Juvenile Pubic Symphysiodesis- Hip Dysplasia

[baker_girl]

I'm writing in the hope that someone can shed some more light on my situation. I posted this thread also in the Health/Grooming section but thought to post in the Breeders section hoping for maximum traffic.

In the last few weeks our 18 week old pup Jet started displaying symptoms of swaying in his walk and hind legs. Yesterday we took preliminary steps in having him checked out by the Orthopedic Veterinary Surgeon. They checked his mobility and joints by slight manipulations. He displayed quite alot of pain in this examination and yelped and whimpered through this. They walked him to view his sway. The Vet's opinion that based on these initial observations the diagnosis could be Hip Displaysia. At this time we have now booked him in for an x-ray next Monday for a confirmation on diagnosis. At the time of diagnosis, should it be confirmed hip displaysia, our vet is then highly recommending we proceed with JPS. Based on their advice, we need to make a decision on the same day so that they can complete the procedure while the dog is already under anesthetic for the x-ray. Also JPS from my understanding is really only recommended for dogs up to the age of 20 weeks.

I will also add at this point, that we got Jet from a labrador breeder. He was the last dog in his litter. He did have a short tail which the breeder advised was x-rayed to see of possible issues. We were told that one or two vertebrae of the tail look to be missing but the vet's opinion is the dog is sound otherwise. We never saw the x-rays when purchasing Jet. We trusted the Breeders and his Vet's opinion on this matter. The fact the Jet had a shorter tail didn't bother me at all. I'm only mentioning this as I am now wondering if it could be pre-cursor or cause of another underlying condition?

I have contacted our Breeder to let him know of the situation as I believe he would have a vested interest. He is not supportive of the surgery and feels there are other symptoms to manage the condition. I guess to me this is where I am so torn. I want to make the right decision. Of course I don't want to put a dog this young through surgery unless it is absolutely necessary. From what I've been told and from what I've been reading on my own, I understand that this surgery can be successfull and seen as a proactive step in trying to treat HD? If I leave Jet and not go through with the surgery what are my options? Do I wait for his HD to progress and then manage the symptoms as they appear? I have a sister who has a large Rottweiler who has had two cruciate ligament operations and now has to manage his condition. He still can't walk well, his hips are now causing him pain, he can't play with other animals, he doesn't have a great quality of life. I don't want the same thing for my dog and really want to give him the best chance and not just have to manage the symptoms. I know there is no cure.

I am doing as much research as I can on the JPS procedure. I guess what I really want to know are what are the downsides and what can go wrong? I've read "It is effective, virtually complication-free, has minimal postoperative restrictions and is far less invasive and expensive compare to traditional surgeries". If I do this operation and it's not successfull, is the worst case scenario that I am faced with having to manage the condition as I would have had to in the first place? Will it hinder the prospect of any future treatment if this is not successful? Will it do more damage?

My breeder also does not speak highly of my vet and feels they are pressuring me into this. He feels they too freely advocate aggressive surgery and this is not his choice. Fair enough. This is a whole other issue and I am not taking this decision lightly. I can only base my decision with the information I have received and have to put a certain amount of trust with my vet. I have had no problems with them previously and feel they have been outstanding in the service they offer me.

I have tried to book in with another vet for a second opinion however the vet recommended by my breeder cannot see my until early next month. As I said earlier, the vet would like to try and do the surgery on the same day if we decide to go ahead due to him already being under anesthetic and due to the window of time recommend this surgery be done in.

Sorry for the long post. I am really trying to seek out advice and opinions here. Of course everyone has a different school of thought and I know alot of people probably won't agree with the surgery. I understand this is viewed as quite a controversial topic. This is why I'm here, for advice but not for a public flaming

Any information greatly appreciated.

Thanks.

[Turkey Trip]

Good grief I know nothing about breeding Labradors and may be out of my depth here, but this is an 18week old baby!

