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Facts
about Canine Hip Dysplasia
Diagnosis
of CHD
OFA
and PennHip
Occurrence
in the Dogo Canario
Possible
Treatment Options
Summary
Listing
of Dogo Canario with OFA ratings
Facts
About Canine Hip Dysplasia
The Hip Joint
The
hip joint of the dog is made up of two parts- the femoral head
(thigh bone) and the acetabulum (the socket of the pelvic bone).
The acetabulum and the femoral head form a "ball and
socket" joint. The femoral head surface is covered with a
smooth articular cartilage. There is a thin layer of fluid
(synovial
fluid), which serves as a lubricant for the joint and
nourishment for the articular cartilage, separating these opposing
surfaces. Muscles encase the entire hip, stabilizing and allowing
movement. The head of the femur is held in the acetabulum by the
pelvic muscles, joint capsule, surface tension and the round
ligament. Proper development of the joint still depends on the
head of the femur being held firmly within the acetabulum until
all parts are mature.
Dysplasia literally means "bad development". Sometime
after birth, something initiates a bad fit or function of one or
more parts. What this (or these) initiating factors might be is
still not known. It is likely that there are multiple causing
factors and they may fodder between genetic lines. CHD is caused
by the interaction of many genes (polygenic). Any attempt to
define the process in exact sequence is speculative.
In normal dogs there is a smooth and even fit between the
femoral head and the acetabulum. In dogs with CHD there is a
poor fit of the joint due to abnormal laxity (space between the
bone) and/or remodeling of the femoral head and/or acetabulum
(changes in bone structure).
The current concept is that CHD is an inherited trait and
controlled by the genetic makeup (genotype) of each dog.
Genotype is controlled by the genes received from each parent,
one half from each the sire and dam. The concept that it is
polygenic has been supported by research since the 1960's.
Regardless of any changes in theories as to how or why these
genes interact with each other as to the mode of inheritance,
one thing remains constant. Scientists have repeatedly
demonstrated that CHD is controllable with selective breeding.
Signs and
Symptoms of CHD
Many
dysplastic dogs show observable signs between 3 and 15 months of
age, while some can take up to 36 months. This is generally the
severest form, characterized by marked pain and lameness. In
others, a more chronic form with gradual onset increasingly
becoming more affected in advanced age. In some cases the
chronic form dog may be asymptomatic. Some of the signs are
-
reluctance or inability
to go up or down steps
-
difficulty in rising
from a sitting or prone position
-
stiffness early in the
day that improves as the dog "warms up"
-
changes in disposition
due to pain
-
lameness
after exercise
-
wobbly
gait or bunny hopping gait when running (moving rear legs
together)
-
painful reaction to
extension of the rear legs
Because
the hip joint is weakened in a dog with CHD, it is more subject
to injury with normal activity such as jumping off the couch or
playing with another dog. Often times this results in acute lameness that the owner thinks was caused by the injury, when in
fact it is the underlying CHD that has made the joint more
susceptible to injury.
Canine Hip Dysplasia cannot be diagnosed by observing how the
dog moves, acts, lies down, etc.... The clinic signs may or
may not be present and only an orthopedic and radiographic
examination can conclude the diagnosis.
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Diagnosis
of CHD
Radiographic
evidence of CHD
The
only way to determine the conformation of CHD free or
affected is by radiographic examination of the hips.
Radiographic criteria of subluxation, shallow acetabulum,
remodeling and/or secondary degenerative joint disease (DJD) are
well documented. DJD of the hip is characterized by one or more
of the following: cartilage damage, joint effusion, synovitis
and bony remodeling. DJD is synonymous with osteoarthritis and
its radiographic evidence is considered a diagnosis of CHD.
Joint Laxity
Joint
laxity (looseness of the joint) is a dynamic state that cannot
be determined by routine radiography. The joint may appear
radiographically normal but in actuality be loose.
Laxity is considered to be one of the earliest pathologic findings in
CHD. Therefore, demonstration of laxity in young
dogs from 3-6 months of age could be a diagnosis of CHD or
possibly a predictor of dysplasia. Palpation of the hips is not
accepted as a single method of diagnosing CHD. The use of a
wedge or fulcrum (placed between the thighs to force the head of
the femur out of the acetabulum) is used to determine the degree
of radiographic subluxation. Some type of measurement criteria
must be employed (Norberg, millimeters, distraction index, etc.)
to demonstrate the amount of displacement of the femoral head
when compared to a fixed anatomical structure or to a standard
radiograph taken without a wedge or fulcrum. The use of the
fulcrum has shown that some laxity is expected in a normal joint
and that many dogs with laxity beyond a certain point later show
characteristic radiographic evidence of CHD.
