What are we checking?
At your puppy’s 16 week joint check we will carefully examine every joint in their body. That is from their digits to wrists and ankles, elbows and knees, shoulders and hips, and spine. What we are assessing and ensuring with this check is that all of their joints and their surrounding muscles are moving comfortably and freely through their usual range of movement. Some puppies can be a little wriggly and vocal on examination, but when it comes to their joints we want to make sure that there is no pain or restriction occurring.
Some of the common joint problems that we want to make sure your pet is free from are elbow disease, shoulder OC +/- D and excess hip laxity also known as hip dysplasia. The reason it is important to assess your puppy for these conditions is that if they are left undiagnosed they cause an immense amount of pain and discomfort.
What is Elbow Disease?
Elbow disease is a broad term which covers 3 different diseases that can affect your puppy’s elbows. All 3 cause pain on movement of your puppy’s elbow, or present with your puppy not wanting to move their elbow through the normal range of movement.
• FCP – Fragmented Coronoid Process
A fragmented coronoid process is where the ulna, inside the elbow joint, has a bone fragment which has chipped off. As you can imagine a loose fragment of bone rubbing within the joint causes a lot of pain to your pet and inflammation to occur within the joint.
• UAP – Ununited Anconeal Process
The anconeal process is the top bony portion of the ulna which makes up the elbow joint, and can be felt at the back of the elbow protruding. This part of the ulna grows from a separate “centre of ossification”, which in short means that it is separate from the rest of the ulna in your young pup and then joins with the rest of the ulna bone and should be solidly joined from 5-6months of age.
• OC and OCD – Osteochondrosis and Osteochondrosis Dissecans
This is a disease that is not only common to the elbow, but also other joints in the body as well. The reason it can occur anywhere is that it occurs in bone growth plates, which are on most bones. Growth plates contain cartilage that has to undergo a process to turn into bone. A dog with OC has cartilage where the process of turning cartilage to bone has been disrupted, and as a result the cartilage stays and becomes thicker and thicker.
OCD is a progression of OC, where the thickened piece of cartilage hasn’t been able to get nutrients properly due to its thickness. When the cartilage cannot get nutrients it dies and detaches from the underlying structure. The “D” in OCD stands for ‘dissecans,’ and refers to the little flap of cartilage that is no longer attached.
What’s the next step if there is elbow pain?
The next step is imaging! We can only tell so much from the outside of your puppy. If we have found that your puppy is painful, unable to move their joints as much as what we would consider to be normal, or they seem to be consistently wriggly and vocalising on movement of the joint, we will recommend imaging. This usually means a simple radiograph, but sometimes we will recommend a CT scan instead or in addition to radiographs because this allows us a much more informative and in depth look at your puppy’s painful joint.
If there are abnormalities on imaging the following step is usually surgery done through little holes into the elbow joints with a camera and instruments. This is referred to as arthroscopy and is performed by specialist veterinary surgeons through referral clinics.
What is shoulder OC +/- D?
When it comes to the shoulders the largest issue which can affect them is usually OC and OCD. This occurs exactly the same as it does in the elbows, see OC and OCD above in elbow disease. It is usually investigated with further imaging and arthroscopy.
What is hip dysplasia?
Your Puppy’s hips are a ball and socket joint, made up of the ball from the femur or thigh bone and the socket of the hip. For a comfortable fit the ‘ball’ should fit snuggly into the ‘socket’ and shouldn’t be able to come out from underneath the socket during movement. The term hip laxity is used to describe how much movement there is from where the ball is snug in the socket to the loosest point in the socket. Between each individual dog there will be a different level of hip laxity, and this can be measured.
Hip dysplasia is a strongly inherited trait, being passed from parents to puppy, but it is also affected by environmental factors such as level of activity, diet, body type etc. It has been commonly associated with larger breeds, German Shepherds, Labradors, Australian Border Collies, but can also affect smaller breeds, King Charles Cavaliers, Terriers, Cavoodles. If hip laxity is high in your puppy you may see signs of your puppy not wanting to jump up, not wanting to go up stairs, bunny hopping up stairs, decreased activity or length of exercise, or soreness with activity. Although, it is worth saying that because puppies are so young and they haven’t had a lifetime of wear and tear on their hips, they may not show any signs at all.
Uncomfortable hips, what next?
If your puppy has been examined and is found to be uncomfortable on hip movement, we want to make sure they are not suffering from hip dysplasia. The only way to tell this is again with further imaging, which is carried out with radiographs. However, unlike elbow and shoulder disease, hip dysplasia requires that we do a series of radiographs called PennHIP radiographs. These radiographs ideally need to be performed between 16-18weeks of age, as surgical therapy needs to be performed before 20weeks of age in puppies with hip dysplasia.
What is a PennHIP radiograph series?
To perform this procedure your puppy will need to be sedated or under a general anaesthetic. PennHIP radiographs are a series of 3 radiographs including a hip extended view, a compression view and a distraction view. The hip extended view allows us to assess the actual anatomy of your puppy and their hips in particular. Followed by a compressed view which shows how tight the ‘ball’ can fit in the ‘socket’, and a distraction view which shows how far the ‘ball’ can come out of the ‘socket’. Through this series of images we can assess whether excess laxity is present in your puppy.
What is a JPS and what is it going to do for my puppy’s loose hips?
JPS stands for , and it is the “preventative” surgical procedure of choice if your puppy has excess hip laxity on PennHIP radiographs. The surgery aims to fuse the pelvis at the growth plate so that as your puppy grows the ‘socket’ will be forced to rotate slightly and grow over the top of the ‘ball,’ thus covering it with more of the ‘socket’. In turn the hip joint is more supported and the degree of arthritis and pain that comes with it in the future for your puppy will be lessened.
The JPS procedure is a minor surgery performed under a general anaesthetic. The surgery carries minimal complications, and your puppy will be able to go home the same day. The biggest thing to remember with a JPS surgery is that it is performed to try and minimise arthritis in the future and provide comfort for your puppy throughout movement. While it is nice to be able to see a change in your pet after surgery, this is one surgery where we hope to not see any changes in their hips for a long time after surgery.