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Hip Dysplasia and Spine

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These dogs (and many dogs with "hip dysplasia")frequently have postural defects that cause greater loading of the hind legs, frequently asymmetrical, which in addition to causing joint laxity and instability in the hips, causes kyphosis with hypermobility in the low back that results in intrabone flexion as well as segmental hypermobility in the spine. The intrabone flexion results in microfractures that cause thickening of the vertebral bodies and can result in stenosis (lumbo sacral and within each segment.) The primary lesion is usually much further forward, often upper cervical or lower cervical and results in an inaccuracy of righting and balance reflexes in neutral stance that result in the bony and soft tissue changes from inappropriate loading and use. Yes, they will improve with accurate adjusting and postural rehab, prolotherapy and weight management, which is sometimes hard with Berner owners. I can give you several client testimonials, case studies, films etc. If you would like to discuss the techniques, please call.Judith M. Shoemaker, DVM

Always Helpful Veterinary Services

305 Nottingham Road

Nottingham, PA 19362

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www.judithshoemaker.comTo: VetRehab From: lizwiz4@...Date: Fri, 4 Dec 2009 12:39:19 +0000Subject: Hip dysplasia and spine

I have a 10 mo. old Bernese Mtn. dog that was diagnosed with bilateral hip dysplasia, scheduled for a bilateral FHO (first one, then the other to be done), and found that he actually has a spinal injury. Rads of both hips show one hip totally fine, the other with just a slight acetabular shallow spot. This dog has neurological signs...diminished or non-existent reflexes consistent with spinal cord compression, pain upon palpation of L5, L6, L7...anyone else seeing this with 'hip dysplasia' dogs? Thanks!

Liz Powers

Power Dog Rehab

123 Hawley St. #8

Northampton, MA 01060

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Re: 10 mo. old Bernese...Bilat. FHOs have been postponed pending further studies by the veterinarian about to do the surgery. Thanks to all who responded. I am working on getting the owner to a neuro specialist. Negative ortolani, slow placing reflex (decreased proprioception bilaterally), no pudendal reflex, significantly diminished gastroc and cranial tib reflexes, pain upon palpation L5, L6, L7; empty end feel to extension of both hips, with crying pain (which I later determined to be lumbar spine); crouching gait. With some gentle movement of pelvis/spine/hips, I was able to get to the end range of hip extension, which had a normal end feel when finally attained without too much lumbar spinal extension. See attached radiographs of hips, which look pretty good! Thanks again, all input is greatly appreciated.

Liz Powers, MPT, CCRTPower Dog Rehab123 Hawley St. #8Northampton, MA 01060

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Judith,

Your comments are always interesting however I must admit that due to my

ignorance I rarely understand them.

" These dogs (and many dogs with " hip dysplasia " )frequently have postural

defects that cause greater loading of the hind legs, frequently

asymmetrical, which in addition to causing joint laxity and instability in

the hips "

So are you saying that hip dysplasia and lumbosacral stenosis are related to

postural defects resulting in increased loading of the hind legs? You make

an additional comment that the primary lesion is often in the cervical area?

" causes kyphosis with hypermobility in the low back that results in

intrabone flexion as well as segmental hypermobility in the spine. "

When I perform computer gait analysis on kyphotic dogs they tend to show

more loading of the forelimbs. Can you explain your comments.

Additionally, I am just not familar with " intrabone flexion " and have been

unable to find references, could you comment further.

Rick Wall, DVM

Certified Canine Rehabilitation Practitioner

Diplomate, American Academy of Pain Management

Center for Veterinary Pain Management

and

Rehabilitation

The Woodlands, Texas

www.vetrehabcenter.com <http://www.vetrehabcenter.com>

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Judith,

Thank you for your lengthy response however again my ignorance potentates

the possibility of improper interpretation! I always try to remain open

minded about different therapies and philosophies however I always prefer at

least some level of evidence to support. With that said, the discipline of

veterinary physical medicine and rehabilitation, with few exceptions, is

currently based on a level of evidence drawn from expert opinions,

pathophysiologic rationale and single case studies. I am attempting to

understand your comments using the above criteria;

1. I remain respectful and accept your comments as " expert opinion "

2. I accept the premise that you have numerous case studies and

anecdotal observations to support your comments.