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OFA
and PennHIP
OFA
The
Orthopedic Foundation for Animals (OFA) is a not-for-profit
foundation established in 1966. They maintain a dysplasia
control registry as a voluntary service to register hip status
for Breed club affiliation is an important part of the OFA-By-Laws,
as OFA cannot control the frequency of CHD, as they have no
control over breeding. Only breeders who wish to use them as a
tool can reduce the instance of CHD in a breed.
Radiographs
may be submitted to OFA at any age but only dogs 24 months of
age or older at the time of the x-ray can qualify for an OFA
registration number. Hip status of younger dogs will be
evaluated on a consultation report only.
Independent evaluations are done by three veterinary
radiologists. These radiologists are concerned with deviations
in these structures from the breed normal. Consistency and
convergence of the hip joint are considered as well as
-
1-subluxation
-
2-cranial
acetabular margin
-
3-dorsal
acetabular margin
-
4-craniolateral
acetabular margin
-
5-acetabular notch
-
6-caudal
acetabular margin
-
7-size, shape and
architecture of the femoral head and neck
-
8-presence
of exostosis or osteophytes (bone spurs)
-
9-subchondral
bone eburnation
Each
evaluation is independent- meaning that no radiologist knows the
interpretation given by the others. These are then compiled into
the final consensus.
The consensus report can be one of the following. Excellent,
Good or Fair, these are considered within normal range and
assigned an OFA number. Borderline is a grade of marginal hips,
undeterminable with respect to CHD at this time. Normally repeat
films are requested in 6-8 months. Mild, Moderate and Severe are
all reports of CHD affected.
It is important to have the radiographs taken by an experienced
veterinarian as proper positioning and radiographic technique
are essential to accurate diagnosis.
To
learn more about OFA, please visit their website at
www.offa.org.
PennHIP
PennHIP
stands for University of Pennsylvania Hip Improvement Program.
In 1983, Dr. Gail Smith a veterinary orthopedic surgeon and
bioengineer began to actively research a method for early
diagnosis of CHD. The PennHIP was founded as an extension of his
laboratory research.
PennHIP is the scientific method to evaluate a dog for it's
susceptibility to develop CHD. The radiographic procedure
involves using a special positioning to measure a dogs
"passive hip laxity". It uses Distraction Index (DI)
to measure the maximal passive hip laxity. DI is a unitless
number between 0 and 1. A smaller DI means less laxity (tighter
hips). The DI has been shown to correlate strongly with a dog's
possibility to develop CHD. A DI of .5 is interpreted to mean
that the femoral head is 50% displaced from the acetabulum.
The PennHIP method uses 3 different views
-
Hip-extended
Position- this is also known as the standard OFA view. The
purpose of this view is to evaluate the hips for existing
DJD.
-
Compression
View- during compression the femoral head is pushed fully
into the acetabulum. The purpose of this view is to
accurately indicate the hips landmarks and to demonstrate
congruity....how well the hip fits.
-
Distraction
View- A special "distraction device" is placed
between the dogs legs to act as a fulcrum to apply lateral distractive
force to the hips. The femoral heads are pushed
from the acetabulum to view the passive laxity. This amount
is measured using the distraction index (DI).
PennHIP
requires a certified PennHIP veterinarian to take the
radiographs, and it must be done under heavy sedation or general
anesthesia. It is policy that all radiographs taken be
submitted to PennHIP for evaluation. This ensures that
prescreening of radiographs and only sending the best for
evaluation does not occur, resulting in an unbiased data base
for the given breed.
To
learn more about PennHIP, visit their website at www.vet.upenn.edu
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Occurrence
of CHD in the Dogo Canario
There
are currently no firm statistics on the occurrence of CHD in the
Dogo Canario. The original Island breeders did not x-ray their
dogs, but relied on the functionality of the dog to determine
it's health. Many lines of the breed were established before the
necessity of radiographs to determine if CHD was present was
well understood. The Club Espaņol del Dogo Canario has
conducted a survey of 300 Island dogs to determine the
percentage of CHD in the breed. Approximately 12% of the dogs
fell into the Excellent to Good (A) category with
22% affected with various degrees.
