Diary of (what was) Cooper's Hip Dysplasia
Date Event Notes
04/17/1997 Thu Cooper's Birth Date
(6 mos) Heard occasional click or popping sound coming from Cooper's hindquarters.
Checked on the web-from other people's experiences clicking meant hip dysplasia.
Cooper's parents and lines were all OFA clear-- it's got to be something else, but what?
Clicking is becoming more frequent. Went to our regular vet, who wasn't able to hear the clicking. He suggested it could be either a hip or knee problem, and that we couldn't know without x-rays.
10/28/1997 Tue X-rays - Cooper is diagnosed with unilateral mild hip dysplasia in his left hip by another one of our regular vets in the same animal hospital. The x-rays showed laxity in the left hip, and they were able to exhibit the Ortolani sign (dislocation/clicking in the hip with a certain type of movement). She suggests that we get a second opinion to be sure, recommends Dr. Vasseur at the University of California, Davis Veterinary School who is a master at total hip replacement. Our vet's care recommendation is not to do surgery at this time, because Cooper doesn't show any clinical symptoms (limping, obvious pain). She said the femoral heads are slightly flattened, and the surgeon she used to work with said that he didn't have good success doing TPO on dogs that had flattened femoral heads. The surgeon did not see the x-rays. She recommended that we limit Cooper's activities - no jumping, long periods of running, short dashes, etc... She said that the progression would be that Cooper would have some pain in the short term, then there would be build-up in the joint which would stabilize it for about 4 years. During that time the build-up would wear away, leading to severe arthritis.
X-ray from 10/28/1997
(This entry was made on 11/4/99)
Here is the x-ray mentioned above. I've included close-ups of both the right and left hip joints below.
To describe the x-ray-- The body is very well positioned (legs straight, tail straight) except for a very slight rotation of the pelvis. The growth plates around the joints have not closed yet, indicating that Cooper is still growing. On the right hip joint, the femoral head is positioned so that half of the head is in the hip socket. This is not perfect, but still pretty good. There appears to be little (if any) degeneration, except for maybe a slight flattening of the femoral head. On the left hip joint, the femoral head is positioned so that between 1/4 to 1/2 of the head is in the socket. Again, little if any degeneration-- really all that is there is the joint laxity. As mentioned in the previous paragraph, because the pelvis is slightly rotated, it actually is giving the illusion that the left hip is worse than the right. They are probably close to the same in laxity, which means that both are just less than half in the socket. This makes it a very mild case, at least at the time of the x-ray.
This same x-ray was used for the initial diagnosis, and also for the 2nd and 3rd opinion (described in detail in a couple of the later entries). I've been told since then that I should have had new x-rays taken for the 2nd opinion in case hip positioning for the x-ray could have had anything to do with the diagnosis.
10/31/1997 Fri Started Cooper on Solid Gold Yucca. Yucca is a natural anti-inflammatory.
11/05/1997 Wed Started Cooper on Foster & Smith Joint Care (glucosamine/chondroitin sulfate) Glucosamine and Chondroitin sulfate provide nutrients for the joints, and helps to repair cartilage more quickly. It also helps to lubricate the joint by helping in the production of synovial fluid.
11/07/1997 Struggling with the decision whether to have surgery done or go the alternative medicine route. Heard stuff about pups that have mild HD early on, then are OFA good at 2 years of age. Could it be possible? Maybe we shouldn't do surgery...
None of the other pups in Cooper's litter show any signs.
Talked to the hydrotherapy person who said to wait until we have gone to Davis before starting the therapy.
Clicking is getting sharper, but seems to be decreasing in frequency. Not sure why-- the Joint Care couldn't possibly be working so fast.
11/13/1997 Thu UC Davis Veterinary School. Talked to a 4th year student and a resident. The resident conferred with Dr. Vasseur, to whom we never got to speak. They poked and prodded, heard the clicking, said that Cooper showed slight pain in the left hip at full extension of the leg. They confirmed the unilateral hip dysplasia. He (the resident) said that it is unusual to see a unilateral hip dysplasia case. They sedated him slightly and were also able to exhibit the Ortolani sign.
