Veterinary Medicine - December 2008 - (Page 642)

Practical Matters clinical advice and reminders from your colleagues Early screening and the role of DARthroplasty as an intervention in young dogs with hip dysplasia PEER-RE VIE WED F or too long, many veterinarians who have diagnosed hip dysplasia in young patients have informed the owners that the consequences will have to be dealt with later in life, when signs of osteoarthritis develop. When this time comes, we treat the pain associated with osteoarthritis with medications, we advise weight loss, and, for owners who can afford it, we recommend a total hip replacement. DIAGNOSTIC EVALUATION IN PUPPIES A proactive hip wellness program, on the other hand, would attempt to modify the course of dysplasia toward normalcy at an early age, which might result in little if any osteoarthritis during the course of the affected animal’s life. This comprehensive hip wellness program would ideally begin by evaluating 4-month-old puppies of breeds susceptible to dysplasia. These puppies would be sedated or anesthetized and examined for a positive Ortolani sign. If an Ortolani sign is present, conﬁrm joint laxity with a radiographic examination (PennHIP), or possibly an ultrasonographic examination. These procedures can be easily accomplished as part of an early-age wellness diagnostic examination (Figure 1). Hip laxity identiﬁed in puppies < 5 months old might beneﬁt from juvenile pubic symphysiodesis.1-3 For puppies examined later in adoles- cence, from 6 to 12 months of age, the same diagnostic evalDavid Luck, DVM uations should Veterinary Surgical Relief Services be performed. 2237 Meade St. Puppies in Denver, CO 80211 this age group showing laxity may beneﬁt from one of two procedures: triple pelvic osteotomy (TPO) or dorsal acetabular rim arthroplasty (DARthroplasty). For patients that do not qualify for a TPO procedure because of a lack of dorsal acetabular rim, excessive subluxation of the femoral head, or beginning osteoarthritic changes,4 DARthroplasty may be appropriate (Figure 2).5 Figure 1: Comprehensive Hip Wellness Program for Large-Breed Puppies If the dog is 4 months old, sedate or anesthetize the dog and evaluate for an Ortolani sign. If the dog is 6 to 8 months old, check for hip dysplasia by performing a radiographic examination and checking for an Ortolani sign. If an Ortolani sign is present, conﬁrm hip dysplasia with radiography and possibly ultrasonography. Consider recommending juvenile pubic symphysiodesis. If an Ortolani sign is not present, reevaluate the dog at 6 to 8 months of age as described above. If the hip is abnormal, consider recommending a triple pelvic osteotomy, DARthroplasty, or a total hip replacement, depending on the dog’s age when laxity is diagnosed and the criteria for performing the procedure. If the hip is normal, recheck the dog’s hip at 12 to 16 months of age. When the dog is 12 to 16 months old, reevaluate the hip joint by palpation and radiography. If the hip is normal, reevaluate the dog at 24 to 36 months of age. If the hip is normal, periodically reevaluate hip joint health throughout the patient’s life. 642 December 2008 VETERINARY MEDICINE

Table of Contents Feed for the Digital Edition of Veterinary Medicine - December 2008

Veterinary Medicine - December 2008 Contents Letters Thanking Our Valued Reviewers Practical Matters Idea Exchange Why Do Dogs and Cats Eat Grass? Managing Atypical and Critical Cases of Primary Hypoadrenocorticism in Dogs Behaviors Suggestive of Postoperative Pain in Cats What to Consider When Considering Digital Radiography Avoid Common Bandaging Mistakes in Dogs and Cats IMHA: Diagnosing and Treating a Complex Disease CE Form/Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - December 2008

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