Hip dysplasia is a well recognized disease that has been around for a long time and has many treatment options. It is also known as degenerative joint disease of the hip and arthritis of the hip. It seems to affect mostly large-breed dogs, but doesn't discriminate in that medium- and small-breed dogs can also be affected. Certain breeds of cats can also be diagnosed with it. The word dysplasia means bad or disordered, but has come to have a literal translation of badly formed, and in this case we mean the hip. Although the acetabulum, the socket of the hip, is particularly affected (subluxation, or partial dislocation, of the hip), the problem will come to involve all the components of the hip joint, subjecting it to unnatural stress and wear thereby creating a degenerative and regenerative situation within the joint itself.

In some of the small breeds the disease is often mistaken for Legg-Calve Perthes disease or aseptic necrosis of the femoral head. This disease shares some characteristics with hip dysplasia such as hind end lameness, difficulty in getting up and down and hip pain, but is quite different in its treatment and outcome.

Although hip dysplasia is known to be inherited, some environmental factors can have a play in its progression and development. Nutrition, weight, diet, exercise and daily routine are important factors in the development of degenerative joint disease, be it unilateral or bilateral (one or both hips). I have seen one-sided degenerative joint disease in some older dogs that do agility and are well into the athletics of Frisbee games. I mention this because, in my opinion, not all degenerative joint disease of the hip is hip dysplasia, but hip dysplasia is an important cause of secondary degenerative joint disease or osteoarthritis.

Clinically, these pets present with different degrees of pain. In some cases, young dogs are presented because they spread both hind legs behind themselves when they lie down. Some dogs bunny hop when they run and others are reluctant to climb stairs or get into the car. Obviously in these cases pain isn't the issue as far as the owner is concerned as much as there is the issue of changing habits and customs. Some of these pets show signs of muscle atrophy in the hind quarters and have different degrees of crepitus, or noise and grinding, in the joint on physical examination. Some pets may not show any lameness until later on when secondary degenerative changes become obvious.

The diagnosis is usually straightforward. With the proper radiographs taken, the usual changes and the degree of severity can be documented. It is important to note that how they present clinically doesn't necessarily correlate with the radiographs. It has happened that when taking x-rays for other issues a doctor will note that the pet has degenerative joint disease of the hip, but shows no signs of lameness.

The treatment is varied. Conservative treatment may include the use of nutraceuticals that contain glucosamine, chondroitin sulfate, MSM and manganese. Homeopathic remedies such as calendula, rhododendron, chrysanthum, Ruta gravolens, Bryonia, arnica and Symphytum have been used quite successfully.

Some practitioners will use Rimadyl (carprofen) and EtoGesic (etodolac) and in many cases weekly chondroprotective injections.

The surgical route offers many options that may include total hip replacement, TPLO (tibial plateau leveling osteotomy) and FHO (femoral head ostectomy). These are best discussed with a veterinary orthopedic surgeon. Rehab, massage and laser therapy are other modalities that have shown to be helpful in the treatment of hip dysplasia.

Acupuncture has been used quite extensively in managing the pain of degenerative joint disease and arthropathies in human and veterinary medicine. It has been shown that acupuncture has an analgesic effect vis-a-vis neural and neurohumoral mechanisms. It acts as an anti-inflammatory, thereby helping to address muscle-tendon issues that can be subsequent to the pain and inflammation. This may on occasion cause local stiffness and thus more joint trauma. Another factor important in treating hip dysplasia is the myofascial trigger points that may also develop. They are hyperirritable areas in skeletal muscle that can be palpated in most cases as a firm nodule. These areas are very painful and tender and are often caused by osteoarthritis. Since acupuncture has a potent effect on muscle and joint stiffness, it also serves to treat trigger point issues since a large percentage of them correlates with acupuncture points.

As mentioned in an earlier issue of The Pet Tribune (Nov-Dec 2000), another treatment modality for degenerative joint disease of the hip is gold bead implants. These are implanted at various sites, some of which are acupuncture points and some which are considered reactive points that merit the implant. The procedure involves the implantation of magraine gold beads or 24kt. gold wire into specified areas by using a 14 gauge 1 1/2-inch needle and a 3ml. syringe (in the case of the gold beads).

The procedure is considered a surgical procedure requiring general anesthesia although there is no cutting and no sutures are placed. I use magraine gold beads, which are very small gold-plated magnets with a very low magnetic charge. Implantation is with a needle and syringe, which once again is why there is no need for sutures. These pets go home the same day the procedure is done and the recuperative period is quite short. It is important to note that the gold bead procedure is an extension of an acupuncture procedure and in doing it, there will be no need for any further acupuncture treatments for the issue at hand.

Age at implantation does play a key factor in the procedure. The sooner after diagnosis that implants are done, the better the outcome.

-Dr. Robert Ferran, a holistic veterinary practitioner in South Miami, has been in practice for 18 years. He is certified in veterinary acupuncture and also graduated as an acupuncture physician. Most of his practice is dedicated to the art of acupuncture and related applications, such as gold bead implants, sports-related injury, rehabilitative acupuncture and laser acupuncture. His practice is located at 8271 South Dixie Hwy., Miami, FL 33143, tel: (305) 662-4202, fax: (305) 662-7973, www.naturalpetdoc.com.