Achieving Balance and Harmony

DOG CARE

Treatment Options for Hip Dysplasia

Written by Dr. Sherry Weaver

Our dog has very bad hip dysplasia. Bruno has just turned six years old, and his hind end is almost completely lame. Do you have any suggestion to help me?

We have already started him on glucosamine, joint relief, and rejuvenation vitamins. I just hate to see him suffer. I don't think that he is in a lot of pain; it is just that it takes him five to six tries to get up. He really loves to play with his Frisbee and can not run after it anymore. Please help me. We are just not ready to say good bye to him. We love him so much, so we need to help him in any way possible.

Thank you for your help.

Karen Feikema
Ontario, Canada

Dear Karen,

Supplements and vitamins are very helpful adjuncts to treating mild arthritis, but they are only somewhat useful in severe arthritis. Mainly they are helpful in slowing the progression of arthritis. First, if you haven’t already, I would urge you to be sure that the diagnosis is arthritis by x-raying the hips. Back problems can resemble arthritis very closely and are treated very differently.

If we are sure that the diagnosis is dysplasia with secondary arthritis, then the inability to get up is related to pain with many treatment options. Dogs with chronic pain usually don’t cry in pain. Think of a person you know with arthritis pain. Do they cry when it hurts? No, usually they are just slower to move, which is what you are seeing in your dog. A dog with arthritis, which is not enjoying Frisbee anymore or can’t get up, is in pain.

The good news is that, with this sort of life-altering pain, there are some very exciting options for improving quality of life. There is a whole new group of nonsteroidal anti-inflammatory drugs (NSAID’S) on the market specifically targeting arthritis pain control. These drugs are not without side effects, but they are minimal when compared to the improvements in quality of life and nothing when compared to the side effects of drugs like aspirin. Your vet is the best one to help you decide which medications to use, but here are a few examples.

Rimadyl (a NSAID) has been used for years to control arthritis pain with minimal side effects and is now available in a generic, so it is very cost effective. There have been some very rare liver diseases linked to this drug, so blood values should be monitored. Deramax, Zubrin, Etogesic, and Previcox are other similar drugs that are available.

Neurontin is a very exciting drug for chronic pain. It is mildly sedating but otherwise has almost no side effects, even into higher doses. The disadvantage of neurontin is that it takes a week or so to start to work, so it cannot be given as needed. This is usually okay in chronic arthritis since it is not very expensive. Neurontin can be given with the group of drugs above.

Tramadol is another drug that I have used that has really gotten dogs back on their feet and chasing Frisbees. It also sedates very mildly but has very few other side effects, is extremely cost effective, and can be given with other medications.
      
There is a strong movement in our culture against anything classified as a “drug”. I myself don’t take or prescribe medications any more than I have to. In the case of a dog who is no longer enjoying life, however, I feel that it is worth almost anything to give them back the enjoyment of life as long as possible.

In discussing hip arthritis (secondary to dysplasia), I would be remiss if I did not discuss the surgical options that are available. Total hip replacements are becoming more and more common and, when successful, are just as life-changing in dogs as in people. These surgeries are relatively expensive, but, if they are at all a financial possibility, they are well worth it. There is also an older surgery called an FHO that is usually much more cost-effective but still makes a huge quality of life difference. (This surgery is only appropriate in certain dogs and does involve a long course of intensive physical therapy.) 
       
The best thing is to discuss these options with your vet or local veterinary orthopedic surgeon. They will help you to decide which approach is right for you.

Dr. Weaver

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