Advice on options for [possible] CHD in pup?

[Alchemist]

My seven-month-old pup is becoming well-travelled, in a medical sense. Seven weeks ago he had bilateral arthroscopic surgery for shoulder OCD. He seems to be recovering fantastically well from that. As of a couple of weeks ago his gait was perfectly normal, he was regaining muscle mass in the forelimb that was more affected, and he'd fully regained his range of motion in both forelimbs. We were cautiously optimistic.

 

I was telling him "only five more weeks until you can play all you want with your doggie friends, the frisbee can come out again, and I'll let you off the leash!". But then on our walk this week he started limping in his hind leg. It was subtle at first, but within a couple of hours he wasn't putting any weight at all on the limb.

 

He had an appointment for physical therapy that day anyway. The vet (Veterinary Orthopedic Sports Medicine Group in Maryland, not our regular vet) looked him over and saw some swelling in the knee; guess he must have torqued it, though I couldn't tell you how or when. (He does tend to startle a bit when he's staring at a squirrel and someone's electric garage door opens or a dog on one of those dratted invisible fences sneaks up on us and launches into bark attack mode).

 

Of greater concern - she said she could sense subluxation (partial dislocation, "popping") in his right hip. (I'd asked her about it a week ago because I thought I'd heard some during some of his physical therapy exercises, but on that week's physical exam she hadn't seen signs of anything). At this point she thinks there's a very good chance he may have hip dysplasia. If so, he's one of the unlucky ones; his parents had "good" and "excellent" ratings. I know that's no guarantee, but the poor pup has gone through so much already...

 

She said they prefer to go with "management" in their practice, that they're not convinced that the long-term outcome of triple pelvic osteotomy (TPO) or juvenile pelvic symphysiodesis is such as to represent any benefit. (Our pup's probably too old for the latter). That they do fly in a vet for total hip replacements, but that often dogs come off the "surgical list" before surgery happens because exercise does wonders for them.

 

This was encouraging to me, until I went to their website and read "The last part of medical management is exercise adjustment. This is different than exercise reduction. It is important to retain muscle mass in hip arthritis and so it is still important to have exercise. Low impact activities are ideal such as walking and swimming for dogs. Activities which are not ideal are activities such as playing with other dogs and fetch which include twisting, turning, starting, and stopping. For some dogs, these activities will be an important part of their quality of life. If they are, surgical intervention may be needed to allow them to return to these activities."

 

If there was ever a pup for whom playing with other dogs, and fetch, are an important part of "quality of life", it's our pup. And no, he doesn't like swimming. Too bad as there's a heated hydrotherapy pool five minutes from our house. (Can you teach a dog to enjoy swimming?).

 

I've read through prior threads on this board about CHD. Some stories have been truly heartwarming, like Julie Poudrier's stories of her Open dog with severe CHD.

 

Our pup is still young. If he's subluxating now, it makes me suspect this isn't mild CHD. He hasn't yet been X-rayed so I could be worrying about nothing. (Though the vet and I have both heard the 'popping'). Of course, maybe it's just that he's seeing an orthopedic vet every week that makes everyone more attuned to anything that might have gone unnoticed otherwise.

 

When we got him, I'd planned on doing obedience (to the extent I could find of the non-AKC variety) and agility. I don't know whether agility is even remotely in his future at this point. If it's not, I worry about how I'll keep a young dog sufficiently mentally stimulated. I still view agility, or trialing, as an indicator of how fit/active a dog can be with CHD. I saw posts that said that there were dysplastic dogs doing agility quite successfully, which was encouraging. But... if he's got clinical signs at only seven months?

 

Has anyone treated a pup (not a grown dog) with CHD? What did you pursue? Physical therapy, to strengthen the hindquarters? Exercise "adjustment" (no fun activities)? Surgery? If so, what sort - TPO? FHO? Total hip replacement? Not sure we can afford all of these at present; the OCD surgery was awfully pricey, and we don't have pet insurance. [in my next life...] It's also agonizing to even consider putting a pup through more surgery and another three-month rehab period. By the time he recovers fully from the present surgery, he'll have been on restricted activities for fully a third of his life.

 

He's a big guy (45 lb at seven months), and I gather size has a bearing on what sort of treatment might work best. He's also an absolute sweetheart... the vet techs were all coming up to me this week to ask me what had happened, because he's everyone's favorite. The regular vet has told me that he's got the nicest temperament he's ever seen in a Border collie, and I've overheard his vet techs in the other room discussing what a nice dog he is.