His recommendation is to do TPO as soon as possible. He said that whether or not we do the surgery, Cooper will have arthritis eventually, possibly severe. No opinions on alternative medicine. Said TPO is better than medical management, and we'd be better off doing it within our "window of opportunity", the next 1-2 months.
Gloom and Doom.
TPO stands for Triple Pelvic Osteotomy, which is a procedure where the surgeon breaks the pelvic bone in 3 places in order to rotate that area so that the femur fits into the acetabulum (hip socket) better. The pelvic bone is then held back together with a combination of metal plates and wires. Done in a puppy it is quite successful because the pup's bones are still elastic and can mold well to the new configuration.
(7 mos) Went to Dr. Gurevitch, another orthopedic surgeon in Petaluma, CA, on my breeder's (the owner of Cooper's sire) continued recommendation. During his examination he confirmed the hip laxity in the left hip, but also exhibited pain in Cooper's right hip at full leg extension. Upon viewing the x-ray (the original one), he noted immediately that the pelvis was very slightly rotated which made one side look worse than the other. He diagnosed Cooper with bilateral mild hip dysplasia.
Dr. Gurevitch was wonderful-he explained everything to us in great detail and really listened to what we had to say. He was very good with Cooper, too. He watched Cooper gait, and said that he does have a true bunny hop (he was explaining that all dogs appear to bunny hop at some speed, but only the ones with problems will use both legs simultaneously when watched from the side. Otherwise one leg will be slightly in front of the other.
His recommendation was not to do surgery while Cooper shows no clinical signs. He recommended that we watch his hip progression closely with x-rays every couple months. If the progression is rapid, then do the TPO, otherwise let him be. Interesting note-he said that TPO can be done on dogs of any age as long as the x-rays show they are a good candidate. Of course, with older dogs the bones will not mold, but it could make the hip sit better than it would otherwise. He definitely recommended TPO over Total Hip Replacement, as he considered the Total Hip a salvage operation (no other alternative). Femoral Head Excision is not an option for dogs over 50 pounds.
He said that the supplements couldn't hurt, but that Cooper doesn't have much degeneration right now so the Joint Care might not have much to do at this time.
11/21/1997 Fri First hydrotherapy session with an RVT specializing in hydrotherapy at the Animal Fitness Center at my animal hospital. Kathy was able to tell that Cooper is compensating by tightening his inner leg/groin muscles, which causes the hip bones to pop out more than it otherwise would. The symptoms are very tight inner thigh muscles, and a very tight back. She said that dogs have a lot of extra skin on the top, and that you should be able to roll and stretch the skin easily all the way down the back from the neck to the tail. In Cooper's case it was very tight. Her recommendation was to do the skin roll/stretch on Cooper 3-4 times a day in at least one session. This would cause Cooper to relax the inner leg muscles and force him to use the outer leg muscles. Sure enough, when I get the back relaxed when he's standing, he practically collapses on his hind legs. He is hardly using the outer leg muscles at all, which explains why his legs have been looking kind of hollow- not much muscle mass. The other thing to do is to massage his inner leg muscles to relax them.
She says that with this therapy it is possible to arrest the dysplasia at this stage. (REALLY?!?) By training him to use his muscles properly, and with a good diet and use of supplements, he might not get worse. Also, since he is still growing and developing bone, he might even get better!
Things are looking up. His second session is tomorrow!
11/22/1997 Sat Second hydrotherapy session. Cooper was more relaxed today, but Kathy said that he is still tight, particularly in the left inner thigh area and the area above the hip. She said it is very important for us to do the roll & stretch relaxation exercises. She stressed again that he feels really good, and that the therapy should do very well for him.
11/23/1997 Sun Third hydrotherapy session. This was a fairly short session-they said that he's doing really well, and his hips/legs are much more relaxed. Recommendation to use Ester-C and maybe even talk to Dr. Belfield (mentioned in Dr. Pitcairn's book) about his vitamin C therapy. We'll probably do another session in 2 or 3 weeks to try to get more definition in the outer leg muscles. Kathy says that with the last 3 sessions he has become much more relaxed with good circulation, so we should start seeing some improvement in the muscles by tomorrow. Hmmm... we'll see!
Kathy doesn't consider his problem dysplasia at this point. She said the problem now is hip laxity. I guess it's all just how you look at it. I don't mind looking at it her way-- I guess it's more optimistic. Perhaps I should change the title of this to 'Diary of Cooper's Hip Clicking'.
