Diagnosis as last!

Finally Duke’s on-off limp has been diagnosed, kind of good news and bad news…. The good news being that it isn’t a cruitiate ligament, with it six months of light exerecise, the bad news being that it can only get worse – he has OCD lesions to the back of the left shoulder joint. He is big for a Border Collie and my vet thinks that he simply grew too fast. Thankfully it is very very minor, and most likely will be controlled with gloucosomin supplements.

So what on Earth are OCD lesions?

Osteochondritis Dissecans (OCD): This disorder occurs when calcification does not follow cartilage growth. The cartilage continues to grow, becomes thicker than normal, and vessels from the bone marrow are unable to penetrate. Under these conditions, bone formation does not proceed and cracks and crevices form in the abnormally thickened cartilage. Fragments of cartilage eventually detach from the underlying cartilage and become lodged within the affected joint. Affected joints, listed from most to least commonly involved, are the shoulders, knees, elbows, hocks, and rarely the joints of the spinal column. Males have a higher risk than females for developing OCD.

Age of onset: 4-12 months (Duke was 14 months when the limping started)

Cause: Several factors are indicated in the development of OCD including nutrition, rapid growth, joint conformation and genetic predisposition. In regard to genetic predisposition, certain instances of OCD are suspected of being inherited as a polygenic trait since common OCD lesions are frequently found among littermates. None of his brothers or sisters suffer.

This is particularly the case in elbow dysplasia. OCD is also suspected of playing a role in the development of certain hip dysplasias, but it is not known with certainty whether the presence of OCD lesions is a cause or effect of the various changes taking place within the hip joint.

Symptoms: OCD presents as persistent, mild to moderate lameness that usually progresses in severity over time. Symptoms are most obvious immediately after rest periods when the dog first attempts to get up and walk. This was very apparent in Duke!

Joint swelling may or may not be evident, however, hyperextending the affected joint will almost always elicit an unmistakable, often vocal, pain response from the dog. Though lameness may only appear to present on one side (unilateral), asymptomatic OCD will usually be found in one or more joints of the opposite extremity (bilateral).

Diagnosis: Survey radiography is often reliable for identifying lesions associated with OCD. Though free-cartilage in the joint-space is not consistently evident on x-ray, bone irregularities and widening of the joint-space are consistent with a diagnosis of OCD. In advanced cases, evidence of degenerative joint disease may also be observed on the x-ray.

Treatment: Treatment for OCD may be non-surgical or surgical. Conservative treatment includes weight control and exercise limitation combined with administration of non-steroidal anti-inflammatory drugs [NSAIDs] (ex. buffered-aspirin, carprofen, or etodolac) to reduce pain and inflammation, and chondroprotective drugs (ex. polysulfated glycosaminoglycans, glucosamine, or chondroitin sulfates) to limit cartilage damage and degeneration. Surgical treatment now commonly utilizes arthr oscopy, a microsurgical procedure that is minimally invasive, to remove loose and diseased cartilage. Clinical data suggests that both conservative and surgical methods have been effective for treatment of OCD. No long-term follow-up to compare dogs treated by either approach, however, has yet been conducted. Dogs treated by either method eventually do develop progressive osteoarthritis. In light of significant improvement observed in dogs treated surgically compared to untreated dogs, many orthopedic specialists consider surgery to be the primary treatment for OCD. Surgical intervention is strongly indicated when non-surgical treatment fails to produce improvement in symptoms within 6-8 weeks or radiographic evidence suggests that lesions are becoming more severe despite conservative therapy.

Prognosis: Mild to moderate OCD lesions may heal spontaneously with 4 to 6 weeks of crate rest and leash walking. More severe OCD lesions or those occurring in dogs whose owners are unable to enforce exercise restriction usually require conservative or surgical therapeutic intervention to reduce secondary and long-term complications associated with osteoarthritis. Untreated, advanced lesions or those that do not respond to conservative therapy usually require surgical intervention to inhibit progression of debilitating disease.

Thanks to http://www.labbies.com/dysplasa.htm for the above info!

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