 

Needless to say, we're a bit distraught. If any of you have experiences - positive or negative - with CHD in a pup, I'd be grateful if you'd share them with me. We have another appointment with the orthopedic vet next week; we may opt to have him X-rayed at that point. I certainly want to be better prepared than I was this week. Surgical vets will say "oh, we can fix this!", but the reality of two hours of home exercises per day for twelve weeks (not countng walks), coupled with an unhappy pup who can't do the things he loves, is tough. I certainly want to know what to expect.

[Ooky]

I don't have any experience with HD but just wanted to tell you how sorry I am to hear this. Fingers crossed that the vet was just feeling some of that BC laxity that they can have.

 

I know some people on here before have expressed the opinion that with hips you should let them mature and see how they actually end up before you start trying to alter the joint structure, completely unlike OCD, but again I don't know much about this stuff at all.

 

The last thing I wanted to mention is that my ortho vet (Tufts grad, does surgery our of UC Davis, did excellent job on Odin) is big on stem cell treatment. I don't know if it helped Odin or not because I could not experiment so to speak, only having one of him. But she fully believes it is amazing for her patients, and told us about using it on a dog the owners had originally thought would need to be put down, for HD. They couldn't afford TPO if I remember the story right. So that may be something to ask about/research. Whatever happens, best of luck and good joint vibes for your pup!

[3dogs]

I'd agree with the vet at VOSM and try to do conservative management at this point. Down the road surgery may be a necessity, but for now I'd avoid it if it were my dog. I also agree that the TPO is a bad idea. I would go with an FHO or THR if surgery is something you need to do in the future, but I'd try to hold off as long as possible. Talk to the vets at VOSM about putting together an exercise program for your dog. As for activities, see what your dog is comfortable doing. There are a lot of dysplastic dogs that compete in sports, but it really depends on the individual dog as to what exercises can be tolerated. I'd also reconsider the aquatic therapy even though your dog does not enjoy swimming. Once your dog realizes that treats are involved in using the underwater treadmill you may find that he actually ends up enjoying his sessions. Xrays would also not be a bad idea, just to see what you're dealing with. Good luck with all of this, I'm sorry your dog is dealing with so much at only 7 months old. At least it sounds like he has a good attitude about all of it and it's not affecting his temperament.

[Alchemist]

Thanks to Ooky and 3Dogs for their advice and good wishes.

 

The pup's hind leg was much better at the visit this week. (Still a touch lame, but definitely a lot better than it was a week earlier). And no discomfort on palpation. Best of all, no perceptible subluxation (popping) in the hip.

 

The vet still suspects hip dysplasia. Only X-rays would tell for sure. We're going to hold off on those at least for now, though. The exercises she'll recommend in the next stage of his recovery from OCD surgery (as soon as the limp in the hind leg is completely resolved, at least) will include activities (such as an underwater treadmill) that would also be beneficial in case he were to have hip dysplasia. So - since the treatment for "if he were to have CHD" is pretty much what they'd recommend for "if he didn't", there didn't seem (to us) to be a compelling reason to X-ray him right now.

 

Also - I told her how discouraged we were to read what their website said about "exercise adjustment" for CHD, meaning that we'd inferred that the pup would have to abandon playing with other dogs or playing fetch, and that if that was an important part of the quality of his life, then we should consider surgery. Not something I want to subject our poor 8-month-old pup to so soon. She was surprised, said she'd have to (re)read their own website - didn't know why they should make such a claim, that they had had great success with nonsurgical options for CHD without such draconian sacrifices in activities. She specifically said that perhaps [after appropriate strengthening exercises] we'd have to settle for three hours of "fetch" at one go instead of five (!), or that maybe we'd have to give him a Rimadyl on a cold damp day or after a strenuous round of exercise, but she certainly didn't feel he'd have to abandon his favorite activities altogether. It left us feeling a lot better about things.

 

So - we're keeping our fingers crossed.

 

In the meanwhile, the fur around his eye has been thinning in the last week or so, so he has an appt with the regular vet for tomorrow to see if he's somehow picked up mange. (Yes, he's been on Vectra or Frontline every month since he was two months old, but it's sure what it looks like to me). Sigh. Remind me why we didn't sign him up for pet insurance when we first brought him home?

[Jumpin Boots]

In the meanwhile, the fur around his eye has been thinning in the last week or so, so he has an appt with the regular vet for tomorrow to see if he's somehow picked up mange. (Yes, he's been on Vectra or Frontline every month since he was two months old, but it's sure what it looks like to me). Sigh. Remind me why we didn't sign him up for pet insurance when we first brought him home?

 

I am so sorry to hear you guys continue going through such a tough first year. Have you looked into TruPanion insurance, from what I understand they are pretty good about taking on dogs w/ pre-existing conditions, no they won't cover those conditions, but they will cover others, and if you sign up in the first year of the dogs life you can get coverage for hip dysplasia.

