Need Advice. Audible Clicking In Hips.

[baker_girl]

Hi All,

As stated, I have previously posted about my Labrador Jet. At the time he was 19 weeks old and recommended to have pelvic surgery to fuse the joints together to try and prevent hip dysplasia. We took him to an alternative chiropractic vet for a second opinion. He did a thorough examination and based on his advise and from what we saw when examined we decided against the surgery.

Fast forward to now and Jet is 10 months old. We have been keeping a close eye on him and have been giving him joint supplement as the only management to his possible condition. However in the last several months we have noticed an audible clicking in his hips and can also feel the clicking movement when we put our hands on his rear as he walks. He shows absolutely no signs of pain and is a happy energetic dog who loves to run. We took him back to the chiro vet recently for another assessment and on conclusion he did say that Jet's left joint had more laxity than the right and less muscle build up. His advice was to continue with the joint formula, also put us on fish oil, we also give him Vitamin C powder and told us to introduce a swimming regime into his exercise.

It's only been a month or so but we've seen no improvement. The chiro vet has not diagnosed anything at this stage however I do believe there is an underlying issue. The clicking of his hips just doesn't sound right as does the movement I can feel when I touch him. We are most concerned that this is going to develop into something much worse and he will be in pain as he gets older. I want to try and do what I can now to help him but I'm really not sure what else we can do?

I've been suggested by the trainer where we take Jet to do hydrotherapy to seek a natural therapist who works on his tendons and muscles to relieve tension which could also be an underlying issue. I'm wondering if anyone has had experience with this sort of treatment and if it has helped?

We are coming to terms with the fact that later in life Jet may need more aggressive treatment and/or surgery if this does develop or get diagnoses as hip dysplasia.

Any advice or similar experiences would be greatly appreciated.

[Rappie]

I would have hip radiographs taken to get a diagnosis of hip dysplasia if it is present (palpable laxity in the joints is highly suspicious).

At 10 months, there is still a small window of time for a triple pelvic osteotomy to be done to correct anatomical alignment of the hip joint. However, this is a specialist procedure and is not appropriate for all dogs as it is dependent on age, hip structure and degree of degenerative changes in the joint.

Otherwise treatment and management relies on maintaining a lean body weight, moderate exercise, nutritional supplements for joint health, supplementary treatments such as Zydax / Cartrophen injections and pain relief as appropriate (not all dogs will require this).

If these measures are not sufficient then dogs become candidates for other surgical procedures like hip replacements or denervation procedures - which one really depends on whether pain or joint dysfunction is the primary problem.

I'm by no means suggesting surgery is the only way to manage dogs with hip dysplasia, but I would strongly reccomend having radiographs done so at least you know what you are dealing with, and what to expect in the future.

[baker_girl]

I would have hip radiographs taken to get a diagnosis of hip dysplasia if it is present (palpable laxity in the joints is highly suspicious).

At 10 months, there is still a small window of time for a triple pelvic osteotomy to be done to correct anatomical alignment of the hip joint. However, this is a specialist procedure and is not appropriate for all dogs as it is dependent on age, hip structure and degree of degenerative changes in the joint.

Otherwise treatment and management relies on maintaining a lean body weight, moderate exercise, nutritional supplements for joint health, supplementary treatments such as Zydax / Cartrophen injections and pain relief as appropriate (not all dogs will require this).

If these measures are not sufficient then dogs become candidates for other surgical procedures like hip replacements or denervation procedures - which one really depends on whether pain or joint dysfunction is the primary problem.

I'm by no means suggesting surgery is the only way to manage dogs with hip dysplasia, but I would strongly reccomend having radiographs done so at least you know what you are dealing with, and what to expect in the future.

Thanks for your reply Rappie.

At 10 months, would he be far enough developped to now get a good indication of any condition through radiographs? I'm happy to do this. I've been told previously it is hard to diagnose a condition until a dog is fully developped. Not sure how accurate this is and if a 10 month old is considered fully developped?

[aussielover]

Apparently Pennhip scoring can be done from 4 months of age.

Although it doesn't give you a diagnosis of HD, it can be an indicator for likelihood of hip problems later in life.

If I were you I would definitely be getting radiographs done. The clicking noise is abnormal and warrants further investigation.

HD had been diagnosed in dogs younger than 10 months.

Anywya, finger crossed for a good outcome for you and Jet

[persephone]

I would also advise getting Xrays done.. by someone experienced in specifics like HD . That way , anything obvious can be addressed before any more damage is done ..and you will have more information on which to base decisions.

best of luck with it ...

[Staranais]

I will be interested to hear what Rappie has to say.

But I strongly suspect that if you get the OFA rads done at 10 months old and there is already bony degenerative change in the hip (DJD = the results of H.D), then it's only going to get worse if you leave it.

[baker_girl]

Thanks for the replies so far.

I've contacted both the original vet who firstly recommended the pelvic fusing surgery and the chiropractic vet who also sees our dog.

I'm not sure now, which vet would be best to get the xrays done by. Not that I don't trust either but I want an honest, unbiased opinion of the possible condition once xrays are done. Both these vets have been great but I feel both these vets are on complete opposite tangents to each other, one that may suggest surgery and then the other who will recommend every possible alternative treatment first. I'm a bit confused about who to seek further treatment from now.

[Staranais]

If it were me, especially if I didn't know which vet to trust, I'd go to a specialist to get the rads read.