Baby puppies of all breeds go through many kinds of stages as they grow - sometimes parts of their skeletal structure goes out of balance as one area grows at a different pace to another, but give them time to finish growing and it all balances up and comes good again in the adult dog. (Or growing foal-horse, this applies to them as well.) The body grows at different rates in different areas and for a while, this can and does affect appearance and movement of the gawky baby.

I would not allow the type of Veterinary examination your youngster has endured - that in itself could be harmful to its young joints and tender emotional development. I once had a young & over-enthusiastic vet roughly go over my young pup's hindquarters "looking" for HD with unrequired and IMO useless manipulations, it hurt, it also freaked the youngster out on his first vet surgery visit and he remembered that examination for years and remained uneasy in similar situations. (& BTW he was hip-scored as an adult for hip score 0:3 and is still fully sound as a veteran.)

If you are concerned about HD, hips can and should be checked via x-ray once the dog has fully stopped growing. Until that time the skeletal joints and long bones are in a stage of development - the hip joint in particular is made up of multiple bones and these mould around the head of the femur as the puppy grows. It is a dynamic process and you are still "watching" a work in progress.

Personally if it was my pup I would simply feed him a nutritionally balanced diet but keep him fit and lean, allow him natural play and give the poor fellow time to finish growing. Wait and see. Nature works in her own way in her own time.

Not a believer in aggressive intervention and surgery, especially at this young age.

Just my very unqualified opinion, but based on decades of observing and raising dogs and a few horses.

[BRUVIC]

Totally agree with ur breeder and Turkey Trip ... even if urs or ANY dog of a breed where HD goes 'with the territory', DOES have a degree a hip dysplayia (and most do, unless they are scored 0/0, which VERY few are!!), said dog, if kept lean and mean and fit ... sand work and swimming the best ... the dog can live a VERY good life even on a lousy set of hips ... WITHOUT surgical intervention!! I'd be cranky with a vet that is doing all this stuff with a BABY too!! This is maximum growth stage and they should be left alone to GROW and develop ... they are like a gawky teenage boy at this age and all ligamententation is looser than normal to allow for the upward growth, so OF COURSE they are LOOSE. Not ur fault as a caring owner, but no-one knows the breed like the breeder!! I am not a Lab breeder, but as a GSD breeder, we have similar scenarios.

[baker_girl]

Good grief I know nothing about breeding Labradors and may be out of my depth here, but this is an 18week old baby!

Baby puppies of all breeds go through many kinds of stages as they grow - sometimes parts of their skeletal structure goes out of balance as one area grows at a different pace to another, but give them time to finish growing and it all balances up and comes good again in the adult dog. (Or growing foal-horse, this applies to them as well.) The body grows at different rates in different areas and for a while, this can and does affect appearance and movement of the gawky baby.

I would not allow the type of Veterinary examination your youngster has endured - that in itself could be harmful to its young joints and tender emotional development. I once had a young & over-enthusiastic vet roughly go over my young pup's hindquarters "looking" for HD with unrequired and IMO useless manipulations, it hurt, it also freaked the youngster out on his first vet surgery visit and he remembered that examination for years and remained uneasy in similar situations. (& BTW he was hip-scored as an adult for hip score 0:3 and is still fully sound as a veteran.)

If you are concerned about HD, hips can and should be checked via x-ray once the dog has fully stopped growing. Until that time the skeletal joints and long bones are in a stage of development - the hip joint in particular is made up of multiple bones and these mould around the head of the femur as the puppy grows. It is a dynamic process and you are still "watching" a work in progress.

Personally if it was my pup I would simply feed him a nutritionally balanced diet but keep him fit and lean, allow him natural play and give the poor fellow time to finish growing. Wait and see. Nature works in her own way in her own time.

Not a believer in aggressive intervention and surgery, especially at this young age.

Just my very unqualified opinion, but based on decades of observing and raising dogs and a few horses.

Hi,

Thanks for responding.

