Hi
What is the recommendation for hock OCD and a large joint mouse/mineralisation to the DDF? Diagnosed on CT. Has recently become swollen medially and painful on firm pressure with some loss of ROM (flexion). She had a triamcinolone into the hock today ans is an agility dog. Offweights at stance. Thanks!.Kriszty
Hock OCD and DJD
Re: Hock OCD and DJD
Hi Kriszty,
Unfortunately, the hock is not a very forgiving joint. It doesn't have a lot of room for a joint mouse to hide where it's not in contact with any part of the articulating surface. So... removal is likely best. But, damned if you do & damned if you don't, because arthritis will set in either way! So, in addition to the surgical removal, I'd recommend joint supplements (glucosamine, Omega's, MSM... etc.), and I've even had some success with folks using those back on track tarsal wraps. (I honestly just think they keep in the body heat... but that's 'something' at least!) Then forever rehab on some kind of a maintenance schedule. Home PEMF might also be an option.
Agility will be a wait and see. She won't ever be perfect - not at that joint... but that doesn't mean she can't 'do things', which may include agility.
Best of luck!
Laurie
Unfortunately, the hock is not a very forgiving joint. It doesn't have a lot of room for a joint mouse to hide where it's not in contact with any part of the articulating surface. So... removal is likely best. But, damned if you do & damned if you don't, because arthritis will set in either way! So, in addition to the surgical removal, I'd recommend joint supplements (glucosamine, Omega's, MSM... etc.), and I've even had some success with folks using those back on track tarsal wraps. (I honestly just think they keep in the body heat... but that's 'something' at least!) Then forever rehab on some kind of a maintenance schedule. Home PEMF might also be an option.
Agility will be a wait and see. She won't ever be perfect - not at that joint... but that doesn't mean she can't 'do things', which may include agility.
Best of luck!
Laurie
LAURIE EDGE-HUGHES
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David Lane
- Posts: 164
- Joined: Mon Oct 24, 2016 10:51 pm
Re: Hock OCD and DJD
Have a surgeon with a scope review the CT to confirm that removing the mice is likely to yield short term (hopefully a few years) improvement but recognition that the hock will likely never be normal and progression of OA is inevitable.
Return to recreational level agility may be possible, but I'm not sure that is the best sport for long term preservation of the joint. Nosework? Treat for OA as LEH suggested (except my understanding is that MSM doesn't bring anything to the table), with other palliative measures prn.
If the joint progresses to incorrigible, then arthrodesis is an option to remove pain. I know of one surgeon in Calgary that is working with a total tarsal replacement that looks promising... so maybe that will be an option in a few years.
Return to recreational level agility may be possible, but I'm not sure that is the best sport for long term preservation of the joint. Nosework? Treat for OA as LEH suggested (except my understanding is that MSM doesn't bring anything to the table), with other palliative measures prn.
If the joint progresses to incorrigible, then arthrodesis is an option to remove pain. I know of one surgeon in Calgary that is working with a total tarsal replacement that looks promising... so maybe that will be an option in a few years.
David Lane DVM
ACVSMR, CVA, CVSMT, CCRP
ACVSMR, CVA, CVSMT, CCRP
Re: Hock OCD and DJD
Thank you both very much for your replies.
The surgeon does have a scope (ortho specialist) and the CT has been reviewed by him and a radiologist.
He sounded dubious about whether removing the joint mouse would help and wanted to try 2 steroid injections 1st. He does not want to remove the actual OCD fragment itself. This dog is 7 (and mine).
Currently she is not "lame" per say, just slightly offweights at the stance and is knocking bars. Am unsure if Sx is the right option for her due to the invasiveness.
I could retire her, of course and will if I have too, but this dog absolutely loves her agility and both of us would be sad if we had to.
Laurie- I have BOT hock wraps, should she be sleeping in these every night or do you recommend just before exercise? Its pretty hot here 1/2 the year. I have a PEMF bed that I have been lying her on 30mins each side/night for her hocks, I assume this isnt contraindicated post steroid inj ? She doesn't like it much. Which settings would you recommed?
Would you recommend gentle mobes to increase flexion or will this aggrevate the OA..?
Sadly, I bred her as did not know about the OCD as only showed up on CT. I have her daughter and was considering getting her hocks CT'd but the surgeon said not to bother as he would not remove any fragments anyway..would you agree with this David?
Thanks in advance!
The surgeon does have a scope (ortho specialist) and the CT has been reviewed by him and a radiologist.
He sounded dubious about whether removing the joint mouse would help and wanted to try 2 steroid injections 1st. He does not want to remove the actual OCD fragment itself. This dog is 7 (and mine).
Currently she is not "lame" per say, just slightly offweights at the stance and is knocking bars. Am unsure if Sx is the right option for her due to the invasiveness.
I could retire her, of course and will if I have too, but this dog absolutely loves her agility and both of us would be sad if we had to.
Laurie- I have BOT hock wraps, should she be sleeping in these every night or do you recommend just before exercise? Its pretty hot here 1/2 the year. I have a PEMF bed that I have been lying her on 30mins each side/night for her hocks, I assume this isnt contraindicated post steroid inj ? She doesn't like it much. Which settings would you recommed?
Would you recommend gentle mobes to increase flexion or will this aggrevate the OA..?
Sadly, I bred her as did not know about the OCD as only showed up on CT. I have her daughter and was considering getting her hocks CT'd but the surgeon said not to bother as he would not remove any fragments anyway..would you agree with this David?
Thanks in advance!
-
David Lane
- Posts: 164
- Joined: Mon Oct 24, 2016 10:51 pm
Re: Hock OCD and DJD
If the lameness is that mild, then I think most surgeons would elect for not scoping.
David Lane DVM
ACVSMR, CVA, CVSMT, CCRP
ACVSMR, CVA, CVSMT, CCRP
Re: Hock OCD and DJD
In regards to the BOT braces - try putting them on for long stretches (i.e. overnight).
Gentle joint distraction or traction would be okay...but keep it fairly gentle.
As for the PEMF - I'd go with 15Hz - 30 mins total is likely fine. No need to turn her - the PEMF will go right through her body. And I'd not have concerns about using it with the steroid.
I'd agree with your surgeon and with Dr. Lane - if the lameness is very mild or not there at all... then you'll likely get a 'worse looking dog' if you have someone go into the joint! Manage & maintain.
Best of luck!
Laurie
Gentle joint distraction or traction would be okay...but keep it fairly gentle.
As for the PEMF - I'd go with 15Hz - 30 mins total is likely fine. No need to turn her - the PEMF will go right through her body. And I'd not have concerns about using it with the steroid.
I'd agree with your surgeon and with Dr. Lane - if the lameness is very mild or not there at all... then you'll likely get a 'worse looking dog' if you have someone go into the joint! Manage & maintain.
Best of luck!
Laurie
LAURIE EDGE-HUGHES