 

Best of luck, happy to hear that you will be able to play fetch and romp with other dogs eventually

[Alchemist]

We have, indeed, been looking into pet insurance, even before the current hind leg lameness issues began. Trupanion and Embrace were the two carriers that were recommended highly to us at VOSM. I had also followed with great interest the readers' comments to the "Puppy Diaries" article in the NY Times on Oct. 3 that related to pet insurance: http://www.nytimes.com/2009/10/03/garden/05puppy.html?_r=1 (see readers "comments"). VPI, which I understand is one of the biggest carriers, seemed to earn an awful lot of criticism. One of the readers of this NY Times article provided a link to a website that compares pet insurance, along with consumer ratings: http://www.petinsurancereview.com/ . We found their summaries of coverage - as well as consumer reviews - very helpful.

 

Most carriers have a two week "waiting" period for most issues. The wait period is typically extended to six months for orthopedic conditions. Not all carriers cover congenital conditions (hip dysplasia tends to be assigned to this category). I think it definitely pays to do your research, both with respect to what's covered, as well as consumer satisfaction.

 

The VOSM vet felt that mange (if this is what it turns out to be) was likely to be triggered by a depressed immune system, most likely the response to the stress of surgery. It's a small patch, so I'm hoping we can quell it with a topical application of something. Not as if he's likely to spread it to other dogs if he isn't playing with them.

 

Poor pup. You have to ask - how on earth does a pup who is on restricted activities, leash walks only, even manage to get exposed? I'm guessing it's the foxes in our area...

[scomona]

Im so sorry to hear about your pup. About a month and a half ago we thought that Shiloh damaged his growth plate in his hind leg. It was lame and swollen. We took him to the vet/x-rays, the whole deal, and they agreed that the growth plate was damaged ( and sent it out for a second opinion). I was very upset and tried to find food and supplements to help. I was worried that Shiloh would have damage or pain for life!

 

We found that egg shells (the membrane in the shell) is exceptional for joints and is being studied and purchased by companies to be used to help bones/joints reconstruct or heal quickly. We stared to feed him the shell ( and the raw egg at times). We also fed him fish oil and marrow bones (which kept him busy and he could do laying down) the bones would take 2-3 hours and would tucker him out.

 

We also purchased this supplement " http://www.purica.com/recovery_sa.htm "

 

Within honestly 3 days the swelling was gone and he was trying to run,play and jump. We still forced him to rest but returned to the vet for more tests- the vet said it had totally healed and he was good to go! We still waited a bit longer and have kept him on the egg shells, more raw feeding and recovery formula, he is doing very well and shows no signs of damage.

 

I don't know if this will help in your situation (and I am by no means a dog nutritional expert)- but it helped little Shi, so I thought I would pass it on...

[Jumpin Boots]

We have, indeed, been looking into pet insurance, even before the current hind leg lameness issues began. Trupanion and Embrace were the two carriers that were recommended highly to us at VOSM.

 

I work at a vet's office and have had clients frusturated by VPI, it seems they are on a sliding scale w/ percentages of what they pay and people get confused and frusturated. I'm not familiar with Embrace, as I understand they are a fairly new company, correct, or am I getting them confused w/ another? One other neat thing about trupanion is that they are self-insured, so there is no chance of them either losing their provider or having their rates increased. The other thing I liked about them is that your rates won't go up for submitting a claim or the dog aging. But I definately agree with you, it's a tough choice.

[Liz P]

If you are in MD you might want to track down a vet named Chris Zinc. She was supposed to have opened a hospital geared towards canine athletes and physical therapy in or near MD.

 

http://www.caninesports.com/

[Journey]

^^^ what she said!

 

Also, not sure but just how much "frisbee" are you playing with the pup? Has this contributed to the injuries or caused them to be worse then they would have been? You really do need to get the X Rays done, asap, all the talk in the world is useless w/o a confirmed diagnosis. And doesn't his size exclude him from a FHO?

[Alchemist]

Thanks to all for your support and helpful suggestions. To answer some questions/suggestions:

 

We found that egg shells (the membrane in the shell) is exceptional for joints and is being studied and purchased by companies to be used to help bones/joints reconstruct or heal quickly. We stared to feed him the shell ( and the raw egg at times). We also fed him fish oil and marrow bones (which kept him busy and he could do laying down) the bones would take 2-3 hours and would tucker him out.

