Worldwide Screening for Canine Hip Dysplasia: Where Are We Now?

B-mode ultrasonography and ARFI elastography of articular and peri-articular structures of the hip joint in non-dysplastic and dysplastic dogs as confirmed by radiographic examination

BACKGROUND

Canine hip dysplasia is a common orthopedic disease in veterinary practice. The diagnosis is made by radiographic examinations that evaluate bone alterations associated with hip dysplasia. Although radiographic examination is the gold standard for diagnosis, it does not allow a detailed evaluation of soft tissues such as the joint capsule and periarticular muscles. This study aimed to evaluate the accuracy of B-mode ultrasonography and acoustic radiation force impulse (ARFI) elastography in assessing the joint capsule and periarticular muscles of dogs using the Orthopedic Foundation of Animals (OFA) classification and the distraction index (DI) in the early and late diagnosis of hip dysplasia. This study sought to propose a protocol for the ultrasonographic evaluation of the structures involved in canine hip dysplasia.

METHODS

Radiographic and ultrasonographic evaluations were performed on 108 hip joints of 54 dogs. Thirty dogs were older than 2 years and 24 were aged between 4 and 10 months.

RESULTS

It was verified that an increase in pectineus muscle stiffness (cutoff value > 2.77 m/s) by elastography in some dysplastic dogs and an increase in the thickness of the joint capsule (cutoff value > 0.9 mm) in B-mode ultrasonography, were associated with a distraction index > 0.5, with both having a positive correlation. In B-mode ultrasonographic evaluation, the presence of signs of degenerative joint disease, such as irregularities of the cranial edge of the acetabulum and femoral head, were associated with a distraction index > 0.5 in canines, with a specificity of 94%. In adult dogs, the findings of degenerative joint disease on ultrasound were associated with a diseased OFA classification (P < 0.05). Measurement of the joint capsule > 1.10 mm was diagnostic for dysplasia in unhealthy dogs by OFA.

CONCLUSIONS

ARFI elastography has shown that the pectineus muscle may experience changes in stiffness in dysplastic animals. Additionally, changes in joint capsule thickness can be identified in B-mode in young and adult dogs with dysplastic joints, which contributes to the diagnosis of hip dysplasia.

Characterization of FCI (Fédération Cynologique Internationale) Grades for Hip Dysplasia in Five Dog Breeds

The aim of this retrospective study was to verify whether the radiographic morphologic differences detected within the first three grades of hip dysplasia (A, B, C) of each of the five selected breeds and within the same breeds were statistically significant enough to require a breed-specific evaluation. A total of 422 technical evaluation forms of hip dysplasia (HD) in Labrador Retrievers, Golden Retrievers, Rottweilers, Bernese Mountain dogs, and German Shepherd dogs were obtained from the Fédération Cynologique Internationale (FCI) archive. The data were evaluated using a descriptive statistical analysis. In Labrador Retrievers, the craniolateral acetabular rim and femoral head position were already altered in unaffected dogs; however, within the various FCI grades, the most severe changes involved the conformation of the femoral neck. All the radiographic parameters of the Golden Retriever hips changed progressively and evenly. Significant radiographic changes between FCI grades were found in the German Shepherd dogs, and the alterations involving the acetabulum were more severe and appeared earlier than in the femoral head and neck. In the Bernese Mountain dogs, the most severe alterations were in the position of the femoral head and joint space while the femoral head and neck showed no significant progression between grades. All the radiographic parameters of non-dysplastic Rottweilers were normal; however, the progression of the primary signs was similar to the other breeds, although with lower severity. In conclusion, no significant prevalence of the radiographic features was observed for any specific breed. However, significant individual breed variations in the primary radiographic parameters were found between dogs with and without dysplasia which could be useful for better understanding the consequences of biomechanical differences between breeds.

Development and validation of a device to measure the force applied to the coxofemoral joint during stress radiography for early diagnosis of canine hip dysplasia

Hip dysplasia is a common orthopaedic condition in dogs and stress radiography is the best diagnostic tool for early diagnosis. Objective force guidelines are lacking, leaving room for errors and fraud during screening. Our objective was to develop an accurate and validated measuring device that allows quantification of the applied force in vivo in real-time during stress radiographic imaging. A two-step approach was followed. First, four load cells were incorporated in the original Vezzoni Modified Badertscher Distension Device (VMBDD) and a dedicated computer program was developed. In vitro evaluations of the accuracy demonstrated a trueness of 0.19 N (0.1%FS) and precision of 0.26 N (0.2%FS) for the individual loadcells. The trueness and precision of the assembled VMBDmD were 0.02 N (0.02%FS) and 0.52 N (0.38%FS). Secondly, the modified device was tested on several cadavers. The device was similar in use as the VMBDD, did not interfere with radiographic acquisition, gave the operator real-time feedback, and linked the force with the radiograph. Altogether, we describe the accuracy of the VMBDmD and have evaluated its use in cadavers. We saw that the device successfully quantified and stored the applied force in real-time during stress radiography.

