Hip Dysplasia, A Common Condition In Large Breed Dogs
Hip Dysplasia, A Common Condition In Large Breed Dogs

Video: Hip Dysplasia, A Common Condition In Large Breed Dogs

Video: Hip Dysplasia, A Common Condition In Large Breed Dogs
Video: Hip Dysplasia In Dogs (Symptoms & Treatment) 2024, March
Anonim

Dysplasia of the hip joints is well known to dog breeders. This defect is more or less common in most large dog breeds. The journals periodically publish articles on the diagnosis of this disease, issues of its origin and inheritance. However, much less attention is paid to the treatment of this disease. It turns out that they were excluded from breeding and, as it were, put an end to the living and often severely suffering animal.

Dr. Efimov
Dr. Efimov

In recent years, many translated veterinary surgery manuals have appeared on the market. What do our foreign colleagues say? Dysplasia of the hip joints is an incurable disease. The animal needs either lifelong pain medication or expensive surgeries. If this is not done, then the suffering animal must be euthanized. Experienced surgeons are perplexed by this point of view, but young doctors can take it for granted. Therefore, I consider it my duty to outline my own approach to the treatment of hip dysplasia.

Dysplasia of the hip joints is a hereditary underdevelopment of the acetabulum of the hip joint. Small degrees of hip dysplasia usually do not appear in any way and are recognized only on x-ray examination of the animal. The mildest, clinically visible complication of dysplasia is chronic arthritis of the hip joints due to excessive mobility of the femoral head and hyperextension of the joint capsule. Over time, a thickening of the capsule occurs, along the edges of the cavity, bony growths appear, deepening it, and compensation for congenital underdevelopment of the joint occurs. Whether stabilization or destabilization occurs depends on many factors, and here the recommendations of foreign colleagues and our observations fundamentally differ. What can we read in foreign manuals? It is recommended to strictly limit the animal's mobility (up to walking around the garden on a leash until the end of growth) and feeding it to reduce body weight. For lameness, pain relievers are prescribed, which may be needed for life, which in itself speaks of the ineffectiveness of such treatment.

Our recommendations are diametrically opposed. The puppy must live fully. Only in such conditions is it possible to compensate for the congenital underdevelopment of the hip joints. Feeding should be appropriate for age and breed type. Ready-made dry feeds meet these requirements as much as possible. The puppy should not be "plump" with round shapes, but the required amount of protein for the development of muscles, calcium and phosphorus for bones, as well as calories for active movements, he should receive. A growing dog, especially with mild forms of uncomplicated dysplasia, needs a lot of movement. The length of the walks and their intensity can be determined by the owner of the animal. If the puppy gets up with difficulty after a walk, whines when getting up, then the load should be reduced for several days, and then gradually increased again. Medical treatment in a growing dog is of secondary importance. Funds are prescribed to promote the development of muscles (3). Pain relievers are highly undesirable and are prescribed in short courses during exacerbation of lameness. What are the results of this treatment? At grade "B" it is usually possible to completely compensate for the congenital defect. At grade "C" and "D" there is a significant improvement. In the second half of life, dogs with grade "C" and especially "D" dysplasia develop deforming arthritis, the treatment of which is also possible. What are the results of this treatment? With grade B, it is usually possible to completely compensate for the congenital deficiency. At grade "C" and "D" there is a significant improvement. In the second half of life, dogs with grade "C" and especially "D" dysplasia develop deforming arthritis, the treatment of which is also possible. What are the results of this treatment? At grade "B" it is usually possible to completely compensate for the congenital defect. At grade "C" and "D" there is a significant improvement. In the second half of life, dogs with grade "C" and especially "D" dysplasia develop deforming arthritis, which can also be treated.

Abroad, conservative treatment of hip dysplasia is prescribed only in cases where the owners of the animal are unable to pay for surgical treatment, despite the fact that a satisfactory result can be obtained in 76% of cases. The so-called triple pelvic osteotomy is offered for solvent clients. The principle of the operation is osteotomy, that is, the intersection of three incisions of all three bones that form the pelvis, isolation of the pelvic bone area in which the glenoid cavity is located, turning this fragment over the head and fixing it in a new position using metal structures. For this operation, "patient selection" is very important and the main cause of complications is precisely the failure to meet this condition. And among other indications, the preservation of the edges of the glenoid cavity stands out,while its underdevelopment leads to joint instability, lameness and seeking medical attention. That is, non-lame animals are the main candidates for this healing operation. In other words, this operation cannot solve real health problems, since a good result can be obtained by operating on the dog before the appearance of lameness, and if it is present, the operation is usually too late. Or maybe with proper conservative treatment and raising the dog, there will be very little, if any, indications for this operation? A positive result with triple pelvic osteotomy can be obtained in 80-90% of cases (1). How little this differs from the results of even conservative treatment, which, in our opinion, is incorrect!That is, non-lame animals are the main candidates for this healing operation. In other words, this operation cannot solve real health problems, since a good result can be obtained by operating the dog before the appearance of lameness, and if it is present, the operation is usually too late. Or maybe with proper conservative treatment and raising the dog, there will be very little, if any, indications for this operation? A positive result with triple pelvic osteotomy can be obtained in 80-90% of cases (1). How little this differs from the results of even conservative treatment, which, in our opinion, is incorrect!That is, non-lame animals are the main candidates for this healing operation. In other words, this operation cannot solve real health problems, since a good result can be obtained by operating the dog before the appearance of lameness, and if it is present, the operation is usually too late. And maybe with proper conservative treatment and raising a dog, there will be very little, if any, indications for this operation? A positive result with triple pelvic osteotomy can be obtained in 80-90% of cases (1). How little this differs from the results of even conservative treatment, which, in our opinion, is incorrect!and if it is available, it is usually too late to perform the operation. Or maybe with proper conservative treatment and raising the dog, there will be very little, if any, indications for this operation? A positive result with triple pelvic osteotomy can be obtained in 80-90% of cases (1). How little this differs from the results of even conservative treatment, which, in our opinion, is incorrect!and if it is available, it is usually too late to perform the operation. And maybe with proper conservative treatment and raising a dog, there will be very little, if any, indications for this operation? A positive result with triple pelvic osteotomy can be obtained in 80-90% of cases (1). How little this differs from the results of even conservative treatment, which, in our opinion, is incorrect!