 

It turns out he does have localized demodectic mange. The regular vet told us today that it might be due to the stress of surgery, or to the stress of hormones. As it's a sign of a somewhat weakened immune system, I'm a bit nervous giving him raw eggs (or egg shells) lest he become sick from Salmonella. On the other hand, there may be people here more knowlegeable than I - are dogs immune from Salmonella?

 

We also purchased this supplement " http://www.purica.com/recovery_sa.htm "

 

I checked it out. It appears similar to the joint supplement, Dasuquin, that both the orthopedic vet and my regular vet recommended. (He's to be on that for life; he was also on Adequan for a while). Does anyone know whether "Recovery" has advantages over Dasuquin?

 

If you are in MD you might want to track down a vet named Chris Zinc. She was supposed to have opened a hospital geared towards canine athletes and physical therapy in or near MD.

 

Chris Zink is actually (at least according to their website) on the staff at our veterinary orthopedic vet's practice.

 

Also, not sure but just how much "frisbee" are you playing with the pup? Has this contributed to the injuries or caused them to be worse then they would have been?

 

It's hard to put a Border collie pup in bubble wrap for their first year. I did check with the vet (even before he came home) to make sure that the sorts of activities the pup enjoyed weren't putting him at risk of joint injuries. (We also, on the advice of his breeder and our vet alike, switched over to adult food of the "not high protein" variety at the age of four months). We were very careful in playing fetch, with balls and frisbees alike. Mindful of the advice "never let a puppy jump higher than its elbows" , I always limited "fetch" to short intervals (5 or 10 minutes, with breaks in the middle). Frisbees were always thrown low (and he virtually never caught them in midair; besides, we used the Kong type that don't fly all that well). For his part, Duncan was always good about taking a break after every couple of tosses; he was always better at chasing something than returning it. (Most of this "fetch" took place during the summer, before he started limping in August, so the heat imposed some limits; if he dropped with his object and panted, we were happy to wait it out until he wanted to re-initiate things). Although there was a month or so when I'd take him to the dog park once or twice a week, my goal was to get him to socialize with other dogs. He'd chase a couple of balls, then I'd try to distract him from it to meet a friendly dog or to hop in the pool. Or he'd notice kids playing soccer in the next field, and then he simply plastered himself against the fence for the rest of his stay. He certainly wasn't "fetching" for protracted intervals. Can I be sure that didn't contribute to his shoulder problems? Of course not. Once he did slip on wet grass in chasing a ball and limped for a minute or two. Who knows - maybe he hurt one shoulder then and it predisposed the other one to injury. We also forbade him from jumping out of the back of the car. There was a time or two, though, when he'd start to leap out and we'd only semi-catch him in time. He also had fun running in our (fenced) back yard. It's on a hill, and wooded. Can I be certain he didn't slip at some point? No, there were a few times he was outside unsupervised, though he never came back inside sporting a new limp. Could he have hurt himself playing with one of the doggie friends he made in our neighborhood? Sure; they liked to bowl each other over in the process of chasing each other around.

 

As far as whether play could have made his injuries worse: when he first started limping in early August, the regular vet recommended we abandon play with other dogs and fetch. At that point we limited him to leash walks. At that point the limp was so slight as to be barely perceptible (the vet had to walk him up and down the hallway before she could even pinpoint which leg was affected). After a week, though, it was getting worse, and he went on crate rest, going outside (on the leash) only to eliminate. Our regular vet did X-rays of one shoulder (inconclusive) so we made an appt. to see an orthopedic vet. They diagnosed OCD and he had surgery the next day. So we really didn't give him much opportunity to make things worse. But Border collies are great at hiding injury. I wouldn't be surprised to find he'd been hurting for a while before he started limping. Certainly although it was less than a month from the first signs of lameness to surgery, by that point one flap of cartilage had fully detached from the joint, and had grown considerably in size; he also had some pretty good tendonitis that had set in.

 

And doesn't his size exclude him from a FHO?

 

Our orthopedic vet isn't inclined to discuss surgery right now (she believes in exercise therapy first), so we didn't end up getting to the point of discussing FHO vs total hip replacements this week (though from what I've read, I'm with you; FHO doesn't sound like a great option for a pup who's this large already). Building up muscle mass through exercise seems the best option for his shoulders and his (possibly problematic) hips alike. She agreed that holding off on X-rays for right now seemed like a reasonable course of action. The rear leg lameness seems to be resolving by itself and with luck we can start on an exercise regimen soon.

 

We do plan to get him X-rayed before starting him on any activities that could potentially result in injury. I'm not even inclined to let him chase a low-flung frisbee before securing her blessing, let alone something like agility; who knows whether the latter is ever in his future. I'd rather sacrifice some degree of activities he finds "fun" in the near term just to keep him from the stress of back-to-back surgeries and rehab periods. Plus I really want to give the exercise regimen a chance first.

