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Hip Dysplasia at Abvet Clinic, Neuilly-sur-Seine

Hip dysplasia is a deformity of the joint in young growing dogs characterized by joint laxity. Hip dysplasia is associated with a poor covering of the head of the femur causing the head to slip with increasing dislocation (subluxation) (Photo 1 and 2) and degradation of the associated cartilage leading to osteoarthritis. The laxity and abnormal conformation of the hip are responsible for the appearance of degenerative changes in the joint (osteoarthritis).

Is dysplasia a genetic disease?

The cause of hip dysplasia is multifactorial, but the main factor is genetic. Many genes are involved in the disease. Some breeds are predisposed: Labrador, Golden Retriever, Bernese Mountain Dog, Rottweiler, English Bulldog, Pug, Newfoundland, Mastiff, Cane Corso, Saint Bernard, Staffordshire Terrier, German Shepherd, Chow-chow, Boxer. Environmental factors favor the expression of the disease: rapid weight gain, excessive nutritional intake and too much activity of the young dog.

What is the evolution of a dysplastic hip?

Hip dysplasia does not exist at the birth of the puppy but appears during its development. It progresses with time: here is an example of the radiographic evolution of a small dysplasia in a German Shepherd at the age of 8 months (photo 4) but worsening at 18 months (photo 5) to become very severe at 4 years (photo 6). The disease can evolve without being obvious for their owner because there is no relation between the radiological expression of hip dysplasia and pain.

Hip dysplasia is a deformity of the joint in young growing dogs characterized by joint laxity. Hip dysplasia is associated with a poor covering of the head of the femur causing the head to slip with increasing dislocation (subluxation) (Photo 1 and 2) and degradation of the associated cartilage leading to osteoarthritis. The laxity and abnormal conformation of the hip are responsible for the appearance of degenerative changes in the joint (osteoarthritis).

How is hip dysplasia diagnosed by Dr Bardet at Abvet Clinic, Neuilly-sur-Seine?

The diagnosis of hip dysplasia is based on the observation of the gait, search for pain by palpation of the hips and X-rays by your referringveterinarian or a specialist veterinary surgeon. Specific manipulations will allow to eventually reveal joint laxity.

The ventro-dorsal X-rays in the dysplasia position are ideally carried out under tranquillization or general anesthesia. Different positions may be necessary to determine if a young dog's hips are at risk of developing dysplasia (distraction technique) and if a prophylactic hip dysplasia surgery procedure is indicated.

The radiographic check-up allows the selection of young dogs showing radiographic signs of hip dysplasia for prophylactic procedures for osteoarthritis such as pubic symphysiodesis or triple pelvic osteotomy (which will prevent the development of dysplasia and osteoarthritis). It is fundamental to carry out radiographic screening tests at an early stage. Remember that there is no correlation between the radiographic severity of hip dysplasia and the severity of the symptoms.

It is sometimes necessary to use CT scans or arthroscopy in order to specify the joint lesions and to choose the appropriate surgery.

After thorough clinical and orthopedic examinations by a specialist and after analysis of the radiological data, treatment options will be offered to you.

How is hip dysplasia treated by Dr Bardet at Abvet Clinic, Neuilly-sur-Seine?

The best treatment for hip dysplasia depends on many factors, the most important being the severity of symptoms at the time of diagnosis. For some dogs, the symptoms are minimal and for others the results may come from the screening of breeding stock. Two types of treatment are available: medical treatment and surgical treatment.

What are the modalities of medical treatment for hip dysplasia?

Non-surgical treatment of hip dysplasia is recommended for dogs with a diagnosis of hip dysplasia without apparent symptoms. Non-surgical treatment is based on weight management, modification of physical activity and the use of medication (non-steroidal anti-inflammatory drugs, painkillers and chondroprotectors) or stem cells. The quality of response to treatment is variable. However, improvement is rarely long-lasting. Nine out of 10 dysplastic dogs present pain when examined by your veterinary surgeon at Neuilly-sur-Seine. Even if anti-inflammatory drugs are recommended on a long-term or even life-long basis by some, the harmful effects, digestive (digestive perforation and peritonitis), bone (severe bone atrophy) and renal (kidney failure) effects are medically recognized. When non-steroidal anti-inflammatory drug cures become frequent or ineffective, surgery is recommended.

What is the role of stem cells in the treatment of hip dysplasia?

Stem cells of mesenchymal origin (MSC) are now used in the treatment of osteoarthritis and are injected into the joints. Although MSCs do not graft onto osteoarthritic cartilage, they have chondroprotective, anti-inflammatory, pain-relieving effects and delay cartilage degradation. A study on the effects of injecting autologous MSCs of adipose origin for the treatment of osteoarthritis of the hips in dogs shows an improvement in lameness for 6 months after injection and all degrade and regress after 10 months.

MSCs are indicated for dogs that do not respond to non-steroidal anti-inflammatory drugs (NSAIDs), those that do not tolerate them, those that need them in the long term and finally for animals that are too old for surgery or those whose owners refuse it. Find the article on CSMAs by Dr Bardet from the ABVET veterinary clinic in Neuilly-sur-Seine.

What are the surgical treatments for hip dysphasia in dogs?

Juvenile pubic symphysiodesis

This procedure is carried out on dogs between 12 and 20 weeks of age. It prevents the development of hip dysplasia by the premature surgical closure of the growth of part of the pelvis. The purpose of this procedure is to return the joint cavity on the head of the femur during the rest of the dog's growth. Careful selection of candidates is based on the presence of low to moderate joint laxity. To be effective this technique must be performed before the age of 5 months while puppies do not show symptoms until 6 months of age.

Photographies de cellules souches en culture

Triple pelvic osteotomy

This technique is carried out in immature dogs from 6 to 8-9 months of age. Its aim is to limit the development of hip dysplasia by correcting the defect of covering of the femoral head by the acetabulum (cavity in which the femoral head fits). This technique allows the acetabulum to be turned over to cover the femoral head (Fig. 9). Careful selection of candidates is necessary to obtain particularly good results. This procedure is reserved for dogs with moderate dysplasia without osteoarthritis, which may justify the use of a CT scan and preoperative arthroscopy. The aim of this intervention is to avoid the progression of arthrosis and to maintain normal hips for the rest of the animal's life. The prognosis is good and the number of complications is currently limited.

Pre-operative X-ray Postoperative: 1 month after the excision

Removal of the head and femoral neck (excision of the hip)

This procedure is usually performed in adult dogs with severe hip dysplasia who no longer respond to medical treatment and for whom total hip replacement is not a financial option for owners. It consists of removing the head and neck of the femur. The result of this procedure will depend mainly on the weight of the dog. Theoretically, smaller dogs have a better prognosis. Studies over the last 10 years have shown that the clinical results of hip excision are good in only 38% of cases. Optimal clinical recovery can only be observed after a long, painful transition period that justifies the use of anti-inflammatory and analgesic drugs as well as prolonged physiotherapy. This is an operation of last resort.

Total hip prosthesis

This procedure is carried out in growing and adult dogs suffering from hip dysplasia which does not respond to medical treatment. This procedure consists of replacing the hip with an artificial hip as in human surgery. It allows the dog to return to normal walking and above all to normal comfort and activities in 96% of cases. It is the surgical technique of choice for dogs of all breeds and cats. Currently, we perform hip prostheses in all dogs, even small dogs and cats with the same excellent prognosis. The operated animals are comfortable after a few days and return to completely normal activity without limits after a month.

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