Three-dimensional assessment of the influence of juvenile pubic symphysiodesis on the pelvic geometry of dogs

OBJECTIVE To evaluate the 3-D geometry of canine pelves and to characterize the long-term effects of juvenile pubic symphysiodesis (JPS) on pelvic geometry by comparing the pelvic configuration between littermates that did and did not undergo the procedure. ANIMALS 24 Labrador Retriever, Golden Retriever, or Labrador Retriever-Golden Retriever crossbred service dogs from 13 litters. PROCEDURES At 16 weeks old, puppies with a hip joint distraction index ≥ 0.5 were randomly assigned to undergo thermal JPS (n = 9), mechanical JPS (7), or a sham (control) surgical procedure (8). Ten years later, each dog underwent a CT scan of the pelvic region. Modeling software was used to create 3-D reconstructions from the CT scans, and various pelvic measurements were made and compared among the 3 treatments. RESULTS Compared with the control treatment, thermal and mechanical JPS increased the hemipelvis acetabular angle by 4°, the acetabular angle of lateral opening by 5°, and the orientation of the medial acetabular wall in a transverse plane by 6°, which indicated that JPS increased dorsal femoral head coverage by the acetabulum. Both JPS procedures decreased the pelvic canal area by approximately 20% and acetabular inclination by 6° but did not alter acetabular retroversion. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that thermal and mechanical JPS were equally effective in altering the 3-D pelvic geometry of dogs. These findings may help guide future studies of alternatives for optimizing canine pelvic anatomy to minimize the risk of hip dysplasia and associated osteoarthritis.

Retrospective evaluation of the long-term outcome of non-surgical management of 74 dogs with clinical hip dysplasia

The long-term outcome for dogs treated non-surgically for clinical signs of canine hip dysplasia were evaluated retrospectively; 74 dogs were evaluated by a postal questionnaire sent to their owners, and 24 of these were also evaluated by a veterinary clinical examination. A total of 11 outcome variables were evaluated. Depending on the variable assessed, between 31 (41.9 per cent) and 49 (66.2 per cent) of the dogs remained clinically affected according to their owner's assessment, and between 17 (70.8 per cent) and 23 (95.8 per cent) of the 24 dogs had abnormalities attributed to hip osteoarthritis according to the veterinary assessment. Orthopaedic abnormalities other than hip dysplasia affected 17 of the 24 dogs. Long-term medications had been prescribed for the treatment of clinical signs associated with hip dysplasia in 41 of the 74 dogs.

Comparison of three distraction methods and conventional radiography for early diagnosis of canine hip dysplasia

Two radiographic distraction techniques (one employing a wooden lath and, the other, a PennHip distractor), an ultrasonographic distraction method and conventional radiographic Fédération Cynologique Internationale (FCI) hip score were evaluated in eight-month-old Labrador retrievers to determine the most reliable method for predicting radiographic FCI hip score at the age of one year. With reference to the FCI hip score, sensitivity and specificity of the PennHip method were 100 per cent and 54 per cent; sensitivity and specificity of the lath technique were 85 per cent and 71 per cent; whereas they were 62 per cent and 67 per cent for the ultrasonographic method. For all distraction methods, the positive predictive value (PPV) was moderate and the negative predictive value (NPV) was high. Sensitivity, specificity, PPV and NPV were 100 per cent for the FCI hip score. It is concluded that, at the age of eight months, FCI hip score is the most reliable method for predicting FCI hip score at the age of one year in the colony of dogs investigated. Both the PennHip and lath method were also clinically reliable techniques in predicting true negatives. The ultrasonographic distraction method was moderately reliable.

Prevalence of canine hip dysplasia in a veterinary teaching hospital population

The purpose of this study was to determine the prevalence of canine HD in a population in which there was minimal or no prior screening of radiographs for the disorder. Patient information was obtained from the radiographic database at the University of Missouri-Columbia Veterinary Teaching Hospital during the five-year period of 1991-1995. The coxofemoral joints on ventrodorsal radiographs of the pelvis were independently evaluated by three veterinary radiologists. A consensus evaluation of normal, borderline, or dysplastic was compiled. There were 2885 dogs identified representing 116 breeds and the mixbreds. There were 2236 purebred dogs (1071 males and 1165 females) and the prevalence of HD was 19.7%. There were 649 mixbred dogs (340 males and 309 females) and the prevalence of HD was 17.7%. There was no significant difference in the prevalence of HD between sexes or between purebred and mixbred dogs (P = 0.16; P = 0.29). Degenerative joint disease (DJD) was the most common radiographic manifestation of HD and there appeared to be a threshold at 12 months of age after which the presence of DJD was the primary diagnostic criteria.