ICRP PUBLICATION 153 Approved by the Commission in September 2022

Veterinary use of radiation in the diagnosis, management, and treatment of disease has expanded and diversified, as have the corresponding radiological protection concerns. Radiological exposure of personnel involved in veterinary procedures and, where applicable, members of the public providing assistance (e.g. owners or handlers) has always been included within the system of radiological protection. Veterinary practice is now addressed explicitly as the modern complexities associated with this practice warrant dedicated consideration, and there is a need to clarify and strengthen the application of radiological protection principles in this area. The Commission recommends that the system of radiological protection should be applied in veterinary practice principally for the protection of humans, but with explicit attention to the protection of exposed animals. Additionally, consideration should be given to the risk of potential contamination of the environment associated with applications of nuclear medicine in veterinary practice. This publication focuses primarily on justification and optimisation in veterinary practice, and sets the scene for more detailed guidance to follow in future Recommendations. It is intended for a wide-ranging audience, including radiological protection professionals, veterinary staff, students, education and training providers, and members of the public, as an introduction to radiological protection in veterinary practice.© 2022 ICRP. Published by SAGE.

Prevalence of Primary Radiographic Signs of Hip Dysplasia in Dogs

Hip dysplasia is a disabling orthopedic disease in dogs. The aim of this retrospective study was to evaluate the morphological aspects and radiographic changes in the development of hip dysplasia in adult dogs, and to describe the frequency of each radiographic parameter according to each Fédération Cynologique Internationale (FCI) grade. Brass descriptive forms for the evaluation of hip dysplasia were obtained from the archive of the Italian Fondazione Salute Animale, and the radiographic evaluation of 642 hips were processed. Sixteen radiographic criteria were assessed, divided into six main parameters: acetabulum, femoral head and its position in the acetabulum, femoral neck, joint space, and Norberg angle. The initial mild alterations were shown in the craniolateral acetabular rim (31.8%), slightly divergent in the joint space in 58.6% of FCI-A. The spherical shape of the femoral head was mildly small/flattened in 56.9% of FCI-B, in addition to a slightly cylindrical-shaped femoral neck (60.5%) and slightly lost contours (55.0%). Changes in acetabular depth (45.0%), and in the cranial acetabular margin (56.7%) were found in FCI-C. The center of the femoral head was lateral to the dorsal acetabular rim in 70.0% of FCI-B; the Norberg angle appeared normal in 70.6% of FCI-B. Elaboration of the radiographic criteria from the Brass descriptive forms allowed for the extrapolation of accurate knowledge regarding morphologic changes in the development of dysplasia by providing detailed information for each individual. In particular, the present survey showed that the morphological alterations of the acetabulum prevailed over those of the femoral head only at the beginning of the development of canine hip dysplasia, and then worsened after the changes occurred in the femoral head and neck.

Acetabular Coverage Area Occupied by the Femoral Head as an Indicator of Hip Congruency

Accurate radiographic screening evaluation is essential in the genetic control of canine HD, however, the qualitative assessment of hip congruency introduces some subjectivity, leading to excessive variability in scoring. The main objective of this work was to validate a method-Hip Congruency Index (HCI)-capable of objectively measuring the relationship between the acetabulum and the femoral head and associating it with the level of congruency proposed by the Fédération Cynologique Internationale (FCI), with the aim of incorporating it into a computer vision model that classifies HD autonomously. A total of 200 dogs (400 hips) were randomly selected for the study. All radiographs were scored in five categories by an experienced examiner according to FCI criteria. Two examiners performed HCI measurements on 25 hip radiographs to study intra- and inter-examiner reliability and agreement. Additionally, each examiner measured HCI on their half of the study sample (100 dogs), and the results were compared between FCI categories. The paired t-test and the intraclass correlation coefficient (ICC) showed no evidence of a systematic bias, and there was excellent reliability between the measurements of the two examiners and examiners’ sessions. Hips that were assigned an FCI grade of A (n = 120), B (n = 157), C (n = 68), D (n = 38) and E (n = 17) had a mean HCI of 0.739 ± 0.044, 0.666 ± 0.052, 0.605 ± 0.055, 0.494 ± 0.070 and 0.374 ± 0.122, respectively (ANOVA, p < 0.01). Therefore, these results show that HCI is a parameter capable of estimating hip congruency and has the potential to enrich conventional HD scoring criteria if incorporated into an artificial intelligence algorithm competent in diagnosing HD.

Repeatability of radiographic assessments for feline hip dysplasia suggest consensus scores in radiology are more uncertain than commonly assumed

Variation in the diagnostic interpretation of radiographs is a well-recognised problem in human and veterinary medicine. One common solution is to create a 'consensus' score based on a majority or unanimous decision from multiple observers. While consensus approaches are generally assumed to improve diagnostic repeatability, the extent to which consensus scores are themselves repeatable has rarely been examined. Here we use repeated assessments by three radiologists of 196 hip radiographs from 98 cats within a health-screening programme to examine intra-observer, inter-observer, majority-consensus and unanimous-consensus repeatability scores for feline hip dysplasia. In line with other studies, intra-observer and inter-observer repeatability was moderate (63-71%), and related to the reference assessment and time taken to reach a decision. Consensus scores did show reduced variation between assessments compared to individuals, but consensus repeatability was far from perfect. Only 75% of majority consensus scores were in agreement between assessments, and based on Bayesian multinomial modelling we estimate that unanimous consensus scores can have repeatabilities as low as 83%. These results clearly show that consensus scores in radiology can have large uncertainties, and that future studies in both human and veterinary medicine need to include consensus-uncertainty estimates if we are to properly interpret radiological diagnoses and the extent to which consensus scores improve diagnostic accuracy.

Early hip laxity screening and later canine hip dysplasia development

Background and Aim:

Passive hip laxity (PHL) is considered the primary risk factor for canine hip dysplasia (HD) and is estimated, in stress hip radiographs, using the distraction index (DI). The study aimed to associate the early PHL using the hip Distractor of University of Trás-os-Montes and Alto Douro (DisUTAD) and the late HD grades.