We definately have kept in mind it's not uncommon for pups to go through growing pains. In regards to the kind of examination our dog has gone through- What would you suggest we have done? I've been told to get thorough examinations and an xray to get a proper and well informed diagnosis of his condtion. Without that, I would assume some people would consider that I have not done all I can to diagnose his condition properly.

I have read and I'm quoting here:

"Whereas this is regarded as an inherited disorder, recently it has been shown that it develops during the first weeks or months after birth. Consequently hip dysplasia may be regarded as congenital or developmental. Developmental hip dysplasia is also referred to as environmental HD. HD is common in many larger breeds of dogs however many breeders have worked hard to reduce the incidence of HD in their dogs. This has been achieved by having their dogs X-rayed and scored for hip dysplasia when they are young and before they are bred."

"How do I know that my dog has HD?

Some dogs have HD and they go through life without showing much of a problem until they develop osteoarthritis (OA) when they are much older. Other dogs show signs when they are much younger around 16 weeks of age."

The above was from a holistic vet that uses alternative therapy to surgery. So my point is, I believe HD can be diagnosed at an age of 18 weeks.

We won't be making this decision lightly if he is diagnosed. Either way he will be facing a lifetime of management of his condition. Even if we do go ahead with the surgery, we will still need to manage his weight and exercise to make sure we don't undo what can be achieved with this procedure.

Thanks.

[Kostalot]

Get a second opinion I believe should be your first move. Some vets are far too quick to recommend surgery when in fact it is not required and will not improve the dog's quality of life. I am sure your breeder would be happy to recommend another vet or preferably orthopaedic specialist?

[baker_girl]

Hi,

Yes, I've made an appointment for a second opinion for this afternoon. I've made it with a holistic, alternative and chiropractic vet. So I will see what his opinion is. I feel much better in doing this.

[Andisa]

Hi,

Yes, I've made an appointment for a second opinion for this afternoon. I've made it with a holistic, alternative and chiropractic vet. So I will see what his opinion is. I feel much better in doing this.

That's good to read - I would imagine the first thing they will recommend is raw natural diet and supps. with physio.

Good luck and hope you have a more positive report from them than the 1st vet and fingers crossed no invasive surgeries will be necessary.

[Tarmons]

Please follow the advice of your breeder. Wait until you have received a second opinion.

Your puppy is only 18 weeks old. Some Vets are too quick to diagnose HD Juvenile Pubic Symphysiodesis for a baby puppy that is still growing and will be loose until it finally tightens up in its joints and ligaments.

The suggested surgery may end up doing more harm to the on-going skeltal development of your puppy than good.

[baker_girl]

Please follow the advice of your breeder. Wait until you have received a second opinion.

Your puppy is only 18 weeks old. Some Vets are too quick to diagnose HD Juvenile Pubic Symphysiodesis for a baby puppy that is still growing and will be loose until it finally tightens up in its joints and ligaments.

The suggested surgery may end up doing more harm to the on-going skeltal development of your puppy than good.

Thanks Tarmons.

I guess your above statement is exactly what I'm trying to find information on. The specifics. What harm can come of this procedure. I'm waiting for a call back from the specialist who has recommended this procedure and also will ask when I see the other Vet today.

[Tarmons]

Please PM me.

[ozwildflower]

I'm hoping your appointment with the 2nd opinion vet has gone well. The only pup I have known to have major surgery that young was one that had a serious injury and shattered the bone when it fell off a very high verandah (not mine, but friends pup). 6 years later that dog is still having fun on the farm but is on daily medication.

That brings me to my other point. Pups of this age often hurt themselves when playing..keep them quiet for a day or two and 'voila' happy pup. Good diet a must as others have said..in fact, I agree with everybody. I have standard poodles, and I'm sure it is the same with most large or larger breeds - be careful of how much they exercise when young and try and avoid racing up or down steps when playing.

Let us know how you've gone with your appointment.