[herdcentral]

I can really feel for you and it is hard to control everything with pups. You cant think about what you cant answer about what caused what.

 

My ACD who was to be my young up and coming agility dog, was diagnosed with elbow dysplasia before she was 9 months old. I kept her lean, didnt throw things for her, she came on limited walks and did have play with my young BC which I monitored and still we ended up with mild ED that required bilateral surgery at age 9 months old after many tests and finally surgery to diagnose the problem.

 

She was the dog I took most care of and monitored most closely as a pup and yet she was the one with the ED

 

She is now rising 2 and is so far sound and very fit and nicely muscled and doesnt hold back on her walks and runs like the wind, but I am always aware of the potential of ED to become a continuing shadow on the horizon. I do limited agility with her but dont allow her to do the contact equipment.

 

Xrays at the time of the ED diagnosis also indicated a potential hip problem in my ACD, but so far that has never surfaced and she is very lean and fit. I do regular egg ball work with her which really gives her a good workout and keeps her toned and balanced. She has grown to enjoy swimming after being a bit worried about water in the beginning.

 

I give her variuos supplements and 3 monthly cartrophen injenctions and so far she is a normal dog. A friend of mine is about have stem cell treatment on her dog that has very bad elbow dysplsia so that will be interesting to see the results.

 

I know several dogs with bad hip dysplasia who compete in dog sports and their level of fitness is very helpful to their condition. I also know that one of our agility champions was operated on as a pup for bilateral OCD and he has never looked back.

 

Good luck with itall. Chris Zinc has a DVD called strenghtening the canine athlete and I believe with dogs like ours with problems, that some extra attention in this area regardless of if they become performance dogs is very useful.

 

I have a friend with a very fast growing and large male BC and as a pup he had terrible bouts of limping, primarily in his front end, with xrays showing signs of mild arthritis. He is now 12 months old and there is now no trace of a problem

[Jumpin Boots]

I checked it out. It appears similar to the joint supplement, Dasuquin, that both the orthopedic vet and my regular vet recommended. (He's to be on that for life; he was also on Adequan for a while). Does anyone know whether "Recovery" has advantages over Dasuquin?

 

I will agree that Recovery SA is an amazing product. We have our 7 year old bc and 8 year old toller on it, and both who were waking up w/ aches and pains, and Boots (the 7 year old) who was loosing his jumping form in agility is back to his 5 year old self.

 

However, I don't know anything about the comparison between it and Dasuquin. The one warning I will give you about Recovery is that as of now, in the US we can only get the unflavored powered form, not the nice chew tablets. We sell it at the vet clinic I work at and people do comment that it's not very palitable so they must mix it with beef broth or canned food. I happened to be in Canada for a horse show not too long ago, so brought some of the meat tabs with me, which makes feeding it a breeze

[Alchemist]

Thanks, herdcentral, for sharing your and your friend's experiences, and for your encouraging words. It's hard not to feel guilty, isn't it, even when you're trying to be as vigilant as you can?

 

I do regular egg ball work with her which really gives her a good workout and keeps her toned and balanced.

 

Forgive my ignorance - but what's "egg ball"?

 

She has grown to enjoy swimming after being a bit worried about water in the beginning.

 

Oh, good, I'm really glad to hear of a dog that's learned to enjoy swimming. My prior dogs hated it and we simply gave up. I'm soon going to be taking the pup to an underwater treadmill twice a week, but it's an hour's drive away (and they're not open weekends or evenings), so I will be losing close to half a day's work each time. There's a doggie hydrotherapy pool not five minutes from our house that's open evenings and weekends, and I'm really hoping to transition him to that. I worried it'd be torture, though, as he really hated it the one time we took him (before surgery). Even tennis balls (which to him are better than any treat) didn't provide sufficient appeal to get him swimming. I know, the treadmill provides more realistic "range of motion" and is better therapy, but somehow I have to actually earn the money that pays for all the vet bills, don't I?

 

I give her various supplements and 3 monthly cartrophen injenctions and so far she is a normal dog. A friend of mine is about have stem cell treatment on her dog that has very bad elbow dysplasia so that will be interesting to see the results.

 

I looked up cartrophen - it looks very interesting! I'll definitely ask the vet about it when we're there this coming week. I know this practice offers stem cell therapy as well, so I'm sure they'll suggest it if they think it'll help.

 

Chris Zinc has a DVD called strenghtening the canine athlete and I believe with dogs like ours with problems, that some extra attention in this area regardless of if they become performance dogs is very useful.