His hip clicking might have decreased somewhat. Right now he's chewing on a huge beef knuckle bone that I gave him for being so good.
11/25/1997 Tue Started Cooper on daily 500mg Ester-C (vitamin C) with bioflavinoids. Actually, I started taking this too. <grin> Vitamin C is supposed to act as an anti-inflammatory as well, and there are theories that it helps repair/build cartilage much like what the Joint Care does. There are also theories that one cause of dysplasia is lack of vitamin C. Anyway, a couple of the links above talk about vitamin C.
Amazing-- the clicking has reduced dramatically. Where he used to click with every few steps, he now only does a few times every hour.
The clicking seems to be increasing again slightly, although it's still nowhere near where it was originally. I'm not quite sure, but he may be starting to click on the right side instead of (or in addition to) the left. Also, when I do the massage he doesn't really seem to like it. When I massage the inner left thigh he acts like it's uncomfortable and tries to remove my hand with his mouth.
Time to schedule another hydrotherapy session, and the next set of x-rays.
12/06/1997 Sat Fourth hydrotherapy session. Cooper went in a few times, and Kathy says that his hips feel pretty good. She says that she can feel more definition in his outer leg muscles now. I mentioned to her the problem I was having with his massage skin rolls, and she said that as soon as I get to the point where he acts uncomfortable I need to move back up his neck and work my way down again. Apparently he was still tightening up in the middle of his back, and some inflammation had developed. This session did not further reduce his clicking. I plan to take him in for x-rays again next week.
The clicking has pretty much completely stopped. At the last update I thought that the hydrotherapy had done about all it could do, but I guess I just wasn't patient enough. I haven't done the next set of x-rays yet. Perhaps after the holidays.
(8 mos) Fifth hydrotherapy session. When Cooper is swimming, he doesn't seem to want to do full leg extension with his back legs. He does little kicks instead of doing the full range of motion. However, when he's not in the water he is just fine with leg extension. Also, the reason I brought him in this time is because his outer leg muscles are really tight, and his inner muscles are relaxed (opposite of the original situation). Kathy says that as he goes through his growth stages, he will likely continue to compensate in different ways, so it's good to keep bringing him back when I notice any changes like this. She said that he seems to have pulled a muscle in his right leg-- this is probably true because I did take him hiking and he was straining to climb back onto a rock when he almost fell off.
12/31/1997 Wed This is the 8th week after Cooper started the Joint Care, so now I'm lowering the dosage to two capsules a day from three. Also stopping the Solid Gold Yucca. Lately I've noticed that Cooper's attitude has been noticeably changing. He has always been a happy pup, but recently he has had a new spring in his step that wasn't really there before. He now goes up and down the stairs more often on his own accord (not just when we need him to), and he has been doing this springing thing (all four legs off the ground!) that we've seen his sire do but never knew if Cooper would. I'm not sure which of the treatments that we're doing for him is helping the most, but certainly something seems to be working!
Someone on the net convinced me to do a PennHip on Cooper instead of another traditional OFA-type x-ray. The PennHip measures the degree of joint laxity from a scale of 0 to 1 (0 being the tightest), and also notes whether there is any joint degeneration occuring. I may do this sometime in January.
We took Cooper to the beach today to run around. Occasionally he will favor his right leg, but for the most part he is looking pretty normal. What we noticed was that his pawprints in the sand were uneven in weight. The right foot for short periods of time would be noticeably lighter. I may get some canine buffered aspirin for more active days like these *just in case*.
Also, another helpful person on the Golden e-mail list suggested that Cooper use at least 1000mg Ester-C daily without the bioflavinoids. I'll save the bioflavinoid ones for myself, then!
After a long time without hearing a click, we started hearing a few random (but loud) clicks coming from his right hip. It has been a month since his last hydrotherapy -- probably too long. He is still running around like a madman, loves to get his legs massaged (he now "asks" for it), but shows a lot of discomfort when I massage his back. His back is hot in the middle, like it's inflamed.
1/22/1998 Thu Sixth hydrotherapy session. Kathy immediately noticed the tightness in his back, and said that the pelvis was rotated such that his legs are uneven. She worked and swam him for about 45 minutes to "get more room in his back". She seemed pleased with it afterwards. We'll see what happens... He sure was tired after this session!
