By Dr. Becker
It’s a scene most large-breed dog owners fear and many have unfortunately experienced.
About five years ago, J.D., then an active, athletic 6 year-old Standard Poodle living in Fremont, Ohio, leapt into the air to catch his Frisbee … and landed spread-eagled on the ground. He was able to stand up again, but he began limping as soon as he tried to walk.
J.D.’s mom got a referral from her local veterinarian to take the dog to Dr. Gary Thompson, who has advanced training in repairing complex fractures and performing corrective osteotomies. (An osteotomy is a procedure in which a bone is divided or a piece of bone is cut away to correct a deformity and improve alignment.)
J.D. Undergoes Hip Replacement Surgery at Age 8
Dr. Thompson diagnosed J.D. with hip dysplasia. One of his hips was in worse shape than the other. Dr. Thompson told J.D.’s owners that while nothing needed to be done immediately, they should watch how things progressed.
J.D.’s limp disappeared and he continued chasing balls and Frisbees until eventually, the limp returned. The dog’s owners elected to have Dr. Thompson perform a total hip replacement on the really bad hip, acknowledging that in the future they would probably face the same situation with the other hip. So in May 2008, when J.D. was 8 years old and about 85 pounds, he underwent the $5,000 procedure.
J.D.’s owners were very happy with the outcome.
Canine Hip Replacements Are Growing in Popularity
According to Dr. Thompson, hip replacement surgery is becoming a fairly common treatment for dogs with severe hip dysplasia. He says hip replacement implants are well-tolerated and most dogs, like J.D., experience an immediate return to normal function following surgery.
An alternative to total hip replacement is a procedure that is performed in young dogs that are still growing. The surgery, called a triple pelvic osteotomy (TPO, is intended to improve the function of the hip joint and hopefully prevent arthritis from developing in the joint.
Femoral head ostectomy (FHO) is another surgical option for dogs with hip problems. In this procedure, the ball of the hip joint is removed to eliminate the painful rubbing of bone against bone that often occurs with hip dysplasia. The procedure tends to be most successful in small to medium-sized dogs.
Dr. Thompson points out that the severity of hip dysplasia revealed on an x-ray may or may not correlate to how the animal functions long-term. Some dogs have terrible looking hips on x-rays, but are able to function normally. Dr. Thompson has seen many canine patients less than a year old with advanced hip dysplasia on x-rays who go on to have healthy, active lives, as long as their owners keep them lean and make sure they get regular exercise.
A Proactive Approach to Treating Joint Problems in Large Breed Dogs
Today at age 11, J.D.’s other hip is starting to go and he relies heavily on the artificial hip to support his weight and movement. Because of his age, J.D.’s owners are hesitant to put him through another complete hip replacement procedure and are considering other forms of treatment.
If J.D. were my patient, I would have recommended certain joint-protecting supplements and treatments starting at an early age – and certainly once his hip dysplasia was diagnosed -- as I do for all my large-breed canine patients.
At my practice we organize chondroprotective agents (CPA’s) into six categories according to their intensity of action. We have preventive protocols for young healthy pets and canine athletes. We have more aggressive protocols for pets with moderate degenerative joint disease and very comprehensive protocols for pets with severe musculoskeletal degeneration or trauma. This approach allows us to not only match our patients with the correct protocol, but also accounts for an animal’s dynamically changing body.
One of the most important steps in managing canine hip dysplasia is building and maintain excellent muscle, tendon and ligament health, so I would encourage J.D.’s owners to continue to keep him well-exercised. The type of exercise, intensity, frequency and duration can all be tailored to the pet’s specific musculoskeletal issue. Therapeutic exercises can also be added to target and strengthen specific muscles or limbs.
Avoiding inappropriate movement is also very important. This requires a little bit of an environmental risk assessment on your part, as well as lifestyle evaluation for your pet. Does your pet repeatedly lose traction on slippery floors? Pets that “skate” around the house on slippery surfaces are at a significantly higher risk of suffering from chronic, painful soft tissue inflammation from recurrent slips, trips and falls. Slippery floors should be covered with nonskid rugs or “high risk” areas gated off.
Does your senior pet still act like a crazy puppy? Heartwarming, yes, but also a potential risk to her frame. Some animals seem to have no regard for their bodies or lack body awareness, even at retirement age. These pets never learn where the end of the leash or tie out is, try jumping down entire flights of stairs on a regular basis, or insist on getting the ball every throw, even if it means bashing into the fence head first. These pets have more cumulative “life trauma” and require maintenance “damage control” efforts over a lifetime to avoid inevitable degeneration.
Many animals become “weekend warriors” by default. Pets can sometimes get roped into our hectic weekday schedules that often don’t allot enough time for cardio training. Many pets lay around all week, then go great guns on the weekends. Young animals with good muscle tone can often keep up with this unbalanced exercise routine, but this is the recipe for acute injury in older pets.
I would also recommend a balanced, species appropriate diet, supplemented with joint supportive supplements such as eggshell membrane, glucosamine sulfate with MSM, and cetyl meristoleate. I would discourage carbohydrates in J.D.’s diet, because they promote inflammation. Animals with musculoskeletal issues should eat a naturally anti-inflammatory diet to help reduce and control inflammation. Fresh, unprocessed foods provide unadulterated enzymes which are also beneficial for reducing inflammation.
I would also recommend physical therapies like regular at-home strengthening exercises, stretching, massage, routine chiropractic care, water therapy on an underwater treadmill or in a pool, laser therapy to control inflammation and pain, and acupuncture. A commitment to rehabilitation therapies can often dramatically reduce the likelihood a pet diagnosed with hip dysplasia will go to surgery, and is always what I recommend first.
In addition, I would consider ubiquinol and other antioxidants; super green foods like spirulina and astaxanthin; vitamin C, natural anti-inflammatory herbs such as turmeric, proteolytic enzymes and nutraceuticals; homeopathic remedies (Rhus Tox, Bryonia, and Arnica can be particularly helpful depending on your pet’s specific symptoms); and Acetyl-D-glucosamine injections. Stem cell therapy, cytokine therapy and prolotherapy may also dramatically improve quality of life and assist in slowing degeneration (and the need for surgery).
By taking a proactive approach to preserving the integrity and function of a pet’s ligaments, tendons and joints throughout life we are often able to avoid the need for surgery. Supporting those all-important hip and knee joints should be a primary focus for every owner of a large breed dog. The physical therapies I mentioned, combined with the right nutrition, supplementation, and exercise, can go a long way toward keeping a big dog active, agile and pain-free for a lifetime.