A few definitions and comments to avoid confusion
Arthritis simply means inflammation of the joints.
We are being taught now that most diseases of the different joints... such as bursitis for the shoulder, stenosis for the spine, hip dysplasia for the hips, arthritis of the hand, fingers, knees and so forth are really localized versions of the same disease.... what is now known as degeneraive joint disease.
Underlying factors or causes include genetics ... this is a big factor in hip dysplasia, truama, excessive weight, hormones, nutrition, immune system problems, and infection.
Hip Dysplasia is simply another name for arthritis of the hip joint due to a poorly formed (or dysplastic) hip socket. Inflammation or arthritis of dysplastic or poorly formed hips develop over time because the socket in the hip is not quite the right shape to keep the ball shaped femur head from sliding and grinding the joint down.
The main cause of this malformation is genetics.
A good example in humans... now that everyone seems to be wearing sandals ... are pinky toes; a lot of people have weird looking little toes because their parents or grand parents had weird looking little toes ... it's a genetic thing.
Well hip sockets in dogs... especially large breed dogs, are a little like small toes in humans. Certain breeds and some individual dogs of other breeds are prone to having less than perfectly formed hip sockets... because the parents or grandparents passed on their genetic code for this.... For better or for worse.
Unfortunately, little toes are pretty insignificant whereas hips are the biggest load bearing joint in the body.
What To Expect When You Go To The Vet
For Hip Dysplasia
(Of course, your vet may do things a little differently)
If we're talking about hip dysplasia (and we are), you'll be going to the vet for 1 of 3 reasons:
1. Your dog is often lame, stiff, sore, reluctant to get up and down, has trouble getting up or down steps, "bunny hopping" and so forth. In other words, it's becoming obvious to you that something's wrong with the rear end of your dog.
2. Your dog seems fine, but you're a concerned, aware, and super responsible pet owner or breeder who wants to know if your dog has hip dysplasia and you want to know this early enough to prevent breeding this pet and/or to manage this disease in the early stages to minimize future problems.
3. You, the responsible and caring pet lover will be seeing your vet for some other problem or for your pet's annual exam and your astute and wonderful veterinarian will detect or suspect hip dysplasia and offer you advice and options
Our Diagnostic Options:
Unfortunately, as I indicated in the introduction, it's quite difficult to determine if a young dog is a genetic carrier of hip dysplasia or is likely to suffer from the disease in latter life. There aren't as yet, any blood tests, genetic tests, etc that detect the disease. Perhaps such tests will be available soon, which would be great, because then we could avoid breeding carriers of the disease and maybe in one or two decades hip dysplasia would be a rare disease instead of the the most common crippling disease we vets see after car accidents.
So, here's what we do have:
1. Use our skills and experience to recognize the disease with a good exam and history. Detecting hip dysplasia in this manner is usually too late for making breeding decisions...but it's often early enough to make some changes that will greatly minimize future suffering of the pet involved.
2. Radiographs. This is our main diagnostic tool. High Quality radiographs can detect the poorly shaped hip socket long before the pet exhibits lameness.
By two years of age, a pet's pelvic bones are fully developed and by convention, we recommend taking x-rays of large breed dogs at 2 years of age prior to breeding in hopes of breeding only those individuals without obvious problems. The success of this world-wide endeavor...trying to avoid breeding of hip dysplastic dogs...has been limited by various hurdles, non-compliance, and the inability of radiographs to detect non-symptomatic carriers of the disease. I'm going to skip over this topic and get back to what to expect at the vet for your individual pet except to say that we strongly encourage you to avoid having puppies with breeds prone to hip dysplasia until after having radiographs that rule out obvious hip dysplasia. You don't necessarily have to wait until the dogs are 2 years old for the x-rays to pick up bad cases of dysplasia, so if you're anxious to breed, talk to your vet about pre-breeding radiographs. (There is a 2 year old requirement for official certification and it's true that x-rays taken before physical maturity of the pelvis aren't as accurate)
If you take your pet to the vet for lameness etc and hip dysplasia is suspected, your vet will encourage you to take radiographs for a couple of reasons:
1. To confirm the disease and to make sure there isn't some other explanation or problem that needs to be tackled. Quite a few times in my experience what I suspected was hip dysplasia turned out to be an old fracture, a pellet or bullet, disc disease, bone cancer, an abdominal tumor, or a prostatic cyst. One time it turned out to be from a bone pin that was put in years ago when the young dog fractured it's femur; the pin had migrated up into the socket. You never know unless you look.
2. To see how bad the condition is (staging), to see if one side is much worse than the other (making a femoral head removal a possible option), and so that we compare to future radiographs which allows us to determine if our treatment plan is working well or not.
