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HIP DYSPLASIA, (methods and technique), clinically affected - Coggle…

- - - - must be over 2 years of age
      - normal range (include four grade)
        
        Excellent: Nearly perfect conformation
        
        Good: Normal conformation for age and breed
        
        Fair: Less than ideal but within normal radiographic limits
        
        Borderline: poor positioning during radiographic procedures
      - Dysplastic hip joint (include 3 grade)
        
        mild : slight flattening of the femoral head and minor subluxation
        
        Moderate: evidence of a shallow acetabulum, flattened femoral head, poor joint congruency
        
        severe: Complete dislocation of the hip and severe flattening of the acetabulum and femoral head.
    - - Percent coverage of the femoral head (PC): normal: 50% or greater coverage
      - Norberg angle (NA)
      - define physeal scar to detrmine PC
    - - puppies as young as 4 months of age
      - general distraction index of less than 0.3
      - separation between normal dogs and dogs with conformation susceptible to DJD from hip dysplasia
  - - - method of Bardens
        
        accuracy of 83% in predicting dysplasia in puppies
        
        requires deep sedation or light general anesthesia
        
        best done on 8- to 9-week-old puppies
      - measure hip joint laxity
      - method of Ortolani
        
        not a painful maneuver
      - for puppy
      - clunck sound result in posetive
    - - stethoscope bell on the trochanter major
- - - - Weight Management
        
        Weight reduction: 1% to 2% per week until the target BCS
        
        RER = 70(kg?)3/4
        
        most important aspect
        
        low in fat
        
        The animal should be weighed weekly and its caloric intake determined
      - Nutritional Supplementation
        
        Omega-3 fatty acids
        
        nutritional supplements
        
        decreased pain and inflammation associated
        
        decrease the need for NSAID
        
        fish oil and anti-inflammatory supplements
        
        fishy smelling breath
        
        Oral chondroprotective supplements
        
        modify pain associated with osteoarthritis
        
        glucosamine, chondroitin, and manganese
        
        chondroprotectants
        
        not approved by the Food and Drug Administration (FDA)
      - Exercise Moderation
      - Physical Rehabilitation Therapy (PT)
      - Medical Therapies
        
        NSAID
        
        side effect
        
        gastric ulceration/erosion (especially dog)
        
        extended clotting times
        
        misoprostol & Omeprazole
        
        “wash out” period before changing drug choice
        
        some NSAID forbidden like naproxen, indomethacin, ibuprofen
        
        COX I and COX II inhibitor
        
        Aspirin is inexpensive and accessible
        
        Carprofen is more effective than aspirin
        
        Etodolac
        
        Deracoxib: specific COX II
        
        polysulfated glycosaminoglycans IM every 4 days for six doses
        
        hyaluronic acid (HA)
        
        Antibiotics
        
        treatment of bacterial septic arthritis
        
        gram +: Cephalexin & Amoxicillin-clavulanate
        
        gram -: Doxycycline
        
        Clindamycin for anaerobic
        
        gram + is most commonly cultured from septic joints
        
        first generation cephalosporins for gram +
        
        typically be administered for 4 to 6 weeks
        
        surgical infection
        
        repeated every 90 minutes to 3 hours during surgery
        
        cefazolin should be administered after an IV line and anesthesia
        
        Glucocorticoids
        
        phospholipase A inhibitors
        
        effectively reduce synovial inflammation
    - - short term
        
        treated for an acute sprain
        
        Complete enforced rest is mandatory and for 10 to 14 days.
        
        PT
        
        Anti-inflammatory drugs are indicated to relieve pain and make PT more tolerable
        
        Administer nonsteroidal anti-inflammatory drugs at the lowest effective dose.
        
        antiinflammatory drugs make the patient more comfortable,and enforcement of rest more difficult
      - long term
        
        five basic principles of arthropathies management