Hip Dysplasia

The word literally means a displacement of the hip joint. The cause is multifactor.

• In rapid growing breeds the weight of the animal cannot be supported by the bone structure.  This can cause a collapsing of the head of the femur, “twisting” of the cap, and thickening and collapsing of the femur neck.  Bone spurs can sometimes be seen at the rim of the acetabulum or neck of the femur.
• Hereditary joint abnormalities
• Flat acetabulum
• Narrow acetabulum
• Abnormal angulations femur head and neck
• Weakness of ligaments resulting in rupture of Ligamentum Teres
• Immune Mediated / Hereditary?
• Lupus\ inflammation
• Rheumatoid arthritis
• Vasculitis can lead to under nourishment of femur head and eventual collapsing or "Legg Perthes".

Symptoms: Hip Dysplasia occurs more often in large rapid growing breeds of dogs, but is also diagnosed in small dogs and cats. Wobbly gait hips and back end, frequent “lazy” sits, lying down a lot, straight angulations, short gait on hind legs, toeing out and hocking in, bunny hopping, not able to stretch hind legs out, sore back, irritable, poor muscles, no jumping, stiff in the morning, limping, and pain.

Symptoms and Diagnosis

The symptoms of acute arthritis are pain, swelling and heat in the affected joint(s).  In the case of trauma, where the joint is opened through bite(s) or car accident, joint fluid can leak out.  In a closed trauma, such as in crusiate ligament rupture, there will be acute pain with little or no weight bearing on the affected leg.  In the case of the back being affected, the animal will be reluctant to go up or down stairs or jump, just getting up or even approaching the animal might elicit a yelp or bite.  O.C.D. of the shoulder or hock joint will also be expressed with little or no weight bearing.  Legg Perthes disease or aseptic necrosis of the femur head will show up in intermittent lameness of a hind leg in small breeds of dogs.

In immune mediated arthritis there is typically a periodic attack once a week or month. Weather changes and / or stress or stimulation of the immune system (as in vaccinations) can initiate an attack.  There might be signs of general illness such as sore muscles, anorexia, lethargy and irritability.  The hips or shoulder might be sore or the neck or back.  This can look very similar to acute spondylitis or meningitis.  If the jaw muscles are affected, the animal might not be able to eat or yawn.  It is sometimes difficult to differentiate between joint or muscle pain; both can be present at the same time.

Degenerative and osteoarthritis develops over time.  The presence of inflammatory agents in the joint creates an acidic environment.  It is also possible that a defect in the sodium and chloride pump in the cell membrane could create an acid environment. The body’s response is the same as that of a gardener when he faces acidic soil; he will use lime to neutralize the soil.  So does the body.  The calcium deposits we see on radiographs in osteoarthritis are the result of a long-standing attempt of the body to correct the acidic environment.  The amount of calcium deposit is not equivalent to the degree of pain the patient experiences.  It will, however, create a limitation of movement and rough joint surfaces, which will continue to contribute to the problem.  Typical signs will be stiffness rather than acute pain, difficulties in getting up, improvement with exercise, and dampness and cold weather making it worse. After heavy exercise followed by the rest, the soreness and stiffness is worse; however the animal walks it out.

Treatment and Prevention
Prevention is the best treatment.  Preventing car accidents through training and leashes and never transporting your dog in the back of a pick up (open or closed), will be a good start to prevent traumatic injuries. Avoiding excessive workloads such as long hikes or backpacks at too young of an age will give the joints and spine a chance to mature.

Not using any dogs for breeding that have genetic joint defects such as hip dysplasia, elbow dysplasia or anconeal process problems is sensible and responsible breeding. These animals should all be eliminated from the breeding stock.  Since immune mediated diseases might have a hereditary predisposition, these animals should also be eliminated from the breeding stock until we have a better understanding of the origin of immune diseases.

Providing your dog and cat with a warm and dry shelter to sleep will go a long way to preventing arthritis, as well as towel drying your dog after it gets wet from a walk in the rain or from a swim.  A soft, dry and draft-free sleeping quarter will also help.

The right nutrition, not too high in protein as a pup and low in carbohydrates, a good quality commercial or, even better, a raw, home-cooked diet with appropriate vitamin and mineral supplementation.

Early detection, without denial of the problem, will enable you to initiate a treatment at an early stage, preventing it from getting worse.

Treatment:

Traumatic arthritis: In case of an open wound, seek immediate veterinary advice.  The sooner the wound is cleaned and sutured, the better the chance of recovery.  The use of antibiotics is appropriate in this case!  Additional help can be found with herbal and homeopathic remedies.  (See handout on Homeopathy for Pets).  Your veterinarian should also assess closed wounds and ligament damage; sedation is sometimes a necessary procedure.  Rest and homeopathic Arnica are helpful, as well as Rhus Tox.

Ruptured ligaments, avulsion fractures and other bony problems might require surgery.  O.C.D. lesions respond very well to rest, acupuncture and homeopathy. Sometimes surgical intervention is needed to remove loose bone or cartilage fragments. Elbow dysplasia and un-united anconeal process have also been responsive to acupuncture, homeopathy and glucosamine sulfates.  Problems in bone maturation (or cartilage) are related to a low kidney Ying and kidney Qi herbs might also be helpful in these cases.  Hip dysplasia has responded very well to acupuncture and gold bead implants.  The younger the animal, the better the results of the treatment.

