Some Canine Hip dysplasia information

Last modified: Sun Jul 6, 2003

In this page:

Various Web pages dealing with hip dysplasia
Diary of (what was) Cooper's Hip Dysplasia

Various Web pages dealing with hip dysplasia

When Cooper was diagnosed with mild HD, I immediately tried to learn all I could about it. I know lots of other people do, too, so here's a compilation of some that I found and others that people sent to me. I haven't searched around for new links in the last year or so, so this should provide a starting point but certainly also do searches at sites like Dogpile, Yahoo, Google, About.com, etc... to see what else is out there.

Diary of (what was) Cooper's Hip Dysplasia

Date Event Notes
04/17/1997 Thu Cooper's Birth Date
10/24/1997 Fri
(6 mos)		 Heard occasional click or popping sound coming from Cooper's hindquarters.

Checked on the web-from other people's experiences clicking meant hip dysplasia.

Panic mode.

Cooper's parents and lines were all OFA clear-- it's got to be something else, but what?

10/25/1997 Sat
Clicking is becoming more frequent. Went to our regular vet, who wasn't able to hear the clicking. He suggested it could be either a hip or knee problem, and that we couldn't know without x-rays.
10/28/1997 Tue X-rays - Cooper is diagnosed with unilateral mild hip dysplasia in his left hip by another one of our regular vets in the same animal hospital. The x-rays showed laxity in the left hip, and they were able to exhibit the Ortolani sign (dislocation/clicking in the hip with a certain type of movement). She suggests that we get a second opinion to be sure, recommends Dr. Vasseur at the University of California, Davis Veterinary School who is a master at total hip replacement. Our vet's care recommendation is not to do surgery at this time, because Cooper doesn't show any clinical symptoms (limping, obvious pain). She said the femoral heads are slightly flattened, and the surgeon she used to work with said that he didn't have good success doing TPO on dogs that had flattened femoral heads. The surgeon did not see the x-rays. She recommended that we limit Cooper's activities - no jumping, long periods of running, short dashes, etc... She said that the progression would be that Cooper would have some pain in the short term, then there would be build-up in the joint which would stabilize it for about 4 years. During that time the build-up would wear away, leading to severe arthritis.

Total devastation.

X-ray from 10/28/1997

(This entry was made on 11/4/99)

Here is the x-ray mentioned above. I've included close-ups of both the right and left hip joints below.

 

 

To describe the x-ray-- The body is very well positioned (legs straight, tail straight) except for a very slight rotation of the pelvis. The growth plates around the joints have not closed yet, indicating that Cooper is still growing. On the right hip joint, the femoral head is positioned so that half of the head is in the hip socket. This is not perfect, but still pretty good. There appears to be little (if any) degeneration, except for maybe a slight flattening of the femoral head. On the left hip joint, the femoral head is positioned so that between 1/4 to 1/2 of the head is in the socket. Again, little if any degeneration-- really all that is there is the joint laxity. As mentioned in the previous paragraph, because the pelvis is slightly rotated, it actually is giving the illusion that the left hip is worse than the right. They are probably close to the same in laxity, which means that both are just less than half in the socket. This makes it a very mild case, at least at the time of the x-ray.

This same x-ray was used for the initial diagnosis, and also for the 2nd and 3rd opinion (described in detail in a couple of the later entries). I've been told since then that I should have had new x-rays taken for the 2nd opinion in case hip positioning for the x-ray could have had anything to do with the diagnosis.
10/31/1997 Fri Started Cooper on Solid Gold Yucca. Yucca is a natural anti-inflammatory.
11/05/1997 Wed Started Cooper on Foster & Smith Joint Care (glucosamine/chondroitin sulfate) Glucosamine and Chondroitin sulfate provide nutrients for the joints, and helps to repair cartilage more quickly. It also helps to lubricate the joint by helping in the production of synovial fluid.
11/07/1997   Struggling with the decision whether to have surgery done or go the alternative medicine route. Heard stuff about pups that have mild HD early on, then are OFA good at 2 years of age. Could it be possible? Maybe we shouldn't do surgery...

None of the other pups in Cooper's litter show any signs.

Talked to the hydrotherapy person who said to wait until we have gone to Davis before starting the therapy.

11/10/1997 Mon
Clicking is getting sharper, but seems to be decreasing in frequency. Not sure why-- the Joint Care couldn't possibly be working so fast.
11/13/1997 Thu UC Davis Veterinary School. Talked to a 4th year student and a resident. The resident conferred with Dr. Vasseur, to whom we never got to speak. They poked and prodded, heard the clicking, said that Cooper showed slight pain in the left hip at full extension of the leg. They confirmed the unilateral hip dysplasia. He (the resident) said that it is unusual to see a unilateral hip dysplasia case. They sedated him slightly and were also able to exhibit the Ortolani sign.

