Moderate to severe hip dysplasia in 8 month old pit bull

[WendyRobinson]

Rue is an 8 month old, spayed female pit bull mix who started showing signs of PL pain and lameness about 2 months ago. Her pain is progressive. She was recently diagnosed with moderate to severe bilateral hip dysplasia and mild OA.
Recent Penn Hip results:
Distraction Index (DI): Right DI = 0.90, Left DI = 0.81.
Osteoarthritis (OA): Radiographic evidence of MILD OA on the right hip, evidence of MILD OA on the left hip.
Interpretation
Distraction Index (DI): The laxity ranking is based on the hip with the greater laxity (larger DI). In this case the DI used is 0.90.
OA Risk Category: The DI is greater than or equal to 0.70. This patient is at high risk for hip OA.

She is currently in a lot of pain and really weight shifting off of her pelvic limbs.
She is currently on Carprofen and Gabapentin for pain and just started Adequan injections two weeks ago.

I am looking for other tools to manage her pain that are safe in a growing puppy.
Can laser be safely used on a growing dog if growth plate areas are avoided? Such as only treating sore muscles.
Tools I have available at the clinic - PEMF, Acupuncture, Class iV laser, shockwave, Estim/NMES

Once she is less painful I plan to work on PL and core strenghtening, balance and coordination and proper posture retraining.

Thank you in advance for your insight

Dr. Wendy Robinson

[lehughes]

Hi Wendy,

Poor pup!

So, I would just want to ensure that there was no other area of pain for the dog (i.e. lumbosacral, or SIJ)...

Other than that, I would laser. I think you would be hard pressed to deliver a high enough dose that could penetrate to the growth plate level of the femur on such a regular basis to cause any damage. And since you are simply doing your best to try for pain management as you hope for her to settle into her hips or get old enough for surgery... you really have not much to lose. That's my take on it anyways. Here's the links to a blog I did on the topic and one that Peter Jenkins (SpectraVET) on that topic:
https://www.fourleg.com/Search-Results?t=b&id=335
https://www.fourleg.com/Search-Results?t=b&id=336

I would laser Deep Gluteal and around the hip.
I'd acupuncture the 'bowling ball points" - GB29, GB30, BL54 and any others you like. You could also throw a few extra needles into the deep gluteal (i.e. anywhere around GB29)... if you have electroacup clips... add the electro part. PEMF would be fine. I'd shockwave that same ares (GB29 region). You could use the estim on the glutes while doing balancing exercises.

My hope program would look at strengthening the glutes. (Hills, stairs, sit to stands, tug of war... as able)
And perhaps show the owner how to do some massage... for the overall pain and stress relieving effects.

I think you're on the right path overall!

Cheers,
Laurie