Thursday, July 2, 2015

The Pet PT Pit Stop: Prevention and Management of Hip Dysplasia in Puppies: Attention all Breeders!

by Susan E. Davis, PT “pull in for a helpful refuel!”  

It’s all about guiding and empowering you to help your dog avoid injury, provide practical solutions and achieve rapid restoration of health and function!   


Here’s an interesting fact: all (or nearly all) puppies are born with NORMAL HIPS. 

Radiographs taken of their hips appear normal for the first few weeks of life.

Puppies with hip dysplasia will start showing changes in the shape and congruity of the hip joint as early as 2 weeks of age.

From 2 to 5 months further changes are seen, including more luxation, roughening of the top rim of the socket and flattening of the ball (femoral head).

Beginning about 4 months, puppies with hip dysplasia begin to show the first outward signs of hip dysplasia.

Samples of these signs include:
  • stiffness rising from the floor
  • lameness with running, jumping, going up/down stairs
  • reduced muscle development in the hips and thighs
  • bunny-hopping pattern of running.  
Regular walking will still usually look normal at this stage.

By the time a puppy with hip dysplasia reaches 11-12 months of age, they start to display forward weight shifting, to take weight off their hind limbs.  

The hind limbs may be held narrowly together and the pelvis waddles from side to side during gait. The young dog may appear hesitant to run, slow to stand, and painful when attempts are made to pull the hips backward, into extension. The gait pattern shows short, choppy stride lengths.

It all sounds pretty depressing, right?  But wait, didn’t we say above that pups start out with normal hips?

Doesn’t that mean that there might be a chance in the very early stages of life to make a positive change?

Here’s what Piermattei, Flo and Decamp say in their 2006 publication:  “The disease CHD (Canine Hip Dysplasia) is preventable if hip congruity is maintained until ossification makes the acetabulum less plastic and the surrounding soft tissues become sufficiently strong to prevent femoral head subluxation. Under normal circumstances, tissue strength and ossification progress sufficiently to prevent the disease by 6 months of age”.

Whoa, in other words, you have time to do something to help prevent CHD before the growth plates start to close and bone maturation occurs.  

This concept was not on the forefront of veterinary medicine until very recently.

I took a course this past spring at STAAR (Symposium of Therapeutic Advances in Animal Rehabilitation) taught by superstar canine physical therapist  Laurie Edge-Hughes, who broke it down for us.  Super cool information!

As recent as 2012, Krontveit et al found a reduced rate of CHD in puppies allowed to have daily walks and exercise on soft ground and moderately rough terrain. 

Puppies born on a farm and those with off-leash exercise outdoors, between birth and 3 months, had less CHD. But they also found puppies allowed to walk on stairs 0-3 months had an increased risk of developing CHD.

In 2013, Green et al found that longer daily exercise duration is associated with lower lameness scores in dogs with CHD.

I can hardly contain myself!

Here’s one more:  Smith et al, in 2006 found that limiting a dog’s diet yielded radiographic signs of hip arthritis that came on much later in life ( 12 vs 6 years of age) affecting far fewer of the littermates, as compared to dogs fed ‘at liberty’.

Back to the conference: at this point Ms. Edge-Hughes separated us into small groups and gave us the task of making a list of things breeders and puppy owners (especially during the 2-5 month period) can do to help prevent or reduce CHD, based on these findings.


Here are our top ten recommendations:

Diet and weight management
I will not pretend to be an expert in this area! You already know by past lessons that Jana Rade shared with us about looking at your dog’s waistline and feeling the ribs to determine if they are overweight, etc. If they are overweight, adjust their food intake and increase exercise and activity to reach ideal body condition. Your vet can help determine weight range.

There is a formula to help determine daily calorie intake to maintain ideal weight: start with the ideal/target weight your dog has attained in kg (divide pounds by 2.2). Next multiply this weight times 30. Add 70 to this value and you will have you will have the number of kcal per day needed to maintain weight. Your dog food manufacturer can tell you the number of kcal per serving measurement.   

Restrict access to stairs
Puppies clumsily climbing and slipping up and down stairs may look cute, but it is risky business!

Keep pups off stairs and carry them up/down stairs and steps for the first 3 months of life.  At four months, they can start to be trained to climb steps and staircases only if carpeted or have non-slip tread runners or pads. Use a leash with the training initially.


Coordination and body awareness
Get early starts by having puppies experiencing physical challenges and activity that help the firing of joint sensory receptors such as walking on packed or wet sand, moving around obstacles such as chair legs, vertical cones, and cardboard boxes; climbing over low soft objects such as sandbags, pillows, beanbags. Stimulate their balance by standing atop an uneven surface like a rocker board (non-skid on top).


Include joint stimulation and compression exercises
Have the puppy standing on a rubber or yoga mat, and gently bounce them on it, pushing lightly down and up on their shoulders and hips. Gently roll them from side to side, and onto their back and play a game of ‘push-a ways,’ by placing your palms against their paw pads, pressing their legs toward their belly in a bent position, and the puppy will respond by pushing their limbs against you. Another method is moving their limbs in a reciprocal ‘bicycling ‘motion with the pup on their back or side.


Strengthen specific muscle groups such as the gluteals (‘butt muscles”)
Stand the puppy with one side to a wall, then lift their outer rear leg and hold it up 1-2 seconds.  Repeat 4 times, and then place the pup with their other side against the wall, etc.