Materials and Methods:

A total of 41 dogs (82 hips) were submitted to a follow-up study. First, between 4 and 12 months of age, dogs were radiographed using the DisUTAD hip distractor and were determined the DI for each hip joint. Then, after 12 months of age, dogs were reevaluated for HD using the conventional hip ventrodorsal projection and hips were evaluated for HD using the Fédération Cynologique Internationale (FCI) scoring system.

Results:

Hips of dogs’ in the second examination with FCI grades of A (n=28), B (n=11), C (n=22), and D and E (n=21) had an early DI of 0.32±0.1, 0.38±0.08, 0.50±0.12, and 0.64±0.11, respectively. Statistical analysis using the general linear model univariate, with the DI as dependent variable and the FCI grades, side and sex as fixed factors, and the post hoc Bonferroni correction test showed significant differences among FCI grades (p<0.05).

Conclusion:

These results show the association between early DI and the late FCI HD grades and the DisUTAD is recommended for the early canine HD diagnosis.

Modified FCI (Fédération Cynologique Internationale) Scoring of the Coxofemoral Joint in Labrador Retrievers Without and With Hip Dysplasia

The objective is to propose a modified FCI scoring protocol of the canine hip joint via: (1) providing morphometric criteria of each score; (2) quantifying the extent of lateral and dorsal acetabular femoral head (AFH) coverage; (3) evaluating the steepness of cranial acetabular edge (acetabular index angle) and inclination angle (IA) in normal and dysplastic coxofemoral joints of Labrador Retrievers. The long-term goal is to achieve a selective breeding protocol using parental phenotypically healthy coxofemoral joints based on the standard extended-leg VD radiograph to help reduce the prevalence of CHD among offspring. Investigated populations were classified into normal (grade A) and dysplastic coxofemoral joints (grades B to E) based on the morphometric criteria previously established by the conventional FCI scoring system. Center-edge (CE) angle, Norberg angle (NA), indices of dorsal AFH coverage width and area, acetabular index angle, and inclination angle were determined for each group. Variables were compared between groups using ANOVA. Spearman correlation coefficient was used to determine the linear relationship between selected variables. Overall, all radiographic measurements differed significantly (P < 0.0001) among the five tested groups using ANOVA test. Dorsal AFH coverage area index was the only measure that differed significantly (P ≤ 0.007) between every two consecutive groups using Tukey's test. Significant correlations were identified between the Norberg and CE angles (r s = 0.95, P < 0.0001), the width and area of dorsal AFH coverage (r s = 0.96, P < 0.0001), and the radiographic techniques utilized to assess lateral vs. dorsal AFH coverage (r s ≥ 0.80, P < 0.0001). Evaluation of CE-angle, dorsal AFH coverage area index and acetabular index angle is recommended during selective breeding to include parents with radiographically healthy joints and reduce the incidence of hip dysplasia among offspring. Dogs with CE-angle <27°, dorsal AFH coverage area index <53%, and/or acetabular index angle >9° may be consistent with hip dysplasia and are recommended to be excluded from potential breeding groups. Re-evaluation of coxofemoral joints with borderline values located between near-normal and mildly dysplastic coxofemoral joints is strongly recommended to be performed after 6 months.

Part I of Finnish Agility Dog Survey: Training and Management of Competition-Level Agility Dogs

Knowledge regarding training, competition, and management routines of agility dogs is lacking. Through a retrospective online questionnaire, Finnish owners and handlers of 745 competition-level agility dogs provided information on training routines and management of these dogs during one year free of agility-related injuries. Competition routines were collected from the national competition results database. Most dogs trained agility 1-2 times a week, with a median active training time of 18 min a week. Dogs competed in a median of 2.1 runs per month at a speed of 4.3 m/s. Common field surfaces were different types of artificial turfs and dirt surface. Warm-up and cool-down were established routines, and 62% of dogs received regular musculoskeletal care. Moreover, 77% of dogs underwent conditioning exercises, but their frequency was often low. Additionally, dogs were walked for a median of 1.5 h daily. Pearson's chi-squared and Kruskal-Wallis tests were used to evaluate the association between a dog's competition level and training and competition variables. A dog's competition level was associated with competition (p < 0.001) and training frequency (p < 0.001); dogs at higher levels compete more but train less than dogs at lower levels. This study provides information on training, competition, and management routines of competing agility dogs.

Genome-wide association studies for canine hip dysplasia in single and multiple populations - implications and potential novel risk loci

BACKGROUND

Association mapping studies of quantitative trait loci (QTL) for canine hip dysplasia (CHD) can contribute to the understanding of the genetic background of this common and debilitating disease and might contribute to its genetic improvement. The power of association studies for CHD is limited by relatively small sample numbers for CHD records within countries, suggesting potential benefits of joining data across countries. However, this is complicated due to the use of different scoring systems across countries. In this study, we incorporated routinely assessed CHD records and genotype data of German Shepherd dogs from two countries (UK and Sweden) to perform genome-wide association studies (GWAS) within populations using different variations of CHD phenotypes. As phenotypes, dogs were either classified into cases and controls based on the Fédération Cynologique Internationale (FCI) five-level grading of the worst hip or the FCI grade was treated as an ordinal trait. In a subsequent meta-analysis, we added publicly available data from a Finnish population and performed the GWAS across all populations. Genetic associations for the CHD phenotypes were evaluated in a linear mixed model using 62,089 SNPs.