His recommendation is to do TPO as soon as possible. He said that whether or not we do the surgery, Cooper will have arthritis eventually, possibly severe. No opinions on alternative medicine. Said TPO is better than medical management, and we'd be better off doing it within our "window of opportunity", the next 1-2 months.

Gloom and Doom.

TPO stands for Triple Pelvic Osteotomy, which is a procedure where the surgeon breaks the pelvic bone in 3 places in order to rotate that area so that the femur fits into the acetabulum (hip socket) better. The pelvic bone is then held back together with a combination of metal plates and wires. Done in a puppy it is quite successful because the pup's bones are still elastic and can mold well to the new configuration.

11/20/1997 Thu
(7 mos)		 Went to Dr. Gurevitch, another orthopedic surgeon in Petaluma, CA, on my breeder's (the owner of Cooper's sire) continued recommendation. During his examination he confirmed the hip laxity in the left hip, but also exhibited pain in Cooper's right hip at full leg extension. Upon viewing the x-ray (the original one), he noted immediately that the pelvis was very slightly rotated which made one side look worse than the other. He diagnosed Cooper with bilateral mild hip dysplasia.

 

Dr. Gurevitch was wonderful-he explained everything to us in great detail and really listened to what we had to say. He was very good with Cooper, too. He watched Cooper gait, and said that he does have a true bunny hop (he was explaining that all dogs appear to bunny hop at some speed, but only the ones with problems will use both legs simultaneously when watched from the side. Otherwise one leg will be slightly in front of the other.

His recommendation was not to do surgery while Cooper shows no clinical signs. He recommended that we watch his hip progression closely with x-rays every couple months. If the progression is rapid, then do the TPO, otherwise let him be. Interesting note-he said that TPO can be done on dogs of any age as long as the x-rays show they are a good candidate. Of course, with older dogs the bones will not mold, but it could make the hip sit better than it would otherwise. He definitely recommended TPO over Total Hip Replacement, as he considered the Total Hip a salvage operation (no other alternative). Femoral Head Excision is not an option for dogs over 50 pounds.

He said that the supplements couldn't hurt, but that Cooper doesn't have much degeneration right now so the Joint Care might not have much to do at this time.

11/21/1997 Fri First hydrotherapy session with an RVT specializing in hydrotherapy at the Animal Fitness Center at my animal hospital. Kathy was able to tell that Cooper is compensating by tightening his inner leg/groin muscles, which causes the hip bones to pop out more than it otherwise would. The symptoms are very tight inner thigh muscles, and a very tight back. She said that dogs have a lot of extra skin on the top, and that you should be able to roll and stretch the skin easily all the way down the back from the neck to the tail. In Cooper's case it was very tight. Her recommendation was to do the skin roll/stretch on Cooper 3-4 times a day in at least one session. This would cause Cooper to relax the inner leg muscles and force him to use the outer leg muscles. Sure enough, when I get the back relaxed when he's standing, he practically collapses on his hind legs. He is hardly using the outer leg muscles at all, which explains why his legs have been looking kind of hollow- not much muscle mass. The other thing to do is to massage his inner leg muscles to relax them.

She says that with this therapy it is possible to arrest the dysplasia at this stage. (REALLY?!?) By training him to use his muscles properly, and with a good diet and use of supplements, he might not get worse. Also, since he is still growing and developing bone, he might even get better!

Things are looking up. His second session is tomorrow!

11/22/1997 Sat Second hydrotherapy session. Cooper was more relaxed today, but Kathy said that he is still tight, particularly in the left inner thigh area and the area above the hip. She said it is very important for us to do the roll & stretch relaxation exercises. She stressed again that he feels really good, and that the therapy should do very well for him.
11/23/1997 Sun Third hydrotherapy session. This was a fairly short session-they said that he's doing really well, and his hips/legs are much more relaxed. Recommendation to use Ester-C and maybe even talk to Dr. Belfield (mentioned in Dr. Pitcairn's book) about his vitamin C therapy. We'll probably do another session in 2 or 3 weeks to try to get more definition in the outer leg muscles. Kathy says that with the last 3 sessions he has become much more relaxed with good circulation, so we should start seeing some improvement in the muscles by tomorrow. Hmmm... we'll see!

Kathy doesn't consider his problem dysplasia at this point. She said the problem now is hip laxity. I guess it's all just how you look at it. I don't mind looking at it her way-- I guess it's more optimistic. Perhaps I should change the title of this to 'Diary of Cooper's Hip Clicking'.