3. However, it is from a " pathophysiologic rationale " that I have the

greatest difficulty in my understanding.

Your comments, " Much research can be found in quality chiropractic sources

but the majority of the neurophysiology and mechanics of posture is much

older research that can't be Googled, as it is more than 25 years old " , is

of special concern for numerous reasons. Is this philosophy no longer

accepted in chiropractic circles? Why has this discipline not continued to

evolve with more current writings, reports, studies, etc.

There is no question that abnormal postures exists and can be a factor in

many veterinary rehabilitation and pain management cases. It is my opinion

that most abnormal posture is more of a result a pre-existing injury or

medical problem and in addition, accept that these abnormal postures can

lead to additional complications. However your comments " These dogs (and

many dogs with " hip dysplasia " ) frequently have postural defects that cause

greater loading of the hind legs,-------------------- The primary lesion is

usually much further forward, often upper cervical or lower cervical and

results in an inaccuracy of righting and balance reflexes in neutral stance

that result in the bony and soft tissue changes from inappropriate loading

and use. " , suggest that both hip dysplasia and LS disease are secondary to

postural defects caused by primary cervical problems. These statements are

what incited my previous questions.

Your course offerings appear interesting and I would consider attending one

or more in the future! However, at least some level of evidence should be

offered to justify your comments regarding this particular post without

having to attend your courses. I sincerely respect your passion and your

apparent desire to educate others! I look forward to continuing this

discussion and your assistance in my better understanding of the

pathophysiologic rationale behind your comments!

Rick Wall, DVM

Certified Canine Rehabilitation Practitioner

Diplomate, American Academy of Pain Management

Center for Veterinary Pain Management

and

Rehabilitation

The Woodlands, TX

www.vetrehabcenter.com <http://www.vetrehabcenter.com>

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Judith,

Thank you for your lengthy response however again my ignorance potentates

the possibility of improper interpretation! I always try to remain open

minded about different therapies and philosophies however I always prefer at

least some level of evidence to support. With that said, the discipline of

veterinary physical medicine and rehabilitation, with few exceptions, is

currently based on a level of evidence drawn from expert opinions,

pathophysiologic rationale and single case studies. I am attempting to

understand your comments using the above criteria;

1. I remain respectful and accept your comments as " expert opinion "

2. I accept the premise that you have numerous case studies and

anecdotal observations to support your comments.

3. However, it is from a " pathophysiologic rationale " that I have the

greatest difficulty in my understanding.

Your comments, " Much research can be found in quality chiropractic sources

but the majority of the neurophysiology and mechanics of posture is much

older research that can't be Googled, as it is more than 25 years old " , is

of special concern for numerous reasons. Is this philosophy no longer

accepted in chiropractic circles? Why has this discipline not continued to

evolve with more current writings, reports, studies, etc.

There is no question that abnormal postures exists and can be a factor in

many veterinary rehabilitation and pain management cases. It is my opinion

that most abnormal posture is more of a result a pre-existing injury or

medical problem and in addition, accept that these abnormal postures can

lead to additional complications. However your comments " These dogs (and

many dogs with " hip dysplasia " ) frequently have postural defects that cause

greater loading of the hind legs,-------------------- The primary lesion is

usually much further forward, often upper cervical or lower cervical and

results in an inaccuracy of righting and balance reflexes in neutral stance

that result in the bony and soft tissue changes from inappropriate loading

and use. " , suggest that both hip dysplasia and LS disease are secondary to

postural defects caused by primary cervical problems. These statements are

what incited my previous questions.

Your course offerings appear interesting and I would consider attending one

or more in the future! However, at least some level of evidence should be

offered to justify your comments regarding this particular post without

having to attend your courses. I sincerely respect your passion and your

apparent desire to educate others! I look forward to continuing this

discussion and your assistance in my better understanding of the

pathophysiologic rationale behind your comments!

