Pupscan Project

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What is PUPscan?

The PUPscan Project is to research and develop the diagnosis and treatment of inherited hip and elbow disorders using Ultrasound.  

The project is headed by a team of people dedicated to the health and wellbeing of dogs who will identify the post-natal events that are described as ‘dysplasia’ at skeletal maturity as distinct from inherited disorders by scanning hips in the first 2 months of life.

Over the period of the research the PUPscan project will produce breed and gender specific data and measurements that can be used as guidance for puppy care for the future in order to minimise the risk of disability.

The team member’s CV is impressive in a way that brings a vast wealth of experience and knowledge to this emerging field. 

 Vets (with Orthopaedic interest) 
 Consultant Surgeon with a special interest in paediatric Orthopaedics 
 Lawyer 
 Experienced Breeders 

PUPscan is a division of Woof House Ltd which has been established since 2011. The PUPscan project began 3 years ago, with the aim of finding a cause/diagnosis for why the incidence of hip and elbow ‘Dysplasia’ in dogs has not reduced despite a complex scoring system. 

The current scoring method was introduced in 1965. While the overall appearance of dogs has changed significantly in the past 50 years the current scoring system has not adapted to reduced the incidence of abnormal hips or elbows in most breeds of dogs. 

PUPscan refines the diagnosis in a way that is specific to the first weeks of puppy life as opposed to the generalised description ‘Dysplasia’ which is only observed on x-ray at full skeletal maturity. By imaging puppies at the age of 6 – 8 weeks we are able to clearly identify abnormal hip or elbow joints consistent with congenital disease. There is more likely a genetic basis for changes seen soon after birth and more likely an acquired reason for changes later in growth. This has not been studied in large numbers of dogs of different breeds and over 2 years of growth and development. We will produce breed and gender specific data and measurements that can be used as guidance for puppy care for the future in order to minimise the risk of disability.

PUPscan uses Ultrasound scanning to identify abnormal hips before two months of age. Each puppy scanned will also have a DNA sample taken for identification and genetic analysis and the data will be sent to the Kennel Club.  If the PUPscan Project can help separate the genetic problem from those acquired that have no genetic basis, numerous dogs could be restored to the gene pool; this is one of the many reasons why breeders are welcoming the project with such enthusiasm. The Vets who are involved with the PUPscan Project are looking forward to the day when an early diagnosis will allow them to start a treatment program which could very well restore hips to good health. For the last 30 years in human babies this treatment has usually lead to normal hips. This time human research could be used for the benefit of dogs, a very welcome change!
PUPscan have asked breeders to continue to use the BVA\KC scoring process so that as the puppies grow to full skeletal maturity we will be able to correlate the early scan with the later appearance. This will separate genetically acquired ‘Dysplasia’ from all the other processes that can lead to the appearance of ‘Dysplasia’. 

All scans are carried out using Ultrasound because this can image soft tissues such as cartilage in great detail long before there is any substantial bone formation. Ultrasound can also be used to image puppies with limb injuries without the need for general anaesthetic. If puppies are injured and lame for a few days appropriately trained Vets will be able to scan the injured limb and make a diagnosis, something that is believed to be risky with x-ray because of the need to anaesthetise a puppy for x-ray. Where a limb has been injured the veterinary sonographer will also be able to identify ligament injuries in the injured joint; it is the Laxity from ligament damage that is known to cause Arthritis in dogs and humans.

PUPscan Ultra Sound imaging is carried out without anaesthetic or muscle relaxation in a natural position of load bearing so that normal joint mechanics are not disturbed unlike the procedure used to produce a ‘standardised’ x-ray. We are working with nature rather than against it! 

Breeders understand that bitches and dogs mature at different rates and in different breeds. As the data accumulates we will be able to provide material support for breeders: guidance to assist the new owner on how to care for their puppy that will be both breed and gender specific.

In the time we have been planning this project and in our discussions with the Kennel Club it has been agreed that some breeds appear to be more at risk than others. Therefore some will only require hip scans while others will require both hip and elbow scans.

Large numbers of puppies will need to be scanned before there is a statistically significant sample. Once all the data has been collated papers will be presented for peer review for publication in international learned Journals.  Our discussions with the Kennel Club and others will remain confidential until publication. In the meantime all data will be shared between PUPscan and the Kennel Club genetics team.

What is the Procedure of PUPscan?