The majority of the
breed fell into the Fair to Borderline (B) rating. They are
working towards requiring radiographs on all breeding dogs. In
the USA, The Dogo Canario Club of America is working towards
that same goal on stock used by American breeders. The Dogo
Canario has a typical hip confirmation of a molosser dog with
little angluation. At this time the breed averages more
subluxation than is typically allowed by OFA examination,
resulting in mild ratings on dogs that are otherwise
normal. Dogs scoring OFA mild should be evaluated under
the PennHip method to get a true reading of their subluxation.
Dogs scoring at or under the current breed median, with no DJD,
can be considered fit for breeding.
Do not believe any breeder that tells you that CHD is NOT a
problem in the Dogo Canario, based on "old history" or
"functionality of the dog". It is being reported with
more frequency, but usually only when the disease is severe
enough to be crippling. Due to the muscle mass and higher pain
tolerance of these dogs, they are often asymptomatic until the
disease is well advanced, or of the severest form. Investigate
the breeders before you purchase. Purchase only from breeders
who x-ray their stock and are willing to guarantee your new dog.
Ask where the x-rays were taken and who evaluated them? Although
many veterinarians are capable of diagnosing an obviously dysplastic
dog, not all are as skilled in radiography as a board
certified specialist. Ask for written proof of the x-ray
results. When your dog is old enough have him/her x-rayed. To
date there are only a handful of Dogo Canario dogs even examined
by the OFA and recorded into the PennHip database.
Selective breeding is at this time the only tool a breeder has
to reduce the frequency in the breed. By breeding normals to
normals you increase the chances that a higher percentage of
offspring will also be normal. Normal dogs should have normal
parents and over 75% normal siblings. But until there is a large
enough data base of x-rayed stock breeders can only select those
dogs known to be normal.
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Possible
Treatment Options
Canine
hip dysplasia is an inherited genetic disease with a minor environmental
roll in its expression in some circumstances. Some environmental factors
can influence the expression of the disease and mask or
exacerbate the symptoms. Some common factors are:
-
rough play, jumping,
climbing stairs or slick floors
-
excessive caloric
intake during rapid growth phase
-
calcium supplementation
-
forced running for
distances, especially on tarmac, asphalt or other hard
surfaces
-
nutrition, illness,
trauma, exposure to chemicals
Non
surgical methods of treatment for pain management may include,
aspirin, phenylbutazone, non steroidal anti-inflamitories,
steroids and Rimadyl (Pfzier). All of these drugs should be used
under direct supervision of your veterinarian and all but
aspirin are by prescription only.
Another product that is
showing great promise in alleviation of symptoms is glucosamine.
Adequan, Cosequin, Glycoflex are some brand name products which
contain this homeopathic substance. Vitamin C is controversial
but has been shown to help reduce inflammation.
Reduction in the weight of the dog and a modified exercise program
helps to lessen the stress on the dog's weakened joints. An
ideal exercise for a CHD affected dog is swimming, which doesn't
stress the joints. Keeping the dog mainly indoors and with
softer surfaces to lie on will also help to make his life more
comfortable.
Surgical treatments are generally reserved for animals for when
other treatments offer no relief. There are many surgical
options that must be discussed with the advise of your
veterinarian. He or she will recommend the best option for your
dog.
If your dog is diagnosed with CHD you should notify your breeder
so they can evaluate their breeding stock. Without your
notification they will be unaware of the problem.
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Summary
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CHD is an
inherited disease. It is resulting from the action of many
genes, but how many and how they interact is not yet known.
-
No
environmental factors have been shown to cause CHD. They can
affect the outcome of expression and/or symptoms, but they
in themselves are not the cause.
-
While it is
unrealistic to expect to eliminate CHD in the breed, with
careful selective breeding it is proven to reduce the amount
of affected dogs. PennHip method has proven to reduce
subluxation in some breeds.
-
CHD cannot be
accurately diagnosed by observation or physical
examination, nor can a dog be "cleared" by these
methods. The only conformation of hip status is
radiographic examination.
-
All dogs have
a degree of normal laxity, but increased laxity may be a
predictor of CHD development.
-
OFA and
PennHIP are 2 methods of radiographic examination and
recording of status that are available to breeders in the
USA.
-
CHD is proven
to exist in the Dogo Canario breed, but firm statistics are
not yet available.
-
Choose your
breeder carefully and require they are doing the best they
can to reduce the frequency of CHD in the breed.
-
If your dog is
diagnosed with CHD, inform the breeder. Treatment options
are best discussed with your veterinarian.
-
Too frequently
information on CHD is misleading and may be hazardous.
Always check with your veterinarian or nearest veterinary
college for the best advise.
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