Good Luck!

[Fordogs]

Please do a search on this site regarding JPS surgery and please DO NOT LISTEN TO YOUR VET RE THIS ISSUE.

I am too emotional about this surgery and already had issues with vets on the subject. Some vets will really try very hard to push the surgery onto young puppies before they are 20 weeks old.

PLEASE DO NOT TAKE NOTICE UNLESS YOU HAVE SEEN A SPECIALIST FOR A SECOND OPINION !!!!!!!!!!!!!!!!

[baker_girl]

Please do a search on this site regarding JPS surgery and please DO NOT LISTEN TO YOUR VET RE THIS ISSUE.

I am too emotional about this surgery and already had issues with vets on the subject. Some vets will really try very hard to push the surgery onto young puppies before they are 20 weeks old.

PLEASE DO NOT TAKE NOTICE UNLESS YOU HAVE SEEN A SPECIALIST FOR A SECOND OPINION !!!!!!!!!!!!!!!!

Hi Fordogs,

I have done a search on this forum and can only find two articles classified under JPS.

I went and had a second opinion this afternoon with another vet. A chiropractic alternative treatment vet. He was thorough. Initially he did say that from his observations of how our pup was walking, it was a slight concern. From there he did his physical exam and manipulations. His checks were very extensive and I felt confident from what I saw with my limited knowledge of the condition. Our pup did not display any pain and seemed comfortable. He did say that his left hip seemed to have more laxity than the other. He did discourage us to have the surgery, however I expected this. He also though, suggested we don't have the xrays at all either as he felt the vet would pressure us. He feels my dog does not have signs of HD.

I am less inclined to go ahead with the surgery. However I was still considering the xrays to at least have a more informed picture of the state of his hips.

Another member on DOL contacted me and offered some advice. Coincidentally she had visited the exact same vet and Dr as the one of my second opinion. Her experience with this vet is almost exactly the same as mine. She too was told that her dog did not have HD after her pup was displaying symptoms. However 2 years later the dog has now been positively diagnosed with HD. My only concern is that like my regular vet, this second opinion comes highly biased with his opinion on the correct method of treatment?

I wonder if I should still have the xray.

[Fordogs]

Baker Girl, click on my user name and you will find a number of posts regarding JPS. After selling a couple of puppies to ACT I researched JPS and most clinics use USA data for their reference BUT here in good old OZ we are more vigilante in health testing than in USA. The puppies I sold to ACT were PENN hip x-rayed and found to be very good BUT the vets still recommended doing the procedure simply because they were LARGE BREED PUPPIES so BEWARE and be sure to get a second opinion PRIOR TO HAVING A MAJOR PROCEDURE PERFORMED ON YOUR PUPPY.

[SkySoaringMagpie]

Baker girl before having surgery of any kind I would get an opinion from a well respected orthopaedic veterinary specialist. As you have found out, sifting through veterinary advice is hard when you have vets trying to over-treat and vets with biases about natural remedies. A true specialist tho' is where I would go because apart from anything else, if I do have to put a dog through that kind of surgery I want the best.

We did this years ago when our Afghan puppy was diagnosed with a skeletal development disorder and the local vet was saying "surgery, now!". We drove to Sydney and saw Tony Black. We were concerned about putting a young puppy through a such big operation so young. Tony did xrays, accurately diagnosed the problem (and there was a problem) but he advised AGAINST surgery. It was an expensive consult, but it saved us a whole heap of trouble and unnecessary pain for the puppy and expense for us.

We still have the dog and he is active and happy 7 years later.

Edited April 17, 2010 by SkySoaringMagpie

[zenchel]

Also please read the following - it is a direct cut and paste from the PennHIP web site:

"My vet has advised a surgical procedure to avoid the development of arthritis in my dog later in life based on the results of his PennHIP examination. Should I have my dog operated on?