Evaluation of risk factors for degenerative joint disease associated with hip dysplasia in German Shepherd Dogs, Golden Retrievers, Labrador Retrievers, and Rottweilers

OBJECTIVE

To determine whether age, breed, sex, weight, or distraction index (DI) was associated with the risk that dogs of 4 common breeds (German Shepherd Dog, Golden Retriever, Labrador Retriever, Rottweiler) would have radiographic evidence of degenerative joint disease (DJD) associated with hip dysplasia.

DESIGN

Cross-sectional prevalence study.

ANIMALS

15,742 dogs.

PROCEDURE

Hips of dogs were evaluated radiographically by use of the ventrodorsal hip-extended view, the compression v ew, and the distraction view. The ventrodorsal hip-extended view was examined to determine whether dogs had DJD. For each breed, a multiple logistic regression model incorporating age, sex, weight, and DI was created. For each breed, disease-susceptibility curves were produced, using all dogs, regardless of age, and dogs grouped on the basis of age.

RESULTS

Weight and DI were significant risk factors for DJD in all breeds. For German Shepherd Dogs, the risk of having DJD was 4.95 times the risk for dogs of the other 3 breeds combined. In all breeds, the probability of having DJD increased with age.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that the probability of having hip DJD increased with hip joint laxity as measured by use of DI. This association was breed-specific, indicating that breed-specific information on disease susceptibility should be incorporated when making breeding decisions and when deciding on possible surgical treatment of hip dysplasia.

Recent information about hip dysplasia

Dogs suffering from HD have a genetic background, but the releasing factors are many. Two of the most important are overnutrition and overexercising, especially in the young puppy. Radiography can give an estimate of the degree of secondary OA, and by evaluating the laxity in the hip joints at an early age, it seems to be possible to predict the chances for later development of OA. The eradication program has to be instituted in such a way that only the best dogs are accepted into breeding programs. It seems to be more efficient to eradicate the genetic part of the etiology by creating a breeding index by means of evaluating the offspring of the male dogs.

Correlation between hip joint laxity and subsequent coxarthrosis in dogs

In a prospective study the degree of hip joint laxity was compared with subsequent hip joint development. A total of 70 non-selected adult dogs from 34 breeds presented for hip dysplasia screening was examined. The degree of hip laxity was quantitated using a newly developed radiographic stress technique. The dogs were re-examined according to the standard radiographic technique after 1 year or more. There was a positive correlation (r = 0.58) between the degree of subluxation (SI) and the subsequent Canine hip dysplasia (CHD) grade. All dogs with an SI value of up to 0.35 developed hip joints ranging between normal and mildly dysplastic at worst. Of the dogs with an SI value higher than 0.35, 76% developed hip dysplasia. Of those 40 dogs grading normal or borderline normal on standard radiographs, 15% demonstrated lax hip joints with an SI of more than 0.35. Breed-specific differences in the correlation of degree of hip joint laxity to the development of coxarthrosis were noted. If both excessive hip joint laxity and development of arthrosis are considered exclusion criteria for breeding dogs, then the current mode of selection does not adequately restrict potential breeding stock. Only dogs demonstrating an SI of 0.35 or less on stress radiographs and graded normal or borderline normal on standard radiographs should be used for breeding, equivalent to 49% of all dogs examined in this study. A further 36% of the dogs examined, most of them currently still accepted as breeding dogs, would not pass. Breed-specific acceptable degree of hip joint laxity in breeding dogs should be determined. Selecting breeding dogs based on the results of hip joint laxity assessment may further decrease the incidence of CHD in the offspring.

Association between pelvic muscle mass and canine hip dysplasia

OBJECTIVE

To investigate the relationship between pelvic muscle mass and development and expression of canine hip dysplasia (CHD).

DESIGN

Prospective study.

ANIMALS

5 Greyhounds with anatomically normal hip joints, 59 German Shepherd Dogs (23 with CHD, 24 with near-normal hip joints, and 12 with normal hip joints), and 18 German Shepherd Dog-Greyhound crossbreeds (7 with CHD, 6 with near-normal hip joints, and 5 with normal hip joints) between 12 and 47 months old in which pelvic muscle mass was evaluated. Pectineal muscle and hip joint development were evaluated in 25 German Shepherd Dogs at 8 and 16 or 24 weeks of age.

PROCEDURES

For evaluation of pelvic muscle mass, individual pelvic muscles were weighed and hip joints were assigned a score on the basis of severity of degenerative changes. For evaluation of pectineal muscle development, muscle sections were stained and examined.

RESULTS

Pelvic muscle mass was greatest in Greyhounds, intermediate in crossbred dogs, and smallest in German Shepherd Dogs. Differences in pelvic muscle mass among breeds were attributable to differences in weights of individual muscles. Hip score was negatively correlated with pelvic muscle mass and weights of selected pelvic muscles. Dogs with pectineal hypotrophy at 8 weeks of age had type-2 muscle fiber paucity or muscle fiber-type grouping at 16 or 24 weeks of age. At 8 weeks of age, hip joints were composed of multiple centers of ossification, and the acetabulum was largely cartilaginous. By 24 weeks of age, the pelvic bones were largely, although incompletely, fused.

CLINICAL IMPLICATIONS

Diminished pelvic muscle mass in dogs with CHD and altered muscle fiber size and composition in 8-week-old dogs that subsequently develop CHD strongly suggest that abnormalities of pelvic musculature are associated with development of CHD. The complex development of the hip joint from multiple centers of ossification may make the joint susceptible to abnormal modeling forces that would result from abnormalities in pelvic muscle mass.

An overview of the pathogenesis of canine hip dysplasia

Canine hip dysplasia (CHD) is an inherited, developmental condition that involves a lack of conformity between the femoral head and acetabulum and invariably leads to osteoarthritis. In this paper, the author briefly reviews what is known about the genetics of CHD, how joint laxity and growth rate are related to development of CHD, and the possibility that CHD is a systemic disease involving multiple joints, not just the hip joint.

The joint capsule and joint laxity in dogs with hip dysplasia

Present knowledge of the complexity of joint diseases makes it difficult to investigate the causes and early pathogenesis of canine hip dysplasia. Clinical signs of canine hip dysplasia including joint laxity may be a result of primary or secondary alterations of the joint. We already know that joint laxity is related to effusive synovitis (ie, accumulation of synovial fluid) and to other primary collagenous diseases. Canine hip dysplasia may be a third collagenous disease associated with joint laxity. This paper summarizes some of the studies that investigated the relationship between joint laxity and a defect in collagen metabolism and the influence that alterations in transsynovial flow have on joint laxity.

Advances in diagnosing canine hip dysplasia

The DI method was developed, at least in part, because of perceived variations among radiologists in regard to subjective hip scores assigned to radiographs. It also was recognized that the prevalence of CHD among many dog breeds was disturbingly high, despite efforts to lower the prevalence using subjective score as a selection criterion. The DI method was developed on the basis of results of mechanical testing of cadaver hip joints, which accomplished 3 principal objectives. First, it showed that when the hip joint is in the standard, hip-extended, internally rotated position, passive laxity is minimized. Second, it showed that passive laxity was maximized when the hip joint is in the neutral position. Third, it demonstrated the sigmoidal nature of the load/displacement curve for the hip joint in the neutral position, which suggested that high repeatability from examiner to examiner in regard to DI could be expected without the need to standardize applied force. The mean and range of DI were shown to vary from 1 breed to the next, but within an individual dog, DI appears to remain constant (within limits of scientific acceptability and clinical applicability) from 16 weeks of age. Passive hip laxity measured on the distraction view is, on average, 2.5 to 11 times greater than that measured on the standard, hip-extended radiographic view. Performance Borzois and Greyhounds, which have an extremely low prevalence of CHD, uniformly have tight hip joints (DI < 0.3), and mean DI for dog breeds that have a high prevalence of CHD is significantly greater than mean DI for Borzois and Greyhounds. However, individual dogs that have DI < 0.3, even though members of breeds prone to CHD, have a low risk of developing DJD. Some, but not all, dogs with DI > 0.3 will develop DJD by 3 years of age, and DI has been shown to be the principal risk factor for development of DJD. Susceptibility to development of DJD appears to be breed-specific. For example, given equivalent DI, German Shepherd Dogs are more at risk for developing DJD than are Rottweilers. Heritability of DI is higher than that of the subjective hip score; thus, selection pressure based on DI should result in faster genetic change than selection pressure based on subjective hip scores. Finally, the DI method has been performed on approximately 14,000 dogs, some of which were evaluated multiple times. It is apparent that this method is no more harmful than the standard, hip-extended radiographic method or palpation performed as part of a routine orthopedic examination.

Dynamic ultrasonographic measurement of passive coxofemoral joint laxity in puppies

A new method of dynamic ultrasonographic evaluation of passive coxofemoral joint laxity was used to examine a total of 30 greyhound (n = 13) and nongreyhound (n = 17) puppies. Puppies were evaluated sonographically at four, six, eight, 12, 16, and 26 weeks of age. The coxofemoral joints were distracted manually, and the femoral head displacements were measured during distraction. The greyhounds had significantly smaller (p less than 0.01) maximum distraction distance (mean +/- standard deviation [SD], 0.11 +/- 0.04 cm) than nongreyhound puppies (mean +/- SD, 0.26 +/- 0.10 cm). In six- to eight-week-old puppies, the maximum distraction distance was correlated significantly (p of 0.0001, adjusted correlation coefficient [r2] of 0.27) with stress radiographic indices. Coxofemoral joints interpreted as being abnormal on hip-extended radiographs taken at one year of age were associated significantly (p of 0.0001) with higher maximum distraction distances in six- to eight-week-old puppies.

The pathogenesis and diagnosis of canine hip dysplasia: a review

Hip dysplasia is a common developmental problem affecting the canine population. Despite extensive research into the condition, many questions remain unanswered and numerous misconceptions are present among the general public. The purpose of this paper is to review the current knowledge on the development of hip dysplasia, factors modifying its development, and current diagnostic techniques.A computerized literature search was conducted for the period of January 1983 to April 1985 using the MEDLINE and CAB databases, and the keywords hip dysplasia, hip, dog, and canine. Other articles,wherever possible original research articles, published before 1983 were also reviewed. Animals affected by hip dysplasia are born with normal hips, but quickly develop subluxation of the femoral head. Degenerative joint disease follows. Hip dysplasia is a complex, inherited, polygenic trait. Selective breeding of only normal dogs with normal littermates, parents, and grandparents is there commended method of reducing the incidence in the general population.Gene expression in affected individuals may be modified by a number of environmental factors. These factors do not cause hip dysplasia, but they alter manifestations of the trait and its severity. Nutrition is a major environmental factor. Excess energy consumption increases the frequency and severity of hip dysplasia in genetically predisposed dogs. Food intake should be regulated to maintain a slender figure with the ribs and dorsal vertebral spines easily palpable, but not visible. Excess dietary calcium and vitamin D contribute to hip dysplasia in genetically predisposed individuals and should be avoided. High dose vitamin C supplementation ingrowing puppies does not prevent hip dysplasia, and this practice should be discontinued. Animals must be 2 years old before they can be certified as normal, but the disease may be diagnosed earlier. Earlier diagnosis of the condition would be very useful for the selection of breeding stock, but palpation techniques and the standard extended view radiographs have unacceptably high rates of error in young puppies. Stress radiography techniques may improve the accuracy of early diagnosis in the future.

Evaluation of risk factors for degenerative joint disease associated with hip dysplasia in dogs

Passive coxofemoral joint laxity of dogs, as quantitated by a distraction-stress radiographic method, may have important prognostic value in determining susceptibility to hip dysplasia. Data from 151 dogs, representing 13 breeds, were included in a logistic regression model to evaluate the contribution of factors such as age, breed, weight, sex, distraction index, and Norberg angle to the risk of developing degenerative joint disease (DJD) of the coxofemoral joint. Of the factors studied, the amount of passive hip laxity, as quantitated by the distraction index, was the most significant (P < 0.0001) determinant of the risk to develop DJD of the coxofemoral joint. In the longitudinal and cross-sectional components of the study, distraction index was a significant (P < 0.001) risk factor for DJD, irrespective of age at evaluation (4, 12, or 24 months). The strength of the hip laxity:DJD correlation increased with the age of dog. In contrast, the Norberg angle, a measure of hip laxity on the standard hip-extended radiograph, was not found to be a significant risk factor for DJD, either in the longitudinal or cross-sectional analyses. Breed-specific probability curves of DJD susceptibility indicated that German Shepherd Dogs had a significantly (P < 0.05) greater risk of developing DJD than did the pool of non-German Shepherd Dogs. The information derived from this statistical model will help to scientifically characterize the role of passive hip laxity as a component in the pathogenesis of DJD of the coxofemoral joint.

Inclination and anteversion of collum femoris in hip dysplasia and coxarthritis

Femoral neck angles were measured radiographically in 41 dogs examined for hip dysplasia. Steep femoral neck inclination was found to be a phenomenon of hip dysplasia and coxofemoral joint laxity. The altered biomechanics of a steep femoral neck inclination may be a factor in the pathogenesis of hip dysplasia and secondary osteoarthritis.

The pathogenesis of canine hip dysplasia

Dogs with CHD are born with normal hips that subsequently undergo varying degrees of subluxation of the coxofemoral joint. Although the etiology of CHD is multifactorial, the pathogenesis or stages of change within the affected coxofemoral joint(s) are similar regardless of cause. With the onset of the disease, there are progressive structural changes including joint laxity and femoral head subluxation; swelling, stretching, fraying, and eventual rupture of the teres ligament; a shallow, flattened acetabulum, deformity of the head; erosion of articular cartilage, eburnation of subchondral bone, DJD; and periarticular osteophyte formation.

The role of nutrition in canine hip dysplasia

The role of nutrition in canine hip dysplasia is a multifactorial as the disease itself. Large and giant breeds primarily are at risk for the disease. Rate of growth, feeding methods, feed consumption, specific nutrients, and electrolyte balances within the diet have all been shown to influence hip dysplasia. Known nutritional risk factors are rapid weight gain and excessive calcium supplementation. Nutritional factors with less secure roles in their influence on the disease process are vitamin C, protein, and carbohydrates. There exists a need to identify further and control the various nutritional factors in the diet that influence canine hip dysplasia.

Radiographic development of canine hip dysplasia

The radiographic changes observed in the development of CHD in the dog are complex and not fully understood despite years of research. Moderate to severe CHD is relatively easy to diagnose using standard radiographic views and evaluation techniques. However, early detection of mild or borderline CHD continues to be difficult to reliably detect radiographically. Efforts continue to be made to develop new views, techniques, and evaluation methods that will improve the radiographic evaluation of CHD. Until better methods are proven, the standard ventrodorsal leg extended view, evaluated by an experienced reviewer, will remain the method of choice for radiographic detection of CHD.

Canine hip dysplasia and the breeder. A layman's point of view

Many, though certainly not all, breeders are becoming fairly knowledgeable about CHD and other joint problems. The veterinarian should encourage prevention through selective breeding and lead the client to further understanding of the disorders. Breeders need help in separating scientific evidence from insufficiently tested hypotheses based on testimonials. "Quick-and-easy" cures can be exposed and discounted with just a little search of the literature. The veterinarian's job is similar to that of the teacher in the old one-room country school: some client may have to be taught the basics, whereas those in other stages of progress receive different help. Breeders perhaps need more assistance than do pet owners, because they will affect future generations of dogs. The veterinarian who concentrates on building a trust relationship based on shared facts and a sincere desire to contribute to the well-being of his clients (and his patients) will enjoy a most rewarding relationship with them.

