Chase has dysplasia

Thank you for referring Chase for orthopaedic assessment. On exam today, Chase was bright and boisterous, but had a mild right fore lameness. He has mild muscle atrophy affecting the right thigh and gluteal musculature, and also had mild generalised muscle atrophy affecting the right fore limb. Chase has an obvious palpable joint effusion in the right elbow, and seemed sore on full extension of the right elbow. He did not show obvious pain on manipulation of either hip today.

The jPegs of radiographs provided show marked asymmetrical hip dysplasia, with subluxation of one of his hips (L vs R is not specifically labelled?). We could reassess Chase radiographically and by palpation under general anaesthesia to determine whether he might still benefit from triple pelvic osteotomy (TPO), as I would expect him to be at risk for degenerative joint disease in the affected hip in the future. It is likely that at 10 months of age, Chase might have secondary hip changes that might make him not a good candidate for TPO, so we might have to settle for conservative management (weight control, Hills j/D food, synoquin, hydrotherapy, physiotherapy) until such time as Chase develops more obvious lameness and arthritic pain. In many dogs, hip arthritis can be managed using non-

steroidal drugs relatively successfully, but in some, salvage surgical procedures such as femoral head excision arthroplasty or total hip replacement might be considered.

Mild degenerative changes and very slight flattening of the right distal medial humeral condyle are noted on the jPegs of Chase’s radiographs of the right elbow.

I suspect that he has either fragmentation of the right medial coronoid process of the elbow and or distal medial humeral condylar osteochondritis dissecans (OCD) based on his examination today. Although we could obtain advanced imaging (eg elbow CT) to investigate this further, it would likely be more cost effective for a charity for us to perform an exploratory right elbow arthrotomy so that we can treat according to the findings under the same anaesthetic. I estimate that withhip radiographs and repeat views of the elbows, the cost of diagnostics and surgery might be up to $3000 excluding todays’ consultation.

The prognosis for surgical treatment of elbow dysplasia is a little guarded as most dogs are left with at least some degree of joint arthritis and stiffness in spite of surgical treatment. Although Chase did not show much pain in his hips at today’s visit, I would expect him to require medical or surgical treatment for hip arthritis at some stage in the future. This could be as minor as intermittent non-steroidal drug use, or as major as a hip replacement or excision arthroplasty.

While decisions are made regarding Chase’s care, his caregivers already have some Metacam for use on days that he is particularly sore, and will continue to restrict his activity as much as possible. I realise that Hurrah will need to fund raise for Chase, and that his problems might have an effect on re-homing for him. Please do not hesitate to contact us if you would like to discuss this case further.

Regards,

Ruth Youmans

BVSc, DVCS, MVetClinStud, FANZCVSc

Registered specialist in small animal surgery