BACKGROUND TO HIP DYSPLASIA?
The PUPscan Project is to research the diagnosis and develop the treatment of inherited hip and elbow disorders using diagnostic Ultrasound imaging.
The project is headed by a team of people dedicated to the health and wellbeing of dogs. We will identify the pre- and post-natal events that contribute to ‘dysplasia’ at skeletal maturity (as distinct from inherited disorders) by scanning hips in the first months of life.
The PUPscan project will produce breed and gender specific data and measurements that can be used as guidance for puppy care to minimise the risk of disability.
The team members bring a vast wealth of experience and knowledge to this emerging field.
The Pupscan project began in early 2015 with the aim of finding the reasons why the incidence of hip and elbow ‘Dysplasia’ in dogs has not reduced despite five decades of a complex scoring system.
While the overall appearance of dogs has changed significantly in the past 50 years the current scoring system has nevertheless failed to reduce the incidence of abnormal hips or elbows in most breeds of dogs.
All Pupscans are carried out using Diagnostic Ultrasound.
Ultrasound can also be used following trauma to image puppies with limb injuries without the need for general anaesthetic. If puppies are injured or lame appropriately trained Vets can immediately scan the injured limb and make a diagnosis of fracture or ligament injury. With x-ray, because of the need to anaesthetise a puppy the risks are unknown; breeders will recognise that some breeds are more at risk from anaesthesia than others. It is ligament damage that is known to cause Arthritis in dogs and humans and notLaxity alone.
Pupscan Ultra Sound imaging is carried out without anaesthetic or muscle relaxation in a natural position. Normal joint mechanics are not disturbed unlike the procedure used to produce a hip score x-ray. We are working with the natural biomechanics of the canine joint.
Breeders recognise and understand how the genders mature at different rates within their breeds. They also appreciate how this differs across the breeds.
In the time we have carried out this research and in our discussions with both international breed and European Kennel Clubs it has been agreed that some breeds appear to be more at risk than others.
This has not been studied prospectively in large numbers of dogs across multiple breeds. Pupscan will help and support breeders make an informed decision about the dogs they select for the gene pool. Some dogs may have been previously considered for removal from breeding based on x-rays without diagnosis.
Pupscan have therefore created the x-ray diagnostic referral panel.
By bringing together Veterinary, Human and Biomechanical Engineering Consultants we will deliver the ONE true medicine.
WHAT IS THE PROCEDURE OF
The procedure is very straight forward. From soon after birth when the hip (or elbow) is predominately cartilage a diagnostic image is acquired using Ultrasound. The examination is a non-invasive imaging technique and does not require any hair removal.
The image is taken while the puppy is in a natural position.
The Ultrasound scan is acquired without the need for sedation or muscle relaxants there is no ionising radiation and therefore there is no risk to Ovaries or Testes. The Breeder and the technician can view the images immediately while examining all areas of the joint.
The images acquired will be stored, downloaded and reviewed by the appropriate clinicians, thereafter the data will be interrogated by the heads of research.
The procedure can be safely repeated for analysis over time.
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 popular breeds and therefore the most numerous presenting to vets.
‘Dysplasia’ is a term frequently used to describe the general appearance of abnormal joint development 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 abnormalities. These conditions are acquired after birth and the genetics not proven despite decades of research.
The historic scoring methods are based on phenotypic features. A score given from x-rays does NOT include a diagnosis. One of the 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; however non -traumatic laxity has NOT been correlated with premature arthritis.
It is acknowledged that research involving dogs and other species has been for the benefited humans; 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 principal has been in the main forgotten and rarely applied for the benefit of dogs.
From 1957 to 2018 there is still a failure to learn from Norberg and his colleagues who believed that: ‘environmental factors are responsible for at least 50 per cent of the variation of the severity of hip dysplasia. Is this largely down to selective use of their pioneering work?
Elbow ‘Dysplasia’ diagnosis is even more confusing with at least five different conditions all being labelled ‘Dysplasia’; probably with very different causes. The Pupscan pilot study for elbow disorders in dogs using Ultrasound imaging demonstrated that excellent diagnostic images could be obtained. Applying the same hypothesis as we did for hips will be the baseline for a parallel study for elbows
Slipping Patella is another condition that the team are considering for investigation as it again exists in humans and had been previously studied across species.
The Pupscan research project is using the most modern diagnostic Ultrasound technology to separate joint disorders at birth from those that are acquired later in life through environmental or nutritional factors.
Pupscan have confirmed that there are significant differences in the development of puppy hips between breeds and even between the genders. Publications produced in collaboration with UCD will confirm the findings.
The benefit to both the dog and breeder is that good pictures of hips and elbows can be obtained soon after birth to 16 plus weeks (depending on breed) confirming normal development. The breeder therefore has as much information as possible about joint development of each puppy in the litter.
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 are working with Breed Clubs to produce breed specific booklets giving clear evidence-based husbandry guidance to new puppy owners.
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 soft tissue injuries, thus reducing the need for more invasive procedures.
Ultrasound guided treatments can reduce risk, recovery times and disability.