About Legg Perthes Disease
As I noted, I started this website
because, when Manny was first struggling with Legg Perthes disease, very
little information was available about the disease, the treatment and the
recovery period. I have included information from the two resources that
were most helpful to us - Wikipedia and WestieClub America.
I hope that by blogging about Manny's experiences, I can help dog owners
with similar issues issues by providing useful information to
consult.
About Legg Perthes (from Wikipedia)
Legg-Calvé-Perthes syndrome is a degenerative disease of the hip
joint, where a loss of bone mass leads to some degree of collapse of the
hip joint, that is, to deformity of the ball of the femur and the
surface of the hip socket. The disease is typically found in young
children and small dogs, though in extremely rare cases it also affects
adults.Legg-Calvé-Perthes
Disease in dogs
This is also known as aseptic necrosis of the femoral head.
Yorkshire Terriers, Pugs, Jack Russell Terriers, and Dachshunds can be
affected. Hip pain is usually seen by the age of 6 to 8 months. The
disease is bilateral in 12 to 16 percent of cases. X-rays are necessary
to make the diagnosis and show increased opacity and focal lysis in the
head of the femur, and later in the disease, collapse and fracture of
the neck of the femur. The recommended treatment is surgical removal of
the head of the femur, but conservative treatment (rest, exercise
restriction, and pain medication) may be effective in a limited number
of cases (less than 25 percent, according to some studies). The
prognosis is excellent with surgery.
What is
it Legg Perthes (from WestieClubAmerica)?
Legg-Calve-Perthes Disease, also known as Legg-Perthes, is caused by the
disruption of the blood supply to the head of the femur (the round bone
which fits into the hip socket). Legg-Calve-Perthes results when the
blood supply to the femoral head is interrupted, resulting in the death
of bone cells. This is usually followed by a period of
revascularization, where the femoral head is subject to remodeling
and/or collapse, creating an irregular fit into the hip socket. This
process of bone cells dying and chipping followed by new bone growth and
the remodeling of the femoral head and neck, leads to stiffness and pain
in the rear leg or legs.
What
causes Legg Perthes?
In some cases, trauma, such as a twisting injury or fracture, can be the
initiating factor. Other speculative predisposing causes can be
inflammation, nutritional factors, hip dysplasia, circulatory problems
and possible excessive hormones. Although no specific causes of the
disease are known, it is generally believed to have a genetic mode of
inheritance, and is not believe to be caused by trauma alone. Because
there is a genetic component, it is recommended that dogs affected with
Legg-Perthes not be used in breeding programs. It is considered a
polygenic trait in several small breeds of dogs. Onset can occur from
three to eleven months of age.
What are
the Symptoms?
The young dog will begin to favor one hind leg, or will walk or limp
with a stilted gait. In the rare cases where both hips are affected, the
dog will sometimes "bunny-hop". As the disease progresses, the dog may
suspend the affected limb in the air, and may or may not exhibit pain
when the leg is flexed. In very mild cases, often no symptoms are
apparent, while in severe cases; the dog can be in great pain and become
very irritable.
How is
Legg Perthes Diagnosed?
Diagnosis is accomplished through radiographs (X-rays) of the hips,
often done under light anesthesia.
What is
the treatment?
Current veterinary thinking is that a general rule of thumb is to allow
non-surgical therapy, limiting activity and treatment with non-steroidal
anti-inflammatory drugs for one month. In severe cases, the dog may
become totally lame and avoid use of the affected leg. Furthermore, the
leg muscles may begin to atrophy after extended periods of non-use. If a
good response is not seen, surgical repair by excising the head of the
femur should be considered. By removing the femoral head and neck, the
bone on bone contact that is the source of pain and discomfort is
eliminated. Within two months of surgery, a false joint of scar tissue
will form by muscle and tissue, and the dog may again walk without pain.
What is
the prognosis?
Usually excellent, and within several months, the dog can again walk and
run. In some cases, the affected leg may remain slightly shorter and the
muscles may be somewhat atrophied. Some veterinarians feel there may be
an increased risk of arthritis as the dog ages.
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