I'll tell you up front, we don't have a cure or super great treatment for hip dysplasia yet. Whenever this is the case...where we can't all agree on which treatment is best...you'll find some vets enthusiastic about one type of treatment and others all for another type or method of treatment. And often it depends on what you can afford or are willing to spend. Here the more common options:
Medical Treatment and Relief of Symptoms
1. Weight Loss I mention this first for no special reason, but if your dysplastic pet is overweight, it's well worth the trouble and effort to get that weight off.
2. Pain and Inflammation Relief. Newer medications available (I like Rimadyl, Previcox, Adequan, & Duralactin) have been wonderful, giving a lot of suffering pets the relief needed to live a fairly normal life. Prior to the availability of these new meds, we used aspirin, bute, motrin, and steroids with varying degrees of success, but these newer medications are much better and safer.
3. Joint Lubrication and medications that promote joint health: This group of medications includes glucosamine, vitamin C, injections into the joint, anti-oxidants, MSM, and probably other supplements and medications I'm not familiar with yet. Some of these treatments are still somewhat controversial or at least unproven.
There's little doubt left that these treatments are often beneficial; they are. The remaining controversy centers on how beneficial, which brands are the best, which combinations are the best and so forth. I personally am a big fan of the Glucosamine-MSM-VitaminC product made by VetriScience and the products made by Nutrimax.
At any rate, such products help to increase joint lubrication, reduce damage to the cartilage, and to some degree help repair cartilage damage. To put a finer point on the topic; if your pet is stiff, sore, or limping due to dysplasia, you have about a 30% chance of noticing great improvement after using high quality glucosamine combinations (it takes 1- 3 weeks to see the improvement). You have about a 30% chance of seeing some improvement, and about a 30% chance that no obvious improvement will be noted.
Even if the benefits aren't obvious, these neutriceuticals are probably at least slowing down this progressive disease.
3. Laser Therapy. At our practice, we've been having good success making arthritic patients feel better and move around better using our class 4 laser. Laser energy increases blood flow to the area, reduces swelling and inflammation, and stimulates tissue healing.
4. Acupuncture. I just don't know enough about the pros and cons of this treatment modality to advise you. It's got a lot of popular press and mystique, but that doesn't necessarily make it a good choice.
5. Chiropractic. I'm impressed with the benefits of chiropractic treatment for some spinal injuries...and arthritis of the lower spine is often present in dogs suffering from hip dysplasia, in which case I think chiropractic treatment might be very helpful. But: I don't see how spinal adjustments are likely to help the wear and tear pain associated with a bad hip joint.
Surgical Treatment Options
Medical treatment and acupuncture can be used to alleviate arthritis pain and promote joint health, but these treatments do not correct the underlying cause of the hip pain which is a malformed joint. Because of this, the primary treatment for hip dysplasia is surgery and it can be very successful.
This is the surgery I do most often, mainly because it's relatively inexpensive, usually works fairly well, and just so you know; it's the only procedure for hip dysplasia I know how to do well. We simply remove the top of the femor and that solves the painful problem of grinding away at the hip joint. Of course, without the leg bone attaching to the hip bone, you might think that the poor animal would be unable to stand on that leg...and it's true...at first, but after a few weeks a false joint is formed by the muscle being scarred around the top of the cut off femor and most patients are soon weight bearing and get along quite well. This is not a perfect solution by any means, but it does allow most pets to get around without a lot of pain. This is an especially good choice if only one leg is bad or you simply can't afford other methods of repair. Some vets do both legs at the same time, others, like me, usually do one leg at a time.
Total Hip Replacement
Total hip replacement is used primarily for larger dogs and is very similar to the procedure performed on people.
The entire hip is replaced using high density, medical grade plastic for the socket and a high quality, non-corrosive alloy for the ball.
This is probably the very best solution for many patients and has a high degree of success, pain elimination, and nearly complete resumption of activity. This type of surgery is done by specialists and is quite expensive.
Triple Pelvic Osteotomy
This special surgery is different in that it must be done BEFORE the joint is damaged and is done on dogs under a year old in order to prevent future dysplastic problems.
We perform this surgery on young dogs with early symptoms or radiographs indicating malformed joints. Some owners with breeds prone to hip dysplasia...or with puppies from a line of hip dysplastic dogs...will sometimes have x-rays done as early as 6 months old that can detect an obviously malformed hip joint. In these cases, this surgery works well at preventing future pain and problems.
The surgery basically involves cutting the pelvis in 3 places which allows the surgeon to rotate the hip sockets to better fit over the femur heads. The pelvis then heals into this new and better position. This is another surgery done by specialists and is quite expensive.
Other Surgical Methods for this problem:
There are a few other methods in the "surgical literature" .
Stem Cell Therapy:
It seems incredible to me, but some vets now offer stem cell therapy. Results are apparently fantastic but for most people the cost (2014 prices are about $4-6 thousand dollars) is too prohibitive.