3.12 Orthopedic Screening

       Jason C. Nicholas, BVETMED (Hons)

       Independent Consultant, Author and Speaker, Co-founder, Preventive Vet, Portland, OR, USA

BASICS

      3.12.1 Summary

      From congenital and early‐onset conditions, such as angular limb deformities (ALD), luxating patella (LP), and hip dysplasia (HD), to developmental conditions that show up later in life, like degenerative joint disease (DJD) and osteoarthritis (OA), orthopedic conditions can cause significant pain, dysfunction, and secondary complications in our canine and feline patients. Such conditions can also cause emotional distress, logistical complications, and financial strain for our clients. Proactive screening and early client education and intervention are crucial to help avoid or mitigate the problems associated with orthopedic conditions both for our patients and our clients.

      On the other hand, a reactive approach typically results in affected patients suffering unnecessarily until such time that their owners recognize a problem and present their pet for evaluation. By this point, treatment options may be more limited or prognosis for the best level of return to function and good quality of life (QOL) may already be reduced.

MAIN CONCEPTS

      Orthopedic conditions in cats and dogs can be more common than many people realize and they can often have a significant negative impact on the comfort and QOL of affected animals. Orthopedic conditions can cause a host of problems, both for the affected pet and also for their people. Associated problems can include:

      Earlier detection and intervention can help improve the QOL for affected pets and their people. Since many pet owners don't appreciate the prevalence of orthopedic conditions in cats and dogs, and many don't pick up on the earliest signs of such conditions, veterinary teams must be proactive in educating clients and encouraging early and appropriate screening for orthopedic issues to help advocate for and provide the best comfort and care for our patients.

      3.12.2 Congenital and Acquired Orthopedic Conditions Can Be Common

      3.12.2.1 Canine Hip Dysplasia (HD)

Data from the Orthopedic Foundation for Animals (OFA) puts the likelihood of canine HD at 18.3–21.2% for Rottweilers, 20.1–20.5% for German shepherd dogs, 15.5–19.9% for golden retrievers, and 8.5–12.0% for labrador retrievers [1]. (Bulldogs had the highest prevalence of HD according to OFA data, at 65.9–71.2%!)

      3.12.2.2 Canine Elbow Dysplasia (ED)

      OFA data also show high prevalence of ED in certain dog breeds: chow chows (48.6%), Rottweilers (38.9%), German shepherd dogs (19.1%), and golden retrievers (11.4%) [1].

      3.12.2.3 Canine Osteoarthritis (OA)

      In a OA screening study done on dogs undergoing dental prophylaxis, it was found that 68% had radiographic evidence of OA in at least one joint (many had more than one joint affected) [2]. It was also found in this study that 71% of the owners of the dogs that were found to have radiographic OA weren't appreciating any clinical signs of their dog's OA [2].

      3.12.2.4 Feline Osteoarthritis (OA)

      In one study, radiographic evidence of OA was present in approximately 30% of cats over 8 years old [3]. Another study found that 90% of cats over 12 years old had radiographic evidence of DJD [4].

      3.12.3 Diagnostic Methods for Screening for Orthopedic Disease and Risk Factors

      While radiographs are a central modality of orthopedic disease screening, they aren't the only diagnostic testing method to use when looking for orthopedic problems in patients.

      3.12.3.1 Pain Assessment Questionnaires

      Validated pet owner questionnaires exist that can help increase a clinician's index of suspicion for orthopedic (or other painful) disease in pets. When orthopedic disease is anticipated or suspected based upon breed, age, activity level, or other factors,