Veterinary Articles and Case Examples

X-rays: Normal Hips vs Severe Dog Hip Dysplasia

Posted on in Case Reports, Dog Hip Dysplasia, Radiographs, Uncategorized 2 Comments

X-rays of Normal Dog Hip Joints

and those with Severe Dog Hip Dysplasia

 

Dog hip dysplasia is a malformation of the hip joint – instead of a nice round ball fitting smoothly into a deep socket, the joint contains a shallow socket and irregularly shaped ball.  These malformations cause uneven contact between the joint surfaces, as well as compromised stability.  Arthritis is an expected outcome from having dog hip dysplasia.

The root cause of dog hip dysplasia is genetic, but over feeding, and either over or under exercising can also contribute to its manifestation.  In cases of unilateral (one sided) dog hip dysplasia, one has to wonder if underlying sports injury causing muscle imbalances during the puppy’s crucial developmental period of life is playing a role.

Posted below are radiographs of normal and abnormal hips.  In an effort to highlight the relevant features, I have once again called upon my limited photoshop skills.
normal hips rads

 

This first x-ray is of a dog with normal hips.  The ball is round and fits well into a deep socket

 

 

 

normal hips rads graphics

 

 

 

Here is the same x-ray again, this time with fancy graphics.  The red line highlights the socket and the green line outlines the femoral head (ball) and neck.  Notice the hourglass appearance of the thin femoral neck.  The region of solid green colour represents the part of the femoral head that is buried within the socket.

 

 

Dog Hip Dysplasia

 

 

This is an x-ray of a dog that has severe hip dysplasia.  Notice the areas of roughened bone, with spurs off the top of the socket and extra calcified masses.  These regions of extra bone growth indicate degenerative arthritic change.  Both the ball and the socket are irregularly shaped and fit together poorly.  There is poor coverage of the femoral head.

 

 

Humphrey's hips graphics

 Here is the same x-ray again, this time with fancy graphics.  The femoral head and neck are outlined in green.  Notice how thickened this femoral neck is compared to the normal dog hip x-rays above.  The region of solid green colour reflects the amount of femoral head that is seated within the socket.  Notice how much flatter these femoral heads are, and how much poorer the amount of seating is on this x-ray compared to that of the normal dog hip x-ray.  The green or red circles with no colouring in the centre represent abnormal calcified masses.

 

Despite these horrific looking x-rays, with minimal treatment this dog is leading an active, pain free life, with only the occasional use of prescription medication.  He recently earned his CKC TD tracking title at 7 years of age.  His hips and low back are getting stronger with time.

severe hip dysplasia pre-op

 

 

 

This next x-ray shows such severe dog hip dysplasia that no fancy graphics are needed – the ball and socket are so poorly formed that they aren’t even touching.  Notice all regions of roughened bone that indicate advanced arthritis.  This dog is relying entirely on muscular support for these hips.

 

 

severe hip dysplasia post op

 

 

 

 

Here is the same patient again, this time after receiving total hip replacement surgery.

 

 

  

Although this case was clearly surgical, the vast majority of dog hip dysplasia cases can lead active happy lives with non-surgical therapy.  Key components of non-surgical therapy include:

  • Treat the inflamed joint itself using nutriceuticals (glucosamine, omega-3’s etc.), a structured exercise program to build hip strength and stability, manual therapy (e.g.: mobilizations), acupuncture, anti-inflammatories etc.

 

  • Address secondary sources of pain – myofascial trigger points, sacro-iliac and/or low back pain, pinched nerves etc. etc.  More often than not, it is these secondary sources of pain that are limiting the dog’s quality of life.  If anti-inflammatories aren’t making a huge improvement in comfort, then the likelihood of secondary pain arising from somewhere besides the hip joint is very very high.  Treating secondary sources of pain is as important as treating the hip joint itself.  Chiropractic adjustments and/or physiotherapy style mobilizations are the single most effective tool for treating secondary muscle pain, pinched nerves, reduced mobility etc.

 

  • Keep the rest of the body as fit, strong, and comfortable as possible so that it can better compensate for the poor hips.

 

With the above treatment, most dogs with hip dysplasia can lead active comfortable lives without the need for surgery. If you would like to learn about dog hip dysplasia, click here.