Interesting-- found a hot spot on Cooper's back where the tightness/hotness was on his back. It was already in the healing stages, but I didn't even realize it was there! His clicking has gone away again, as far as I can tell. His back is not hot, either. We went hiking today, though, and he was insane-- jumping everywhere, making mad dashes done the steep hills... I just hope he didn't reverse all our progress so far.
Since the last entry, I have been taking Cooper to hydrotherapy once every 2 weeks more as maintenance and preventive care than because of any symptoms. (To see his hydrotherapy place's website, go to Animal Fitness Center). He has continued to be stable, although the spot on his back warms up occasionally (points to some kind of misalignment or some kind of misuse). The hydrotherapy keeps it down. Cooper has been doing extremely well, and is very active. I have yet to get him x-rayed, though. More when there's more info.
Summer 1998 Started adding raw meaty bones to Cooper's kibble. These include whole raw chicken wings, raw chicken necks, raw turkey necks. Soak it in apple cider vinegar for an hour before feeding to kill bacteria.
Books I've referenced about this are Billinghurst'sGive Your Dog A Bone and another really good one that I use often is Schultze's The Ultimate Diet. Although they advocate a complete raw diet with veggies I haven't made it there yet. I give him kibble (either Innova or Wysong) with the raw meat added and occasionally do add veggies.
The rationale for doing this is that the reason I give Joint Care is to support the joints. Well, the natural source for this is in raw bones, and why not go directly to the source. I still give Joint Care, though.
(19 1/2 mos) I have still been taking Cooper to hydrotherapy once or twice a month-- Cooper is one of the springiest dogs I have ever seen-- he springs straight up in the air sometimes. Quite a trick! In about 5 months he most likely will have stopped growing, so I will get him x-rayed then. The way he jumps around, though, it's hard to believe that anything could be wrong with his hips.
On occasion, I do hear clicking coming from him, but I think it is actually coming from his left shoulder. He might have injured it jumping off a rock (this dog thinks he's a mountain goat). I will probably have it x-rayed at the same time as his hips.
Other than that-- no other info. Keeping our fingers crossed.
5/1999 If you have been following this page, I just added an event about feeding above (Summer 1998).
X-ray day!! The day we have been waiting for for what seems like an eternity. I'm extremely nervous, just hoping that Cooper hasn't gotten any worse.
Are you ready for this?
His x-rays look *awesome* -- none of the hip laxity in sight. The vet is going to submit them for OFA evaluation, and I'll update this page with the results and some of my hypothesis/conclusions.
(2 yrs, 3 mos.)
We got the OFA results back, and Cooper got an OFA Good rating! That is more than we dreamed of getting way back when he got his diagnosis.
So... I've learned a few things from all this. First of all, 6-9 months is a when a lot of puppies go through a growth spurt, so it's quite possible that a true diagnosis can't be made if you see mild laxity with no joint degeneration. Secondly, hip positioning is VERY important in diagnosing hip dysplasia. If the dog is rotated incorrectly even slightly it could make all the difference in a laxity diagnosis. Go to an expert in hip positioning when you get the x-rays done. Thirdly, be aware of the difference between laxity and dysplasia. If you are told that your dog has hip dysplasia, find out whether there has been joint degeneration or if there is simply laxity with possibility of future degeneration.
In Cooper's case, I believe that he was going through the awkward growth stage when we got him x-rayed at 6 months. Also, we did not take him to an expert on hip positioning. In any case, it doesn't erase the fact that his rear leg muscles were weak, and that he had the clicking. I think that the supplements and *especially* the swimming therapy we did with him made a big difference in making sure that things went the right way. I don't know that the swimming is what made the difference between being dysplastic and being OFA Good -- somehow that seems a bit of a stretch. Whatever the case, it did strengthen his muscles during a critical growth time and that could only be good.
I'm SO glad that we decided to take a "wait and see" attitude towards Cooper's treatment. If we had been aggressive, he would have gone through unnecessary surgery 1 1/2 years ago.
Hope this helps others, too! Good luck with your dog(s).