His hip clicking might have decreased somewhat. Right now he's chewing on a huge beef knuckle bone that I gave him for being so good.

11/25/1997 Tue Started Cooper on daily 500mg Ester-C (vitamin C) with bioflavinoids. Actually, I started taking this too. <grin> Vitamin C is supposed to act as an anti-inflammatory as well, and there are theories that it helps repair/build cartilage much like what the Joint Care does. There are also theories that one cause of dysplasia is lack of vitamin C. Anyway, a couple of the links above talk about vitamin C.
11/26/1997 Wed
Amazing-- the clicking has reduced dramatically. Where he used to click with every few steps, he now only does a few times every hour.
12/02/1997 Tue
The clicking seems to be increasing again slightly, although it's still nowhere near where it was originally. I'm not quite sure, but he may be starting to click on the right side instead of (or in addition to) the left. Also, when I do the massage he doesn't really seem to like it. When I massage the inner left thigh he acts like it's uncomfortable and tries to remove my hand with his mouth.

Time to schedule another hydrotherapy session, and the next set of x-rays.

12/06/1997 Sat Fourth hydrotherapy session. Cooper went in a few times, and Kathy says that his hips feel pretty good. She says that she can feel more definition in his outer leg muscles now. I mentioned to her the problem I was having with his massage skin rolls, and she said that as soon as I get to the point where he acts uncomfortable I need to move back up his neck and work my way down again. Apparently he was still tightening up in the middle of his back, and some inflammation had developed. This session did not further reduce his clicking. I plan to take him in for x-rays again next week.
12/15/1997 Mon
The clicking has pretty much completely stopped. At the last update I thought that the hydrotherapy had done about all it could do, but I guess I just wasn't patient enough. I haven't done the next set of x-rays yet. Perhaps after the holidays.
12/20/1997 Sat
(8 mos)		 Fifth hydrotherapy session. When Cooper is swimming, he doesn't seem to want to do full leg extension with his back legs. He does little kicks instead of doing the full range of motion. However, when he's not in the water he is just fine with leg extension. Also, the reason I brought him in this time is because his outer leg muscles are really tight, and his inner muscles are relaxed (opposite of the original situation). Kathy says that as he goes through his growth stages, he will likely continue to compensate in different ways, so it's good to keep bringing him back when I notice any changes like this. She said that he seems to have pulled a muscle in his right leg-- this is probably true because I did take him hiking and he was straining to climb back onto a rock when he almost fell off.
12/31/1997 Wed This is the 8th week after Cooper started the Joint Care, so now I'm lowering the dosage to two capsules a day from three. Also stopping the Solid Gold Yucca. Lately I've noticed that Cooper's attitude has been noticeably changing. He has always been a happy pup, but recently he has had a new spring in his step that wasn't really there before. He now goes up and down the stairs more often on his own accord (not just when we need him to), and he has been doing this springing thing (all four legs off the ground!) that we've seen his sire do but never knew if Cooper would. I'm not sure which of the treatments that we're doing for him is helping the most, but certainly something seems to be working!

Someone on the net convinced me to do a PennHip on Cooper instead of another traditional OFA-type x-ray. The PennHip measures the degree of joint laxity from a scale of 0 to 1 (0 being the tightest), and also notes whether there is any joint degeneration occuring. I may do this sometime in January.

1/2/1998 Fri
We took Cooper to the beach today to run around. Occasionally he will favor his right leg, but for the most part he is looking pretty normal. What we noticed was that his pawprints in the sand were uneven in weight. The right foot for short periods of time would be noticeably lighter. I may get some canine buffered aspirin for more active days like these *just in case*.

Also, another helpful person on the Golden e-mail list suggested that Cooper use at least 1000mg Ester-C daily without the bioflavinoids. I'll save the bioflavinoid ones for myself, then!

1/19/1998 Mon
(9 mos)
After a long time without hearing a click, we started hearing a few random (but loud) clicks coming from his right hip. It has been a month since his last hydrotherapy -- probably too long. He is still running around like a madman, loves to get his legs massaged (he now "asks" for it), but shows a lot of discomfort when I massage his back. His back is hot in the middle, like it's inflamed.
1/22/1998 Thu Sixth hydrotherapy session. Kathy immediately noticed the tightness in his back, and said that the pelvis was rotated such that his legs are uneven. She worked and swam him for about 45 minutes to "get more room in his back". She seemed pleased with it afterwards. We'll see what happens... He sure was tired after this session!
1/24/1998 Sat
Interesting-- found a hot spot on Cooper's back where the tightness/hotness was on his back. It was already in the healing stages, but I didn't even realize it was there! His clicking has gone away again, as far as I can tell. His back is not hot, either. We went hiking today, though, and he was insane-- jumping everywhere, making mad dashes done the steep hills... I just hope he didn't reverse all our progress so far.
3/27/1998 Fri
(11 mos)
Since the last entry, I have been taking Cooper to hydrotherapy once every 2 weeks more as maintenance and preventive care than because of any symptoms. (To see his hydrotherapy place's website, go to Animal Fitness Center). He has continued to be stable, although the spot on his back warms up occasionally (points to some kind of misalignment or some kind of misuse). The hydrotherapy keeps it down. Cooper has been doing extremely well, and is very active. I have yet to get him x-rayed, though. More when there's more info.
Summer 1998 Started adding raw meaty bones to Cooper's kibble. These include whole raw chicken wings, raw chicken necks, raw turkey necks. Soak it in apple cider vinegar for an hour before feeding to kill bacteria.

