May this can help it is an excerpt from the following website:
www.peteducation.com
How is hip dysplasia treated surgically?
There are several surgical procedures available depending on the age and the severity of the joint degeneration.
Triple Pelvic Osteotomy (TPO): TPO is a procedure used in young dogs usually less than 10 months of age that have radiographs that show severe hip laxity, but have not developed severe damage to the joints. The procedure involves a surgical breaking of the pelvic bones and a realignment of the femoral head and acetabulum restoring the coxofemoral weight-bearing surface area and correcting femoral head subluxation. This is a major surgery and is very expensive, but the surgery has been very successful on animals that meet the requirements.
Total Hip Replacement: may be the best surgical option for dogs that have degenerative joint disease as a result of chronic hip dysplasia. Total hip replacement is a salvage procedure that can produce a functionally normal joint, eliminate degenerative changes, and alleviate joint pain. The procedure involves the removal of the existing joint and replacing it with a prosthesis. To be a candidate for this procedure, the animal must be skeletally mature and is usually performed on dogs weighing at least 20 pounds. There is no maximum size limit. If both hips need to be replaced, there is a three-month period of rest recommended between the surgeries. As with the TPO surgery, this is a very expensive procedure but has had some very good results.
Femoral Head and Neck Excision: Femoral head and neck excision is a procedure in which the head of the femur is surgically removed and a fibrous pseudo-joint forms. This procedure is considered a salvage procedure and is used in cases where degenerative joint disease has occurred and total hip replacement is not feasible. The resulting pseudo-joint will be free from pain and allow the animal to increase its activity, however, full range of motion and joint stability are decreased. For best results, the patient should weigh less than 45 pounds, however, the procedure may be performed on larger dogs.
Juvenile Pubic Symphysiodesis: A new, less invasive surgery for treating hip dysplasia, called Juvenile Pubic Symphysiodesis, is currently being evaluated. This surgery prematurely fuses two pelvic bones together, allowing the other pelvic bones to develop normally. This changes the angle of the hips, lessening the likelihood of arthritis. Early diagnosis is critical, since the procedure must be done before 20 weeks of age, preferably 16 weeks.
Pectineal Myectomy: This is a somewhat controversial treatment for patients with chronic hip dysplasia. The pectineus is one of the muscles attaching the femur to the pelvis. By cutting and removing this muscle, the tension on the joint and joint capsule are reduced. This offers some pain relief for some patients, but does not slow the progression of the disease. There are possible complications with this procedure and with the introduction of the newer, better procedures. This surgery is rarely performed anymore.
How is hip dysplasia treated medically?
Because hip dysplasia is primarily an inherited condition, there are no products on the market that prevent the development of hip dysplasia.
Medical treatment of hip dysplasia and osteoarthritis has greatly improved in the last several years thanks to the introduction and approval of several new supplements and drugs. Because hip dysplasia (and other types of dysplasias) are primarily inherited conditions, there are no products on the market that prevent their development. Through proper diet, exercise, supplements, anti-inflammatories, and pain relief, you may be able to decrease the progression of degenerative joint disease, but the looseness in the joint or bony changes will not change significantly.
Medical management is indicated for both young dogs with clinical signs and for older dogs with chronic osteoarthritis. Because of the high cost involved with many surgeries, medical management is many times the only realistic option for many pet owners. Medical management is multifaceted. For the best results, several of the following modalities should be instituted. For most animals, veterinarians begin with the first recommendations and work their way down this list as needed to control the pain and inflammation associated with degenerative joint disease.
Weight Management
Weight management is the first thing that must be addressed. All surgical and medical procedures will be more beneficial if the animal is not overweight. Considering that up to half of the pets in the U.S. are overweight, there is a fair chance that many of the dogs with hip dysplasia/osteoarthritis are also overweight. Helping a dog lose pounds until he reaches his recommended weight, and keeping it there, may be the most important thing an owner can do for a pet. However, this may be the hardest part of the treatment, but it is worth it. You, as the owner, have control over what your dog eats. If you feed an appropriate food at an appropriate level and keep treats to a minimum, your dog will lose weight.
Exercise
Exercise is the next important step. Exercise that provides for good range of motion and muscle building and limits wear and tear on the joints is the best. Leash walking, swimming, walking on treadmills, slow jogging, and going up and down stairs are excellent low-impact exercises. An exercise program should be individualized for each dog based on the severity of the osteoarthritis, weight, and condition of the dog. In general, too little exercise can be more detrimental than too much, however the wrong type of exercise can cause harm. While watching a dog play Frisbee is very enjoyable and fun for the dog, it is very hard on a dog's joints. Remember, it is important to exercise daily; only exercising on weekends, for instance, may cause more harm than good if the animal is sore for the rest of the week and reluctant to move at all. Warming the muscles prior to exercise and following exercise with a "warm-down" period are beneficial. Consult with your veterinarian regarding an exercise program appropriate for your dog.
Warmth and good sleeping areas
Most people with arthritis find that the signs tend to worsen in cold, damp weather. Keeping your pet warm, may help him be more comfortable. A pet sweater will help keep joints warmer. You may want to consider keeping the temperature in your home a little warmer, too.
Providing a firm, orthopedic foam bed helps many dogs with arthritis. Beds with dome-shaped, orthopedic foam distribute weight evenly and reduce pressure on joints. They are also much easier for the pet to get out of. Place the bed in a warm spot away from drafts.
Massage and physical therapy
Your veterinarian or the veterinary staff can show you how to perform physical therapy and massage on your dog to help relax stiff muscles and promote a good range of motion in the joints. Remember, your dog is in pain, so start slowly and build trust. Start by petting the area and work up to gently kneading the muscles around the joint with your fingertips using a small, circular motion. Gradually work your way out to the surrounding muscles. Moist heat is also beneficial.
Making daily activities less painful
Going up and down stairs is often difficult for arthritic pets, and for dogs, it can make going outside to urinate and defecate very difficult. Many people build or buy ramps, especially on stairs leading to the outside, to make it easier for the dogs to go outside.
Larger breed dogs can especially benefit from elevating their food and water bowls. Elevated feeders make eating and drinking more comfortable for arthritic pets, particularly if there is stiffness in the neck or back.
Oral Disease-Modifying Osteoarthritis Agents
Glucosamine and Chondroitin: Glucosamine and chondroitin are two ingredients of supplements that have become widely used in treating both animals and humans for osteoarthritis. Due to the overwhelming success in treating patients with osteoarthritis, these products have come to the forefront of therapy and are becoming the most popular products for managing arthritis today.
