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as well. That's great. So for those of you that
were tuning in and way too embarrassed to call, which
is crazy, it's free. We were talking about the last
several weeks we were doing a series on the variations
in the presentation of different problems and kind of give
you some guidelines as to how many different types of vomiting,
for example, there are, and when you have to worry,
and when you don't have to worry, When do you
have to rush to get a hold of your veterinarian
or rush to an emergency center if it's in the
middle of the night, and when you don't have to,
And we're sort of giving you some guidelines. And last
week and oh, actually kind of the week before that too,
we started talking about another condition which we see extremely commonly,
especially in our dogs, but cats as well, and that
is limping. And we went through the gamut of the
different types of limping problems, the different problems that would
cause limping, and which ones are ones again that you
need to really worry about, like now, like today, make
an appointment with your veterinarian, if it's in the night,
When to rush to an emergency center, when you can
wait till the next morning, etc. And one of the
things we were talking about that we left last week
talking about a very very common, often overdiagnosed problem, especially
in our older pets, and we'll get to that in
a minute, and that is canine hip dysplasia. Now, anybody
who has a large breed dog, especially the popular ones,
whether it's a Golden Retriever, a Labrador Retriever, a German
shepherd dog, a Rottweiler, these dogs are notorious. And even
some of our smaller interestingly chondro distfoid break. He's a
phallic breeds. Those are the really short legged dogs that
have funny curved legs and long bodies. They too, can,
believe it or not, have hYP dysplasia as to chow chouse.
We say a lot of chowchows with hypdysplasia as well.
And I think I shared a story, but I'm going
to share it again. How I was at the market
here in town, and I'm out here in Los Angeles
and a guy comes over to me that was actually
in my older sister's class back in elementary school. I
just don't want to tell you how long ago that was,
but trust me, it was a long time ago. And
he obviously knows I'm a veterinarian, and he came up
with he says, Jeff, I can ask you a question.
I said, I'm like, yeah, sure. So he's telling me
about his daughter's dog who was taken to the veterinarian
and they diagnosed hYP dasplasia, and a couple of kind
of those flashing red lights went on in my number one.
I asked him what the breed was, and the breed
was a kind of a mixed herting dog type of
dog in about a forty five pound range. And just
so you know, interestingly, a lot of the hurting dogs,
the Australian shepherds, the Queensland healers, really don't have huge
hip problems. Secondly, the dog was seven years old, and
when did the onset of clinical disease start started fairly suddenly.
That's another red flag because, as we're going to learn,
hip displasia symptoms in older dogs don't come on suddenly.
I mean, yeah, there was one or two scenarios, as
I mentioned, where you can have severe hyptosplasia and then
free up a little joint, mouse a little piece of bone. Well,
you become a floater, get into the joint. Yes, that
might cause some acute sudden pain, but typically it doesn't.
So and the third thing that bothered me was they
thought they saw some what they call incongruent on the
X rays. I said, you know what, Joe, send me
the X rays. I want to see the X rays
and then we'll go from there. So of course he
sends me the X rays and there there is no
way this dog was limping for hip displaysia. I mean,
it is true that you can't always gauge and predict
a dog's clinical arthritic pain based on the X rays
and others. I've seen dogs with horrendous hips on X rays,
the worst arthritis I've seen, and yet they're moving around fine.
And I've also seen dogs that I mean the havocs arthritis.
It's not terrible on the X ray, but they can
barely move. So I understand that. But there's no way.
It didn't fit the breed model, it didn't fit the
onset of clinical disease, and it certainly didn't fit the
X rays. So I said, you know what, have your
daughter making a point with me? So actually, my friend
Joel brought the dog in and sure enough, in two seconds,
out of my diagnosis. And clearly it wasn't HIPS, and
it was another problem. Well we'll get to It's called
lumbo sacred instability, a very common cause of acute onset
of pain, even when the condition is chronic. In others,
the condition could have been there for years, but the
onset of clinical pain can be sudden. But not so
much hips. And here's what I often will say to
a young doctor who you know, dog comes in limping
on the hind leg, hind end, some tenderness, some pain,
take X rays you see lousy hips and they want
to say, oh, here's your answer, hiplasia. And I want
to say, wait a second, when and how did the
clinical signs start well they started like pretty suddenly Monday morning.
Uh okay, then it's not hyptosplasia. Why because had I
taken five weeks earlier, it would have looked exactly the same.