With a pronounced underdevelopment of the glenoid cavity, the head of the femur cannot linger in it and, with an increase in body weight, gradually leaves it - a dislocation of the hip joint occurs. This is the most severe complication of dysplasia. In addition to dislocation, even small degrees of dysplasia over time lead to deforming arthritis, which causes hip pain and lameness. In such cases, our foreign colleagues strongly recommend replacing the hip joint with a metal structure, otherwise endoprosthetics by analogy with humanitarian medicine. It would seem not bad: the principles of the operation are well developed, endoprosthetics are performed for millions of people all over the world, the results of the operation are usually good. But is everything so good in veterinary medicine? First of all, the result of the operation depends on the quality of the endoprosthesis. Our industry does not make any dentures for dogs. Of course, it is possible to bring an endoprosthesis from abroad, but for one operation it is recommended to have three sets in order to accurately match the size of the femur of the operated animal, and one endoprosthesis costs $ 500-700. All this makes this operation a little realistic in Russia. But is it worth grieving about this? In addition to the 85-95% probability of a satisfactory result in hip arthroplasty, there are 5-15% complications. It is noteworthy that in the event of complications, it is no longer possible to help the animal, and it remains disabled. Is there any alternative? There is!to accurately select the size of the femur of the operated animal, and one endoprosthesis costs $ 500-700. All this makes this operation a little realistic in Russia. But is it worth grieving about this? In addition to the 85-95% probability of a satisfactory result in hip arthroplasty, there are 5-15% complications. It is noteworthy that in the event of complications, it is no longer possible to help the animal, and it remains disabled. Is there any alternative? There is!to accurately select the size of the femur of the operated animal, and one endoprosthesis costs $ 500-700. All this makes this operation a little realistic in Russia. But is it worth grieving about this? In addition to the 85-95% probability of a satisfactory result in hip arthroplasty, there are 5-15% complications. It is noteworthy that in the event of complications, it is no longer possible to help the animal, and it remains disabled. Is there any alternative? There is!that in the event of complications, it is no longer possible to help the animal, and it remains disabled. Is there any alternative? There is!that in the event of complications, it is no longer possible to help the animal, and it remains disabled. Is there any alternative? There is!

The so-called resection arthroplasty of the hip joint has long been developed and widely used. The operation consists in removing the femoral head. There are several modifications of the next stage of the operation.

I have been using resection arthroplasty for pathology of the hip joint for more than 20 years. At the initial stage, when the surgical techniques described in the foreign literature were used, the results in most cases were quite satisfactory, but the number of unsatisfactory outcomes was quite significant. This required research and development of other methods. As a result, over the past 10 years, our clinic has been using its own technique, which consists in removing the head of the femur and forming a layer in the form of a flap of one of the gluteal muscles. Over time, a cartilaginous plate is formed from this layer, which allows the limb to move freely and painlessly in the hip joint. In recent years, the clinic has performed more than 20 such operations annually. When analyzing the results of the operation, attention is drawn primarily to the absence of unsatisfactory results, in contrast to the results of endoprosthetics. That is, if before the operation the animals were limping, then after the operation they could use the limb. The worst result was assessed as satisfactory because the dogs were free to move, while not limping, but at rest they sometimes kept the limb suspended. After heavy exertion, a slight passing lameness could appear. The number of satisfactory results is higher in small dogs, probably because such dogs prefer not to touch the ground at rest, even with minimal discomfort in the limb. A barely noticeable limp during intense prolonged exercise was considered a good result. With an excellent result, the dogs moved without restrictions and consequences under any load.

These data allow us to assert that, despite the fact that although dysplasia of the hip joint is an incurable hereditary disease, the animal can be helped in any case. All that is needed is the desire of the owners of the dog to engage in its treatment and the sufficient qualifications of the doctor to whom they turned. Correctly carried out conservative treatment for small degrees of dysplasia can prevent the progression of joint destruction and raise a practically healthy animal. In the presence of complications, resection arthroplasty of the hip joint is indicated, which does not require complex equipment and special instruments and gives a stable positive result.

In conclusion, I would like to say that veterinary surgery should develop, the technique of operations should be improved. It is possible that as the prosperity of St. Petersburg residents improves, triple pelvic osteotomy and hip arthroplasty in St. Petersburg will become common operations in a few years and will be used strictly if there are known indications. But at present, the problems of treating dogs with hip dysplasia are completely solved by the existing methods. And especially for young doctors I will quote the words of Hippocrates, after 20 years they will also quote these words: “Above all, in the art of medicine, the ability to make the sick part healthy should be put forward. If you can heal in many ways, then you should choose the simplest one,for it is more worthy of a decent husband and more in line with the art of not chasing cheap fame."

List of used literature: 1. Denny H., Butterwoff S. Orthopedics of dogs and cats. Aquarium, M. 2004 2. Shebits H., Brass V. Operative surgery of dogs and cats. Aquarium, M. 2001 3. Yagnikov S. A. Surgical treatment of hip dysplasia in dogs. Thesis for the degree of Doctor of Veterinary Medicine. Sciences, St. Petersburg 2005.

Recommended: