Degenerative Joint Disease and Hip Dysplasia

DJD

What exactly is this … DJD?  Is it the name of a hip new DJ (Disc Jockey) on the club circuit?  NOPE  Is it a vaccination?  NOPE  Is it a … terribly debilitating disease that will eventually lead to inflammation, immobility, and the painful suffering of your dearly beloved pet? YES!!!

DJD (Degenerative Joint Disease) occurs when the smooth cartilage that covers and protects the end of the bones in a movable (synovial) joint is destroyed. The cartilage has no nerves, so when it touches the cartilage of another bone, there is no pain. When the cartilage wears away, the bone is exposed. The bone does have nerves, so when the two bone ends in a joint touch each other, it results in pain and inflammation.  Unfortunately, DJD naturally occurs as your animal ages.  This is called primary DJD.  During this process, the natural breakdown and (lack of) restoration of cartilage causes bone on bone friction.  Friction in turn triggers the bone to remodel, causing bony spurs and what we now know to be osteo-arthritis.  DJD can affect the hips, shoulders, elbows, stifles (knees) and hocks (ankle).

Most often, secondary DJD is a preordained condition based on the genetic make up of your animal, however, there are other contributing factors such as weight, diet, and other congenital disorders, like hip and elbow dysplasia, that can play a large part in the process.  There are certain breeds of canines that are predisposed to having DJD due to these contributing factors such as … Labrador and Golden Retrievers, Shepherds, and most other large breeds. However, we are starting to see a larger number of small breeds with DJD.

We do have good news though …

While there is no cure for this debilitating disease, the introduction and approval of a new surgical procedure, as well as several new pain management drugs and supplements, we are able to effectively reduce pain, and in some cases, actually slow the progression of the disease.

Wait … There’s More!!!

Here at Arlington Animal Clinic, we are suggesting hip evaluations (for hip dysplasia) between 12-16 weeks of age for all puppies that will likely grow to be in excess of 40lbs.  Your pet may not show signs or symptoms of lameness as young as 12-16 weeks of age, however, he/she should still be evaluated.  If your pet is found to be at risk of developing hip dysplasia, one of our doctors will suggest an orthopedic consult with a surgeon to evaluate the expected effectiveness of having surgery to help prevent future onset of hip dysplasia.  The procedure is called Juvenile Pubic Symphysiodesis (JPS) surgery.  It is a minor procedure that is usually done on an outpatient basis and may be done in conjunction with your animals spay/neuter.  It is not a curative procedure, but research has shown the procedure to be up to 95% effective.

What if my dog is older?

Excellent question … This procedure is typically done no later than 5 months of age.  The procedure entails making a small incision between the hind limbs to expose the pubic bone of the pelvis.  Next, electro-caudary is used to cauterize the growth plate thus destroying the growing cells of this part of the pelvis.  If the procedure is done past the recommended age, the ability to alter the growing cells greatly decreases, thus rendering the procedure ineffective.
There are, however; many other ways of managing this destructive disease without surgery.

1. Weight management is key!!!  If your pet has a BCS (body condition score) of 5/9 or greater, he/she NEEDS TO LOSE WEIGHT … his/her life literally depends on it.  These animals should be kept on the skinny side of lean.  This will allow for better mobility.
2. Physical therapy is a great way to strengthen the muscles around the hip joints that ultimately end up compensating for the degenerating joint.  Water therapy is the best type of physical therapy because the ability of strengthening the muscle is not being impinged by gravity, plus the weight of the animal.  Water therapy can unfortunately be expensive, so … there are some home exercises that can be very effective.  When you take your animal for a walk, you may want to shorten the distance a little.  Instead of your usual romp, going up hill will help build up the muscles in the quadriceps consequently improving the stability of the hip socket.  The same can be true of just practicing the “sit/stand” command.  Have your animal stay in one place, and practice the “sit/stand” command.  Use little pieces of kibble, or carrots, as reward.
3. The use of anti-inflammatory drugs and natural supplements is also an affective way of managing your animal’s pain.

Glucosamine and Chondroitin are naturally occurring molecules within cartilage … one may say that they are the building blocks of cartilage.  Glucosamine is responsible for the formation and repair of cartilage while Chondroitin is responsible for it’s resiliency.  Consuming oral Glucosamine and Chondroitin is assumed to help provide the body with more “building blocks” thus contributing to faster turnover.

Fish oil (Omega-3 Fatty Acids, also known as EPA and DHA) has also been shown to decrease inflammation as well as improve coat health, and heart health.

Hill’s Science Diet® makes a prescription diet J/D.  In a university study, 82% of dogs fed j/d Canine experienced   improvement in weight bearing ability.  It is clinically proven to help dogs with arthritis walk and run better, play better and climb stairs more easily.

Adequan® is an FDA approved injectable drug that slows the naturally occurring process that breaks down the cartilage that protects from bone on bone contact.  Using this drug as directed by your veterinarian can actually support the repair process.

NSAIDs (non-steroidal anti-inflammatory drugs) are also very effective at reducing inflammation that results from bone on bone friction.   This particular class of drugs should only be given based on the prescribed regimen as set forth by your veterinarian.  Some of these drugs are species specific and all are metabolized by the liver, so regular blood tests should be obtained to rule out organ damage every 6 months … Sooner if organ compromise is detected.

Gabapentin (Neurontin) is a neuropathic drug originally developed to control epilepsy.  It’s exact mechanism of action is unknown, but it has extremely effective therapeutic action on neropathic pain.

Tramadol (Ultram) is a centrally acting opiod analgesic.  Tramadol possesses weak agonist actions, and releases serotonin, and inhibits the reuptake of norepinephrine.  This drug action can be likened to the effect of morphine in humans.

If you are concerned that your pet may be affected by DJD in the future, or is currently suffering from DJD …

 

Do Not Pass Go
Do Not Collect $200
Go Straight To Your Veterinarian!

References:

http://www.vetsurgerycentral.com/jps.htm

http://www.adequancanine.us/about/en/effective_treatments.shtml