At 6 – 8 weeks of age when the hip (or elbow) is predominately cartilage an image is acquired by Ultrasound. An Ultrasound examination is a non-invasive imaging technique, and does not require any hair removal. 

Ultrasound imaging allows internal body structures to be seen by recording echoes or reflection of ultrasonic waves. No anaesthetic or sedation is needed. The image is taken while the puppy is in a natural load bearing position or cradled in the breeder’s or a team member’s arms. Both hips or elbows can be imaged in less than 15 minutes. 

The Ultrasound conductive water based gel is applied to the puppy’s coat and leaves no residue when wiped away. The gel is non-toxic so has no impact on the coat. 

The Diagnostic Technician (Sonographer) will image the area to be scanned and the transceiver will produce an image from which measurements can be taken during the procedure.

The Ultrasound scan is performed in real time, there is no ionising radiation and therefore there is no risk to Ovaries or Testes. The Breeder can see the images immediately.

A 6 week old Belgian Shepherd 

A 3 weeks old Bernese Mountain Dog

A 6.5 week old Labrador Retriever

 

'Dysplasia' History

In the 1950’s increasing numbers of dog owners were finding very early hip arthritis to be a problem, some having symptoms from 2 years of age. The commonest breeds in which this was noticed were Labradors, Retrievers and German Shepherds; however, this may simply be because they were the most numerous presenting to vets.

‘Dysplasia’ is a term frequently used to describe the general appearance of an abnormal joint, but this is not specific to any single diagnosis. For example, an x-ray taken at skeletal maturity will show changes from healed trauma, growth plate injury and Perthes disease which can all look similar to genetic or congenital abnormality. These conditions are acquired after birth and the genetics not proven despite decades of research.   

The ‘Dysplasia’ score given from x-rays does NOT include a diagnosis but despite this frequently leads to complaints against the breeder which are often unjustified. The traditional scoring method takes account of many factors without being breed specific. One of these factors scored is Laxity, which breeders understand varies greatly between breeds and gender. 

In human studies, joint laxity following trauma is highly correlated with early onset of Osteoarthritis; Non -Traumatic Laxity has NOT been correlated with premature arthritis.

It is widely known that research for the benefit of humans has involved dogs; Norberg (famous for the Norberg angle) used his knowledge of human joint disorders, stating in his original published work from the early 1960s ‘However, the Basic features are similar and for this reason one has the right to assume that the disease is basically the same in the two species.’

Sadly it would seem that this knowledge has rarely been applied for the benefit of our dogs. 

From 1957 to 2017 there is still a failure to learn from Norberg and his colleagues who believed that: ‘environmental factors are responsible for about 50 per cent of the variation of the severity of hip dysplasia.’  Is this largely down to selective use of their pioneering work?

With elbow ‘Dysplasia’ the diagnosis is even more confusing with at least five different conditions all ending up labelled as ‘Dysplasia’ even though probably with very different causes.  Ultrasound scanning of elbow joints in the pilot study has been shown to give good images which can be the base line for similar on going study to the hip scanning project.  Slipping Patella is another condition that the team have been asked to consider for investigation.

The Future

The PUPscan research project is using the most modern diagnostic Ultrasound technology to separate joint disorders at birth from those that are certainly acquired later in life through environmental factors. 


PUPscan have established there are significant differences in the development of puppy hips between breeds and even between the genders. This is the basis for the guidance that will be produced by breed clubs and councils on the best way to look after a new puppy.


The benefit to both the dog and breeder is that good pictures of hips and elbows can be given from 14 days of age to 8 weeks, confirming normal development.  The breeder therefore has as much information as possible about joint development of each puppy bred.


Ultrasound diagnostics can support you as a breeder and can help to defend you from subsequent allegations or claims of selling ‘Dysplastic’ puppies.  

One of the key aims of the PUPscan Project is to generate scientifically based data to highlight the importance of breed and gender specific husbandry.


The PUPscan team is working with clubs to produce breed specific booklets giving clear guidance to new puppy owners. The booklet will reinforce the duties of care and responsibilities in the care of the puppy with clear evidence based holistic guidance to include, among other things, breed specific health issues. 


PUPscan trained Vets will be best placed to support the breeder but also the new puppy owner.  Ultrasound diagnostic techniques for imaging joints can be used to diagnose and manage acute bone and joint injuries in the immature skeleton. It is also possible to diagnose and manage adult dogs with similar conditions, thus reducing the need for more invasive procedures. Ultrasound guided treatments can reduce recovery times and disability.