Canine hip dysplasia (CHD) is a genetic disease of the canine hip, which may occur unilaterally or bilaterally.
This condition is a leading cause of osteoarthritis in large-breed purebred and cross-bred dogs such as German Shepherd, Burnese Mountain Dog, Great Dane, Newfoundland, Labrador Retriever, Leonberger, Irish Wolfhound and Rottweiler.
The disease has a partly genetic, multifactorial aetiology and is often evident at birth, manifesting from 3 - 4 months of age in severely affected pups. Because of the genetic underpinning of this condition, concurrent elbow dysplasia is frequently observed.
This disease is caused by congenital maldevelopment of the hip joint with characteristic shallow acetabulums, resulting in joint laxity. As the pup grows, the joint laxity results in abnormal wear of the femoral head against the acetabulum, resulting in excessive erosion, arthritis and secondary osteoarthritis. This disease mirrors the frequently observed human congenital hip dysplasia/subluxation which is readily corrected with conservative bracing.
Clinically affected dogs usually present with hind-leg ataxia, reluctance or inability to stand, reduced exercise intolerance and stiffness after exercise.
Diagnosis is usually attained by clinical signs (characteristic 'bunny-hopping' or waddling), evidence of pain and joint laxity during hip manipulation.
The Ortolani test may assist a diagnosis and can be performed under sedation, where axial pressure is placed on the femur to elicit any tendency for subluxation.
Ultrasonography can also be used as an adjunct to establish the presence of hip joint disease but cannot be used as a predictive tool.
Radiography is usually required for a definitive diagnosis, although experience is essential and interpretation varies between clinicians.
Diagnostic as well as predictive radiographs are usually taken from 5 - 6 months of age in predisposed breeds or those at risk which are potential breeding dogs.
A standardized radiographic technique is normally employed in order to assess the extent of dysplasia. This involves placing the dog in dorsal recumbency with the hips extended and legs placed in parallel using slight internal rotation to render the patellae directly above the stifle joint.
- Norberg Angle
- Cranial Acetabular Edge
- Dorsal Acetabular Edge
- Cranial Effective Acetabular Rim
- Acetabular Fossa
- Caudal Acetabular Edge
- Femoral Head/Neck Exostosis
- Femoral Head Recontouring
Scoring ranges from 0 - 6, with 0/6 being a good score and 6/6 implying severe hip dysplasia.
Treatment involves either conservative medication or surgical intervention, depending primarily on the severity of the disease and the breeding potential of the dog.
Non-surgical intervention usually requires long term palliative treatment with acupuncture, activity restriction, physiotherapy and NSAID-based medications such as carprofen, tramadol, meloxicam, gabapentin or in severe cases, prednisolone.
Use of exercise has significant benefits in long-term therapy associated with osteoarthritis, and leash-held walking is recommended in dogs that are not unduly ataxic or in pain.
Adjunct medication such as pentosan polysulfate, glucosamine, veterinary therapeutic diets rich in omega-3 fatty acids, curcumin and root extracts of Brachystemma calycinum (an indigenous plant of southwestern China) have predictable improvements in clinical amelioration of symptoms.
Preventative measures include ensuring that puppies under 4 months old have restricted access to stairs and allowed outdoor exercise on soft ground in moderately rough terrain to decrease the risk of developing hip dysplasia. Weight management is critical in obese patients.
Managing chronic pain is the critical aspect of this relatively incurable disease, affording as good quality of life as possible based on economic feasibility and response to medical and physical therapy.
Surgical corrective techniques include juvenile pubic symphysiodesis (dogs <6 months), femoral head excisional arthroplasty (ostectomy), double or triple pelvic osteotomy (dogs > 10kg; osteotomy of the ilium, pubis, and ischium), myotomy of the superficial gluteal muscles, gluteal tenotomy and gluteal tenodesis.
In severe cases, total hip replacement may be considered (dogs >20 kg), although expensive and not without complications.
CHD is a significant welfare problem and may result in significant disability and lead to euthanasia on humane grounds.
- Whitebear Animal hospital
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