Now if you thought Cooper's story was good, read Merlin's story. Merlin is a sheltie, owned and loved by Cyndee Walklet. They have a very similar and very heartwarming (as well as inspiring!) story to share.
What's particularly interesting to me about their story is that Merlin didn't get x-rayed and diagnosed with mild hip dysplasia until he was 18 months old. Even at that age, with the work they did they were still able to make a tremendous difference for him-- quite possibly dysplasia-free. That kind of blows away the idea that you can only "reverse" hip dysplasia symptoms with a relatively young (< 1 yr) puppy.
Ester-C: Miracle Cure for Hip Dysplasia???
By Larry Mueller, Hunting Dogs Editor, Outdoor Life.
Reprinted from Outdoor Life, January, 1996.
An acquaintance of mine, B.J. Richardson, was calling from Texas, doubt and hope in his voice. "My English Pointer isn't a year old, and he's already lame in the rear end, especially the left hip," Richardson said. "The X-rays show hip dysplasia. The veterinarian says there are two choices: operate to alleviate the pain, or put the dog down. I can't afford one and won't do the other. Is it true that Vitamin C might help?"
I had to say that I'd never heard of Vitamin C curing canine hip dysplasia, but I was aware that veterinarian Wendell Belsfield of San Jose, CA, did prevent CHD -- or least its symptoms -- in eight litters of German shepherds, a breed that is prone to crippling abnormal development of a dog's hip joints. In those instances, all of the dogs' parents had CHD or had previously whelped pups that became dysplastic. Belsfield gave the bitches Vitamin C throughout pregnancy and lactation. The pups received Vitamin C from weaning until they were two years old. None of the pups developed CHD during that entire period.
Though Belsfield's work wasn't scientific in the strict sense, it certainly indicated that CHD could be prevented. Still I couldn't see how the joint could be remodeled once it had grown improperly, at least not without surgery. However, Vitamin C therapy seemed to be Richardson's only hope, so I told him what I knew.
Many readers had written and told me that their arthritic dogs normally were laid up after a few hours in the field, but when given Vitamin C, they could hunt several days in a row. None had said they did it with dogs that had CHD, but maybe....
I also recalled reading about the efforts of Dr. Bob Cathcart, a medical doctor in California who championed the use of Vitamin C in curing a wide variety of joint ailments and illnesses. Much of his work centered around using the vitamin in large quantities, increasing the doses until the body reaches "bowel tolerances." Though Cathcart's work was with human patients, many veterinarians adopted his method, saying that Vitamin C should be given in increasing doses until the dog's stools loosen, at which point the dose should be backed off a half a gram or a gram at a time until the stools became firm again. At that point, the dog's body receives the maximum Vitamin C that it can utilize.
I also understood that a superior form of the vitamin is Ester-C, which can be purchased in health food stores. The vitamin in Ester-C is molecularly locked to calcium, so it doesn't cause the acidity problems normally associated with ascorbic acid (the common form of Vitamin C), which can upset a dog's stomach. Ester-C also has natural C metabolites that get it into the cells faster and more effectively (common ascorbic acid is slower getting out of the blood serum, so it passes through the kidneys, where much of it is rapidly lost in the urine).
A month or two later, I heard that Pinto, Richardson's dog, had begun improving less than a week after receiving maximum doses of Ester-C. Pinto, the grandson of Miller's Chief -- an 11-time champion in horseback-style bird-dog trials -- was now running like the wind. I was as surprised as I was delighted.
Two years later, I was in Texas and dropped in to see Pinto. Richardson had kept him on a maintenance dose of Ester-C. The dog was moving with a fluid grace and power in the hips. Twice, for a step or two, I saw a bunny hop, suggesting that not everything was 100 percent correct. But both times, Pinto immediately shifted back to a normal gait.
I still couldn't understand how Ester-C could remodel a defective joint, but I was hopeful. Nobody I knew whose debilitated dog had improved clinically on Ester-C had ever taken X-rays of the joints, so I asked Richardson to have X-rays taken.
He did and mailed me the original X-ray taken two years before and a new one. I showed both to Dianna K. Stuckey, a board certified radiologist in St. Louis, who looked at the original and pointed out the hip dysplasia with the left hip most severe. The second? "Arthritis that customarily follows hip dysplasia," she said. I explained Pinto's quick and lasting response to Ester-C. "How could this dog go from lame to moving freely, and apparently without pain, in a few days -- and stay that way without something improving in the joints?"