Yet two three, five weeks earlier, the dog wasn't limping
because it wasn't caused by the hyptosplasia. We need to
look for other things. So when we do talk about dysplasia,
because it is a common problem, there is this strong
genetic predisposition. But again, to burst a few bubbles out there,
only about fifty percent of hyptysplasia is congenital is genetic,
So what does that mean. That means the other fifty
percent is environmental. It is how we feed these large breed,
rapidly growing dogs, how we exercise these large breed, rapidly
growing dogs. So in other words, I can have a
dog that genotypically is carrying genes for dysplasia, and depending
on how I rear them, how I keep them fed,
and while during their growth phase, I can actually minimize
or eliminate the actual signs of disease the phenotypical signs
of disease. Conversely, I can take a dog that does
not have strong genetic predisposition, yet abuse some of the
rules of rearing these large breed, rapidly growing dogs, and
they can develop dysplasia. So one of the things we
like to do early, first of all, some guidelines when
you have a dog that fits the breed model of dysplasia.
We want to not as many of my former rottweiler
owners would make the mistake of doing. Want to have
the biggest, baddest, meanest dog on the block and feed
them like cute and get him by the time he's
a year old, he's already muscular and tremendous and quite
the athlete, sometimes even overweight, etc. Keep them lean. Likewise,
if you're an athlete, and this burns me up when
I see it, I see a guy who you can
tell or even a girl that is very fit, loves
to run, gets on the bike, does the ten mile
bike ride, does the five and a half ten mile run,
and they have their young six month old golden or
labrador trailing behind them. That is one of the worst
things you can do for a rapidly growing large breed dog.
Go to the park, get out the tennis ball, get
out the frisbee, do some playing running around ten fifteen
twenty minutes back and forth, stop and go. That's the
kind of exercise that these dogs can have. You don't
want to force them into that persistent running pounding the
pavement during the growth phase, not until they're at least
eighteen months, preferably two years. As a matter of fact,
the organization that will certify hips called the OFA, the
Orthopedic Foundation for Animals. They also certify elbows. They also
work with SURF, which is the Canaine I Registry Foundation.
But the OFA will not even certify a dog's hips
until they're at least two years of age. So that
tells you something. That tells you that until they're about two,
we don't want to make judgments. I've seen dogs that
have great hips early on and end up with lousy hips,
and I've seen dogs with very questionable hips, but by
the time they're done growing, everything fit into place. Those
hips moved into the nice deep sockets and we have
beautiful hips. So what should we do when we have
that dog that we know is potentially a walking time bomb?
So this is where we want to be very smart.
And I recommend that if you have or know somebody
who has a family member, a friend gets that large
breef puppy, whether it's going to be the labrador, the golden,
the shepherd, the roddy, you name it. Okay, that you
should have a scan X ray film done of the
hips at around nine to ten months of age. Why
because there is a surgical procedure that can be done.
It needs to be done if it's appropriate based on
some other clinical diseases factors. We look out on the
X rays. But if we have the candidate, the best
time to do it is before a year of age.
They like to do it between ten and twelve months
of age, they being the surgeons. And it's called a TPO,
a triple pelvic osteotomy, And what it does basically is,
when you have that bad hit, there's an incongruity between
the head of the femur called the ball of the
ball and socket joint and the acetabulum, which is the
socket of the ball and socket joint. And they're supposed
to fit nice and tight into each other, but often
they don't, and the ball is sitting somewhere out here.
And the general rule of thumb is greater than fifty
percent of the head of the femur should be tucked
in deep into the socket less than fifty percent. We
may have an issue. What the TPO does. It creates
what's called a hemipelvis, a half of a pelvis. Since
you can't bring the ball to the socket, let's bring
the socket to the ball, and so it repositions socket
to cover the ball appropriately, and then the surgeon will
put a plate in and reattach the now modified hemi
pelvis transpositioned hemi pelvis into the actual pelvis into the
bone itself to create a sort of a differently shapen pelvis.
But now it's going to cover the hip completely, cover
the ball of the ball and socket joint. Now, this
does not mean that if you were thinking, and you
shouldn't be thinking this anyway, but if you were thinking
because of whatever papers and lifestyle you had, that you
wanted to breed your dog, this clearly does not give
you the green light to breed your dog. As a
matter of fact, if anything, you should have your dog
neutered asap or spade asap. This is not a pet
you should be used for breeding. The reason why we
are in the situation we're in with the number of
dogs in America and the world that have hypdysplasia is
because nobody was paying attention to their dogs condition, hip
condition and continue to allow this bad fifty percent of
hypdsplasia genetics into the gene pool. So that's why we
recommend the early dysplasia X rays to rule out, because
if we can figure out early, there is something we
can do to help prevent the onset of arthritis later
on down the road. So I want to go talk
about after the break, which will be coming up in
about ten seconds, some of the other limb problems. A
big one that we see in dogs, just like we've
seen people, is called the cranial cruciate ligament rupture, which
is the ACL of dogs. And again some different treatments,
different things to look at, and we'll talk about that
in just a minute. When we get back here at
pet Life Radio, ask the vets with doctor Jeff. I'm
your host, Doctor Jeff Werber. We'll be right back. We'll
be right back right after these messages.
