Hi all,

Our lab puppy has had an initial Hip Dysplasia diagnosis. Our vet said that he should only ever be lead walked and will get arthritis when he's 12-18months old.
We asked for a referral to get as much info as possible and, after seeing the clinical director yesterday, obatined one for Anderson Abercromby (we are in Guildford).
However we have done some research and there is an op, touted as a minimally invasive HD prevention, that should be performed about 12-16 weeks (our pup is 14 wks today) - it's called Juvenile Pubic Symphysiodesis (JPS) and is one of the ops offered by the orthopaedic vet Noel Fitzpatrick so we wanted to chat to him (asap in view of the timeline) about the possibility. Our vet has agreed to refer us to him but under a lot of duress. So my question is: has anyone any experience of the JPS and/or Noel Fitzpatrick? I have only ever read good things about him but am confused as to why my vet isn't keen?

Thanks to all (this is my first post!)

Sorry to hear that your lab has HD and so young too, did he have exrays to confirm this?   I'm surprised that this has been diagnosed at such an early age?

You should only be giving your pup short lead walks (about 10 minutes) for his age anyway so your vet is right about that, he will get all the play he needs running around in the house or your garden.  Don't let him use the stairs or jump on and off furniture, all will prevent his HD getting any worse.

I would defintley get a second opinion ask your vet to refer you to a specialist but I would be quite careful about any surgery unless it is really necessary, dogs do not recover from this type of surgery as quickly or easily as people imagine, surgery should definitley be the last resort.  If you take care of your puppy while he is growing, with limited exercise, prevent him from running up and down stairs etc there is no reason why your puppy will not grow up sound and healthy.

I had a dog with HD and we did see a couple of specialists, we were advised that no operation should be carried out on his limbs until he was fully grown and this was put at the age of 2.  He was a retreiver so similar size to a lab. 

I don't know anything about the operation you refer at 12 - 16 weeks but just going from what we were advised it doesn't seem quite right.  Your dogs limbs and joints will be growing all the time and the operation would need to be carried out at intervals until he is fully grown which cannot be in the dogs best interest.

Please think long and hard before putting such a young puppy through such a traumatic operation, your vet seems wise not wanting to refer you for this procedure, maybe ask your vet to refer you to a specialist he has confidence in.

 

I presume your puppy has been PennHIP assessed or is being referred for PennHIP assessment ? Noel is one of only two vets in the UK who do this assessment & corrective surgery is available to reduce the effects of the HD in later life

I whole heartedly agree with Pery, you dog is no where near fully grown & you really shouldn't be operating until she's at least 18 months but 2 would be better.  I know first hand how heart breaking this will be to you but there are so many others things other than surgery that can help HD - if you search on here many many people have experience of it & can recommend some good alternatives to surgery.  I am surprised this has been diagnosed so young, I thought the symptoms generally started to show about 14-18 months.  Where the parents scored? Have you made the breeder aware of the problem?

The dog I had with HD was diagnosed at 6 months old, we were advised by the specialist to limit walking, stairs, jumping etc all very difficult for a bouncy pup.  We found hydrotherapy really helped his muscle tone.

As you say Gembo it is heartbreaking to see a young dog with HD.  Also agree that the breeder should be made aware as it seems to me that it has to be everything to do with breeding when a puppy is so young, as he/she certainly hasn't had time to do any damage to it's joints with the new owners.   Or maybe it was an accident with littermates that has caused the damage/injury?

> We found hydrotherapy really helped his muscle tone.
>

I'll second that, worked wonders for Molly!

The link Moonmaident has posted & I have also read some info on Fitzpatrick's website which makes very interesting reading.  I'll be really interested as to how this pans out, hope the OP keeps us updated.

Thanks all. He was x-rayed due to a slight limp (which now seems to have gone) and the fact that his wobbly gait was commented on. We have an appt with Noel on Friday so I imagine he will PennHip test him first (MoonMaiden - I'd love to hear about your experience with Noel).

There is no way I'd put our beloved pup through any of the serious surgical ops (TPO, hip replacement etc) until a) he was of a suitable age and b) only if he was suffering. But the op I am talking about is supposedly minimal and is done on young dogs precisely because their bones are still growing - the pubic bone is prematurely fused together so that as the dog grows the socket rotates for a better fit. If successful (and obviously we need to get an idea of the success rate amongst so many other questions) it could avoid HD and the associated arthritis. It just seems to me that this could be less cruel than limiting his free running.

At the mo it is just an option, which is why I'd like as much info as possible!

A huge thankyou for everyone's opinion though, so much appreciated.

I forgot to say:

Yes both parents hip scored - all fine
Yep, I've today emailed the breeder with info.
And finally, of course I'll keep you all updated, whatever we do. But I'm pretty sure hydrotherapy will be included if only because I suspect Beardsley will LOVE it!