"We occasionally see this," Stuckey said. "A dog is arthritic yet moves as if it feels no pain. We don't know why. Great 'heart' maybe, or high pain tolerance."
I'm sure that veterinarians do see this. But the answer to my question, Pinto's improvement was not because of great heart or high pain tolerance. He had been hurting and he had been limping badly. If his response to such pain improved in just a few days, something caused that change.
Dr. Chuck Noonam of Weston, CT also compared the X-rays. He noticed slight improvement in the severity of the dysplasia but said the hip joint had clearly succumbed to degenerate arthritis from the dysplastic hip joint banging around in and out of the socket.
"Eighty-three percent of dysplastic dogs either show an improvement in their hip dysplasia or they learn to deal with the problem as they grow older," Noonan said. "The second X-ray shows that the dysplasia is slightly less severe, but because of the arthritis, the joint is worse overall than in the earlier X-ray. It is possible that the Vitamin C was helping to sort of lubricate the joint so the dog felt less pain."
In my investigations, I had found that Pinto's results from Ester-C weren't unique. Soon after Richardson first called, I received a letter from Steve Dudley of Arizona. His young black Lab, who showed great promise at hunting Gambel's quail, went lame with CHD. Dudley's vet suggested that Dudley replace the hip -- or expect to put the dog down by age four. Dudley tried Ester-C instead and the dog promptly improved. Kept on Ester-C, the dog lived until age 13 without showing signs of soreness, lameness, or unwillingness to hunt, Dudley wrote.
Flood of Proof
My investigation also led to Charles Docktor, an Arizona veterinarian who was the first to test Ester-C for its effectiveness in healing joint problems. In 1983, he used Ester-C on a large number of arthritic dogs, finding that 75 percent improved in various degrees in a short period of time.
Independently, a continent away, Dr. Geir Erick Berge, a veterinarian in Oslo, Norway, performed a similar study, that was reported in the August-September 1990 issue of The Norwegian Veterinary Journal. Berge selected 100 dogs with a variety of joint ailments. His testing revealed that 75 percent of the dogs rapidly improved on Ester-C, some only slightly, some almost totally. Dr. Berge added that large amounts of Vitamin C metabolites, substances essential to a body's metabolic processes, are required in rebuilding diseased joint tissue.
Corroborating data were also reported by Dr. N. Lee Newman, who conducted 18 months of clinical tests using Ester-C to combat degenerative joint disease in performance horses. She reported a remarkable 90 percent success rate, ranging from good to excellent. Furthermore, 80 percent of the improved horses remained sound after Ester-C was discontinued. Newman credited supplemental Ester-C with maintaining the integrity of collagen and connective tissue and with mobilizing white cells in the immune system, while deactivating free radicals that damage cell membranes.
But other respected voices were making contradictory statements. The Cornell University College of Veterinary Medicine Animal Health newsletter in May 1995 denied that Vitamin C was of any value for either preventing or treating skeletal diseases in dogs. "There have been absolutely no confirmed reports that Vitamin C is helpful in any such instances," the newsletter stated. It went on to theorize that supplemental Vitamin C has no value because dogs produce adequate amounts of the vitamin in their livers.
But that reasoning is questionable. Vitamin C production varies from dog to dog, individual bodily needs vary, and circumstances -- health and environment -- vary enormously. "Adequate" in human medicine only means enough Vitamin C to prevent scurvy. What is adequate for a strict carnivore like a dog? And in any case, "adequate" should not be assumed to be a synonym for "optimum."
This is where a Vitamin C standoff occurs, and getting people to change their scientific opinion is like asking them to change their religion. In Cornell's favor, the evidence that has existed supporting the use of Vitamin C on dysplastic dogs is heavily anecdotal. Even the various veterinarians' research that has been cited was actually efficacy tests -- that is, all of the dogs tested were given similar doses of the vitamin and no controlled comparisons were made. Efficacy testing strongly suggests conclusive evidence, but it does not provide scientific proof.