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Speaker 3: Let's Talk, Let's Done Pets, talk about headline.
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Speaker 2: And welcome back. You're here with doctor Jeff Weerber, host
of Askabats with doctor Jeff here on pet Life Radio,
and before the break we were talking about hips and
hip dysplasia and the poor likelihood that any in an
adult dog that has hip dysplasia that is moving around
just fine, that onset of clinical disease is going to
be sudden, so in that your doctor takes those X
rays and comes back to you and says, oh, it's
the hyptosplasia. You need to question it because it's most
likely not the hyptosplasia that's causing Today's probably not to
say that it doesn't cause chronic arthritis, but the classic
presentation is a dog who's just really starting to slow down,
having that trouble getting up and downstairs, doesn't want to
get up and lying down, takes a while to sit
down or to get up, and when you take pictures
then you see either spondylosis along the spine, you see
lousy hips that's kind of more like it just kind
of stiff and sore and adr just ain't doing right.
But when they're doing kind of just fine, and they're
going and they're chasing that ball, and all of a
sudden they come up lame one day and the X
rays show bad hips. You keep looking, keep looking. Speaking
of before we leave the hip thing and hip dysplasia,
I had a case this week and reminding me that
there are some other things that pet parents need to know,
especially with young small breed dogs and hips. You know,
typically we always say that we don't see hypt displays
in the small breeds, and we don't, except we talked
about some of the contragysfroid breeds. I know, I have Frenchies.
Frenchies could show hyptosplasia. Peaks can show up with hip
displays of pugs can show up. It'splasia. But this is
a different kind of condition. I had a dog in
It was a rescue. He was in. They pretty much,
you know, bring one of those carriers, We put them
into our cages, we examined, we check them out. Usually
does not include take them out for a run. And
these little little guys, they're always going from arm to
arm to arm from the rescue group's arms, you know,
one of the volunteers to our arms into the cage,
back into arms to again anesthetized to get the surgery done,
et cetera. So we had one such dog and it
was like a little pooh cross. I think it was
a sheet poo sheets, a pool sheet too, poodle, one
of those. We see a lot of these, you know.
You know, it was just years ago. We used to
call these dogs mutts and they had zero value other than,
of course, the value to the home. But you wouldn't
sell them mutt. You were just happy to get rid
of it, right, to find a home for it was
you know, if your dog there was an accidental breeding,
or you know, whatever the case may have been. And
you had these puppies behind fifty seven. You had no
idea what they were. You were just calling all your
friends trying to find, you know, homes for them. Now
there's the multi poo and the sheep poo, and the
and the buggle and the puggle, and I mean they've
come up with all these designer dogs and actually selling them,
which I just find so amusing. But anyway, so after
the surgery that afternoon, the volunteer can't pick the dog up.
It was fine, the dog was cute, did great for
the surgery. And they call me the next day and
the dog is limping. What did we do? Now? How
funny is that that the assumption is, oh, we must
have done something, and I asked, I said, start a
question and I said, well, do you really know what
the dog was like beforehand, because usually you bring them
right to us as we have to get them a
spadeer neuter. And she says, well, not really. I said, well,
so we don't know what the dog was like beforehand.
I said, you know what, Well, look, no problem, bring
the dog in. Let me feel so feeling the dog
and I feel an incongruity, a little of what we
call crepitis, something going on in the left hip. So
take an X ray and I got my diagnosis in
two seconds. There is another disease that you need to
know about that I wouldn't tell you is common. But
in medical leads we get to use the word it's
not uncommon, and not uncommon doesn't mean common. It's like
that double negative. But when it comes to medicine and
medical terms, it's not always the same because when something's
on common, it hardly ever happens. It's uncommon. If you
say it's not uncommon, it just means it doesn't never happen.
It doesn't mean it happens all the time. It's not common.
It just when you say it's not uncommon to see.
It's one of those things that you could see it.
It fits the history. It's not uncommon. But no, don't
get me wrong to say, well, if it's not uncommon,
that means it's common, because no, it's not common either.