RESULTS

Multiple SNPs with genome-wide significant and suggestive associations were detected in single-population GWAS and the meta-analysis. Few of these SNPs overlapped between populations or between single-population GWAS and the meta-analysis, suggesting that many CHD-related QTL are population-specific. More significant or suggestive SNPs were identified when FCI grades were used as phenotypes in comparison to the case-control approach. MED13 (Chr 9) and PLEKHA7 (Chr 21) emerged as novel positional candidate genes associated with hip dysplasia.

CONCLUSIONS

Our findings confirm the complex genetic nature of hip dysplasia in dogs, with multiple loci associated with the trait, most of which are population-specific. Routinely assessed CHD information collected across countries provide an opportunity to increase sample sizes and statistical power for association studies. While the lack of standardisation of CHD assessment schemes across countries poses a challenge, we showed that conversion of traits can be utilised to overcome this obstacle.

Imaging diagnosis of canine hip dysplasia with and without human exposure to ionizing radiation

Hip dysplasia (HD) is one of the most common hereditary orthopaedic diseases in dogs, with serious implications for the quality of life of the affected animals. Radiographic screening is essential for the selection of breeding stock in some at-risk breeds, and radiography is also used in the diagnosis of clinical HD cases. A definitive diagnosis of HD is based on radiographic examination, and the most commonly used view is the ventrodorsal hip extended projection, sometimes in combination with various hip stress-based techniques. Radiographic images require high quality positioning and dogs are usually anesthetized and often manually restrained to facilitate optimal positioning. The 'as low as reasonably achievable' (ALARA) principle used in human radioprotection is not always fulfilled in veterinary practice, except in the UK, where human exposure to ionizing radiation in veterinary medicine is strictly regulated. While each dose of ionizing radiation is small, doses accumulate over a lifetime, which can eventually result in substantial radiation exposure. Therefore, manual restraint should be avoided and mechanical immobilization, sedation or general anaesthesia should be used. This review examines the biological effects of human exposure to ionizing radiation and common sources of veterinary exposure. The diagnostic quality of imaging methods for the diagnosis of canine HD is compared between manually restrained and hands-free dog positioning. Hands-free radiographic techniques are available to assess hip laxity, degenerative joint changes and hip osseous structure while preserving image quality, and can be used to select animals for breeding or for the diagnosis of HD.

Deep transfer learning can be used for the detection of hip joints in pelvis radiographs and the classification of their hip dysplasia status

Reports of machine learning implementations in veterinary imaging are infrequent but changes in machine learning architecture and access to increased computing power will likely prompt increased interest. This diagnostic accuracy study describes a particular form of machine learning, a deep learning convolution neural network (ConvNet) for hip joint detection and classification of hip dysplasia from ventro-dorsal (VD) pelvis radiographs submitted for hip dysplasia screening. 11,759 pelvis images were available together with their Fédération Cynologique Internationale (FCI) scores. The dataset was dicotomized into images showing no signs of hip dysplasia (FCI grades "A" and "B", the "A-B" group) and hips showing signs of dysplasia (FCI grades "C", "D," and "E", the "C-E" group). In a transfer learning approach, an existing pretrained ConvNet was fine-tuned to provide models to recognize hip joints in VD pelvis images and to classify them according to their FCI score grouping. The results yielded two models. The first was successful in detecting hip joints in the VD pelvis images (intersection over union of 85%). The second yielded a sensitivity of 0.53, a specificity of 0.92, a positive predictive value of 0.91, and a negative predictive value of 0.81 for the classification of detected hip joints as being in the "C-E" group. ConvNets and transfer learning are applicable to veterinary imaging. The models obtained have potential to be a tool to aid in hip screening protocols if hip dysplasia classification performance was improved through access to more data and possibly by model optimization.

Joint laxity in canine hip dysplasia assessed using the hip flexed not distracted ventrodorsal view

OBJECTIVES

The ventrodorsal hip extended standard view is conventionally used for radiographic screening of canine hip dysplasia. However, because the ventrodorsal hip extended standard view minimises hip joint laxity, several alternative views have been proposed. Our aim was to evaluate a new ventrodorsal hip flexed and not distracted view to assess joint laxity, by comparing it with the ventrodorsal hip extended standard and ventrodorsal hip flexed and distracted views.

MATERIALS AND METHODS

Between April 2013 and March 2017, all dogs referred to the University of Naples "Federico II" for the diagnosis of canine hip dysplasia were studied using the ventrodorsal hip extended standard, ventrodorsal hip flexed and not distracted and ventrodorsal hip flexed and distracted views. The Norberg angle and the laxity index were measured for each view.

RESULTS

Overall, 102 dogs, 67 males and 35 females, mean age 15 months, were included. The mean (±standard deviation) Norberg angles were 99.77° (±10.42°), 89.29° (±14.32°) and 91.80° (±13.50°) for the ventrodorsal hip extended standard, ventrodorsal hip flexed and not distracted and ventrodorsal hip flexed and distracted views, respectively. The mean (± standard deviation) laxity indices were 0.19 (± 0.14), 0.39 (± 0.25) and 0.36 (± 0.21), respectively. The ventrodorsal hip flexed and distracted and ventrodorsal hip flexed and not distracted views had lower Norberg angle and higher laxity index values compared with the ventrodorsal hip extended standard view. The ventrodorsal hip flexed and distracted and ventrodorsal hip extended standard views are in strong agreement for the measurement of both Norberg angle and laxity index, as confirmed by Bland-Altman analysis and the intraclass correlation coefficient.

