Fierce
Patient of the Month
Hip Dysplasia
and
Femoral Head Ostectomy
Signalment: Fierce is a 3 year old male/neutered Labrador who presented to us for a left rear limb lameness. His owner had noticed it for about one week. She said that Fierce would still run in the yard, but at a walk or trot, he really noticed him favoring the leg.
Physical Examination: Fierce was alert and responsive. All vital signs were within normal limits. He had a grade 3 out of 4 lameness, indicating he was limping very bad, but would touch the paw down on the ground at a walk. An orthopedic examination was performed and Fierce's pain appeared to be in his left hip.
Diagnostic plan: Schedule Fierce for heavy sedation and radiographs of his pelvis and hind legs. Fierce had a negative fecal examination for intestinal parasites, a negative heartworm test 6 months ago, and was taking heartworm preventative so he was at minimal risk for complications. Fierce's radiographs showed severe hip dysplasia with secondary arthritis of the left hip (coxofemoral joint). Because of the severity of Fierce's pain and the progressive changes on the radiographs, surgery was recommended.
Surgery: A femoral head and neck ostectomy was performed by Dr. Charles Whitford. This is a salvage procedure performed to eliminate pain in a severely degenerative hip.The hip next to this paragraph is Fierce's left hip. Notice that there is hardly any socket (acetabulum) for the ball (head of femur) to fit in. This is called a shallow acetabulum and it is a hallmark of hip dysplasia. The head of the femur has become deformed from chronic joint instability.
This is a post-operative radiograph. Notice the left femoral head and neck have been removed. The leg can still function because of muscle attachments and there is no pain from bone rubbing on bone. A normal hip joint glides smoothly and has healthy cartilage. Advanced hip dysplasia causes the joint surfaces to degenerate, leading to advanced arthritis.
ABOUT HIP DYSPLASIA:
Hip dysplasia (HD) is a hereditary disorder, meaning the condition is in the genetic make-up of the dog. Dogs with hip dysplasia should not be bred because it is an undesireable trait. HD may be diagnosed at any age, comes in varying severities, and causes several symptoms.
Symptoms:*May be all or some of the following:
*Limping or swaying gait
*Bunny-hopping (back legs seems to move together when running)
*Decreased muscle mass in rear legs
*Slow to rise
*Stiffness after exercise, may come and go
*Does not like hip area touched or massaged
*A dog can have HD and not have signs until older. That is why it is extremely important to have radiographs taken to check for HD at 6-12 months of age if you are planning to breed, or if you have a dog at risk (Labrador retreiver, golden retreiver Sheppard, Rotweiler, Bulldog, many others)
Mild forms of HD can be controlled by diet, supplements, and pain medication (as needed). Obesity is the most important factor which causes these dogs to have a poorer quality of life-- arthritis worsens at a much faster rate in overweight pets.
Some dogs, like Fierce, seem to show signs all of a sudden, but the problem has been there all along. This happens because the arthritis has progressed to a point where he is showing clinical signs.
For more information on hip dysplasia, you can visit...
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