I went to a specialist when my young pup got shoulder OCD (a developmental joint disease). We had a specialist radiologist interpret our rads, & a specialist surgeon did the surgery. I was lucky to get a bit of a discount, but even if I hadn't it still would have been money very well spent.

Edited November 1, 2010 by Staranais

[baker_girl]

If it were me, especially if I didn't know which vet to trust, I'd go to a specialist to get the rads read.

I went to a specialist when my young pup got shoulder OCD (a developmental joint disease). We had a specialist radiologist interpret our rads, & a specialist surgeon did the surgery. I was lucky to get a bit of a discount, but even if I hadn't it still would have been money very well spent.

Hi Staranais.

Thanks for the advice. I'm not even sure where to find a specialist or ask for a recommendation but I'll try and do some research today and find out.

[Staranais]

I'm sorry, I don't know where in Queensland you'd go either. Perhaps your regular vet can refer you. & if there's a Vet School in Queensland, they probably either have specialists or will know where they are?

[OSoSwift]

I would get xrays and see if you can get them read by a specilaist. UQ should have specialists there.

[Rappie]

For the purposes of identifying abnormalities then the rads can be taken at any age. If you have a vet locally that is PennHip accredited then those results can be useful, but if there is palpable laxity then the standard extended hip view and a thorough examination under anaesthesia should be sufficient.

Once they are taken, you can request a specialist opinion - either from a radiologist (they can be posted or submitted online if digital images are taken) or from a surgical specialist. People in your local area could advise your of their recommendations.

[Fordogs]

For me I would suggest that you wait until your puppy is 12 - 15 months old and then have xrays and send them off to Dr Wyburn for assessment. Many puppies of even 6 - 12 months old can have laxity and clicking as they develop as long as they are not showing any lameness I would not stress too much until you have then assessed by a specialist.

JMHO I would not do Penn Hip as very few vets are capable of assessing them.

Edited November 1, 2010 by Fordogs

[Rappie]

JMHO I would not do Penn Hip as very few vets are capable of assessing them.

The vets that take PennHip rads are not supposed to be assessing them. Clients who have PennHip rads taken should be signing a form that says they agree that if PennHip rads are done, they MUST be sent off to be assessed formally no matter what the results. The vet might take them and say they look good, bad, whatever but that is not the end of the process.....

[labsrule]

You need to get xrays done and I would take him to either a Specialist Orthopaedic Surgeon for this or a vet very experienced in taking xrays for hip scoring for breeders and and if you are in the same area as your breeder then they will be able to recommend a vet who does xrays for their dogs for hip scoring. It is so important to get these xrays done by either the Specialist Orthopaedic Surgeon or the hip scoring xray experienced vet, as not all vets get the dogs in the correct position for the required xrays and if they don't, then an incorrect diagnosis can result.

I can understand your breeder's concern about surgery being recommended, as unfortunately too many times it is recommended as the preferred option even if "mild HD" is diagnosed. Breeders have many experiences with their puppy buyers being advised/recommended all sorts of surgical options by the puppy buyers vets/specialists which in the opinion of the breeder is unnecessary and it is quite normal for a freaked out puppy buyer to take their vet's/specialist word as gospel over the breeder. However, if your breeder is a very experienced and reputable Labrador breeder, then I would advise you to take into account what they say/recommend.

Getting xrays done should be your priority as then a diagnosis can be made as to whether or not your dog has HD and if so, what severity of HD (mild, moderate or severe). IMHO surgery should not be a recommended option if a diagnosis of "mild HD" is made as this can be managed medically with proper diet, exercise, supplements, anti-inflammatories, and pain relief if required. If the diagnosis is moderate or severe HD then surgery may be an option that you may need to explore and discuss your options with a specialist orthopaedic surgeon. With regards to the TPO (Triple Pelvic Osteotomy) that has been mentioned previously, there is a window of opportunity up until your dog is 12months old if your dog is diagnosed as a candidate for this type of surgery.

You are probably feeling a bit overwhelmed and distressed about your boy possibly having HD, so it is important to rule it out/in by having the xrays done. In addition, I would also recommend that you look at his nutrition/weight/exercise to make sure he is not overweight or overexercised and put him on joint supplements if he is not already on some as this all plays a part in preventing joint damage. I am fanatical about my lab pups nutrition/weight/exercising in their first 12months particularly, to ensure that their joints grow and develop normally. This includes minimising the jumping around that lab pups do as we all know they can be pretty crazy full of energy jumping beans and I won't let any other dogs jump on them during play either.

Best wishes for a positive outcome and hope it goes well and just remember there are options if he is diagnosed with HD and even if he does have HD, your options will depend on the severity of the HD. Keep us updated

[baker_girl]

Hi Everyone,

Again thanks for your replies. I'm going to contact my breeder and see who he can recommend to have xrays done perhaps. It seems there's so much to consider, even getting the right person just to take the xrays. I don't want to rush into doing anything more agressive so really want a diagnosis of what really could be wrong.

Like I said, he is displaying no signs of pain or lameness and is really a very happy and energetic boy. He is not overweight and we manage his diet almost obsessively, weighing each feed. We monitor his jumping and excercise and when swimming making sure to only take him to lakes with solid ground etc not the beach. So we are doing all we can at the moment.

[Kimjm1]

I would get a referral to a specialist there are quite a few in QLD google it to find them if you cann't ask your vet. Try and get the process moving as you have a limited window the older your dog is the less options avaliable to you.