CLINICAL SIGNIFICANCE

The ventrodorsal hip flexed and distracted and ventrodorsal hip flexed and not distracted views obtained with the hip in a neutral position reveal joint laxity better than the ventrodorsal hip extended standard view. Unlike the ventrodorsal hip flexed and distracted view, the ventrodorsal hip flexed and not distracted view does not require human operators or special devices for positioning the dog. The wide age range of the dogs enrolled might have influenced the laxity index measurements, since capsular fibrosis in older dogs reduces laxity.

Analysis of a Laxity Index Database and Comparison with the Fédération Cynologique Internationale Grades of This Population

OBJECTIVE

 This study aimed to analyse the distribution of the laxity indices (LI) in a dog population, to compare the LI with the Fédération Cynologique Internationale (FCI) grades and to search for differences of LI between breeds.

STUDY DESIGN

 The database was composed of all dogs presented to the University Hospital of the Faculty of Veterinary Medicine in Ghent for obligatory hip screening between January 2016 and February 2019, and all patients presented to orthopaedic consultation between January 2017 and January 2019 for a complaint of hindlimb lameness, which underwent both a standard extended ventrodorsal radiograph of the hips and a stress radiograph revealing hip joint laxity. The latter was obtained by means of the Vezzoni-modified Badertscher distension device and the LI was calculated. For each dog of the population, the LI was then compared with the FCI grade.

RESULTS

 The LI values ranged between 0.15 and 1.04, with a mean of 0.46. The LI and the FCI grade increased together, and showed a moderate-to-good correlation. There was a highly significant overall difference in the mean value of LI per FCI grade group (p < 0.001). The mean LI of the Labrador Retrievers was slightly but significantly lower than the mean LI of the Golden Retrievers (p < 0.01).

CONCLUSION

 The LI calculated on a stress radiograph taken with the Vezzoni-modified Badertscher distension device shows a good correlation with the FCI grade assigned on a standard extended ventrodorsal projection. A wide range of passive hip joint laxity exists in dogs considered to be phenotypically normal based on the FCI grading method.

Canine hip dysplasia screening: Comparison of early evaluation to final grading in 231 dogs with Fédération Cynologique Internationale A and B

OBJECTIVES

This study aimed to verify if a significant difference exists between parameters in the early evaluation of normal and near-normal hip joints, to evaluate the influence of age and breed on the parameters, and to clarify the usefulness of a total score for differentiating between Fédération Cynologique Internationale (FCI) grade A and B hips.

METHODS

A total of 231 dogs were classified according to whether they had FCI A or B hips at adulthood, with measurements obtained at 14-28 weeks of age. The total score was calculated by the summation of the following quantitative parameters: angle of subluxation (AS), angle of reduction (AR), laxity index (LI), and dorsal acetabular rim slope (DARS). Logistic regression analysis was performed to establish the probability of the study population to develop an FCI B hip based on the total score. This was repeated for the highest score in combination with the worst-rated hip and once more for breeds.

RESULTS

No correlation between age and the parameters was found in the cohort, or for FCI A and B. The values of all the parameters were significantly lower in the FCI A group than in the FCI B group (AR: 4.42° ± 6.0° vs 7.62° ± 7.2°; AS: 0.45° ± 1.9° vs 1.55° ± 3.8°; LI: 0.32 ± 0.1 vs 0.36 ± 0.1; DARS: 3.30° ± 1.8° vs 3.77° ± 1.9°; TS: 11.47 ± 8.3 vs 16.65 ± 10.9). Labrador Retrievers and Golden Retrievers showed significant differences between parameters for both FCI grades. The range, where FCI A and B hips can be predicted on the basis of the total score, was different when assessed for the entire cohort, Labrador Retrievers, and Golden Retrievers.

CLINICAL SIGNIFICANCE

Our results show that even in normal and near-normal hips, the parameters significantly differed in the early evaluation. Moreover, cutoff values should be set for different breeds in the prediction of the FCI grade during early evaluation for a better breeding selection regarding canine hip dysplasia, one of the most common orthopedic diseases among large and giant breed dogs.

Comparison of Reliability of Norberg Angle and Distraction Index as Measurements for Hip Laxity in Dogs

OBJECTIVE

 The main purpose of the study was to compare reliability of measurements for the evaluation of hip joint laxity in 59 dogs.

MATERIALS AND METHODS

 Measurement of the distraction index (DI) of the PennHIP method and the Norberg angle (NA) of the Fédération Cynologique Internationale (FCI) scoring scheme as well as scoring according to the FCI scheme and the Swiss scoring scheme were performed by three observers at different level of experience. For each dog, two radiographs were acquired with each method by the same operator to evaluate intraoperator-reliability.

RESULTS

 Intraoperator-reliability was slightly better for the NA compared with the DI with an intraclass correlation coefficient (ICC) of 0.962 and 0.892 respectively. The ICC showed excellent results in intraobserver-reliability and interobserver-reliability for both the NA (ICC 0.975; 0.969) and the DI (ICC 0.986; 0.972). Thus, the NA as well as the DI can be considered as reliable measurements. The FCI scheme and the Swiss scoring scheme provide similar reliability. While the FCI scheme seems to be slightly more reliable in experienced observers (Kappa FCI 0.687; Kappa Swiss 0.681), the Swiss scoring scheme had a noticeable better reliability for the unexperienced observer (Kappa FCI 0.465; Kappa Swiss 0.514).

CLINICAL SIGNIFICANCE

 The Swiss scoring scheme provides a structured guideline for the interpretation of hip radiographs and can thus be recommended to unexperienced observers.

Epidemiology and clinical management of elbow joint disease in dogs under primary veterinary care in the UK

Background

Conditions affecting the elbow joint are a common cause of lameness in dogs. Primary-care veterinary clinical data are now recognised as a valuable research resource. Using data from the VetCompass Programme, this study aimed to report the frequency and risk factors for elbow joint disease in dogs under primary veterinary care in the UK and describe clinical management.

Results

From 455,069 dogs under veterinary care, the one-year period prevalence for elbow joint disease diagnosis was 0.56% (95% CI: 0.53-0.60). Of 616 incident cases, the most common specific variants of elbow joint disease were osteoarthritis (n = 468, 75.97%), elbow dysplasia (190, 30.84%) and traumatic (41, 6.66%). The most common signs described by the owners were lameness (n = 466, 75.65%), difficulty exercising (123, 19.97%) and pain (86, 13.96%). The most common findings recorded on veterinary examination were pain (n = 283, 45.94%), lameness (278, 45.13%) and reduced range of movement (243, 39.45%). Common medications used included non-steroidal anti-inflammatory drugs (n = 544, 88.31%), tramadol (121, 19.64%) and disease modifying agents (118, 19.16%). Of 109 deaths involving euthanasia with information available from the 616 incident cases, elbow joint disease contributed to the decision to euthanase in 45 (41.28%) dogs.Five breeds showed increased odds of elbow joint disease compared with crossbred dogs: Rottweiler (OR: 6.16, 95% CI 3.89-9.75), Labrador Retriever (OR: 5.94, 95% CI 4.65-7.60), German Shepherd Dog (OR: 4.13, 95% CI 2.88-5.93), Golden Retriever (OR: 3.11, 95% CI 1.93-5.00) and English Springer Spaniel (OR: 2.00, 95% CI 1.26-3.18). Additional risk factors included having an adult bodyweight that was equal or higher than their breed/sex mean, advancing age, being male, being neutered, being insured and larger bodyweight.

Conclusions

Elbow joint disease is a relatively common diagnosis in dogs and has a high welfare impact as evidenced by the high proportion of cases recorded with pain, lameness and analgesic therapy. There are strong breed predispositions, in particular for large breed dogs. These findings present a clear case for improved breeding programmes to reduce the burden of elbow joint disease.

Prevalence of Canine Hip Dysplasia in Switzerland Between 1995 and 2016-A Retrospective Study in 5 Common Large Breeds

Canine hip dysplasia (CHD) is a genetic disease, modulated by epigenetic and environmental factors. To decrease the prevalence of CHD, the hip joints of many pure breed dogs are radiographed to identify dysplastic dogs not qualified for breeding. It has been shown that both, prevalence and severity of CHD may be reduced on the basis of phenotypic i.e., radiographic selection of breeding animals. The method has been used in many countries for over 50 years. In the present study, severity and prevalence of CHD in five common large breeds in Switzerland were evaluated since 1995. Both, prevalence and severity of CHD dropped in each breed between the periods 1995-1999 and 2010-2016. The prevalence decreased in Golden Retrievers from 25 to 9% and in Labrador Retrievers from 16 to 3%, respectively. In the Flat-Coated Retriever, prevalence in general was low, decreasing from 6 to 3%. In the Bernese mountain dog and the German shepherd dog, a decrease from 21 to 12% and from 46 to 18%, respectively, was observed. However, the rather low overall rate of radiographed dogs (Retrievers: 11 to 18%, Bernese Mountain dogs: 23% and German Shepherd dogs: 31%) does not allow to draw reliable conclusions regarding the true prevalence of CHD for the entire population of these breeds in Switzerland.

Phenotypic hip and elbow dysplasia trends in Rottweilers and Labrador retrievers in South Africa (2007-2015): Are we making progress?

Canine hip and elbow dysplasia are major orthopaedic problems prevalent the world over, and South Africa is no exception. Hip and elbow dysplasia phenotypic status is certified by a number of different radiographic schemes in the world. South Africa uses the Fédération Cynologique Internationale system to certify hips, and the International Elbow Working Group scheme to certify elbows. One way of reducing these often crippling conditions is by selective breeding using only dogs with no or marginal dysplastic joints. In South Africa, only seven breeds, including the Rottweiler, have breeding restrictions for hip dysplasia. There are no such restrictions for elbow dysplasia. This study assessed the prevalence of hip and elbow dysplasia over a 9-year-period in the Rottweiler and the Labrador retriever in South Africa as evaluated by official national scrutineers. Records from 1148 Rottweilers and 909 Labrador retrievers were obtained and were graded as normal or dysplastic, and numerical values were also evaluated. Data were compared between the two breeds, males and females as well as over time and were compared with similar data of the Orthopaedic Foundation for Animals in the United States. The prevalence values for hip dysplasia in Rottweilers and Labrador retrievers were 22% and 31%, respectively, whereas for elbow dysplasia the values were 39% and 19%, respectively. In Labrador retrievers, this incidence was much higher than in the American population. Rottweiler hip and elbow dysplasia numerical scores significantly improved over time, whereas in Labrador retrievers, only hip dysplasia showed a minor but significant improvement. This study proved that prescribing minimum breeding requirements, as in the Rottweiler in this study, significantly improved the breeding stock, suggesting that minimum hip and elbow breeding requirements should be initiated for all breeds at risk of these often crippling conditions.

