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POOR CONFORMATION: HIP DYSPLASIA. YOUNG DOGS 5-8 mos AND MATURE ANIMALS WITH CHRONIC DISEASE. POOR CONFORMATION: HIP DYSPLASIA. POOR CONFORMATION: HIP DYSPLASIA. Acetabular vs. Femoral hip dysplasia. Poor conformation combined with genetic, environmental and nutritional factors. - PowerPoint PPT Presentation
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POOR CONFORMATION: HIP DYSPLASIA
YOUNG DOGS 5-8 mos AND MATUREANIMALS WITH CHRONICDISEASE
POOR CONFORMATION: HIP DYSPLASIA
POOR CONFORMATION: HIP DYSPLASIA
Poor conformation combined with genetic, environmental and nutritional factors
Acetabular vs. Femoral hip dysplasia
POOR CONFORMATION: HIP DYSPLASIA
• PHYSICAL EXAM FINDINGS– Pain on palpation of hips– Joint laxity (positive ortolani sign) – early disease
– subluxation of hip– Crepitus– Decreased ROM of hip joints– Atrophy of thigh muscles– Hypertrophy of shoulder muscles
POOR CONFORMATION: HIP DYSPLASIA
http://www.youtube.com/watch?v=2rRKDheDrLs&NR=1
http://www.youtube.com/watch?v=SHCIT87jY0M&feature=related
Hip Dysplasia: Radiographic view
For standard Orthopedic Foundation for Animals–type radiographs to evaluate hip conformation, extend the hips and internally rotate the tibias until the patella lies directly over the trochlear grooves. Be sure the pelvis is straight, with symmetric obturator foramina.
ventrodorsal view of the pelvis with rear limbs extended symmetrically and rotated inward to center the patellae over the trochlear grooves
POOR CONFORMATION: HIP DYSPLASIA and OFA CERTIFICATION
"normal" radiographically may be further classified as excellent, good, fair, or near normal
POOR CONFORMATION: HIP DYSPLASIA and OFA CERTIFICATION
HIP DYSPLASIA and OFA CERTIFICATION
dysplasia are categorized as mild, moderate, or severe
HIP DYSPLASIA TREATMENT
NSAIDs
NEUTRICEUTICALS/CHONDROPROTECTIVE AGENTS
HIP DYSPLASIA TREATMENT: MEDICAL MANAGEMENT
• Aspirin or buffered aspirin: 10-25 mg/kg q 8-12 hr or as needed: Discontinue if vomiting occurs.
• Carprofen (Rimadyl): 2 mg/kg PO q 24 hr Deracoxib (Deramaxx): For chronic dosing use 1-2 mg/kg PO q 24 hr as needed.
• Etodolac (EtoGesic): 10-15 mg/kg PO q 24 hr • Firocoxib (Previcox): 5 mg/kg PO q 24 hr. Do not use in puppies less
than 7 months of age or in dogs weighing less than 7 pounds. • Meloxicam: 0.2 mg/kg first dose; then 0.1 mg/kg thereafter q 24 hr
PO. • Tepoxalin (Zubrin): 20 mg/kg PO q 24 hr x 1 treatment; then 10
mg/kg PO q 24 h. This is similar to carprofen and ketoprofen.
HIP DYSPLASIA TREATMENT: MEDICAL MANAGEMENT
• Polysulfated glycosaminoglycan (Adequan): 5 mg/kg IM every 3-5 days for 8 injections, followed by an injection every 1-2 months for maintenance: – Polysulfated glycosaminoglycans prevent cartilage breakdown by inhibiting the enzymes
of cartilage degradation during inflammation. – Discontinue use if there is no improvement after the third week. Caution, may increase
bleeding time.
• Cosequin: 1-2 regular strength capsules PO q 24 hr for smaller dogs and 2-4 capsules of double strength for larger dogs: – Note that dose is based primarily on empiricism and manufacturer's recommendations.– Adverse effects have not been reported although hypersensitivity is possible. – Cosequin is a brand name for glucosamine HCL combined with chondroitin sulfate which
may stimulate synthesis of synovial fluid, inhibit degradation, and improve healing of articular cartilage.
Hip Dysplasia – Treatment
• Surgical– Total hip replacement
• Salvage procedure in mature dogs with severed DJD unresponsive to medical Tx
• Pain free in 90% of cases• Unilateral replacement provides acceptable function in 80% of
cases– Excision Arthroplasty or Femoral Head Ostectomy
• Forms “false” joint• Removal of femoral head and neck to prevent joint pain• Salvage procedure when medical treatment not working and other
sx too expensive• Best - < 20#; good musculature• Abnormal gait
– Triple Pelvic Osteotomy
Arthroscopy – Juvenille patientsA, Ventrodorsal radiograph of an immature dog with subluxation of the femoral heads and minimal evidence of DJD, typifying a candidate for triple pelvic osteotomy. B, Ventrodorsal radiograph of a dog with advanced hip dysplasia and osteophyte formation. This dog may be a candidate for total hip replacement or femoral head ostectomy if clinical signs cannot be managed medically.