And I've just noticed I used the word "cruel" when referring to limiting his exercise. That's wrong as doing that would always be with the best of intentions. I just meant that if a small op (he'll be up and about the same day or day after) means that he can live life to the full then maybe it's worth considering.

Hi AndiP

Not the same problem as you have but just my experiences. Years ago a dog I owned had a disc problem operated on by another specialist. He was never 100% after & died of a blood clot 3 months later. Then I had a pup with leg growth problems. 2 ops later by same specialist & the legs are worse than when we started. Of course it is possible that this would have happened had the ops been done elsewhere but I lost confidence in them. One of my dogs had a different back problem & I asked for a referral to Noel. He was not my vet's preferred choice - BUT IT WAS MY DOG & MY CHOICE SO I INSISTED).  He was brilliant, and he (not my vet) diagnosed her with hypothyroid so she wasnt able to have the op we'd hoped would save her. Very often Noel would phone me late at night with an update on my dog. I dont think the guy ever slept! We were even allowed to pick her up on a Sunday evening & he would be there.  Another of our dogs had a cruciate rupture repaired by our vet which wouldnt heal then redone by Noel's team which was a success.  I have heard criticism of Fitzpatricks but I've full confidence in them. I think some vets find him too "aggressive" (probably not the right word) in his surgery.  If if ever had anxieties I only had to phone & they'd say "of course you can come back, when would you like to pop in?".  Noel is further away for me than others but I would rather travel the distance. (Just want to add the 4 dogs with problems might seem a lot but this is over a 10 year period & I've owned/own many more healthy ones)!

WolfiesMum

I was referred to Noel by my vet when my then five-month-old dog fractured the growth plate in one of her legs.

He was brilliant and I would have every confidence in him as a surgeon.   He has more than enough business and I think any implication that he is too  "aggressive" when recommending surgery is probably not the case.   He is at the top of his profession in terms of performing pioneering surgical techniques - he lectures all over the world.

Having had a GSD who had severe displaysia - so much so that one vet recommended putting her down when she was only six months old -- I would have given anything to have surgery available to her at that time that even had the *slightest* chance of reducing its impact on her for the rest of her life.

Noel himself is personable, answers any question you might have fully and makes sure you understand it, and all-in-all is just a good human being.

> I whole heartedly agree with Pery, you dog is no where near fully grown & you really shouldn't be operating until she's at least 18 months but 2 would be better.

The reason for the operation whilst young is to prevent having major surgery later in life, it is nowhere near the same operation as the ones done in later life & is also done to prevent pain for the dog.

It is common for dogs in the US & the continent to be PennHIP assessed whilst young(Wukee's brother in the Netherlands has been PennHIP assessed & has better hips that the norm for BCs

I only know of Noel via reputation(good I might add)& he seems a very animal orientented vet at the cutting edge of vet science

Found this that you might be interested in:

Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA.

OBJECTIVE: To examine the effects of juvenile pubic symphysiodesis (JPS) on hip joint conformation, hip laxity, gait, and the development of degenerative joint disease (DJD) in dysplastic puppies operated at 15 and 20 weeks of age. STUDY DESIGN: Randomized controlled prospective study. ANIMALS-Eighteen female hound puppies with increased hip laxity. METHODS: Puppies were randomized to 1 of 4 treatment groups: JPS at 15 weeks of age (n = 6), sham-operated control at 15 weeks of age (n = 3), JPS at 20 weeks of age (n = 6), and sham-operated control at 20 weeks of age (n = 3). Hip extension with pain scoring, Ortolani palpation, hip reduction angle measurement (HRA), PennHIP radiography (University of Pennsylvania) with measurement of distraction index, Norberg angle measurement, and transverse computed tomographic imaging to measure acetabular angle (AA) and dorsal acetabular rim angle (DARA), were tested preoperatively, and at 1 and 2 years of age. RESULTS: JPS resulted in significant changes in AA, HRA, DARA, and conversion to Ortolani negative status. Larger and more rapid changes in hip conformation were seen when surgery was performed at 15 weeks of age. No significant changes were identified in control dogs. Twenty-five percent of JPS dogs developed DJD whereas 83% of control dogs developed DJD. CONCLUSIONS: JPS resulted in significant improvements in hip joint conformation and hip laxity in dysplastic puppies treated at 15 and 20 weeks of age. Improvements in conformation were significantly greater when surgery was performed at 15 weeks of age. CLINICAL RELEVANCE: JPS appears to be a promising treatment for hip dysplasia and is a safe and technically simple procedure to perform. Copyright 2002 by The American College of Veterinary Surgeons

Thanks for the Noel experiences - good to know.

I am starting to think our initial vet was way too pessimistic about Beardsley's x-rays. I spoke to the breeder last night who is obviously concerned plus also massively surprised - the previous litter of 9 from the sire/dam were all hip scored and the "worst" was 3/3, with several at 0. Not that this guarantees good hips for our boy but I will be pleased to get him PennHipped and have Noel's diagnosis.

I'll keep you informed.