A novel iterative mixed model to remap three complex orthopedic traits in dogs

Hip dysplasia (HD), elbow dysplasia (ED), and rupture of the cranial (anterior) cruciate ligament (RCCL) are the most common complex orthopedic traits of dogs and all result in debilitating osteoarthritis. We reanalyzed previously reported data: the Norberg angle (a quantitative measure of HD) in 921 dogs, ED in 113 cases and 633 controls, and RCCL in 271 cases and 399 controls and their genotypes at ~185,000 single nucleotide polymorphisms. A novel fixed and random model with a circulating probability unification (FarmCPU) function, with marker-based principal components and a kinship matrix to correct for population stratification, was used. A Bonferroni correction at p<0.01 resulted in a P< 6.96 ×10-8. Six loci were identified; three for HD and three for RCCL. An associated locus at CFA28:34,369,342 for HD was described previously in the same dogs using a conventional mixed model. No loci were identified for RCCL in the previous report but the two loci for ED in the previous report did not reach genome-wide significance using the FarmCPU model. These results were supported by simulation which demonstrated that the FarmCPU held no power advantage over the linear mixed model for the ED sample but provided additional power for the HD and RCCL samples. Candidate genes for HD and RCCL are discussed. When using FarmCPU software, we recommend a resampling test, that a positive control be used to determine the optimum pseudo quantitative trait nucleotide-based covariate structure of the model, and a negative control be used consisting of permutation testing and the identical resampling test as for the non-permuted phenotypes.

Etiopathogenesis of Canine Hip Dysplasia, Prevalence, and Genetics

First identified in 1935, canine hip dysplasia is thought to be the most common orthopedic condition diagnosed in the dog. It is most prevalent in large and giant breed dogs, with a complex polygenic mode of inheritance, and relatively low heritability. External factors including caloric intake when growing have a significant effect on phenotypic expression. Initial joint laxity progresses to osteoarthritis due to subluxation and abnormal wearing. Selective breeding programs to attempt to decrease prevalence have shown modest results so far.

Genetic mapping of principal components of canine pelvic morphology

Background

Concentrated breeding effort to produce various body structures and behaviors of dogs to suit human demand has inadvertently produced unwanted traits and diseases that accompany the morphological and behavioral phenotypes. We explored the relationship between pelvic conformation and canine hip dysplasia (HD) because purebred dogs which are predisposed, or not, to HD share common morphologic features, respectively. Thirteen unique bilateral anatomical features of the pelvis were measured on 392 dogs of 51 breeds and 95 mixed breed dogs. Principal components (PCs) were derived to describe pelvic morphology. Dogs were genotyped at ~183,000 single nucleotide polymorphisms and their hip conformation was measured by the Norberg angle and angle of inclination between the femoral neck and diaphysis.

Results

No associations reached genome wide significance for the Norberg angle when averaged over both hips. PC1 was negatively correlated with the Norberg angle (r = -0.31; P < 0.05) but not the angle of inclination (r = -0.08; P > 0.05). PC1, 2, 4, and 5 differed significantly between male and female dogs confirming pelvic sexual dimorphism. With sex as a covariate, the eigenvector contribution to PC1 reflected the overall size of the pelvis and was significantly associated with the IGF-1 locus, a known contributor to canine body size. PC3, which represented a tradeoff between ilial length and ischial length in which a longer ischium is associated with a shorter ilium, was significantly associated with a marker on canine chromosome 16:5181388 bp. The closest candidate gene is TPK1, a thiamine-dependent enzyme and part of the PKA complex. Associations with the remaining PCs did not reach genome wide significance.

Conclusion

IGF-1 was associated with the overall size of the pelvis and sex is related to pelvic size. Ilial/ischial proportion is genetically controlled and the closest candidate gene is thiamine-dependent and affects birth weight and development of the nervous system. Dogs with larger pelves tend to have smaller NAs consistent with increased tendency toward HD in large breed dogs. Based on the current study, pelvic shape alone was not strongly associated with canine hip dysplasia.

Electronic supplementary material

The online version of this article (doi:10.1186/s40575-017-0043-7) contains supplementary material, which is available to authorized users.

Analysis of pelvic rotation on the standard hip ventrodorsal extended radiographic view

OBJECTIVES

To study the symmetry of the iliac horizontal diameter (IHD) maximum obturator foramen width (OFW), ischiatic femoral overlap (IFO), pelvic horizontal radius (PHR), femoral head diameter (FHD), and obturator foramen area (OFA) parameters in the normal hip extended radiographic view and to evaluate the correlation of pelvic rotation with the magnitude of asymmetry of these parameters.

METHODS

Nine canine cadavers from adult, large and giant breeds were radiographed in standard hip extended views and with 2°, 4° and 6° degrees of rotation. The variables IHD, OFW, IFO, PHR, FHD, and OFA were analysed in radiographs.

RESULTS

The IHD measurements exhibited repeatability, bilateral symmetry and 95% of confidence interval of asymmetry in different pelvic rotations without superposition (p <0.05); OFW and IFO exhibited repeatability, bilateral symmetry and a small superposition in 95% of confidence interval of asymmetry according different pelvic rotations; PHR, FHD and OFA exhibited repeatability, bilateral symmetry and unacceptable superposition in 95% of confidence interval of asymmetry depending on pelvic rotation.