Answer:

Until appropriate randomized and controlled clinical trials are designed and conducted, it is premature to use the Distraction Index as an indication for hip surgery, either remedial or preventive. At present several different surgical procedures (Triple pelvic osteotomy, Juvenile symphysiodesis) have been advocated by some veterinary surgeons to prevent the development of arthritis (degenerative joint disease) later in life in dogs with excess joint laxity (loose hips). None of these procedures have undergone scientific clinical trials that have proven THEIR EFFICACY in preventing the onset or slowing the development of arthritis in dogs with hip dysplasia. Although WE ARE not fundamentally against the use of preventative surgical management of dogs with excessive hip laxity, WE FEEL THE WHOLESALE CLINICAL USE OF PURPORTEDLY PREVENTIVE SURGICAL PROCEDURES BEFORE ADEQUATE TESTING IS CONDUCTED, IS UNJUSTIFIED. WE ADVISE CAUTION! It may be that in the future when good evidence exists to support the efficacy of these procedures their use will be encouraged"

Sylvia

[Fordogs]

baker girl,

If you go to the Breeders Community way back on 23/02/09 you will find the topic I started back then.

At that time Dogs NSW promised the do an article on it BUT as yet it has never happened, if it had maybe it could have save quite a few puppies from having an unnecessary procedure done.

[baker_girl]

Hi,

Thanks to everyone for the responses so far.

At this point we've decided not to go ahead with the surgery. We are also not going to get xrays at this point because we feel it won't change our decision about the surgery so there is no point. In 2-3 months we will take our pup back to either the chiro vet or osteo specialist at our regular vet and if they feel he is not developping at the normal stages for his age we will get xrays.

We are hoping that his akwardness and his swaying walk is just a puppy stage he is going through. He is a pretty big boy for 18 weeks and I think has a bit of growing left so we will see.

[wayrod]

Hi,

Thanks to everyone for the responses so far.

At this point we've decided not to go ahead with the surgery. We are also not going to get xrays at this point because we feel it won't change our decision about the surgery so there is no point. In 2-3 months we will take our pup back to either the chiro vet or osteo specialist at our regular vet and if they feel he is not developping at the normal stages for his age we will get xrays.

We are hoping that his akwardness and his swaying walk is just a puppy stage he is going through. He is a pretty big boy for 18 weeks and I think has a bit of growing left so we will see.

It is still early days but in USA they are trying stem cell therapy to aid dogs that suffer from hip dysplasia, arthritis and similar complaints. Admittedly in its early days so information is scarce and the lifecycle of the treatment is unknown but information in the clip indicate that the subject dog has improved with the use of stem cell therapy. Details have been documented of hip dysplasia GSD on you tube below:

Hopefully documented scientific documents will be available so that vets in Australia may also possibly see advantages. Note many vets in Australia will not look at this option currently until documented scientific papers are available yet they state to owners that they should have TPO or JPS at that time or miss the "window of opportunity" with little scientific evidence to support their advice.

Also with hip scoring, if hip scoring is optional for undertaking and reporting then the possibility is that more dogs are tested but their results are not included if they have a higher than "normal" averages thus giving a false "breed average".

If it was compulsory that hip scoring occurs and is reported, a clearer picture of the breeds overall performance on hip dysplasia is known. In fact in the short term the breed average may rise significantly, due to previously unreported dogs being added to the scheme. Imagine dogs that previously had unreported scores in the twenties or thirties or even higher being added to the scheme.

Getting all the breeders and owners to agree to such a request is the hard part.

[Fordogs]

Wayrod, you give no indication of where you are but here in OZ especially if you own a GSD you do have to have to provide proof of hip and elbow results of sire and dam in order to register a litter. TOO BAD all other large breeds don't have to follow suit.

Yes I do know that MANY do this voluntarily but it should be compulsory as with GSDs. ( Sorry if I have offended anyone as I am not sure as to other breeds and regulations).

Edited April 17, 2010 by Fordogs