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Osteochondritis Dissecans is commonly referred to as OCD. It is a
disease of the cartilage that affects the joints in a dog's body.
In any joint in the body two bones come together and movement is allowed
between them. Where the two bones meet and exceptionally smooth
area of cartilage covers their surfaces. This acts as a cushion
and protects the underlying bone. If anything disrupts this smooth
cartilage surface, movement of the joint becomes painful. In a dog
with OCD this cartilage is damaged or grows abnormally. Instead of
being attached to the bone it covers, it separates or cracks, causing
great pain. In some cases, small pieces of cartilage break off and
float free in the joint. These pieces of cartilage do not die, but
rather continue to grow and increase in size. These are known as
joint mice. Approximately 15% of all dogs will develop OCD.
This article will cover the disease and its treatments and will explore
some of the suspected causes.
Who Gets OCD?
OCD is primarily a
problem in large or giant breed dogs. It has been reported in
small dogs and cats though it is not very common. It affects male
dogs 2 to 5 times as frequently as females, most likely due to the
males' larger size and increased stress on joints. It generally
occurs when the animal is between 4 and 8 months of age though it can
show up in older dogs. There are several breeds that despite being
larger breeds have decreased incidences of the disease including the
Doberman, Collie and Siberian Husky.
What Are The
Symptoms Of OCD?
The symptoms are lameness
in the affected limb. Some dogs have a barely noticeable limp and
others are unable to bear any weight on the leg. The
lameness tends to worsen after periods of exercise and improves after
rest. 74% of the cases of OCD occur in the shoulder joint, 11% in
the elbow and 4% in the hock. When it affects the front shoulder a
shortened forelimb stride may be noted due to reluctance to flex and
extend the shoulder joint. Occasionally the disease will affect
both limbs simultaneously and the dog may be reluctant to move.
How Is OCD Diagnosed?
Diagnosis is based on
history, physical exam and radiographs (x-rays). On physical
examination we notice joint pain. For instance, most healthy dogs
show no resistance when their shoulder joint is fully extended.
However, if they have an OCD lesion in their shoulder they may resist
shoulder manipulation and may even cry out in pain when it is attempted.
In addition this flexion and extension of the shoulder joint may worsen
the lameness.
Radiographs of the
affected joint are taken to confirm diagnosis. The dog is often
sedated so that full relaxation of the joint can be obtained.
Several views of the affected joint and the healthy joint on the other
side are taken for comparison. The separations of the cartilage or
joint mice are often identified on radiographs. If the radiographs
are not confirmatory but OCD is still suspected, radiographs may be
taken again in 2 to 3 weeks.
What Causes The Formation
Of OCD?
The cause of OCD is
considered to be multi factored. It is thought that there are
several factors that contribute to the formation of OCD lesions
including trauma to the joint, hereditary factors, rapid growth,
restricted blood flow to the cartilage, and nutrition.
Trauma, whether chronic
or acute, may contribute to the formation of OCD lesions. Injury
to the surface cartilage may lead to the separation of the cartilage
from the bone or cause a decrease in blood supply that leads to
cartilage flap formation.
It appears that there is
a genetic link between parents and offspring and the formation of the
disease. Certain breeds and genetic lines are much more likely to
develop the disease. Careful screening of parents against the
disease is recommended during the selection of all breeding stock.
The disease usually
occurs during periods of rapid growth. Therefore it has been
suggested that nutrition that creates rapid growth may lead to the
increase in incidence of the disease. It has been recommended that
animals that are susceptible to the disease be fed a diet that is lower
in protein and fat or that they are fed in a limited manner to allow
steady even growth during the first year of life. This theory may
have merits but more specific studies need to be done before any general
recommendations can be made.
How Is OCD Treated?
There are currently two
ways to treat OCD, conservative medical treatment or surgical removal of
the lesion. Conservative treatment may be indicated for dogs that
have early mild symptoms of OCD or where a specific lesion cannot be
identified on radiographs. Conservative treatment consists of
strict rest of 4 to 8 weeks. Leash walking is permitted but no
running or playing is allowed. Anti-inflammatory and painkillers
may be indicated. In addition, the use of glucosamine/chondroitin
products has been suggested yet there is not current studies that
confirm their beneficial use in this particular disease.
Conservative treatment may be difficult in young active puppies that may
still need to undergo surgery if the symptoms don't improve.
Surgery is indicated in
animals that show severe symptoms; in cases where large lesions are
identified on radiographs or when conservative treatments fail.
The surgery is very straightforward. The affected joint is opened
and the offending flap, defect, or joint mouse is removed. There
is a very high success rate for surgery and most animals recover fully
without any further problems.
How Is OCD Prevented?
Prevention consists of
careful selective breeding that avoids the breeding of animals with a
history of OCD. Young large and giant breed dogs should not undergo
strenuous activity, particularly jumping activities. Housing on
hard concrete surfaces has also been linked to increased OCD lesions in
pigs and may also contribute to problems in the dog. Providing a
well balanced diet that promotes even sustained growth is also
recommended.
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