CLINICAL SIGNIFICANCE

The IHD is the recommended variable and OFW is an acceptable variable in order to evaluate slight pelvic rotation. The data may be used in qualitative analyses of hip extended radiographic views. In the future, complementary studies should be performed to evaluate the impact of degree of pelvic rotation on the hip dysplasia score.

Assessment of medial coronoid disease in 180 canine lame elbow joints: a sensitivity and specificity comparison of radiographic, computed tomographic and arthroscopic findings

Background

Diagnostic imaging is essential to assess the lame patient; lesions of the elbow joint have traditionally been evaluated radiographically, however computed tomography (CT) has been suggested as a useful technique to diagnose various elbow pathologies. The primary objective of this study was to determine the sensitivity and specificity of CT to assess medial coronoid disease (MCD), using arthroscopy as gold standard. The secondary objective was to ascertain the radiographic sensitivity and specificity for MCD compared with CT.

Methods

For this study 180 elbow joints were assessed, of which 141 had been examined with radiography, CT and arthroscopy; and 39 joints, had radiographic and CT assessment. Sensitivity and specificity were calculated for CT and radiographic findings using available statistical software.

Results

Sensitivity and specificity of CT using arthroscopy as gold standard resulted in high values for sensitivity (100 %) and specificity (93 %) for the assessment of MCD. For the radiographic evaluation, a sensitivity of 98 % and specificity of 64 - 69 % using CT as the technique of reference, were found.

Discussion

These results suggest that in case of doubt during radiographic assessment, CT could be used as a non-invasive technique to assess the presence of MCD.

Conclusion

Based on the high sensitivity and specificity obtained in this study it has been considered that CT, rather than arthroscopy, is the preferred noninvasive technique to assess MCD lesions of the canine elbow joint.

A systematic review of the literature describing the efficacy of surgical treatments for canine hip dysplasia (1948-2012)

OBJECTIVE

To systematically evaluate the literature reporting outcome of surgical treatments for canine hip dysplasia (CHD) and to evaluate whether adequate evidence exists to support a procedure that will allow a consistent return to normal function.

STUDY DESIGN

Systematic literature review.

ANIMALS

Dogs with naturally occurring CHD.

METHODS

An a priori question was defined and a computer-based bibliographic search was performed on PubMed, Medline, CAB Abstracts, and Veterinary Information Network through November 2012. Studies were compared and evaluated with regard to surgical technique, study design, outcome measurements, evidence classification, and evidence quality. Unilateral surgeries with >6 months postoperative follow-up were included.

RESULTS

Manuscripts (n = 477) were identified and reviewed; 17 met the inclusion criteria. One study provided level I evidence, 2 provided level II evidence, 3 provided level III evidence, and 11 provided level IV evidence relative to the study question. The most common outcome measurements were orthopedic examination (70.6%), owner interview (70.6%), and visual gait observation (64.7%). Three studies used objective kinetic gait assessment. Two studies with level III evidence (total hip replacement) and 1 study with level IV evidence (juvenile pubic symphysiodesis) documented a consistent return to normal function after surgery.

CONCLUSIONS

Despite a large number of publications describing clinical outcome after surgical treatments for CHD, few provided strong evidence to allow an adequate assessment of therapeutic efficacy.

An exploration of attitudes towards pedigree dogs and their disorders as expressed by a sample of companion animal veterinarians in New Zealand

AIMS

To explore veterinary perceptions of inherited disorders in pedigree dogs within New Zealand and how these affect animal health and welfare.

METHODS

An online questionnaire was distributed to the 647 members of the Companion Animal Society of the New Zealand Veterinary Association using an online survey system. The questionnaire collected details of practitioners, pedigree dog breeds and disorders most often encountered in practice, and responses to questions and statements regarding inherited disorders and pedigree dogs.

RESULTS

Of the 216 respondents, 194 (89.8%) believed inherited disorders in dogs were a significant issue. The most commonly identified breeds presenting with inherited disorders were Boxer, Bulldog and German Shepherd dog. The most commonly reported inherited disorders were hip dysplasia, brachycephalic syndromes and elbow dysplasia. Of 207 respondents, 100 (48.3%) had advised clients against purchasing a pedigree dog due to common inherited disorders and 183 (85.6%) considered the health and welfare of some breeds to be too compromised to continue breeding. Of 199 respondents, 132 (66.3%) reported seeing no change in prevalence of inherited conditions, 103/204 (50.5%) reported seeing a positive change in attitudes towards inherited disorders among dog owners, and 81/207 (39.1%) thought legislative support would help decrease inherited disorders in pedigree dogs. Attitudes were not associated with time since graduation or ownership of a New Zealand Kennel Club registered breed of dog. The most common suggestions to decrease prevalence of inherited disorders were to alter breed standards, educate public or buyers and compulsory genetic testing.

CONCLUSIONS

Among respondents, veterinarians considered inherited disorders as significant issues in a number of pedigree breeds. Veterinarians were concerned about inherited disorders in pedigree dogs, felt they had an obligation to treat such animals and were supportive of measures to make genetic testing for inheritable disorders a requirement for registration of pedigree breeds.

CLINICAL RELEVANCE

Prevalence and perceived importance of inherited disorders influences how clinicians advise their clients. Respondents to this survey provided a number of mechanisms by which inherited disorders may be managed and these could form the basis of future discussions within the profession.