Clinical Application of Dysgen

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Lisa Norris
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1 Expert White Paper Clinical Application of Dysgen GUIDE FOR CLINICAL RECOMMENDATIONS BASED ON THE RESULTS OBTAINED WITH DYSGEN IN LABRADOR RETRIEVER PUPPIES APRIL 2012 AUTHORS: M.D. Juan Martí. Veterinary Surgical Specialists (Virginia - USA) M.D. Andrés Sánchez-Carmona. ASC Veterinary Surgery (Madrid) Gemma del Pueyo. Los Madrazo Veterinary Hospital (Madrid) M.D. Joaquín Cerdeira. Aluche Las Aguilas Veterinary Clinic (Madrid)

2 is a DNA chip that analyses a dog s DNA based on a blood sample and assesses its genetic predisposition to developing hip dysplasia. In this white paper, a group of veterinary experts specialised in trauma, orthopaedics, and rehabilitation offer clinical practice guidelines based on the results obtained with Dysgen for growing dogs. This information will help veterinarians to establish individualised follow-up procedures adapted to the genetic predisposition of each individual animal, and to make the right decisions in order to better control the disease for each risk group. Logically, the following recommendations should be taken into account, together with each patient s clinical history. This paper also aims to improve advice for owners about the possible evolution of this disease. The recommended clinical guidelines for action and monitoring are the following, depending on the result obtained.

4 MINIMAL PREDISPOSITION (3% probability of developing hip dysplasia): General preventive measures: Despite the minimal risk of developing hip dysplasia, it is important to prevent the animal from becoming overweight. It is recommended to ensure moderate exercise regularly, such as walks on a leash, swimming, etc. Follow-up: Clinical and radiological studies of the hip at 8 months of age. In dogs of special genetic value (great breeding value, breeders, etc.) the owner should be advised to request official X-rays according to the criteria established by local governing bodies. Breeding: Encourage the owner/breeder to cross-breed this animal (taking into account other criteria aside from hip dysplasia, of course) preferably with dogs that also have a minimal or low genetic predisposition according to Dysgen. LOW PREDISPOSITION (16% probability of developing hip dysplasia): General preventive measures: Despite the minimal risk of developing hip dysplasia, it is important to prevent the animal from becoming overweight. Avoid strenuous exercise. Any exercise that affects the hindquarters, such as climbing stairs, should be done moderately. Food that is suited to the animal s needs should be selected, and supplements should be administered to protect the joints. Follow-up: Perform a clinical study and assessment of joint laxity at 16 weeks of age (PennHip) or hip X-rays at 6 months of age. In dogs of special genetic value (great breeding value, breeders, etc.) the owner should be advised to request official radiography according to the criteria established by local governing bodies. In asymptomatic dogs, encourage the owner to request X-rays/serial clinical examinations every 3 years. Breeding: If the owner/breeder wishes to cross-breed this animal (taking into account other criteria aside from hip dysplasia, of course), it should only be performed with dogs that have a minimal or low genetic predisposition according to Dysgen.