The Acid Test
But in 1994, veterinarian L. Philips Brown presented the results of scientifically acceptable "double-blind crossover" study on the effects of Vitamin C to a national conference on holistic veterinary medicine. Brown, the owner of the largest veterinary hospital on Cape Code for 22 years, tested Vitamin C on 50 dogs with serious joint problems. The dogs were among a population of more than 500 canines at a large animal sanctuary in Utah. It should be noted here that representatives of Inter-Cal, makers of Ester-C, specifically asked Brown to study the vitamin because they felt it could have a major role in the treatment of joint abnormalities. Dave Stenmoe, one of the representatives of the manufacturer, says "We told [Brown] not to take our word for anything." Just to keep an open mind and conduct a scientific comparison of Ester-C, ordinary Vitamin C, and a placebo. He finally agreed to do it.
Brown, along with the Utah sanctuary's resident veterinarian, hand-picked the dogs with the worst cases of joint disease and placed them in five groups.
After four weeks of testing, the supplements were withdrawn for three weeks. Then, each dog was crossed over to a different group and received another supplement for another four weeks. After yet another three-week layoff, 60 percent of the dogs were switched to a third supplement. The remaining 40 percent went back to whatever they were given during the first four weeks. At the end, mobility scores were calculated to determine the average for each of the five groups.
The results were impressively in favor of Ester-C therapy. Seventy-eight percent of the dogs on 2,000mg of Ester-C experienced improved mobility within four or five days. The average improvement score was 1.52. About 60 percent of the improved dogs relapsed when Ester-C was discontinued, but the group that returned to Ester-C in the third phase then regained mobility. Handlers reported no negative side effects.
On the low (850mg) dose of Ester-C, only 52 percent of the dogs improved, with an average score of 0.45. Obviously, size of dose was important. Of dogs receiving 2,000mg of Ester-C with extra minerals, 62 percent improved by an average score of 0.87. Why Ester-C without extra minerals had better results remains unknown.
Ordinary Vitamin C improved 44 percent of the dogs, with a score of 0.67. As expected, no noticeable change occurred among dogs on the placebo.
Not even the most dyed-in-the-wool skeptic can ignore the results of such a double-blind crossover study. But the success of Vitamin C in treating CHD can still be questioned, or even denied, because X-rays show that the joints remain loose or arthritis remains. Even Brown confirms that X-rays taken for his study reveal defective skeletal structures even after the Ester-C treatment.
Soft Tissue Factor
But those who see improvement with Ester-C are looking primarily at an animal's behavior -- they see an improved ability to function. How can both proponents and skeptics consider themselves correct? Perhaps by each being half right.
A joint is not bone alone. Soft tissue -- cartilage and synovial membrane -- exist between bones to permit movement. If such tissue deteriorates, movement becomes more painful. Vitamin C is essential in the making and rebuilding of soft tissue because it promotes the growth of Collagen, a tough, stringy "mortar" that holds cells together. At the same time, the soft tissue also holds water, which maintains compression resistance to cushion the joint -- this is the "lubrication" described by Noonan in his assessment of Pinto's X-rays.
In healthy cartilage, normal cell loss is balanced by the rebuilding of cells. Under diseased or inflammatory conditions, cell loss is excessive. In the case of a dog's hip joint, this can mean that adequate cushioning no longer exists. The high demand for Vitamin C may begin exceeding the amount made in the dog's liver, so deterioration continues. Or supplemented Vitamin C may turn the process around.
Field experience, although still anecdotal, suggests that dogs on Ester-C lead full lives without terrible pain and debilitation. Ester-C may prove to be a wondrous holistic cure, but OUTDOOR LIFE cautions that it's too early to state definitively that Vitamin C can cure or rectify canine hip dysplasia. Some doctors contend that the treatment is merely a Band-Aid on a far more serious problem.
We should add one point. Hip dysplasia is at least partially inheritable. And it is not a simple, single-gene defect. There is now concern that dysplastic dogs returned to mobility may also be returned to reproduction, which would further spread the malady. It is fair to say that there appears to be a great deal of hope for the benefits of Vitamin C, but before administering the vitamin to your dog, consult your veterinarian. And until more is known, don't breed that dog.
author Larry Mueller -- Source Working Dogs http://workingdogs.com/doc0039.htm
By Carol Beuchat PhD
Hip dysplasia is a hot topic in dogs, if it's possible to stay "hot" for 50 years. Researchers have been working hard for decades looking for solutions, and breeders have been doing their best to reduce the risk of producing affected puppies. But still the problem remains.
