Hip dysplasia is a developmental condition of the hips which often results in arthritis and degenerative joint disease. It is the most common orthopaedic disease encountered in dogs. Unfortunately, most patients seen with hip dysplasia are above middle age, after degenerative joint disease has started to develop and the dog is experiencing frequent pain, discomfort and weakness. At this stage, treatment options are limited. However, early diagnosis of hip dysplasia, ideally between 12-16 weeks of age, enables a number of treatment options and interventions to be pursued.
Dogs with hip dysplasia are born with normal hips, however a combination of genetic and environmental factors leads to abnormal joint development. Large and giant breed dogs such as German Shepherds, Rottweilers, Labrador Retrievers, Golden Retrievers, Saint Bernards, Bulldogs and many other larger breeds are more prone to this disease.
The hip is a ball and socket joint. In dogs with hip dysplasia the ball (femoral head) does not seat in the socket (acetabulum) appropriately. This leads to instability and looseness in the joint, causing both the ball and socket to undergo bony changes as show below. These changes culminate in cartilage degeneration, osteoarthritis and pain.
While signs suggestive of hip dysplasia may be detected on physical examination, the only accurate method for diagnosis is X-rays. A specific technique called the Penn-Hip distraction method is used in conjunction with X-rays to determine hip looseness and predict the likelihood of hip dysplasia developing. Based on X-ray findings, patients are given a score from 0-1, with higher scores having a significantly increased risk of developing degenerative joint disease. We recommend undertaking this technique in young dogs as it enables early interventions to be planned before permanent changes occur.
Patients undergoing these X-rays require a short general anaesthetic as this relaxes muscles and enables imaging of the hip joint in a natural state.
While there are many medication options for management of osteoarthritis, few have a proven benefit for hip dysplasia. The best method for hip dysplasia management is prevention through early surgical intervention. There are two surgical methods available to prevent this disease progressing and both are age-dependant.
Dogs younger than 20 weeks of age:
Juvenile Pubic Symphysiodesis (JPS) - this is a procedure that only benefits young, growing dogs and must be performed before 20 weeks of age. JPS is a relatively low risk and minimally invasive procedure performed on the pubic bone. The aim of the surgery is to fuse the growth of the pubic bone at an early age. This results in a slight change in the shape of the pelvis when it becomes skeletally mature, with improved hip conformation due to better coverage of the ball by the socket. The end result is a reduction in development of degenerative joint disease and osteoarthritis
Dogs older than 20 weeks and younger than 12 months:
If hip dysplasia is not detected before 20 weeks of age but is detected before the dog has reached skeletal maturity (approximately 12 months of age), alternative surgical treatments termed Double Pelvic Osteotomy (DPO) and Triple Pelvic Osteotomy (TPO) are possibilities. These procedures involve making cuts in the bones of the pelvis, rotating the segments and securing these with bone plates. This results in better coverage of the ball by the socket, minimising joint looseness and reducing the development of osteoarthritis and degenerative joint disease. If arthritic changes are detected on the diagnostic X-rays, these procedures cannot be performed.
Once hip dysplasia develops, osteoarthritic changes and degenerative joint disease are inevitable. Early intervention at a young age through the procedures outlined above are the best methods to minimise disease progression and maintain good joint health, mobility and quality of life. These procedures, including the specific X-rays are all available through our clinics and do not require referral to a specialist veterinary hospital.
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