Hip
joint dysplasia (HD) - recent findings
Hipjoint de-nerving on painful Coxarthrosis already became famous, as many surgicaly skilled veterinarians preformed the procedure successfully and according to owners report, their operated pets exhibited no pain but improved fairly good gait considering the muscle-tendon-shorten on both their hind legs.
We entirely abandoned the method of pain relief by the use of gold implantation (permanent acupuncture), as Kuepper's de-nerving seems to have a higher rate of safety.
This method requires de-nerving from 1 to 7 O'clock around the right hip joint and from 11 through 5 O'clock around the left one dorsal to hip bone sockets.
With
advanced osteophyte development about the hip-joints, the using of a
sharp spoon is completely inadequate. We then use a rose-head-drill
and de-nerve corresponding areas with "high speed" under
cold water irrigation.
Resection of the pectineus muscle can
make sense. However, no solution can stand by itself, as declining
degree of the lameness is either negligible (effect lasting for about
six months and that only by young animal) or non existing at all.
Nevertheless, we perform pectineus muscle resection in many cases, but this always together with the "ventral denervation" (joint capsule de-nerving) while simultaneously dissecting the Ileo-psoatic muscle tendon.
These
"PIN surgery" on the HD (Pectineus myotomy,
Ileo-psoas-tenotomy, and neurectomy of the ventral joint capsule by
means of a surgical-laser), preformed additionaly to Küpper's
procedure (dorsal denervation of the pan-roof) with evidently
improved painless-ness for the patient. These were confirmed lately
by Kàsa. Mentioned joint capsula de-nervation is only possible
with a surgery-laser: MLT-diode laser (semiconductor laser),
carbondioxide-laser or YAG-laser. We preffered MLT's diode-laser, as
it is relatively inexpensive compared to other laser-systems and can
be obtained for monthly payments of about 400-500 leasing-Euros.
All
the same purchasing such a laser is an absolute necessary equipment
to master a wide range of therapy procedures for any surgical aimed
practice or clinic.
The laser can be also applied for the Symphysiodese procedure on young dogs (between 12 to 20 weeks of age) which will spare the costly TPO procedure (Triple Pelvic Osteotomy). We preform TPO still by older animals, but only by absence of osteoarthritis signs (Morgan's lines) on their x-rays.
The use of surgical laser instead of electrocautery enables us a beter aimed and more secure physiodese.
We would also like to point out to our dear colleagues that canine Coxarthrosis is accompanied to a very high degree (over 90 percent of the cases) with multiple discs protrusions. Properly performed myelography reveals clearness.
Translation by
Dr. Itche
Silberpriver
President of the Deutsch-Israelische
Tierärztegesellschaft
The Golan Heights, Israel
Tierärztliches
Institut für angewandte Kleintiermedizin
Tierärztliche
Gemeinschaft für ambulante und klinische Therapien
Dirk
Schrader I dr. Steven-F. Schrader
I dr. Ifat Meshulam
I Rudolf-Philipp Schrader
I dr. Itamar Tsur
-Tierärzte-