and Neck Ostectomy (FHO). The FHO involves the removal of the entire head and neck of the femur thereby removing the pain associated with the grinding within the hip joint. Once these structures are removed a fibrous pad develops in the area between the femur and pelvis and results in stability of the hip joint and a pain free condition. This procedure is performed quite frequently since it typically results in a good return to pain free function of the limb(s), has a low complication rate, and is considered far more affordable than a THR. However, patient selection is far more important in FHO’s than in THR’s since the FHO is not initially as stable as the THR and the surgery has a much longer recovery period ( good weight bearing seem typically within 1 month and full recovery in 4 to 6 months). It is also generally accepted that the success of the FHO decreases with the increased weight of the patient. Many surgeons are reluctant to perform the surgery on large dogs while others, Dr. Turpel included, report good success in patients up to 45 kilograms if they are otherwise healthy and not too overweight. FHO’s are considered a salvage procedure since once completed they cannot be reversed or other procedures (i.e. THR) performed. FHO’s are frequently performed if serious complications with a THR are encountered.
The Triple Pelvic Osteotomy (TPO) is a third procedure for hip dysplasia and is briefly mentioned since it is still occasionally performed, however, it has largely fallen out of favour by many surgeons over the last twenty years as the necessity and success of the procedure has been questioned. This procedure involves realigning the bones of the hip joint in young dogs, prior to the development of arthritis, so as to increase stability of the hip joint in hopes of preventing or minimizing future arthritis and pain.
If you suspect that your pet suffers from hip disease please contact your veterinarian since very successful medical and surgical options are available for this very painful condition.
Comments