It's just not uncommon. And it's called leg calve Perths disease.
How funny that we're talking about a leg problem and
one of the guys that discovered this condition his name
was doctor leg LGG. So it's leg calve or caveat
perth is pr ths disease. Basically, what it is, it
is an osteoonecrosis of the themeral head and neck. In English,
that means the bone has lost its blood supply. And
because of the loss of blood supply, it is basically
the bone is dying. So when you have a loss
of blood supply and the bone dies, the femoral head
and neck, it literally it starts to disintegrate, I mean
literally disintegrate. So on the X ray you see what's
left of this fermoral head and neck. It looked like
it also had to slip the piphesis, which is a
growth plate issue. But you could see the bony destruction
was clear, so showed it to them, explained the disease.
It's a pretty easy surgical fix. We do what's called
an excision arthroplasty, also known as FHO ephemeral head ostectomy,
and basically what we do is we just take a
basically a bone chuck like like a little hammer and
a bone chisel, and we remove the femoral head and neck.
We stuff the area with some fat or some fascia,
and these dogs do just amazingly well. We're just eliminating
the joint really, so they can't get our ritis because
there's no bone on bone. We're removing the potential bone
on bone. They do very well, So that is probably,
you know, the last thing we see. And also just
to be to talk about this other dog from my
guy that I saw at the market and the fact
that it was not hypposplasia. It basically was a condition
that we see often, way more often, and it's one
of more underdiagnosed conditions and the reason for that is
a lot of veterinarians don't know what to look for.
And until interestingly I started working with a board certified
veterinary surgeon and I practice, we learn nothing really I
wouldn't say nothing but very little about this in veterinary school,
and you know that was over thirty years ago, so
it's kind of like a newer diagnosis that's being made often,
and it is very similar to the diagnosis that many
of us have. And if you have any lower back pain,
you probably know of LS disease. I have lumbo sacral disease.
And basically what it is it is an excessive movement
between the last lumbar vertebrae. In dogs it's L seven,
and people it's L five that meets up with the
first sacral vertebrae called S one. Therefore l S disease
lumbo sacral disease. Because of this excessive movement between these
two adjacent vertebrae, the nerves that exit through the foramen
of the opening between these two adjacent vertebrae are often pinched,
and when they're pinched, it arts and these dogs will
come up sudden suddenly with pain favoring a limb, not
wanting to get up. And the typical presentation is a
dog that is hesitant jumping up onto the couch or
the bed of the chair, but no trouble jumping off
hesitant to go up the stairs, but no hesitancy going
down the stairs. You know, those dogs will even say
up up, you know you want them to jump up
on you. They won't do that anymore. So that, from
a clinical perspective is what we're going to see, which
is interestingly, when I started questioning my friend Joel when
he saw me at the market, that's how I knew
that we were not dealing with hYP displays.
Speaker 1: Yup.
Speaker 2: I don't care what the x ray yet said, but
he was answering all my questions appropriately. So what happens
is when the dog's legs are pulled back in what
we call extension, the vertebrae come together like this at
the top. I don't know if you can see my fists,
my knuckles, and they shark touching and pinching. Sometimes even
it slides up and this piece goes actually into the
vertierral canal. However, when their legs are tucked under them,
so picture dog about to jump off the way their
curved body is when they're jumping off that couch, when
they're going downstairs, then it opens up that space. It's like, oh,
it's relief. They feel actually feel good and that's the difference.
And therefore LS disease is very common usually can be
treated medically on occasion. If it's really bad, it needs
to be treated surgically. But I will tell you when
you have that large dog arthritic dog that has clinical
onset of signs rapidly. In other words, it's a sudden
onset regardless of what the X rays may show about
the hips, you need to start looking at other things,
and LS disease, lumbo sacle instability is going to be
one of the highest things on my list. So once again,
there's so much to talk about when it comes to
these problems. I really want you to understand your pets better.
So we're going to as I'm gonna make a note
to myself next week, we are going to cover the knees.
We're going to cover the meniscus. We're gonna cover the
cruciate ligament, which is a really common problem and one
of the few that no matter how conservative you want
to be and how much you want to avoid surgery,
and I don't blame you, it's one of those injuries
when it comes to the cruciate ligament that you're going
to have a tough time avoiding surgery. We'll give you
all the pros and cons next week when we're here.
When you join me here ask the best of doctor
Jeff here on pet Life Radios. And we will once
again want to thank our sponsors, which are process pet
products and cong and again none of you gave us
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We'll see you next week.
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