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Healing & Alternative Health
Dr. Carson's Holistic Animal Care:
Conventional Treatment of Hip Dysplasia
by Kathleen M. Carson, D.V.M |
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Conventional Western treatment of hip dysplasia (HD) and its associated arthritis consists of drugs and surgery. Unless the symptoms are especially severe, drugs are usually given first. The types of drugs used most commonly are anti-inflammatory drugs, either non-steroidal or steroidal.
Non-steroidal anti-inflammatory drugs (NSAIDs) are the usual drug of choice. NSAIDs used for dogs with HD include aspirin (preferrably buffered like Ascriptin or Ecotrin), Rimadyl (carprofen), EtoGesic (etodolac), Feldene (piroxicam), Butazolidin (phenylbutazone) and Metacam (meloxicam). These drugs can be very helpful, even miraculous, in relieving the signs of HD.
Most animals with HD benefit from NSAIDs. However, some animals are sensitive to these drugs, especially if they take them over an extended period of time. The side effects seen in these animal include bleeding in the gastrointestinal tract and liver and/or kidney damage, as well as further damage to joints. Because of the possibility of these side effects in some patients, careful monitoring, including periodic blood tests, should be done if these drugs are used for anything other than short-term use. Your veterinarian can advise you about this monitoring if long-term use is anticipated.
NSAIDs need to be used more cautiously in cats than in dogs. Some of the NSAIDs which dogs can take are toxic or even fatal in cats. Others can be used, but at a reduced dose or frequency. Always check with your veterinarian before using any NSAID in a cat.
Some NSAIDs which can be used safely in humans, like ibuprofen, are toxic/fatal not only to cats but to dogs as well. Always consult your veterinarian before giving any human NSAID to your dog or cat.
Never combine NSAIDs or increase the recommended dose without your veterinarian’s advice; unwanted side effects are much more likely if this is done and could prove to be fatal.
Steroidal anti-inflammatory drugs are those related to cortisone; they are called corticosteroids. These usually are reserved for very severe symptoms and should be used for a short time only. They include prednisone or prednisolone, Azium (dexamethasone), and Vetalog (triamcinolone).
If drugs aren’t doing an adequate job, or if the symptoms are very severe, the other conventional treatment method is surgery. There are several types of surgery used for HD. Two are used in the young dog and are meant to change the shape of the pelvis so that the relationship of the pelvis and the femur is more normal. This reduces the likelihood of secondary degenerative/arthritic changes and their symptoms of pain, stiffness, etc.
Surgeries done in young HD patients are the triple pelvic osteotomy (TPO), in which the pelvis is cut in multiple places and re-assembled, and the newer juvenile pubic symphysiodesis (JPS), in which the fibrocartilage which is in place between the two halves of the pubic bone of the pelvis is cauterized, stopping further growth of the pubis (while other parts of the pelvis continue to grow). Age is an important factor in the success of these two surgeries, especially the JPS, in which a candidate must be younger than 20 weeks. The jury is out on the success rate of these surgeries, especially the JPS, which is a very new procedure. If your young pup has HD, consult your veterinarian and/or a veterinary surgical specialist as to whether the TPO or JPS would be indicated for your young dysplastic dog.
Another surgery used for HD is the femoral head ostectomy (FHO), in which the head of the femur is cut off. The body forms a false joint in the hip area; that is, scar tissue forms around the truncated neck of the femur. This new false joint doesn’t have the inflammation, degeneration, and pain associated with the old joint. FHOs are best done in smaller dogs or in cats; the heavier weight of bigger dogs can interfere with an adequate false joint being formed.
Lastly, total hip replacement (THR) can be done. In this surgery an artificial joint is put in place of the previous degenerated one.
Any surgery, especially for a geriatric animal with other orthopedic and/or medical problems, must be considered carefully. Your veterinarian can help you make a decision about whether surgery is a good idea for your animal with HD, or he/she may refer you to a veterinary surgical specialist for a consultation.
Surgical costs can be steep, especially for THRs and TPOs. And, unfortunately, in a small percentage of patients surgery can have unwanted side effects, especially if performed by a veterinarian new to the procedure. It is important to choose an experienced surgeon.
Good surgical candidates can experience excellent, even miraculous, results from these surgeries.
Next month I’ll discuss alternative, non-drug or -surgical treatment of HD.
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Dr. Kathleen Carson, DVM
Veterinarian & Author
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Dr. Carson received her Doctor of Veterinary Medicine degree from the University of California at Davis in 1968. She's been a small animal practitioner (dogs and cats ) for all the years since, except for a short stint at the San Diego Zoo when she first graduated.
She belongs to the American Veterinary Medical Association and the American Holistic Veterinary Medical Association.
Since 1974 she's lived and practiced in the South Bay Area near Los Angeles. She started the area's first house call practice in 1976 and the first pet crisis/loss group in 1989. The human-animal bond is of special interest to her.
She started exploring complementary veterinary medicine in 1987. Her practice became 100% holistic in 1996. She utilizes acupuncture, herbs, supplements, Bach Flower Remedies, homeopathic remedies, nutrition and medications for her patients in her practice.
She's currently taking a leave of absence from her house call practice due to health reasons but continues to do phone consultations and to write.
E-mail:
Critterhlr@aol.com
website:
http://www.holistic
vetconsult.com
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