Severe Hind Leg Weakness in a Cat – Non-Surgical Treatment

Posted on in animal acupuncture, Case Reports, Non-surgical Therapy, veterinary acupuncture, Veterinary Chiropractic Comments Off on Severe Hind Leg Weakness in a Cat – Non-Surgical Treatment

Severe Hind Leg Weakness
Before and After videos of Sally the Cat

 

Sally presented with a history of severe hind leg weakness that prevented her from walking.  Her condition had not changed in the last six months.  She was treated using a combination of chiropractic, acupuncture and physiotherapy techniques. The video below is a good demonstration of how well hind leg weakness patients can respond to non-surgical therapy.

The decision on whether a case of hind end weakness will respond to non-surgical treatment depends on several factors, including the degree of neurologic impairment, how rapidly the condition is progressing, and the amount of concurrent pain that is present. Some cases are clearly surgical, but this one was not.


Why Exercise Reduces Pain

Posted on in Geriatric care, Non-surgical Therapy, Prevention, Uncategorized 2 Comments

relaxed acu dog

Dysafferentation

(don’t worry, that’s the biggest word in this article)

and the Gate Control Theory of Pain

 

The brain is bombarded with tens of thousands of pieces of information every second, information about body movement, input from the sense organs (eyes, ears, nose, etc.), from the internal organs, from thermal and chemical detectors… the list goes on and on.  88% of this information belongs to our subconscious; we are unaware of it.  Everything else, everything we sense, ponder, feel, and experience is only 12% of what the brain is processing at any given moment.  The combined input from our peripheral nervous system, both conscious and unconscious, is called afferent flow.

Not surprisingly, the brain needs to sort this information.  It filters, prioritizes and responds to what it has learned.  Once it has finished sorting, it transmits a response called efferent flow.  In approximate terms, for every 10 bits of afferent information the brain receives, it responds with 1 bit of efferent information.

Part of this sorting and prioritizing happens at the spinal cord level, before signals even reach the brain.  Information about movement flows up one type of nerve, and information about pain flows up another.  If information about both movement and pain happen at the same time, the two signals compete with each other to see who actually gets to project up the spinal cord to the brain.  This is known as the Gate Control Theory of Pain.

Because nerve fibres that convey information about body position are faster than the ones that convey information about pain, they usually win the battle to project up the spinal cord to the brain.  Therefore, the more information the brain receives about changes in body position, the less information it receives about pain.

dogs of the dogocolypse

The Four Dogs of the Apocalypse: Gluttony, Hyperactivity, Barking, and Stick Chewing

This is why you rub your leg after banging your shin; the sensation of skin being touched outpaces the sensation of pain and reduces the amount of discomfort perceived by the brain.  Similarly, this is why people who have an illness or injury might not feel too bad when they are up and moving about, but then once they just lie immobile in bed at night, they really notice their aches and pains.

The same goes for arthritic pets.  If all they do is lie on a blanket, then there is little information travelling to the brain to compete with the sensation of pain.  Dysafferentation is the word used to describe this imbalance in which the brain receives a large amount of afferent flow relating to pain, and little information about movement.  This triggers a downward spiral: reduced movement allows the perception of more pain, which makes the patient reluctant to move, which allows the perception of more pain, which makes the patient reluctant to move….

We’re used to the notion that “practise makes perfect”, that the more we repeat an action, the better we get at it, whether it’s catching a ball or balancing on a narrow beam.  This occurs because the nervous system is constantly rewiring itself for greater efficiency.  The problem is, this phenomenon happens at both a conscious and unconscious level.  In the same way that the nervous system can learn to catch a ball more efficiently, it can become more efficient at slouching, or at having a seizure, or at experiencing pain.  The more pain you feel, the easier it becomes to feel that pain.  This goes back to the downward spiral described in the paragraph above.

Both chiropractic adjustments and acupuncture needles trigger neurologic responses that help reduce dysafferentation, as well as provide temporary relief and the comfort needed to start moving, but the best way to prevent dysafferentation is to remain active.  Encourage your arthritic dog to participate in controlled exercise.  Distract them with activity.  Circulate that joint fluid to disperse inflammatory mediators.  Prescription pain control might be needed – whatever it takes to maintain activity.  The longer they keep active, the happier they will be and the longer their arthritic joints will last.

As was mentioned before in a previous blog on exercising old dogs, any exercise that doesn’t flare them up afterward was good for them.  If you are unsure of how much your dog is capable of doing, consult a professional with experience in developing rehabilitation exercise programs.