Rick Wall, DVM

Certified Canine Rehabilitation Practitioner

Diplomate, American Academy of Pain Management

Center for Veterinary Pain Management

and

Rehabilitation

The Woodlands, TX

www.vetrehabcenter.com

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Judith,

Thank you for your lengthy response however again my ignorance potentates

the possibility of improper interpretation! I always try to remain open

minded about different therapies and philosophies however I always prefer at

least some level of evidence to support. With that said, the discipline of

veterinary physical medicine and rehabilitation, with few exceptions, is

currently based on a level of evidence drawn from expert opinions,

pathophysiologic rationale and single case studies. I am attempting to

understand your comments using the above criteria;

1. I remain respectful and accept your comments as " expert opinion "

2. I accept the premise that you have numerous case studies and anecdotal

observations to support your comments.

3. However, it is from a " pathophysiologic rationale " that I have the

greatest difficulty in my understanding.

Your comments, " Much research can be found in quality chiropractic sources

but the majority of the neurophysiology and mechanics of posture is much

older research that can't be Googled, as it is more than 25 years old " , is

of special concern for numerous reasons. Is this philosophy no longer

accepted in chiropractic circles? Why has this discipline not continued to

evolve with more current writings, reports, studies, etc.

There is no question that abnormal postures exists and can be a factor in

many veterinary rehabilitation and pain management cases. It is my opinion

that most abnormal posture is more of a result a pre-existing injury or

medical problem and in addition, accept that these abnormal postures can

lead to additional complications. However your comments " These dogs (and

many dogs with " hip dysplasia " ) frequently have postural defects that cause

greater loading of the hind legs,-------------------- The primary lesion is

usually much further forward, often upper cervical or lower cervical and

results in an inaccuracy of righting and balance reflexes in neutral stance

that result in the bony and soft tissue changes from inappropriate loading

and use. " , suggest that both hip dysplasia and LS disease are secondary to

postural defects caused by primary cervical problems. These statements are

what incited my previous questions.

Your course offerings appear interesting and I would consider attending one

or more in the future! However, at least some level of evidence should be

offered to justify your comments regarding this particular post without

having to attend your courses. I sincerely respect your passion and your

apparent desire to educate others! I look forward to continuing this

discussion and your assistance in my better understanding of the

pathophysiologic rationale behind your comments!

Rick Wall, DVM

Certified Canine Rehabilitation Practitioner

Diplomate, American Academy of Pain Management

Center for Veterinary Pain Management

and

Rehabilitation

The Woodlands, TX

www.vetrehabcenter.com

RE: Hip dysplasia and spine [1 Attachment]

>

> Judith,

>

> Your comments are always interesting however I must admit that due to my

> ignorance I rarely understand them.

>

> " These dogs (and many dogs with " hip dysplasia " )frequently have postural

> defects that cause greater loading of the hind legs, frequently

> asymmetrical, which in addition to causing joint laxity and instability in

> the hips "

>

> So are you saying that hip dysplasia and lumbosacral stenosis are related

to

> postural defects resulting in increased loading of the hind legs? You make

> an additional comment that the primary lesion is often in the cervical

area?

>

> " causes kyphosis with hypermobility in the low back that results in

> intrabone flexion as well as segmental hypermobility in the spine. "

>

> When I perform computer gait analysis on kyphotic dogs they tend to show

> more loading of the forelimbs. Can you explain your comments.

> Additionally, I am just not familar with " intrabone flexion " and have been

> unable to find references, could you comment further.

>

> Rick Wall, DVM

> Certified Canine Rehabilitation Practitioner

> Diplomate, American Academy of Pain Management

>

> Center for Veterinary Pain Management

> and

> Rehabilitation

> The Woodlands, Texas

>

> www.vetrehabcenter.com <http://www.vetrehabcenter.com>

>

>

>

>

>

>

>

> ------------------------------------

>

>

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