 

Thanks for the suggestion! I know what's going on my Xmas list! (I'm pretty sure it's OK for me to wait that long, as the pup is going to be on restricted activities until at least early December. The OCD surgery and physical therapy have been awfully pricey, so I'm trying to be restrained in my spending, but DH is always pleased to see me put things on an Amazon "wish list").

 

And for everyone else: thank you so much again, for all your good thoughts and constructive suggestions! I'm grateful to all of you, even if I don't single you out individually.

[herdcentral]

Thanks, herdcentral, for sharing your and your friend's experiences, and for your encouraging words. It's hard not to feel guilty, isn't it, even when you're trying to be as vigilant as you can?

Forgive my ignorance - but what's "egg ball"?

 

Yes it is hard not feel guilty when something like this happens. But I have had some very high drive working bred ACDS in my life who were extremely active as pups and nothing like ED happened before. But you still wonder if something you did or didnt do helped to express what is most likely an hereditary roll of the dice.

 

The egg ball comes from Clean Run and is like a physio ball for humans. You blow it up and it is an egg shape, I get my dogs on to it and they sit and stand and turn, while balancing on the ball. You can see every muscle in their body working. Once they get the hang of it they become experts in balancing on it. My lot love it and are really enthusiastic. I usually have it up against the wall and control it with my foot to start with, untill the dogs get control of it.

 

As to the pool, I bought a pool you can errect yourself in the back yard. Most of the major supermarket type stores sell them reasonably cheaply. They are 12-15ft in diameter and a meter deep, with a little pump and is easy to erect. You can use a solar blanket so the water is nice and warm. I have a doggy life jacket so my dog feels secure.

 

And yes I know about the costs involved in all of this. But I belive with something like an egg ball and an insta pool and the correct exercises you can take control of a lot of it yourself.

 

Cartrophen is a mainstream arthritis treatment in Australia where I live and Canada and is very helpful to some dogs. My friend with the big limping BC had the 4 week course on her dog and the effects were almost immediate.

[Alchemist]

The "egg ball" sounds like a great exercise. I'll definitely ask the orthopedic vet about it at our next appointment this Friday. His limp got a bit worse today (no idea why - I'm the one who nearly broke my neck, shoulder, and foot tripping over the fence we erected to keep him from the stairs), so I think we're taking it easy for the next couple of weeks at least. Besides "underwater treadmill", the vet also mentioned "cavaletti" (once the lameness resolves), both of which sound less demanding than "egg ball", yet the vet wanted to defer them until his hind leg was better.

 

We live in Maryland (mid-Atlantic US), and in our portion of the globe, we're heading into fall, with temperatures not rising (typically) above the 60s (Fahrenheit) during the day, often barely above freezing at night - too cool for even solar-supplemented pools. Our local indoor heated hydrotherapy pool seems a much more viable alternative - once the orthopedic vet gives her blessing.

[Journey]

OK, I am a bit perplexed at your questions. If you haven't X-Ray'd you really don't "know" what you are dealing with or if in fact it is CHD. Your vet seems to be calling all the shots, nothing wrong with that, except a simple X-Ray could rule out (or rob your bank account) CHD at this stage. Knowing what is wrong imo is priority especially if it's back (the limp that is) regardless of what the vet thinks. No you can't place them in bubble wrap and if in fact it is CHD I'd be more inclined to lean towards it just being one of those crosses that didn't work. Have any other siblings had OCD/CHD diagnosed yet? What about the sire/dam? Why the hesitancy to X Ray? It's no big deal, no anesthesia necessary. And yes, an egg with shell is fine for them to have, we do them once a week. Demodex is not unexpected with all he's going through. I'd find out just what is going on with the rear and then decide which type of supplement to put him on. Poor pup. Good luck!

[Alchemist]

Journey: On "whether to X-ray" - or not: part of it (sadly) boils down to economics. Between the OCD surgery, and other issues (the GI problems at 8 weeks; the intermittent diarrhea; the inconclusive X-rays for the front lameness our vet regular suggested that did require anesthesia; and now the mange), we've spent more than $7K in vet bills on this pup (above and beyond vaccinations, etc.) over the last six months. Without benefit of pet insurance.

 

We were willing to pay for the OCD surgery, and physical therapy, because all the research we did indicated that the earlier the intervention for this issue, the better the outcome.

 

From all we've read, the picture is not the same if he does turn out to have CHD. Many people (including our orthopedic vet) are recommending a conservative approach - see what exercise does. This is where the other part of the equation (the non-economic one, relating to "quality of life for a pup") enters into things: if a conservative (exercise) therapy is to be preferred over surgery, and if the poor pup is still recovering from surgery - why rush into more X-rays that, at best, might tell us that six months or a year or more from now might call for more surgery? Would anyone really wish back-to-back surgeries, requiring another 3 months of rehab/restricted activities, on a pup? Wouldn't it be better to try to see what "modestly" restricted activities, in conjunction with exercise, might accomplish?

