3. Joint Disease Flashcards
What are the two inter-related categories of joint disease?
Mechanical - ex. hip & elbow dysplasia, patellar luxation, cranial cruciate ligament rupture
Affecting articular cartilage - Ex. osteochondritis dissecans (OCD), Degenerative joint disease (DJD) AKA osteoarthritis
What is hip dysplasia? What can cause it
Congenital malformation of hip (coxofemoral joint)
Polygenetic inherited condition
A large dog dz
Enviro risk factors like too rapid weight gain during growth, high BCS, prior injury, OCD
What are some outcomes of stress on the joints?
wear and tear = osteoarthritis
Lack of stability = mobility issues, pain, lame
sublaxtion to luxation
All above present as lame and pain
Is hip displasia more severe in young or old dogs?
More severe in young dogs, painful and luxation
Less severe in old dogs, pain due to arthritis
How is DJD medically managed to minimize onset?
controlled low-impact exercise
weight control
joint supplements
What are ways to manage pain with joint dz?
Rest
NSAIDS
joint supplements and therapeutic diets
physical therapy
low-impact exercises
weight control
surgery
How can we prevent hip dysplasia
prevent occurence by selective breeding, appropriate diet selection, avoid severe, intensive exercise, especially in large breed puppies
Prevent clinical onset by weight control
What is elbow dysplasia and what can it be caused by?
congenital - inherited condition
caused by up to3 diff join abnormalities
1. fragmented medial coronoid process
2. un-united anconeal process
3. Osteochrondritis dissecans
enviro factors - growing too fast during development, obesity, prior injruy, presence of osteochondritis dissecans (OCD)
Which bone is typically affected in elbow dysplasia with osteochrondritis issecans?
distal aspect of the humerus
usually the medial condyle
What is the clinical onset and presentation of elbow dysplasia?
age of onset of clinical signs depends on severity
Mild changes usually present in older animals - arthritis, tx and prevention as per arthritis
Severe changes present in young animals - mechanical issues cause paid and lameness, sx is an option
How can you treat elbow dysplasia?
sx tc to prair abnormal anatomy, clean up joint, remove cartilage fragments if OCD
Medical mgmt with rest, NSAIDs, joint supplements, physical therapy, controlled low impact exercise, weight control
How can we prevent elbow dysplasia?
selective breeding - elbow certification of breeding animals thru the OFA
nutritionally balanced diet during growth
prevent traumatic injury to joints
weight control -> changes clinical presentation
What is patella luxation and what is it typically seen in?
slipping kneecap
common in toy, miniature and small breeds, occasionally seen in cats as well
How does the dz progression and complications work with patellar luxation?
congenital, chronic, progressive, starts with slipping patella - may alter movements, will eventually lead to arthritis, inc risk of cruciate ligament rupture
What is a cranial cruciate ligament injury?
A tear in the cranial cruciate ligament. Loc in the stifle
What can cause a CCL rupture?
usually a combo of degernerative dz and/or trauma
Can be made worse with a heavy BCS
How do dogs with CCL tear present? What are their clinical signs? How can we diagnose it?
Waxing and waning lameness to non-ambulatory, not an emergency BUT could also be a fracture, etc
dx w/ exam with or w/o sedation, rads
How do we treat CCL tear?
Medical mgmt for small dogs, rest + NSAID + PT/rehad, longer recovery, risk rupture of other limb, will develop arthritis
Surgery, sm/lg dogs, faster recovery (may dec the risk of ruptureing the other CCL)
What are some surgical repair options?
- lateral suture
- tightrope procedure
- tibial plateau levelling osteotomy
- tibial tuberosity advancement
How long is the healing time for CCL tears?
10-12 wks
What are other complications of CCL tears?
rupture of th eother ligament - usually within 1-2yrs
arthritic will occur with or without surgical repair
What is osteochrondritic dissecans?
A developmental dz in young/growing animals, common in big dogs.
Developmental defect in cartilage and/or endochondral bone
Cartilage is weak, abnormal -interferes with articulation of joint, cracks in cartilage, sm pieces cartilage +/- bone break off, less able to withstand normal forces
What are complications of OCD?
can interfere with movement, painful, predispose to below dysplasia and hip dysplasia
predispose to arthritis - shoulder
What treatment and prevention can we do for osteochrondritis dissecans (OCD)
Careful diet selection, controlled calorie and protein lvlvs, controlled exercise to prevent injury during growth
What is degenerative joint disease?
common in SA med
arthritis = inflam of join, may or may not include the synovium.
Degenerative, slow, progressive, any articular joint
What signalment is DJD?
any animal, older, larger breeds, CATS, obesity, animals w/ a hx of prior injury or preexisting joint dz
What is the pathology of an inflamed joint
- damaged cartilage releases pro-inflam molecules
- inflam of synovium causes join fluid ; less viscous
- less cushioning so more damage
- stretching joint capsule triggers osteophyte formation
- thickened joint capsule restricts motion
What are some predisposing factors to DJD?
normal wear and tear, obesity, intense exercise, poor cartilage formation, joint dysplasia - hips, elbows, patellas, chondrodysplasia, prior trauma
How do animals present with DJD?
painful, lame, stiff, sore, slow, reduced jumping, not wanting to use the stairs
What are the most commonly affected joints of dogs and cats?
dogs: hips, stifle, elbows, carpi
Cat: thoraco-lumbar spine, elbows, hips
What are the common animals associated with arthritis of the intervertebral join spaces?
Cats, german sheperds, animals with prior back injury
How do we treat DJD? MUST KNOW THIS
ongoing tx
controlled activity, rest, weight control, prescription medications of NSAID’s, librela, and solensia, joint supplements
What is solensia?
feline specific monoclonal antibody - binds to feline nerve growth factor
SQ injection - monthly
has been tested in cats with IRIS stage 1 and 2 CRF
>7mo of age and >2.5kg
77% of owners reported an improvement in OA pain
What is librela?
canine specific monoclonal antibody - binds to canine nerve growth factor
SQ injection monthly
licensed for use in animals >12 mo
How can we prevent arthritic issues?
selective breeding
weight control
low impact regular exercise
correct existing joint issues
Avoid high nutrition diets that may lead to OCD
joint supplements - nutraceuticals, make sure they are pharmaceutical grade, dose based on weight
