Capers: Juvenile Pubic Symphysiodesis

Capers is a super happy 5 months young Labradoodle puppy. Recently, his family noticed he was bunny hopping (taking short, hopping steps) more frequently, especially during faster gaits. There was also stiffness in his hind limbs.

X-rays were taken and Capers was diagnosed with mild hip dysplasia. A surgical procedure called Juvenile Pubic Symphysiodesis (JPS) is recommended to prevent the development of painful arthritic hip degeneration. Treated early, Capers can continue to live an active and full life!

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“It was mixed emotions for us. Our perfect little puppy being unwell so early. The decision to proceed with surgery was easy. I was open to whatever was needed to give Capers many many great years ahead.”

what is hip dysplasia?

In a normal hip joint, the femoral head (ball) fits snugly into the acetabulum (socket). In dogs with hip dysplasia, there is abnormal looseness between the ball and socket. When these two structures do not fit smoothly, the femoral head slips in and out of the joint (subluxation). Over time, the bones become deformed, resulting in inflammation, lameness, stiffness and pain.

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Ref: vetsurgerycentral.com

how is hip dysplasia diagnosed?

A puppy’s hip dysplasia is usually detected during the second or third vaccination appointment when the vet performs a physical examination and gait evaluation. X-rays are necessary. In order to get the best diagnostic view, the dog is sedated or anaesthetised for proper positioning with the hips distracted (femoral heads “distracted” or pulled out of the acetabula as far as they will go) so that any looseness between the ball and socket can be seen.

Symptoms of hip dysplasia 

  • Bunny hopping
  • Stiffness
  • Limping
  • Swaying gait
  • Difficulty getting up and lying down
  • Reluctance to run, jump or climb stairs/slopes
  • Shifting of weight to forelimbs

DID MY PUPPY GET HIP DYSPLASIA FROM HIS PARENTS?

Genetics do play a part. Puppies diagnosed with hip dysplasia should be neutered or spayed to prevent the breeding of dogs who carry the gene for hip dysplasia. Dogs used for breeding should have their hips evaluated by vets.

Although there is a genetic influence, hip dysplasia can be caused by other factors:

  • Body weight – Overweight puppies and larger breeds who grow rapidly are at greater risk of developing hip dysplasia.
  • Nutrition – Puppies must receive good nutrition to grow but they should not be overweight. Speak with your vet about proper nutrition and supplements.
  • Exercise – Avoid over exercising your puppy and high impact activities like jumping, leaping for balls, running up and down the stairs. Take your pup for a few short walks daily instead of one long walk/run. 
  • Environment – Puppies who frequently walk on slippery surfaces or have access to stairs at a very young age have a higher risk of hip dysplasia.

What can be done?

* Early intervention is critical. If the diagnosis is made at an early age, a minimally invasive surgery known as Juvenile Pubic Symphysiodesis (JPS) is recommended.

If the diagnosis is made at a later stage, Triple Pelvic Osteotomy (cutting the pelvic bone in three places and rotating the segments to improve coverage of the ball) or total hip replacement surgery is required. These are major surgical procedures. If surgery is not an option, the dog may need lifelong pain relief medication.

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Puppies with hip dysplasia may have weak upper thighs that lack muscle mass.  They may also take short, hopping steps especially when running fast.

WHAT IS JPS surgery?

In JPS surgery, the goal is to achieve a better congruency (fit) of ball and socket. This is done by “fusing” the growth plate of the pubic bone to limit the growth. The hip socket is forced to rotate over the ball (femoral head) as it grows.

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A small incision is made between the hind limbs to expose the pubic bone of the pelvis.

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Image 1: The growth plate is cauterised (burn with electrocautery) to stop this part of the pelvis from growing. Image 2: As the remaining parts of the pelvis continue to grow, the hip sockets rotate over the balls (femoral head) resulting in a more stable hip & less chance of future arthritis. (Ref: vetsurgerycentral.com)

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Dr Patrick Maguire, Veterinary Specialist in Small Animal Surgery, Mount Pleasant Vet Centre (Gelenggang) performed the surgery on Capers. JPS is more successful when there is significant potential for growth & thus, the opportunity to alter the hip growth. It is ideally performed at 16 weeks & no later than 20 weeks of age.

should my puppy be neutered at the same time?

Puppies should be spayed or neutered at the same time as JPS surgery, to prevent the breeding of dogs that carry the genes for hip dysplasia.

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Capers waking up from surgery. Exercise is restricted & we will see him in 2 weeks’ time for review & suture removal.