 

A number of people have responded telling me of situations in which time and/or exercise have resolved similar problems. No one, including the orthopedic vet, has told me that the best thing to do in this circumstance is to rush into surgery. If the hind limb lameness continues to heal, and we are able to begin the sort of exercise that would help possible (not certain) problems in the hind end, then what's to be gained by taking X-rays? The therapy would be the same regardless of the outcome of the X-rays.

 

If you know something definitive that I'm missing (in terms of timeliness of intervention), then please say so - I'd love to benefit from your expertise. In the meanwhile, it seems to me (as well as to my vet) as if conservative treatment (i.e., joint supplements plus an appropriate exercise regimen) is the appropriate course of action regardless of what X-rays might, or might not, show. If six months from now (when he's older, and his OCD surgery is in the past) we were to happen to have coverage for orthopedic conditions, and he seemed healed, and we were to be considering more vigorous forms of exercise, then I'd certainly be inclined to first have him X-rayed to make sure we weren't going to compromise his wellbeing. At the moment I'm not convinced the results would lead to any difference in how we'd treat him.

 

I'm not trying to be dismissive of your advice to have him X-rayed right away. I'm more trying to find out if there are specific reasons why you feel X-rays are so important for us to conduct right now, given that there's little that we could do in the near term with the results. The financial implications (especially if he were to need total hip replacement down the line) would be pretty substantial.

 

My initial questions were mainly based on what I'd interpreted from the orthopedic vet's website: for an active dog, either "exercise adjustment" (read: abandon all the activities our pup enjoys), or surgery, were the only options. She was adamant at our meeting with her this week that this is not their recommendation: even with fairly acute hip dysplasia, exercise is a preferred alterenative to surgery.

[Alchemist]

Have any other siblings had OCD/CHD diagnosed yet? What about the sire/dam?

 

In terms of other siblings: to my knowledge no other full siblings (or even half siblings) has had similar issues. The breeder has been more than responsive (indeed, they've been a model of "responsibility over and beyond the call of duty"). They've been in weekly contact since the OCD diagnosis, and even offered a full refund of the purchase price (or exchange for another puppy), even though OCD wasn't specifically covered under the contract. I trust them absolutely. I'm as certain as I've been of anything in life that they'd have told me if there were any such issues with any of his siblings or near relatives.

 

One parent was OFA'd "excellent", the other "good", as I mentioned in an earlier post. But that's no guarantee, as OFA is quick to let anyone know.

 

Just because the risk of being hit by lightning is remote, doesn't mean you can't be injured or even killed by it. I'm chalking all this up to simply the (bad) luck of the draw, hence the subtitle of this post.

 

Thanks for the suggestion about eggs being OK even with a possibly impaired immune syndrome. I'll check with the orthopedic vet about this. (We see her once a week, so there's not much delay involved...).

[Journey]

Economics understood. What you have been through is more than anyone should have to go through, much less in 5 months. Here's my point, you may be worrying over something that no matter what can't be fixed or doesn't exist. You can not tell about the hip joints w/o an Xray. What that picture tells you will determine what you all are looking at in the future either way. And quite frankly, yes, I would rather a pup be out of commission for several months and do what is necessary all at once. I've been through an OCD pup a long time ago, gave him back to the breeder too. Surgery is not the only option but you cannot know what limits are or will be w/o the picture. Fitness, types of exercise, limits, all of those are unknowns w/o a picture. I have never know a CHD dog to get "better", doesn't work that way. however, they can maintain and you can help with proper care. You're with a great clinic I gather, anesthesia is not necessary to shoot the hips, my last 3 were done w/o it. Hips shots are different than OCD shoulder pictures.

 

I'm not saying to do anything regarding CHD if that's the case but you need to know and have a direction to go from based on the picture. Basically, you will either get piece of mind or another headache. Knowing what you have with an X Ray will lead you in the proper direction for him.

 

I'd also be doing some serious talking with the breeder and other pup owners as well.

eta - cross posted with you and see that you have been speaking to the breeder.

[Alchemist]

Journey:

 

Thanks - that helps. I guess I'm willing to sacrifice peace of mind for now. (Sanity is overrated). Even if the X-rays were good, I'd probably tell myself "well, they aren't definitive until they're two years old; he could be fine now but not later", and continue to fret every time I imagined a limp. (Things like OCD tend to spook one). Whether the X-rays were to turn out good, or bad, we're probably looking to pursue the same course of treatment (exercise) in the near term. The orthopedic vet has been very conservative so far in terms of exercises for his shoulders. I trust her suggestions for near-term exercise therapy.

