部分医生都是以触诊或外观来判断,但是根据国外相关研究认为必须照射X光片由专业医生诊断,才能正确无误地判定是否为CHD,在美国有一个组织叫做OFA(Orthopedic Foundation for Animals,网址: http://www.offa.org ),只要缴纳$10费用,就可以将X光片交给他们来判定,依据OFA的做法是两岁以前只作评估,满两岁才做正式判定,因为两岁以前狗狗还在发育有可能幼时由于股骨头与脾臼的发育速度不一,产生髋关节发育不全的现象,然而也有幼犬时期髋关节发育是正常的,但是在成长过程,髋关节进行严重的结构改变,CHD才逐渐显现,因此必须在发育完成后做最后判定。
No one can predict when or even if a dysplastic dog will start showing clinical signs of lameness due to pain. There are multiple environmental factors such as caloric intake, level of exercise, and weather that can affect the severity of clinical signs and phenotypic expression (radiographic changes). There is no rhyme or reason to the severity of radiographic changes correlated with the clinical findings. There are a number of dysplastic dogs with severe arthritis that run, jump, and play as if nothing is wrong and some dogs with barely any arthritic radiographic changes that are severely lame.
Hip Dysplasia Treatment Options 髖關節發育不全的治療選擇
General Guidelines基本原則
Once osteoarthritis is present on a radiograph, dysplastic changes are irreversible and usually continue to progress over time.
If a dysplastic dog has secondary arthritis and pain, most owners elect to first treat their dog with medical management. The
key to medical management of arthritis is weight control and exercise management. Studies have shown that up to 76% of
severely dysplastic dogs with arthritis secondary to HD are able to function and live comfortable quality lives with conservative
management.
With weight control, the goal is to prevent the dog from becoming overweight to reduce mechanical stresses applied to the hip
joints. In general terms, the ribs should be easily palpated and there should be an indentation in front of the pelvic wings (waist
line).
一旦在X光上看到退化性關節炎的症狀,退化性的變化將是不可逆,而且會隨著時間持續變化的。如果一隻患有CHD的狗有二次退化性關節炎和疼痛的情形發生,大部分的飼主會選擇用醫療管理來治療他們的狗狗。針對關節炎而實行的醫療管理,其重點在於體重控制和運動管理。研究指出,高達76%患有嚴重CHD,且發生二次退化性關節炎的狗狗,能夠在保守療法下,維持關節的正常功能並且擁有舒服的生活品質。關於體重控制,目標在預防狗狗變得過重,以減少髖關節受到的機械性壓迫。一般對體重控制的定義,是必須能輕易的觸摸到肋骨,並且有腰身。
Controlled exercise is indicated to prevent or relieve the inflammatory process that leads to the pain associated with arthritis. The
amount and difficulty of the activity is determined on a trial and error basis. Exercise should start with short leash walks and be
gradually increased until the dog reaches the desired level of activity. If clinical signs start to reappear, the amount of exercise is
scaled back to a level that will not cause clinical signs. Overall, exercise should fit to an individual dog's maximum intensity level
with the goal to maintain muscle tone and cardiovascular function without causing pain, stiffness, and inflammation to the joint. The
right amount of exercise helps to maintain muscle tone and strength and stabilizes the unstable dysplastic joint. Exercise also improves
joint range of motion which in turn, keeps the dog more comfortable. Swimming, because it is a non-weight bearing exercise, can be
a very useful means of maintaining muscle tone and range of motion without placing concussive forces on the joint.
總而言之,運動管理應該要合適的達到犬隻個體的最大強度,以達到維持肌肉狀態和心血管功能的目標,並且不能造成關
節的疼痛、僵硬和發炎。正確的運動量可以幫助維持肌肉狀態、強度,並且幫助穩定因發育不全而不穩定的髖關節。運動
也可以改善關節轉動的範圍,讓狗狗能夠感到更舒服。游泳也是一項非常好的選擇,因為它是一項不需承受體重的運動,
游泳對於維持肌肉狀態和增進關節轉動範圍非常有用,而且不會為關節帶來任何衝擊。
Keep the dog in a warm environment. Warmth tends to help control the pain of arthritis from hip dysplasia. As in people, arthritic
pain in dogs tends to be worse in the damp and cold of winter. Providing a well-padded and warm bed will help alleviate some of
the pain associated with osteoarthritis. An egg-crate foam bed for dogs is commercially available. Applying superficial heat in the
form of heating pads may also relieve pain. Care must be taken not to burn the skin especially with an electric heating pad. Heat
works best for chronically inflamed joints from arthritis while cold works better to treat acute (sudden) types of joint injury.