Immune mediated arthritis: My experience has been that these animals are better treated with homeopathic remedies and acupuncture than with Western allopathic drugs alone.  This is one of cases where complimentary medicine combined with western drugs is very effective.

Osteoarthritis:  For long term treatment, herbal medicine and acupuncture, as well as homeopathy, might do less damage to the body than aspirin or Prednisone.  Regular exercise, tailored to the animal’s ability, will be very helpful in keeping things going.

Drugs, Medicines, Remedies, Herbs, etc.

This is just a reference guide; don’t use them all at once!  And not without veterinary consultation!

Aspirin, Advil, Ibuprofen, Phenyl butazone, Tylenol, etc.  These are all non-steroidal anti-inflammatory drugs (N.S.A.I.D.).  They block off histamine release and reduce inflammation.  The two big negative side effects are that they also prevent the blood from clotting and can create ulcers in the stomach or intestines.  This can lead to a fatal bleeding.  The other side effect is that, prolonged use of these drugs erodes the cartilage of the joint surface, making arthritis worse.

Cortisone, Prednisone or dexamethasone are all well used (over used) anti-inflammatory drugs with so many side effects it would fill a page!  They also erode joint surfaces, weaken ligaments and muscles; increase appetite, weight, thirst and urination.  Long-term use exhausts the kidney Yin, soon to be followed by kidney Yang, in western medicine Cushing’s disease and diabetes can be a result of long-term use of Prednisone.  They are not a good choice to use in the long-term treatment of arthritis.

Ketoprofen is a very powerful anti-inflammatory and should be used in the short term only.  Long-term use side effects are similar to aspirin.

Metacam/ Meloxicam is a non-steroidal anti-inflammatory (NSAID), which relieves pain and join inflammation. Long-term side effects are to the intestines (inflammation) liver and kidney.

Cosequan, Cartrophen and Glycoflex are all glucosamine sulphates. They increase the joint fluid thus lubricating the joint better.  Cartrophen is injected while Cosequan and Glycoflex are given orally.  Don’t under dose.  It can be used for long term treatment – months or even years!!  It also helps to repair damaged cartilage, as does chondroitin sulphate.

Shark cartilage can be used to rehabilitate damaged cartilages as in O.C.D. or vertebral disk disease.  A cheaper and more environmentally friendly source can be found in bovine cartilage (chondroitin sulphate).

Yucca is a tropical cactus with anti-arthritic properties and can be used long term.

Alfalfa also has anti-arthritic properties.

Vitamin E and Vitamin C are anti-oxidants and anti-radicals and will be helpful to reduce the toxins produced in the inflammatory process.  Use intermittently.
Dosage:           Vitamin E 100 IU/day up to max 400 IU/day
                        Vitamin C 100 mg /10 lbs up to 1000 mg max/day

Homeopathic Remedies:

Arnica is very helpful in the acute stages.  High levels of arnica should be avoided for prolonged periods of time. Use intermittently.  Dosage --> see Homeopathy for Pets.

Devils Claw Root is also an effective anti-arthritis treatment.

Rhus Tox and Bryonia is found in most homeopathic arthritis remedies.

Ribes Nigrum (black current) is a drainage remedy and should be used for a short period only.  One to three months at a time is suggested and can be repeated twice a year or in acute stages.

Thoraco Lumbar Disc Disease Calcification of intervertebral discs and degeneration of the “Annulus Fibrosa” (elastic tissue surrounding the disc that works as a pillow) are the cause of disc material prolapsing into the spinal canal.  This results in back pain that can lead to lameness and paralysis.

Short legs and long backs, as well as positioning of the pelvis, predispose to an ineffective use of the back. This leads to hyperactivity or hypo activity, nutritional (blood) deficiency, and eventually degeneration. Agility, jumping, and Shutzhund are predisposing factors. Nutrition also has an influence as in previous cases.

Osteoarthritis - “Wear and Tear” / Old Age, Joint Instability - A Traditional Chinese Medicine Perspective.

The first sign of osteoarthritis is stiffness; in TCM stiffness is seen as “ cold” and arthritis is seen as dampness and cold trapped in the joints.The legs or back are stiff because the fluids are not moving. This leads to the accumulation of dampness and a stagnation in the flow of Qi which causes pain. In TCM we now speak of a Bi Syndrome.  In older age we see a deficiency of fluids, blood, and Qi stagnation which can lead to the drying up of joint fluid. The lack of lubrication leads to inflammation.

Tx Prevention:

• Warm soft surface to lie on, dry after getting wet (rain / bath / swimming)
• Adequate nutrition and exercise
• Natural anti-inflammatories Vitamin C and Vitamin E
• Natural joint lubricants such as glucosamine sulphate
• Reduce meat protein at older age
• Acupuncture, physiotherapy, chiropractic, on regular basis
• Herbs to correct imbalance

Back to articles