In-depth Information on Treatment
Various medical and surgical treatments are available today that can ease your dog’s discomfort and restore mobility. The type of treatment depends upon several factors, such as the age of your dog, the severity of the problem and financial considerations.
Medical Management for Hip Dysplasia in Dogs
Very often your dog might not require surgery and can do nicely with medical management. Medical management is indicated in the following cases:
The dysplasia is mild and the dog is young and not a candidate for triple pelvic osteotomy (TPO) or a total hip replacement (THR)
An older dog with severe hip arthritis responds well to such management
A dog needs treatment until a THR is necessary
Financial constraints make the surgical options unavailable
Medical management involves weight control, exercise and medications.
Weight. Medical management begins with obesity management if necessary. Switch young dogs on high calorie high protein puppy diets to adult food. Weight loss programs may require weekly weigh-ins to assess progress and to modify the program.
Exercise. You should realize that the abnormality in the hip joint will put limitations on the amount of exercise beneficial to your dog. The aim is to maintain good muscle mass and tone but reduce high load on the hip joints. Exercise must be moderate and regular, which means walking every day, not just on weekends, and keeping the length of walks fairly consistent. Pet owners must impose exercise limitations because most dogs will not. In fact, most young dogs will run and play without any consideration for the damage and soreness in their hips. Then suddenly the exercise becomes too much, or at the end of the day they become so sore that they can hardly move.
Take your dog on short leash-walks and gradually increase the time until you find what your pet can tolerate. This may vary when other medications are added but is a good starting place to set exercise limits. Swimming is also an excellent form of exercise as there is minimal joint impact but good development of muscle mass.
Medications. The non-steroidal anti-inflammatory medications are the mainstay of medical management. These include deracoxib, aspirin, Rimadyl®, Etogesic®,Tepoxalin and Meloxicam to name but a few of the vast array of drugs in this group. As with all drugs it is important to be aware of their side effects. The aim is to use the minimum dose that produces a beneficial effect.
Before using anti-inflammatory drugs try to determine which chondroprotective agent works best for your dog. Anti-inflammatory drugs are effective in producing a rapid reduction in joint inflammation and pain, while chondroprotective agents provide raw materials for cartilage remodeling and improvement of the joint environment. They are life-long supplements, so you want to be sure they are truly making a difference for your pet. Initially, when these products are given together, it is likely that most of the benefit is due to the anti-inflammatory, rather than the chondroprotective agent. Using them separately, at first, will allow you to determine which combination is best for your pet.
The chondroprotective agents can be given orally or by injection. Some of these include Adequan, which is given in a series of intramuscular injections, Cosequin and Gylcoflex, given by mouth. Most of these products do not require FDA approval and so evidence as to the benefit of these products, in many cases, is anecdotal. Having said this, many owners report significant improvements in the function of their dysplastic pets with these supplements alone.
Surgical Management for Hip Dysplasia in Dogs
TPO. In young dogs, the surgery of choice is a triple pelvic osteotomy (TPO). Candidates for this surgery must have little to no evidence of arthritis on a hip x-ray and a positive Ortolani test that suggests adequate depth to the abnormal hip socket. The surgery aims to cut the pelvic bones in three places in order to free up the socket and allow its position to be altered so that the ball fits better. The new socket position is secured using a special plate and screws. By correcting the dysplastic hip early in the dog’s life, further arthritic change is minimized and this should be the only surgical procedure necessary. TPO is often performed on both sides, if appropriate.
Some young dogs may have too shallow a socket for a TPO, but are too young and not arthritic enough for a total hip replacement (THR). Such dogs may be candidates for a “Darthroplasty” surgery in which a shelf of bone is created over the rim of the socket. This bone fuses in its new position and in doing so, stops the ball from sliding in and out of the shallow socket. This is a relatively new surgery, but in carefully selected cases has produced good results.
Femoral head and neck ostectomy (FHO) is a salvage surgery. Pain is produced by the grinding of the flattened and eroded ball in the arthritic and thickened bony socket. This pain can be alleviated by removing the ball thereby removing the painful bone on bone contact. Despite sounding like a strange concept, a false joint can form that is smooth and allows for walking, running and playing. This new false joint is, however, not a normal joint. There is decreased hip extension; the gait is different but the joint is pain free. The quality of the result tends to improve in smaller breeds. In heavier dogs this surgery may be acceptable where THR is not affordable.
THR is the ultimate salvage surgery for an arthritic dysplastic hip. If the hip joint is the rate-limiting factor behind poor use of the hind leg then replacement with an artificial ball and socket will offer the best possibility for return to function. The standard hip replacement is ideally performed in mature dogs, preferably not less than two years of age, with strong mature bone to hold the implants and a lower chance to need the hip revised during the dog’s natural life span.
When considering surgery, the biggest concern is infection and special precautions are taken before, during and after the procedure to minimize this risk. Your dog will usually require full blood work, chest x-rays and urine analysis prior to surgery. Usually the hip replaced on one side only, mainly for financial reasons. This becomes the dominant side.