Client Education

Diagnosis:  Hip Dysplasia

Jocelyn has hip dysplasia.  Basically hip dysplasia is a malformed hip joint.  The head of 
her femur does not fit correctly into the pelvis.  This is a chronic progressive disease.  
There is no cure for hip dysplasia.  The best treatment we have available is bilateral hip 
replacement.  This procedure has good success and is the best available option.  
However, right now Jocelyn is still growing.  For now we recommend a change in diet, 
some medication for pain, and exercise restriction.  If hip replacement is not possible in 
the future, there is another possible surgery called a femoral head osteotomy, which could 
be possible.  It involves removing the head of the femur.  This surgery helps to ease pain 
but does not give full functionality of the joint.  Also, Jocelyn is heavier than the ideal 
weight to perform this surgery.  

We recommend that Jocelyn be placed on a calorie-restricted diet in place of her current 
free choice meals.  The reason we are placing her on this diet is so that we can keep as 
much excess weight off her hip joints as possible.  Having excess weight on her hip 
makes her more painful and can also speed up degeneration of the joints.

We are going to place Jocelyn on some medication called ÒRimadylÓ.  This medication 
will help ease her pain and should make her more comfortable.  There are some possible 
side effects from Rimadyl that I want to inform you about so you can keep an eye out for 
any possible adverse reactions.  While Jocelyn is on Rimadyl watch for inappetence, 
diarrhea, vomiting, dark tarry stools, increased urination and increased drinking, pale 
mucous membranes, yellowing of her skin and eyes, depression, seizures, change in 
behavior, and incoordination.  If you see any of these side effects please call us 
immediately for instructions.  Periodically we will want to do blood work on her to check 
for any internal drug effects.  Rimadyl is not a ÒfixÓ.  It will not make Jocelyn better, but 
it should help with the pain.  We want to try her on Rimadyl for 6 weeks.  We want to see 
Jocelyn at the end of the 6 weeks for a recheck.

We also recommend restricting JocelynÕs exercise.  Give her exercise only in moderation.  
The more the joint is used the more wear and tear is placed on the joint.  Continue doing 
the leash walking you already do.  And some good exercises include swimming and 
climbing hills.

So to sum things up we want you to restrict her diet, give her daily medication, monitor 
her for any possible side effects from the Rimadyl and restrict her activity to help protect 
her joints.  In the future we would like to have Jocelyn referred to a teaching hospital for 
bilateral hip replacement.  We know this procedure is expensive, but it is the only real 
effective and pain relieving option available.  If you find the cost is too much, one hip 
can be replaced instead of both.  This would provide at least one pain free leg for her to 
maneuver on. 

WHY THESE INSTRUCTIONS ARE IMPORTANT FOR OUTCOME OF CASE:

A diet change is important because Jocelyn is currently on a free choice diet.  We do not 
know what her current body condition is because that information was not provided to us.  
But we do not want her to be overweight because that would add additional stress to her 
coxofemoral joints causing more pain and degeneration.  Jocelyn should also be restricted 
in exercise for similar reasons, mainly to reduce excess stress and wear and tear on the 
acetabulum and femoral head.  Some appropriate exercises for her include swimming 
because it reduces the weight on the hip joints and hill climbing because it strengthens 
muscles that will help stabilize the coxofemoral joints.  Using Rimadyl should help with 
the inflammation and pain but it is important to inform the client of possible side effects 
of Rimadyl so that early detection of any adverse reactions can be caught.  Of course the 
ultimate goal would be to have both hips replaced in the future.