[Analysis of environmentally-conditioned and genetic influences on the frequency of hip joint dysplasia in German Shepherd dogs]

The importance of environmental and genetic influences on the frequency of hip dysplasia was studied in 10,595 German shepherd dogs. Systematic effects were analysed using mixed linear and mixed nonlinear threshold models. Following effects were regarded in the models applied: sire and mother of the dog as random effects, age at x-raying, sex, birth year and season of the x-rayed dogs, litter size, percentage of x-rayed dogs in each litter and sex ratio of the litter as fixed effects. Sire, mother, sex and age at x-raying showed significant influence on the occurrence of hip dysplasia. The heritability estimates in a hierarchical data design (sire, mother within sire) for the polychotomous trait hip dysplasia were for full sibs h2 = 0.30, for maternal half sibs h2 = 0, 48, and for paternal half sibs h2 = 0.11. Only the heritability estimates of the paternal half sibs seem to be reliable because kennel and breeder effects are confounded with the mother effect. Analysing the frequency of hip dysplasia as all-or-none traits, the heritability estimates were usually lowered by 50%. Selection programmes to reduce frequency of hip dysplasia can be improved if the estimation of breeding values with respect to environmental effects and frequency of hip dysplasia in all relatives will be implemented.

New concepts of coxofemoral joint stability and the development of a clinical stress-radiographic method for quantitating hip joint laxity in the dog

From mechanical principles and postmortem observations of coxofemoral joints of dogs, a hydrostatic mechanism influencing hip joint stability was discovered. This discovery led to the development of a stress-radiographic positioning method to quantitate hip joint laxity in dogs. The method incorporated 2 views with the dog in supine position and hips at neutral flexion/extension angle: a compression view, with the femoral heads fully seated in the acetabula; and a distraction view, with the femoral heads at maximal lateral displacement. An index measurement method was formulated to quantitate the relative degree of joint laxity appearing in either the compression or distraction view. Clinical evaluation of 6 dogs was done to compare the compression/distraction method with the standard hip-extended radiographic method. Also, the stress-radiographic method was performed on 16-week-old Borzoi and German Shepherd Dogs to compare the characteristics of inherent hip joint laxity in these breeds. In all dogs tested, hip joint laxity was masked by the standard hip-extended view as indicated by a 2.5-fold improvement in sensitivity to hip joint laxity of the new method (P less than 0.00001). Moreover, the mean hip joint laxity of 16-week-old German Shepherd Dogs exceeded the mean hip joint laxity of Borzois by 79% (P less than 0.00001). Reports in the literature document the incontrovertible association of hip joint laxity to the development of hip dysplasia in dogs. We believe the ability to accurately quantitate hip joint laxity will provide key diagnostic and prognostic criteria for the selection of pet dogs, and more importantly, breeding stock.

The role of hyaluronic acid in joint stability--a hypothesis for hip dysplasia and allied disorders

The concentration of hyaluronic acid (HA) and proteins in synovial fluids of hip and shoulder joints of a variety of canine breeds has been investigated. In the Australian Kelpie, a working dog with a low incidence of hip dysplasia, shoulder synovial fluid viscosity and HA concentration were higher than in similar joints of Alsatians in which hip dysplasia is relatively common. Moreover, the HA levels and viscosity in shoulder fluids of animals with clinically defined hip dysplasia were substantially lower than in all other breeds studied. On the basis of these findings, we propose that hip dysplasia and other joint abnormalities may arise as a consequence of a deficiency in the levels of HA in synovial fluids.

Acetabular dysplasia and osteoarthritis developed by an eversion of the acetabular labrum

To investigate adverse effects of acetabular labrumectomy on the growth and development of the acetabulum, the author subjected the hip joints of 20 young rapidly growing dogs to eversion of the acetabular labrum. It was found to produce acetabular dysplasia. The acetabulum gradually became shallower and more vertically oriented, and the femoral head gradually subluxed but never dislocated. The radiographic appearance of the hip dysplasia was similar to that seen in humans. Histologically, a substantial degenerative change in articular cartilage was observed in the subluxed hip, without any evidence of degenerative arthritis radiologically. When operating on congenital dislocation of the hip, a complete excision or eversion of the acetabular labrum should be avoided. Radial splitting of the acetabular labrum may safely avoid the risk of violating the acetabular epiphyseal cartilage.