 

In a few months, the orthopedic portion of the coverage for the pet insurance we've signed him up for should start to kick in. At that point, the economic equation may change.

 

If the picture is really bad at that point, we may want to revisit the question of surgery; returning the pup to the breeder is not likely to fly (everyone in the family viewed that as a scandalous suggestion). He is a pet, after all, not a working dog, and we're all thoroughly attached to him. I can appreciate that if he were a working dog, my needs for such would be paramount. But that isn't the case.

[Liz P]

You can't rule out HD in a pup of that age with the normal OFA hip extended views. If you see HD on rads in a pup of that age you know they have it, but if you don't see clear evidence of HD it doesn't mean their hips are good.

[herdcentral]

When my vets were trying to diagnose my pups ED they also found pain in the hip region. It was decided while they were doing her front end to Xray her hips and at that time and the rads pointed towards a potential hip problem. She is now 22 months old and her hips appear sound although I have not had them xrayed recently but the powerful even muscle mass of her hind end suggests at this point things are good. I was told to revisit the hip thing at about 24 months if required.

 

ED is a very unforgiving potentially life shortening condition and I am pretty rigourous with keeping her lean and doing her exercises and hopefully it has benefitted her hips as well.

 

With the egg ball I would certainly only start using it once the dog is primarily sound as a continuing maintenence therapy. You can make it very easy or harder depending on how you control the ball. Yes we have reletively warm winters here but I still pack the portable pool away. But in summer it is great and a cheap way of getting my dog in swimming shape right through summer.

 

Good luck with it all, I think it is the not knowing that is the hardest. I live everyday watching my dog like a hawk for a sign of a limp, that is living with dysplasia for you. However as time progresses one tends to become resigned to it and concentrate on managing as best you can. My girl is totally sound at the moment but I know things can change at any time. I still check her gait everday though - cant help it.

 

No way I was returning her to the breeder despite having obtained her as my up and coming agility dog and not being able to pursue that direction with her !

[Alchemist]

An update: it's been about a month since I started this thread. Duncan and I just got back from our latest weekly visit to the ortho vet for physical therapy.

 

Unfortunately the news was pretty depressing on the right hind limp end of things. (His front end is great - increased muscle mass in both forearms). But he's lost 2 cm of muscle mass in his right hind leg. He's clearly offloading a lot of weight onto his left leg as well as onto his front legs. Although he isn't limping a lot, his stance and gait are unbalanced.

 

What's more, she feels that he should have responded better than he has to the physical therapy she's been doing on his hind end (laser therapy, massage, range of motion exercises) every week for the last month. She says that in 70-80% of severely dysplastic young dogs she encounters, this sort of therapy is enough to get them "off the surgery list", meaning they're no longer favoring the leg. At that point she typically finds that she only needs to repeat this physical therapy every month. They can resume normal activities; only after the first 3.5 weeks do they start showing signs, at which point it's time for the next round of physical therapy. But for Duncan, she doesn't have anything more to offer than surgery. She doesn't even think there's any point in our keeping up the once a week physical therapy schedule.

 

I know there are plenty of dogs with hip dysplasia who do very well at trialing (I'd heard of several Open stars with CHD) and at agility, despite their having hip dysplasia. But... these are the ones that are not symptomatic, right? Or whose symptoms are so mild that a little Rimadyl and some physical therapy keeps them happy? From what the vet tells me, not all dogs with CDH are symptomatic. If this is what Duncan has, he's certainly symptomatic and getting worse, not better.

 

The vet doesn't want Duncan to resume any normal activities as long as his hind leg is lame. Poor pup absolutely hates it that he can't play with other dogs, and he can't be allowed off the leash even to run around in our back yard (another place he loves - world's biggest toybox full of sticks). It seems as if he's one of the unlucky ones for whom exercise and physical therapy isn't likely to restore him to a state where he can enjoy the things that matter to him.

 

DH and I have discussed the situation. We've decided to go ahead and schedule some X-rays for next Wednesday.

 

At this point he's nearly three months post OCD surgery. I keep thinking that if he hadn't developed this hind end lameness, he'd be resuming all his favorite activities. But I guess that isn't a productive train of thought.

 

Anyone have experiences to share (positive or negative) with total hip replacement? Not sure we're going there (not sure we can afford to!), but I reckon the better educated I am going into the next vet's visit, the better educated a decision we can make.

 

Wish Duncan some good mojo....

[Journey]

Crap....I am sorry to read this.

 

Good MoJo coming from us!