Thursday, 21 September 2017

Subluxation of the canine hip - meet Ronnie

Ronnie is a 2 and a half year old Golden Doodle – Golden Retriever / Poodle cross. He is a big boy with stunning eyes. 

Some months ago he started to display issues with his mobility. He lives in a house where there are quite a few steps to climb to get indoors. He started to look painfully at these steps up to their house. His Mum said it was like an old man who was reluctant to try them. He also became stiff and hyperextended his back end. His gait was definitely way off balance. This was not due to overwalking as, when his exercise regime was severely cut down, he still displayed these issues 

His local vet could not determine what was going on with him and referred him to a specialist vets. They took CT scans of his elbows and X-rays of his hips. The good news was his elbows were fine but his left hip showed mild subluxation. His right hip was also fine. 

When a joint completely dislocates or separates between the joint and the bone, this is commonly described as luxation. This is often what happens in dysplasia. But when the joint is only partially separated, this is referred to as subluxation although it can be equally painful. The signs for both are similar with limping, lameness, pain, licking or change of mood although subluxation can come on quite quickly as it is typically due to a recent trauma. 

There are a number of ways to treat this, depending on the severity, including surgery. In Ronnie’s case, his was mild and the surgeon recommended that he started with physical therapy. This included massage, exercise and hydrotherapy. If this did not resolve the issue, then surgical interventions might be necessary. He was given some medication although the Gabapentin he was given, did not agree with him. He is now just on NSAIDs 

He has already started hydrotherapy and I was asked to fill in the multi-modal therapy of physical therapy and exercise. Although he is a large boy, he is very soft with a stubborn and a “I-don’t-think-you-should-be-touching-there” glare given when he is not happy. 

He was perfectly fine with 30 minutes work on his right hand side but was not happy with his left – the side of the issue. In fact, he walked out into the garden, under the tree. I sat with him chatting away and eventually he let me rest my hand on his hip. Luckily, we found his Go-To muscles were his left shoulder and his hip. Any amount of massage there sent him straight to sleep. Alternating between the lovely muscle and the iffy muscle seemed to work. He gave up trying to out stare me and rested under the tree. 

 His Mum is now armed with homework and exercises plus a quick warm-up and cool-down routine as Ronnie struggled more after exercise. Hopefully the physical therapy, exercise and hydrotherapy should start him on his road to recovery and may prevent any surgical interventions. 

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