There are some simple things we could do to reduce the incidence of hip dysplasia now if we understand a few basic things. Here are the 10 most important things you need to know.
1) All puppies are born with perfectly normal hips
Hip dysplasia is not a congenital defect; it is not present at birth. Multiple studies have demonstrated that all normal puppies are born with "perfect" hips; that is, they are "normal" for a newborn with no signs of dysplasia. The structures of the hip joint are cartilage at birth and only become bone as the puppy grows. If a puppy is going to develop hip dysplasia, the process begins shortly after birth.
This is the hip joint of a 1 day old puppy. The cartilage tissue does not show up on an x-ray until the minerals are deposited that form bone. Proper development of the joint depends on maintaining the proper fit between the head of the femur and the socket (acetabulum).
"The hip joints of all dogs are normal at birth. The joints continue to develop normally as long as full congruity is maintained between the acetabulum and the femoral head... The acetabular rims are stimulated to grow by mild traction applied by the joint capsule and gluteal muscles attached along their dorsal borders, and from pressure by the femoral heads upon the articular surfaces... The morphologic characteristics of the complex hip structure show that biomechanical behavior is the prime influence in the growth of this joint." (Riser 1985)
[Picture]2) The genes that cause hip dysplasia remain a mystery
Hip dysplasia tends to be more common in some breeds than others and in some lines than others, which indicates that there is a genetic component to the disorder. However, scientists have been looking for genes that are responsible for the development of hip dysplasia in dogs for decades without success.
Genes that are associated with hip dysplasia have been identified in some breeds, but they are breed-specific; that is, the assortment of genes is different in every breed. (For example, see studies on the German Shepherd dog (Marschall & Distl 2007, Fells & Distl 2014, and Fels et al 2014), Bernese Mountain Dog (Pfahler & Distl 2012), and Labrador Retriever (Phavaphutanon et al 2008). Genes that could cause hip dysplasia have not been found in any breed.
It's unlikely that researchers are going to discover an easy genetic solution to the problem of hip dysplasia. It is a complex trait that is influenced by both genes and environment, and there is no simple solution just over the horizon. We should be able to improve genetic progress by using selection strategies that are as efficient and effective as possible such as estimated breeding values, EBVs. One great advantage of using EBVs is that the genes responsible for a trait don't need to be known; you need only a pedigree database and information about affected animals.
3) Environmental factors are also important
Although there is a genetic influence on hip dysplasia, the heritability of the trait is rather low. Many studies have shown that genetic variation accounts for only a modest fraction of the variation in hip scores, usually 15-40%. This means that some fraction of the variation in the quality of the hips is the result of non-genetic, or "environmental" influences. This is one reason why decades of strong selection has resulted in only modest reductions in hip dysplasia in some breeds. At the current rate of progress and selecting only by phenotype, it could take decades to achieve a meaningful reduction in the incidence of hip dysplasia (Lewis et al 2013).
Understanding the specific environmental factors that play a role in the development of hip dysplasia should allow us to reduce the number of animals affected by hip dysplasia even if the genetic basis is not yet understood. This would reduce significant pain and suffering as well as the expense and heartache endured by owners of an afflicted dog. There is no reason why we should not be taking active steps to do this now.
The top three environmental factors that have been found to play a significant role in the develop of dysplastic hips are: a) joint laxity, b) weight, and c) exercise (see below).
4) Joint laxity is the primary cause of hip dysplasia
Puppies are born with perfect hips, and if the hips do not develop laxity the dog does not develop hip dysplasia (Riser 1985). Joint laxity occurs when the head of the femur does not fit snugly into the acetabulum. This could be the result of traumatic injury, overloading of the joint by weight, lack of muscle strength, or adductor forces (e.g., bringing the legs together). Joint laxity is the primary factor that predisposes a dog to the development of hip dysplasia.
Source: please read more of this amazing article at http://www.instituteofcaninebiology.org/blog/the-10-most-important-things-to-know-about-canine-hip-dysplasia
Here is another amazing hip article, Source: