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http://www.endurapet.com/pages/understanding-hip-dysplasia 

Dogs:

Understanding Canine Hip Dysplasia &
Exploring Treatment Options for Your Dog

When visiting the veterinarian, dog lovers around the world dread hearing two words: Hip Dysplasia. But what exactly is hip dysplasia, and what are the options when our beloved canine companions receive this diagnosis?

When hip dysplasia is present, the femur’s head is not-so-round, and the socket is not a snug enough fit.  This can cause the following troubles for your dog:

• Uneven cartilage wear and tear, which necessitates constant regeneration of cartilage. 
  Cartilage regeneration takes a long time, so it becomes a never-ending battle.

• Change in motion. To compensate for the pain caused by hip dysplasia, dogs will change the way they move. This can cause secondary injuries, such as abnormal muscle development (or lack thereof), soft tissue injury or spine problems.

• Osteoarthritis, which adds pain and deterioration to the already compromised joint.

Diagnosis of canine hip dysplasia includes x-rays and mobility tests.  Animals can be tested as young as 10 to 12 weeks of age, but most are diagnosed when their guardians notice signs of mobility pain. These signs can include:

• Reluctance to go up and down stairs

• Rising slowly, and doing most of the work with the front legs

• Tiring quickly while exercising

• Standing with uneven weight distribution 

• “Bunny hopping” (both back legs jumping together) while ascending stairs

Options for treatment include surgery and conservative management. 
Invasive treatments, such as surgery, will require diligent monitoring and could involve a long recovery time. However, conservative management takes time as well, so dedication will be essential, regardless of your decision. Your veterinarian should be a rich source of information while you are evaluating options. 

Triple Pelvic Osteotomy (TPO): Performed in dogs under 1 year old with documented hip socket depth but no active symptoms. This is an extensive surgery, but has been very effective, The procedure involves cutting the pelvic bones in three places, freeing the hip socket so it can be repositioned for a better fit for the femur, then re-securing the hip socket with a plate and screws.
Photo: (by OrthoPat) shows completed TPO 
<Requires 6-weeks strict cage rest.  Cost is around $2500 to $3500.>

 

Darthoplasty: For young dogs without accurate socket space for TPO surgery, Darthroplasty is a relatively new option. In this procedure, bone is harvested and then implanted to create an adequate "shelf" over the rim on the inadequate socket. After fusing to the socket, this new shelf created an almost normal socket for the patient.
Photo: DAR "shelf" highlighted in red (photo: veterinarysurgery)
<Requires at least  6-weeks cage rest. Cost ranges from $200 to $3000>

 

Femoral Head Ostectomy (FHO): This surgery is best reserved for smaller dogs, although success is absolutely possible for larger dogs who are not overweight. In this procedure, the rough end of the femur is removed entirely, leaving the remaining bone to form a "false joint". The false joint is not as flexible as the original, but pain reduction is usually total, especially once the dog has had physical therapy and is used to the altered gait which usually accompanies FHO surgery.
Photo: completed FHO
<Does not require 6-week resting period. The cost is typically around $2000 to $2500>

 Total Hip Replacement (THR): When the hip joint is the problem, it can be replaced with a ball and socket. In the past, the replacement joint would be cemented to the connecting bone. However, some veterinarians are using a fairly new “cementless” procedure, which utilized screws rather than cement. Strict protocol is followed to prevent infection, and extensive cage rest is required, but with a dedicated guardian, dogs can make it through the recovery process quite well.  THR offers the best possibility for return to normal function. 
Photo by Joel Mills. THR (right )
<Extensive cage rest. Cost is estimated around $4500.>

With any of these procedures, complications can occur, so it is important to ask MANY questions, and to be certain you are in a position to adhere to strict cage rest requirements. Total hip replacement is greatly effective, but infection risk, recovery time and prohibitive cost are just a few of the reasons that a lot of pet parents choose to try FHO first. 

Conservative Management (Non-Surgical Options)

Conservative management is simply any non-surgical treatment for an injury.  It is often the choice treatment for canine hip dysplasia, especially when hip dysplasia in dogs is diagnosed early. It is impossible to determine whether conservative management will ultimately work for any particular patient ahead of time, but with success rates of 50-60%, many experts feel that this is the gentlest option, and certainly a good place to begin. Some animals with hip dysplasia are simply not good candidates for invasive surgery because of age or other conditions. The good news is that each year we learn more about alternatives to surgery, and support practitioners and centers are growing in number nationwide.

 Conservative management of canine hip dysplasia involves muscle conditioning, stabilization, painmanagement, weight management, physical and nutritional support. The key in conservative management is to maintain muscle condition.

 The strength and tone of the muscles in a dog with hip dysplasia makes all the difference in recovery. Activities like walking, hiking and especially swimming, are essential to building strong muscles; jumping and acrobatic activities should be avoided. If performed mindfully on the human’s part, most dogs relish the increased opportunities to exercise! Pace your dog’s activity, especially if he or she is not used to workouts. Sometimes a brace is recommended to assist with stability during exercise, and ideally, non-weight-bearing exercises are best for muscle building, while limiting the wear and tear on affected joints.

For dogs with hip dysplasia, pain management is essential. For immediate pain relief, many veterinarians will prescribe a non-steroidal anti-inflammatory drug, or NSAID (common drugs are Rimadyl® Carpofen®, Deramaxx®, Metacam®).  NSAID drugs work quickly, but come with several distressing and even fatal warnings, the most common of which is liver and kidney damage.  Many Veterinarians do not give verbal warnings, so make sure you ask questions about side effects, and take the time to research options. If you’re unsure or confused about a diagnosis or a prescription, or if your veterinarian is unable to answer your questions fully, it may be best to seek a second opinion.

Natural pain management is also part of managing hip dysplasia. This can come in the form of gentle massage, heat/cold therapy, nutritional optimization, and natural joint supplements (like Mobility Plus). Canine rehabilitation centers are becoming popular throughout the US, and even if a center is not available, many groomers are becoming certified in “touch therapies” for pets (canine massage and acupressure). Also, even traditional veterinarians are beginning to see the merits of acupuncture and biopuncture for dogs and cats, and many are offering it within their clinics; the American Academy of Veterinary Acupuncture has a search tool at http://www.aava.org/php/aava_blog/aava-directory/. Whether you’re thinking of trying massage, acupuncture, or acupressure, plan to continue treatment for 4-6 weeks in order to evaluate the benefits. Another good option is hydrotherapy, which we highly recommend it to anyone who has an opportunity to investigate the advantages. A favorite group here in Colorado is Canine Rehabilitation and Conditioning Group (http://www.dog-swim.com/).

Cats:  Wet Food  part II

I had a feeling I would get some arguments on my article about feeding wet food. (see part I : Why Wet Food Is Best For Cats) . “No…just no” One reader replied, and she added “not for ALL cats, anyway”.  This reader is a cat lover and a champion for cats so she may have a compelling argument which I have overlooked.  I do wish I could answer some of the objections more specifically, but I have not been able to get objectors to respond to exactly why they feel not all cats would do better on wet.  What I can say is that I know it is more expensive, and that I know a lot of cats LOVE dry food, but in terms of what is best for their bodies, I have not found any reasons why dry would be better.

In fact, in the September 2011 issue of JAVMA, there is an excellent article supporting all of the reasons we feel wet is best. The article highlights in great detail how the tradition of feeding dry kibble to cats has contributed directly to obeisity,  type 2 diabetes mellitus, Inflamitory Bowell Disease and Urolithiasis.  It is about time, and I am hoping more veterinarians will now start encouraging this more natural way of feeding our beloved felines. 

I did get a couple of questions I can answer though. One reader replied:

Ok..I like this, however I do have some questions. First of all how do I know that my cats are eating enough? How much wet should they have and how often? I have 3 hungry kitties and 2 fosters and wet food time around here (once or twice a week) is every feline for themselves and I have to intervene and make sure no one gets pushed out of their food. Do you think the Wet Food Craze would wear off after a while? Mine are nutty for it and know the sound of the dishes I use.... Also what is a good wet food? Mine are VERY picky (mainly Hendrix), and they will only eat Pate style food, no chunks at all...

Great questions!  No two cats are alike, and what is best for one may not be best for or appeal to another, but we can narrow things down a bit. Let’s take these questions one at a time:

·         First of all how do I know that my cats are eating enough? How much wet should they have…

Most feeding guidelines on can labels and packages (even if you are feeding raw) are really quite broad and can over or underestimate feeding guidelines by as much as 50%. These guidelines are based on young, unaltered animals who are quite active. This is going to get rather technical, but I will give you what the National Research Council recommends:  A 10-pound adult cat should eat approximately 274 kcal per day.  If your cats live indoors, are altered and less active, this requirement has been changed recently to 240kcals/day for cats needing to shed ounces or pounds. Kcals measure the amount of energy in a type of food. Hilary Watson is a Canadian pet nutritionist who has developed an excellent, easy to use kcal calculator. You can find it here:http://www.hilarywatson.com/tools.htm.  Another thing I recommend is to call the company who manufactures your cat’s food. If they are willing and able to answer this and other nutritional questions, that’s a good thing!

·         …and how often?

Twice a day is generally recommended.  Aside from helping guardians to be able to watch intake amounts and changes in appetite (another reason I don’t recommend free feeding: these two things are great early warning signs of illness and will be missed if we free feed), it is also helpful for those felines who just can’t pass up a meal. We feed our cats separately, because Ralph would eat everyone’s portion if left to his own devices. Peg and Joe will not invade each others plates, so if you have cats without boundary issues like Ralph’s, you can feed them together. I would recommend watching them though, until you can get a better gauge on eating habits. 

It is important to remember that while these guidelines are going to get you closer to ideal amounts, there are too many individual factors to give an exact answer.

·         Do you think the Wet Food Craze would wear off after a while? Mine are nutty for it and know the sound of the dishes I use....

Quite simply, when our cats go nuts for wet food, they are telling us something. Some cats will reuse wet, and must be introduced slowly. The good news is that the craze will indeed wear off once they realize this is the new norm. Until then though, we recommend feeding them with supervision, and separating them and feeding in stages if that works best. Ralph also knows the sound of the dishes, and I hope he never stops “helping” at feeding time (as if I would ever forget where we keep the forks) but the craze has worn off enough at least.

·         .... Also what is a good wet food?

Again, all cats are individuals and this may take some trial and error. What will be the best food for one cat will simply not agree on all levels with another.  If you are feeding raw, I like raw formulated specifically for cats (RadCat is one of my personal favorites)

Here’s  some more controversy for you:  Some of my very favorite nutrition experts have gone so far as to say that even the worst canned foods (pretty much anything available in the grocery store is less than ideal) are better than feeding dry kibble.  While I know what they are getting at, this is hard for me to wrap my head around.

Canned food should have a named protein rather than by-product, few grains, and a low carbohydrate content.  How do you determine this? Because pet food labeling guidelines are not as strict as we would like, you may need to call the company.  The absolute best site I have found thus far for this kind of information iswww.catinfo.org . Dr.  Pierson has an abundance of resources and offers great tips on calling food manufacturers. Perhaps most helpful is the link to this chart on major canned cat food content: http://binkyspage.tripod.com/CanFoodNew.html

Picky, Finicky, or Biological predisposition?

Some cats prefer monotony, but most like some variety.  Ours will only eat pate style or raw, and others will eat only chunks.  One study even suggests that different breeds are predisposed to make texture choices based on mouth size. What we do know is that food odor is probably the biggest factor. Sometimes side by side comparisons are the best tools for determining  preference.  Most manufacturers of better cat foods have an unconditional guarantee or will offer taste samples. Another argument for buying better foods indeed.

So, dear cat loving readers, while I may not have won you over completely, I hope you will consider feeding  wet daily for at least part of their meals. Not all of us are able to go to wet exclusively for a variety of reasons, but some is certainly better than none. Your cats will thank you for it!

Lastly, if there are still arguments against feeding wet, please feel free to write in about them.  Like many of you, I am always learning and forever willing to look at things differently. Ultimately the well-being of our furry companions is paramount for us all, and these are the discussions which can only help us to help them in the best way we possibly can, right?

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Cats:
Why Wet Food Is Best For Cats (or the post your cat will love me for) Part I

 (This was published on our Beloved Beasts Blog in March and again in August on the EnduraPet Blog)

This subject has come up SIX times this week, so to the top of the list it goes.

In a nutshell: Feeding cats wet food exclusively is best.

 I know I can’t win you over that easily. And I was a hard sell myself until I dug into this issue, but in my heart of hearts, I believe wet or raw is really best, and here’s why:

• Unlike dogs, cats are obligate carnivores. Their natural prey is only about 10% carbohydrate. Many cats are carbohydrate intolerant and these cats run an especially high risk of developing diabetes if fed a high carbohydrate diet. It amazes me that so many “diet” foods for cats and even the so-called “prescription” diets sold by many veterinarians contain not only carbohydrates well above what we know is optimum for cats, but that the quality of these carbohydrates is so miserable.

•  *** This is a BIGGIE: The idea that dry kibble is necessary to maintain dental health is a MYTH. This is not true at all. There are some dental treats which do help, but kibble is not beneficial, as it shatters into teeny tiny pieces as soon as cats bite it, and these pieces are way too small to do any  cleaning. I would much rather see people feed a good wet diet and add dental treats if they are so inclined.
  

• Cats rarely drink enough water, and certainly do not get enough moisture in dry food. In the wild (and this includes feral and “barn” cats) cats naturally get most of their water from their prey. Studies show that domestic cats who eat dry and have a “normal” water intake still get only half as much water as cats who eat a diet of wet food. And this is super important, because when cats get enough moisture in their diet, they run a drastically reduced chance of developing kidney stones and cal-ox crystals.

• Dry kibble must pass through an extruder, and generally contains much too much carbohydrate.

• Free fed cats who eat only dry food are much more likely to be overweight.

• Cats who eat only dry kibble  are also at higher risk for a plethora of diseases, most of them among the most common reasons cats make non-routine visits to their veterinarians.  And so many of these diseases are directly related to the dry food itself.

(Just one example, but a good one is that most dry food manufacturers, in their effort to combat the high incidence of urinary tract disease in dry food fed cats, started adding urine acidifiers, which in turn can cause metabolic acidosis, which leads to cal-ox stones, impaired kidney function, and potassium depletion. Even natural brands which use things like blueberries to add urine acidity are culprits here.)

So if you aren’t running screaming out the door in search of a great wet food for your cat, I hope you will at least consider switching to a good wet food. Coming up soon: What to look for in a commercially available cat food. If you need this information sooner than that, please  send me a message and I’m always glad to help.

For the cats who simply refuse wet:

The short  answer is to keep trying!  But it is important for cats to eat, and it is never a good idea to let a cat go without eating for 24 hours, so while I do advocate letting them get hungry enough to eat their wetties, there are some cats who simply refuse. If this is the case, find some good brands (stay tuned for our post on what to look for and what to avoid, or for goodness sake, call me. I love talking to you folks!) and cycle them every two or three months. Also, make sure you are having regular blood work done and paying attention to any changes in the cat box.

But Wait… there is just one more reason to switch to wet!

Less poop. ‘Nuff said…