You can also add backward stepping by placing a small treat under the dog’s chin and moving toward them, forcing them to look down and step backwards. Strengthen further by doing ‘sit to stand’ exercises (and can advance this by placing the front paws up on a small box or stool). Core strengthening is also helpful.


During the puppy’s first few weeks of life, allow them to move in a non- slippery, indoor mini-arena with side walls and rubberized floor.


Once a pup is weaned, allow supervised activity and exercise on level non-skid terrain
Let puppies have access to free-range play, walking and movement on grass, sand, packed dirt or straw/hay.  Avoid wet grass, mud, rocks or any slippery uneven surface.


Elongated Stretch on a step or on the stairs
Place the dog with the rear legs on floor or lowest step, and the front paws on a riser few steps above, so the spine and hind limbs are elongated. Keep them there for a minute, coaxing them to look up for a treat or pat on the top of their head. Do this daily if possible.


Perform circular, flat- hand massage over the hips and pelvis, 5 minutes each side, three to four times per week.



What about swimming?
Swimming is not recommended for puppies as the buoyancy will not provide needed stimulation on the joints.  However, for older dogs with advanced CHD and degenerative arthritis, it is highly beneficial.

*** 

Susan E. Davis (Sue) is a licensed Physical Therapist with over 30 years of practice in the human field, who transitioned into the animal world after taking courses at the UT Canine Rehabilitation program.  She is located in Red Bank, New Jersey.

She has been providing PT services to dogs and other animals through her entity Joycare Onsite, LLC in pet’s homes and in vet clinics since 2008.

She also provides pro bono services at the Monmouth County SPCA in Eatontown, NJ.  Sue is the proud “dog mommy” to Penelope, a miniature Dachshund with “attitude”.  For more information see her website www.joycareonsite.com , or follow on Twitter @animalPTsue.


Sue is also the author of a fantastic book on physical therapy, Physical Therapy And Rehabilitation For Animals: A Guide For The Consumer.  

Physical therapy can do so many great things for your dog. Understanding all the possibilities physical therapy can offer will change your dog's life. This book definitely belongs on the shelf of every dog lover.



Articles by Susan E. Davis:
Functional Strengthening Exercises: the What, Why and How
One Thing Leads To Another: Why The Second ACL Often Goes Too
Compensation: An Attempt To Restore Harmony
Paring Down to the Canine Core
Canine Massage: Every Dog ‘Kneads’ It”
Photon Power: Can Laser Therapy Help Your Dog?  
Physical Therapy in the Veterinary World  
Reiki: Is it real? 
Dog Lessons: Cooper  
The Essentials Of Canine Injury Prevention: 7 Tips For Keeping Your Dog Safer 
It's Not Just Walking, It's Therapy! 
Treatment And Prevention Of Canine Intervertebral Disc Disease (Part I)
Treatment And Prevention Of Canine Intervertebral Disc Disease (Part II Physical Therapy)
Range Of Motion: It’s A Matter Of Degree…
The Weight Of Water And How It Helps Dogs 
By Land or By Sea? A Comparison of Canine Treadmills 
Unraveling The Mystery Of Fascia And Myofascial Trigger Points (Part I)
Unraveling The Mystery Of Fascia And Myofascial Trigger Points (Part II) 
Scar Tissue: Is it Too Much of a Good Thing? 
Physical Therapy Tip Of The Month: Ramps! 
Physical Therapy Tip Of The Month: Indoor Duo Dog Exercises!
Physical Therapy Tip Of The Month: Best Practices After Your Dog’s Surgery 
Physical Therapy Tip Of The Month: Ideas to Chew on - Can Physical Therapy Help with my Dog’s Digestive Problems?
Wrap It Up: Using Soft Supports For Your Dog
When Do I Use Heat versus Cold? : A Tale (or Tail) Of Two Temps! (Part I) 
When Do I Use Heat versus Cold? : A Tale (or Tail) Of Two Temps! (Part II) 
Physical Therapy Tip Of The Month: Safe Summer Boating Tips for your Dog 
Physical Therapy Tip Of The Month: Hip Dysplasia - What’s a Dawg Mama to Do?
PT Pit Stop: Wheeled Carts Keep Them Doggies Rollin' (Part I)
PT Pit Stop: Wheeled Carts Keep Them Doggies Rollin' (Part II)
Staying in the Loop with Targeted Pulsed Electromagnetic Field Therapy
Addressing Frailty Syndrome in Geriatric Dogs 
The Pet PT Pit Stop: "Where's The Evidence?"
Physical Therapy is Great, Except When It Isn’t 
Top Dogs and their Toplines at the Westminster Kennel Club Dog Show (Part I)
Top Dogs and their Toplines at the Westminster Kennel Club Dog Show (Part II) 
What's in a Dog's Gait? 
A Practical Method to manage your Dog’s Care Plan 
Wound Care 101 (Part I The Basics) 
Wound Care 101 (Part II Wound Management) 

Related articles:
Hip Dysplasia Prevention And Treatment Options
Hip Dysplasia - What’s a Dawg Mama to Do? 
Ruby's Journey with Hip Dysplasia
JD's Leg Injury And Hip Dysplasia

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