5 MODERATE PREDISPOSITION (45% probability of developing hip dysplasia): General preventive measures: It is essential to prevent the animal from becoming overweight. Avoid strenuous exercise and games that involve sudden jumps, especially during growth. Promote those types of exercises that improve the range of motion, maintain cartilage health, and improve muscle tone (see the exercises detailed at the end of this paper). The owner should prevent placing the animal on slippery surfaces and should administer supplements that help protect the joints. Follow-up: Perform a clinical study and assessment of joint laxity at 16 weeks of age (PennHip) or hip X-rays at 6 months of age. Those animals with lameness, pain, joint laxity (positive sign for the Ortolani test) or osteoarthritic changes in the hip, should consult with an orthopaedics-trauma specialist. In those cases, simultaneous medical treatment is recommended to limit the pain and progression of the osteoarthritis. In asymptomatic dogs, the owner is encouraged to request X-rays/clinical examinations at 18 months of age and every 2/3 years to assess possible changes in the joint. Breeding: It is recommended that the owner/breeder avoid cross-breeding this animal. HIGH PREDISPOSITION (>67% probability of developing hip dysplasia): General preventive measures: It is essential to prevent the animal from becoming overweight. Avoid strenuous exercise and games that involve sudden jumps, especially during growth. Promote those types of exercises that improve the range of motion, maintain cartilage health, and improve muscle tone (see the exercises detailed at the end of this paper). The owner should prevent placing the animal on slippery surfaces and should administer supplements that help protect the joints. Follow-up: Perform a clinical study and assessment of joint laxity at 16 weeks of age (PennHip) or hip X-rays at 6 months of age. Those animals with lameness, pain, joint laxity (positive sign for the Ortolani test) or osteoarthritic changes in the hip, should consult with an orthopaedics-trauma specialist. In those cases, simultaneous medical treatment is recommended to limit the pain and progression of the osteoarthritis. In asymptomatic dogs, the owner is encouraged to request X-rays/clinical examinations at 18 months of age and less than every 2 years afterwards to assess possible changes in the joint. Breeding: It is recommended that the owner/breeder avoid cross-breeding this animal.

6 APPENDIX: EXERCISES BIOIBERICA The objectives are: to improve hip range of motion, maintain joint cartilage health, and increase muscle tone in the area. In general, any of the exercises listed below are suitable for maintaining hip health in a healthy dog with minimal or low predisposition. In the case of moderate or high predisposition, the type, frequency and intensity of the exercise will depend on the patient s condition and whether or not surgical treatment has been carried out. It must be determined whether the patient is symptomatic or asymptomatic, as some of the proposed exercises may cause pain in the patient. RECOMMENDED JOINT EXERCISES BASED ON RISK GROUP. MINIMAL PREDISPOSITION Perform moderate exercise regularly. Avoid strenuous exercise and games that involve sudden jumps, especially during growth. LOW PREDISPOSITION Perform moderate exercise regularly. Avoid strenuous exercise and games that involve sudden jumps, especially during growth. Playing with a Frisbee or a ball thrown high above the animal s head should be avoided in all circumstances with this type of puppy. If the patient is asymptomatic its ability to partake in any sports must be assessed.

MODERATE AND HIGH DISPOSITION In these cases, it is important to determine whether the patient is symptomatic or asymptomatic, as some of the proposed exercises could cause pain in the patient.

1 2 3 4 5 6 7 8 Walks (first walking, then jogging) in a controlled fashion on a leash, changing the surface material to work on proprioception.

7 MODERATE AND HIGH DISPOSITION In these cases, it is important to determine whether the patient is symptomatic or asymptomatic, as some of the proposed exercises could cause pain in the patient. The objectives are: to improve hip range of motion, maintain joint cartilage health, and increase muscle tone in the area Walks (first walking, then jogging) in a controlled fashion on a leash, changing the surface material to work on proprioception. Walks on sand, in tall grass, or soft snow to improve the joint range of motion and stability (working the postural muscles). Swimming. Squats (only if the exercise does not cause pain). Slopes and stairs (slowly, step by step) (only if the exercise does not cause pain). Walking along the shore of the ocean or lake with the water at shoulder level first, then at knee level, to improve joint range of motion and increase muscle mass. Walking on a treadmill (only if the exercise does not cause pain). Cavaletti. Playing with a Frisbee or a ball thrown high above the animal s head, or engaging in similar activities, should be avoided in all circumstances with this type of puppy. NOTE: these are general recommendations. Each patient should be assessed individually to determine which exercises are appropriate during development.

8 BIOIBERICA, S.A. Plaza Francesc Macià, 7 Barcelona Customer Service tel / Y305369/0512

Physical Therapy/Core Strengthening Exercises

303 91 st Ave. NE Ste. A106 Lake Stevens, WA 98258 425-377-8620 www.lakestevensanimalhospital.com Physical Therapy/Core Strengthening Exercises Dogs with osteoarthritis or those recovering from a major