Books I've referenced about this are Billinghurst's Give Your Dog A Bone and another really good one that I use often is Schultze's The Ultimate Diet. Although they advocate a complete raw diet with veggies I haven't made it there yet. I give him kibble (either Innova or Wysong) with the raw meat added and occasionally do add veggies.

The rationale for doing this is that the reason I give Joint Care is to support the joints. Well, the natural source for this is in raw bones, and why not go directly to the source. I still give Joint Care, though.
12/01/1998 Tue
(19 1/2 mos)		   I have still been taking Cooper to hydrotherapy once or twice a month-- Cooper is one of the springiest dogs I have ever seen-- he springs straight up in the air sometimes. Quite a trick! In about 5 months he most likely will have stopped growing, so I will get him x-rayed then. The way he jumps around, though, it's hard to believe that anything could be wrong with his hips.

On occasion, I do hear clicking coming from him, but I think it is actually coming from his left shoulder. He might have injured it jumping off a rock (this dog thinks he's a mountain goat). I will probably have it x-rayed at the same time as his hips.

Other than that-- no other info. Keeping our fingers crossed.

5/1999 If you have been following this page, I just added an event about feeding above (Summer 1998).  

5/10/1999
(2 yrs)

X-ray day!! The day we have been waiting for for what seems like an eternity. I'm extremely nervous, just hoping that Cooper hasn't gotten any worse.

Are you ready for this?

His x-rays look *awesome* -- none of the hip laxity in sight. The vet is going to submit them for OFA evaluation, and I'll update this page with the results and some of my hypothesis/conclusions.

7/27/1999
(2 yrs, 3 mos.)

We got the OFA results back, and Cooper got an OFA Good rating! That is more than we dreamed of getting way back when he got his diagnosis.

So... I've learned a few things from all this. First of all, 6-9 months is a when a lot of puppies go through a growth spurt, so it's quite possible that a true diagnosis can't be made if you see mild laxity with no joint degeneration. Secondly, hip positioning is VERY important in diagnosing hip dysplasia. If the dog is rotated incorrectly even slightly it could make all the difference in a laxity diagnosis. Go to an expert in hip positioning when you get the x-rays done. Thirdly, be aware of the difference between laxity and dysplasia. If you are told that your dog has hip dysplasia, find out whether there has been joint degeneration or if there is simply laxity with possibility of future degeneration.

In Cooper's case, I believe that he was going through the awkward growth stage when we got him x-rayed at 6 months. Also, we did not take him to an expert on hip positioning. In any case, it doesn't erase the fact that his rear leg muscles were weak, and that he had the clicking. I think that the supplements and *especially* the swimming therapy we did with him made a big difference in making sure that things went the right way. I don't know that the swimming is what made the difference between being dysplastic and being OFA Good -- somehow that seems a bit of a stretch. Whatever the case, it did strengthen his muscles during a critical growth time and that could only be good.

I'm SO glad that we decided to take a "wait and see" attitude towards Cooper's treatment. If we had been aggressive, he would have gone through unnecessary surgery 1 1/2 years ago.

Hope this helps others, too! Good luck with your dog(s).

11/4/1999

Now if you thought Cooper's story was good, read Merlin's story. Merlin is a sheltie, owned and loved by Cyndee Walklet. They have a very similar and very heartwarming (as well as inspiring!) story to share.

What's particularly interesting to me about their story is that Merlin didn't get x-rayed and diagnosed with mild hip dysplasia until he was 18 months old. Even at that age, with the work they did they were still able to make a tremendous difference for him-- quite possibly dysplasia-free. That kind of blows away the idea that you can only "reverse" hip dysplasia symptoms with a relatively young (< 1 yr) puppy.

Merlin's Magic

For more information about anything in this page, send e-mail to
Christine Hsu (christine@hsutopia.com)