Hip dysplasia (also called HD) is a very common orthopedic abnormality
in our popular large-breed dogs. It also occurs in some medium-
and small-breed dogs and in some breeds of cats. Dys means “bad”;
plasia means “formation”. Thus, “hip dysplasia”
means “badly formed hip”. A dysplastic hip joint is
too shallow.
The cup-like socket in the pelvis normally has the width and depth
of a half-sphere. The round head of the femur (thigh bone) fits
snugly into this socket where it is firmly held in place as the
hind leg moves and rotates. In a dysplastic hip joint the pelvic
socket is shallow, and so the head of the femur rides in and out
of the socket. Due to the shallowness of the hip joint, the animal
with HD will often, though not always, have more of a swaying
movement in the rear.
This constant movement wears down the cartilage that normally
overlies the bony surfaces of the joint, sooner or later causing
bone to rub on bone. This causes inflammation within the joint,
and this as well as other factors leads to a decrease in joint
fluid, further interfering with smooth and pain-free movement
The body reacts to the excessive joint movement and wear-and-tear
by altering the contours of the femoral head and neck, thickening
the neck and flattening the head. Extra bone is laid down around
the edges of the pelvic socket. Even though the “intent”
of these bony changes is to stabilize the joint, the changes further
interfere with smooth movement. An animal with these changes would
be said to have degenerative joint disease, or DJD in the hips.
(In the following paragraphs I will only refer
to dogs, even though cats can have HD, too . However, due to their
lighter weight, HD doesn’t tend to be so crippling a condition
in the feline as in the canine, so it is a condition far less
frequently seen for treatment in cats..)
2.)
What causes hip dysplasia?
We don’t yet have all the answers to this question. We do
know there is an inherited tendency (genetic predisposition) in
certain breeds and in certain lines within these breeds. The exact
way hip dysplasia is transmitted genetically is still being investigated.
Very roughly speaking, if both parents of a puppy have HD, the
pup will almost certainly have it as well. Even in only one parent
has HD the puppy probably will have it. However, a pup from two
parents without HD can still develop it; this is because the parents,
even though free of the symptoms themselves, still can transmit
the tendency or predisposition to that offspring.
Among the breeds currently most likely to have HD are the Golden
Retriever, Labrador Retriever, and Rottweiler. The first two are
among the most popular breeds in this country today, so it’s
not surprising that we see so much of this condition. Other large
breeds, and some not-so-large, also have tendencies toward HD.
Other theories, such as nutritional deficiencies and/or imbalances,
muscular abnormalities, spinal problems, etc, have been put forth
to explain how HD comes about. It is almost certainly a multi-faceted
condition, so its detection and eradication are not simple but
very complex.
3.) How do I know if my puppy/dog has hip dysplasia?
At this point, the only widely-acknowledged way is with radiographs
(X-rays) of the hips. Sometimes sedation or anesthesia is needed
to take the radiographs, for positioning needs to be fairly exact
to get accurate results.
Radiographs can be taken as early as a few months of age, for,
unfortunately, in some puppies HD shows up this early. However,
it also can show up later in life. Therefore, if early radiographs
are negative your dog may still need to be re-radiographed when
older. Some dogs don’t show signs until 2 years or even
older.
There is a foundation called the Orthopedic Foundation of America
(OFA). OFA experts will evaluate radiographs and determine if
they show that a dog has HD. If they decide HD is present, they
will grade it according to severity. They are invaluable to anyone
who wants to breed a dog from a breed prone to HD. Ideally, no
dog with any signs of HD should be bred, but since this would
leave many, many dogs out of the breeding picture in some of our
popular breeds, at least only those with mild HD should be used.
Of course, as we mentioned above, even dogs with no signs of HD
can still pass it on to their offspring, so this is a relatively
crude method. As we become more knowledgeable and sophisticated
about the inheritance of HD we’ll be better equipped to
work toward eliminating it.
The final, and perhaps most important, factor in eliminating HD
is the courage and far-sighted integrity of those breeders who
must remove from their breeding program otherwise excellent dogs
who could pass on HD.
4.)
What is Spondylosis?
Spondylosis is another common bony condition which affects the
spine of many dogs and cats. Radiographs of animals with spondylosis
show bony spurs reaching out from the body of vertebrae. As time
goes by, the spurs from neighboring vertebrae meet and merge,
making bony bridges between vertebrae.
The body forms the spurs which turn into bridges in order to stabilize
the area between two neighboring vertebrae. Instability between
neighboring vertebrae causes damage to the spinal cord and spinal
nerves as well as surrounding muscles and other soft tissues.