Arthroscopic view of a normal hip joint
HIP DYSPLASIA TREATMENTTRIPLE PELVIC OSTEOTOMY
HIP DYSPLASIA TREATMENT
FEMORAL HEAD OSTECTOMY
“False joint” forms from scar/fibrous tissue
HIP DYSPLASIA TREATMENT
www.kahalapethospital.com/yahoo_site_admin/as...
artreality.com
JUVENILE PUBIC SYMPHYSIODESIS
• Juvenile pubic symphysiodesis (JPS) surgery is a prophylactic procedure performed in puppies 10 to 20 weeks of age that have been diagnosed with hip dysplasia
• causes premature closure of the cranial pubic symphysis
PennHip distraction view of a Labrador puppy at 14 weeks. The DI is 0.55.
The same dog at 50 weeks (36 weeks post-JPS).
Hip Dysplasia – Client Info• Weight control important to decrease load on painful joint• Swimming excellent activity• Lameness may occur due to surgical shortening of the
affected limb• Physiotherapy – decreases joint stiffness, helps maintain
muscle integrity• Joint degeneration progressive• May be heritable – do not breed• Special diets designed for fast growing dogs may decrease
severity
LEGG-CALVE-PERTHES DISEASE
http://www.youtube.com/watch?v=_vvtprqhyoI
YOUNG, SMALL BREEED DOGS
LEGG-CALVE-PERTHES DISEASE
May also be considered a Developmental disorder
LEGG-CALVE-PERTHES DISEASE: TREATMENT
FEMORAL HEAD AND NECK EXCISION
FHNE
DEGENERATIVE DISORDERS: OSTEOCHONDRITIS DISSECANS
OSTEOCHONDRITIS DISSECANS
FAILURE OF THE LOWER LAYERS OF ARTICULAR CARTILAGE TO MATURE INTOBONE RESULTS IN THICKENED CARTILAGE THAT IS PRONE TO INJURY
OSTEOCHONDRITIS DISSECANS
CARTILAGE FLAP OF THE SCAPULOHUMERALJOINT WHICH IS THE MOST COMMON LOCATION
OSTEOCHONDRITIS DISSECANS
CARTILAGE FLAP IN THE STIFLE JOINT
OSTEOCHONDRITIS DISSECANS
http://www.youtube.com/watch?v=_bJqjqh5a2A
INFLAMMATORY CONDITIONS: PANOSTEITIS
LARGE, MEDIUM BREEDS AT A YOUNG AGE 6-18 MONTHS
CAUSE: UNKNOWN, BUT THERE ARE MANY SUSPECTED CONTRIBUTORS
PANOSTEITIS1. PELVIS2. LESIONS OF PANOSTEITIS3. FEMUR
INFLAMMATION IN THE MARROW CAVITIES OF LONG BONES THAT LEADSTO PAIN, LAMENESS, AND FEVER
PANOSTEITISINCREASED MEDULLARY OPACITY
PANOSTEITIS
TREATMENT OF PANOSTEITIS INCLUDESNSAIDS AND CAGE REST
THIS DISEASE IS SELF-LIMITING AND HAS A GOOD PROGNOSIS!
LUXATIONS
HX OF TRAUMA, ACUTE LAMENESS, NON WEIGHT BEARING, POSSIBLESWELLING OVER THE HIP
LUXATIONS
CRANIODORSAL LUXATION IS THEMOST COMMON TYPE
LUXATIONS
THE EHMER SLING IS USED AFTER CLOSED REDUCTION OF THE LUXATEDHIP JOINT; THE DOG SHOULD BE CONFINED FOR 7-10 DAYS
TUMORS OF THE BONE
MOST COMMON IN LARGE BREEDMALE DOGS OLDER THAN 7 YRS OFAGE
THE DISTAL RADIUS IS THE MOSTCOMMON LOCATION
TUMORS OF THE BONE
85%-90% OF BONE CANCER IN DOGS IS OSTEOSARCOMA
TUMORS OF THE BONE
OSTEOSARCOMA TENDS TO OCCUR AWAY FROMTHE ELBOW AND TOWARDS THE KNEE
TUMORS OF THE BONE
METASTASIS OF OSTEOSARCOMA TO THE LUNGS; THERE IS USUALLY ALREADY SOME MICROSCOPIC SREAD OF TUMOR BY THE TIME IT IS DIAGNOSED
TUMORS OF THE BONE
AMPUTATION OF THE AFFECTED LIMBALONG WITH CHEMOTHERAPY IS A COMMON TREATMENT PLAN
SURVIVAL TIME IS ~12 MONTHS EVEN WITH AGGRESSIVE THERAPY
MYOPATHIES: POLYMYOSITIS
MYOPATHIES: POLYMYOSITIS
MYOPATHIES: MASTICATORY MUSCLE MYOSITIS (aka atrophic myositis, eosinophilic myositis)
CLINICAL SIGNS INCLUDE ELEVATED 3RD EYELIDS, ATROPHY OF THE JAW MUSCLES, AND INABILITY TO OPEN THE MOUTH (TRISMUS)
MYOPATHIES: FELINE POLYMYOPATHY
CERVICAL VENTROFLEXION OF THE NECK 2° TO HYPOKALEMIA
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