COMMON NEUROLOGICAL AND ORTHOPAEDIC CONDITIONS - CAN REHABILITATION HELP?

PART 6: CANINE HIP DYSPLASIA AND REHABILITATION

Text: Bianca Rootman, Animal Health and Hydro

Canine Hip Dysplasia (CHD) is a common condition affecting our canine companions. Hip dysplasia is defined as an “abnormal development of the hip joint, resulting in coxofemoral laxity due to decreased coverage of the femoral head by the acetabulum, and ineffective soft tissue stabilisation of the joint” (in essence, an unstable hip joint!)

Hip dysplasia is an inherited condition and is more prevalent in large and giant breeds. The condition usually affects both hips.

Many people will have experienced the sadness of having a large breed companion diagnosed with hip dysplasia. Typically, the picture has been one of an old German Shepherd that perhaps cries when it rises, no longer has the stamina or strength to walk the distance or play with the other members of the pack or starts to drag his/her hind legs.

However, new research shows that this debilitating condition is not restricted to bigger companions; it is also seen in English Cocker Spaniels and Pugs. Furthermore, as veterinarians gain more knowledge in the development of the disease, a new pattern is emerging. This is one of pain in puppies as young as five months, accompanied by hind quarter weakness, a typical swaggering gait and generally poor development of the gluteal region. Your companion may be reluctant to jump up, have difficulty rising, cry out in pain, and be unable to be physically active.

The good news is that if this condition is diagnosed early in its course, then surgery can be avoided in as many as 70% of dogs. For the cases that will require surgery, there are several options.

SURGICAL OPTIONS

Juvenile Pubic Symphysiodesis (JPS)

This surgery aims to increase the acetabular rim coverage of the femoral head. JPS causes premature closure of the pubic symphysis. The procedure should be performed in dogs at 16 – 18 weeks of age.

Triple/Double Pelvic Osteotomies (T/DPO)

A TPO is usually performed on dogs from 6 – 12 months of age. The procedure rotates the acetabular segment over the top of the femoral head to increase the dorsal coverage.

Femoral Head Ostectomy (FHO)

This procedure is also referred to as femoral head and neck excision (FHNE) arthroplasty. The femoral head and neck are removed, which eliminates bone-on-bone contact. Success relies on peri-articular fibrosis and muscle to support the body weight. Even though this procedure gives rise to an abnormal post-operative gait, FHO is still a viable treatment for CHD because of its technical ease, relatively low surgical costs and effective relief of pain. However, muscle atrophy, limb shortening, and a decrease in hip extension are common and affect outcomes.

Total Hip Replacement (THR)

This procedure is performed in dogs usually older than a year when they are skeletally mature. The acetabulum and femoral head are replaced with a prosthesis. The choices are cementless and cemented implants. The expected outcome is to restore normal hip function, range of movement, and muscular development.

Non-surgical options

Hip dysplasia is characterised by instability of the joint. It makes sense then that any exercise that strengthens appropriate musculature will decrease the extent of the instability, thereby slowing down the condition’s progression. Exercise must be low impact (as in hydrotherapy) and aim at strengthening the glutes while maintaining the range of motion in the hip joints. The crux of managing hip dysplasia lies in early intervention with appropriate therapeutic exercise. Weight management also plays a massive role in guaranteeing a comfortable life for your companion.

FINAL THOUGHTS

If you suspect your adolescent companion is showing signs of hip dysplasia, do not delay in obtaining a diagnosis. The sooner you know, the more likely your companion will live longer, with a good quality of life.