If this instability goes on long enough, serious damage and disability
can occur, so the body attempts to remedy the situation by bridging
the gap between vertebrae with bone. Unfortunately, the bony bridges
themselves can further interfere with and damage the nerves and
other surrounding soft tissues. If spondylosis becomes advanced
enough, the spine becomes a solid, fused mass of bone rather than
the flexible entity it was meant to be.
5.)
What causes Spondylosis?
At this point in time, we don’t know all the causes, but
factors which certainly contribute include genetic predisposition,
obesity, injuries, other orthopedic problems, poor diet, and over-
or under-exercising.
6.)
What are the symptoms of Spondylosis?
The most common signs are stiffness, difficulty in getting up
or down, difficulty in jumping, lameness, pain, and sometimes
knuckling or dragging of the feet.
7.)
Can animals have both Hip Dysplasia and Spondylosis?
They most definitely can. In fact, the abnormal postures an animal
with Hip Dysplasia is forced to take can be a major factor in
causing the instability in the spine which lead to Spondylosis.
However, some animals with Spondylosis have normal hips, so HD
is not a prerequisite for Spondylosis.
8.)
How can an animal with Hip Dysplasia and Spondylosis be helped?
There are two approaches: the traditional (Western) way and the
alternative way. Traditionally, drugs and or surgery are used
to treat these two conditions. The former include steroidal or
non-steroidal anti-inflammatory drugs, muscle relaxants, and pain
medication. The latter would include surgery to stabilize the
spine or to replace the hip joints.
Since there can be unwanted side-effects with the traditional
approaches, more and more people now are seeking the alternative
ways. Acupuncture and chiropractic are probably the most common
alternative treatments now being utilized.
9.)
How do acupuncture and chiropractic help animals with Hip Dysplasia
and/or Spondylosis?
Let’s first discuss acupuncture. After over 20 years of
investigation in the West, we know that acupuncture stimulates
nerves, relieves muscle spasm, and increases blood circulation,
as well as causing the release of endorphins (for decreasing pain)
and cortisol (for reducing inflammation).
From a Traditional Chinese Medicine (TCM) point of view, interruption
in the normal flow of energy throughout the body leads to degenerative
conditions like HD and Spondylosis. The stimulation of various
points on the routes (called meridians) along which the body’s
energy flows helps to restore this interrupted flow of energy
. The return of a more natural energy flow helps to reverse some
of the degenerative processes so that more normal function can
return and pain can be relieved.
Fine needles are most commonly used to stimulate the acupuncture
points, but pressure, laser or other high-intensity light, electrical
stimulation, and a healing herb treatment called moxibustion can
also be used. Most dogs don’t mind acupuncture; in fact,
as time goes by and they realize the treatments make them feel
good, they even look forward to them!
HD and Spondylosis respond very well to acupuncture; in my experience,
80-90% of the patients with HD and/or spondylosis improve with
acupuncture. Another wonderful thing about acupuncture is that
it utilizes the body’s own healing forces. It doesn’t
have the serious side effects sometimes seen with drugs and surgery.
Animals receiving acupuncture seem to generally feel better and
have more overall energy and interest in life.
How does chiropractic care help? When a dog has Hip Dysplasia
and/or Spondylosis, the pain and abnormal anatomy of these condition
changes the way the animal moves, stands, sits, and lies. This
causes an adverse effect in the rest of the skeletal/muscular/nerve
structure since they’re all connected to each other in the
body. Sooner or later there are associated problems in the rest
of the back, neck, the shoulders/front legs, as well as other
joints in the hind legs. The spine is thrown (further) out of
alignment; muscles go into spasm. Nerves are impinged on.
Chiropractic adjustments of the bones serves to put these back
into their proper places so more normal function can be restored
and pain reduced. When the bony adjustments are combined with
work on muscles to reduce spasm, the positive results are even
more enhanced, and improvement is more likely to be maintained.
When acupuncture is combined with chiropractic, the results are
synergistic; that is, they each enhance the other treatment.
10.)
How frequently, and for how long, would my animal need these treatments?
The effects of acupuncture and chiropractic tend to be cumulative.
If a condition has come about over several months or years, you’re
unlikely to see instant improvement. It usually takes several
treatments to see noticable results.
The treatments are fairly close together at first. Then, as improvement
comes about, the times between treatments can be increased. Treatments
can be done several times a week to begin with. However, due to
time and budgetary constraints, most people elect weekly treatments
at the beginning.
Some animals do show improvement after the first treatment. By
the third or fourth treatment the majority of animals show definite
improvement. If the improvement lasts the entire week between
treatments, then time between treatments is stretched out to every
week-and-a-half to two weeks, then three weeks, four weeks, etc.
(If not, weekly treatments are continued until the improvement
lasts the entire week.) Eventually, the animal comes in just when
they are getting stiff/painful again.
Hip
dysplasia