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Aseptic Necrosis of the Femoral Head

Issue Description
Legg-Calve-Perthes disease is common in small breed dogs and affects the hip joints of dogs in the ages of 4 to 12 months old. The hip is joined by the thighbone forming a ball and socket joint. The top of the thighbone is also known as the head of the femur. Legg-Calve-Perthes disease causes the center of the head of the femur to degenerate and die. When this bone degenerates in such a young dog, it is severely painful and causes the dog to be unable to walk.
Other Names
Legg-Calve-Perthes Syndrome, Perthes Disease, Legg-Perthes Disease, Coxa Plana

Legg-Calve-Perthes disease is considered to be an inherited disease and possibly occurs when dogs are bred inside the same litter. It is most commonly seen in small breed dogs like terriers, miniatures, and toy poodles though no one is, at this point, sure why the smaller breeds of dogs are targeted more than the larger ones.

A young dog affected with this disease will gradually develop pain and lameness in 1 hind leg, which slowly worsens over 3 or 4 weeks. The pain will become quite severe, and there is usually muscle shrinkage (atrophy) in the affected leg.

Your veterinarian will suspect this disease if your young toy or small-breed dog shows signs of pain and lameness in the hip joint. Usually only one hip is affected, but occasionally both are involved. Depending on how far the disease has progressed, there may be muscle wasting (atrophy) in the affected limb. Radiographs will show whether your dog has the characteristic features of this disease, and also if there are other bony degenerative changes to the hip. Diagnosis is confirmed with a bone biopsy.

Treatment of this condition varies according to the severity of the signs seen. In mild cases, enforced rest may be sufficient to allow healing of the damaged areas to occur. In some cases, immobilization of the affected limb using an Ehmer sling may be beneficial to recovery. Many dogs have advanced cases of this disease by the time they are examined by a veterinarian and medical treatment is not likely to work. In these dogs, excision of the femoral head (ball portion of the hip joint) is often beneficial. Removal of this section of the bone diminishes painful bony contact in the hip joint. Recovery from this surgery can be slow with recovery periods of up to one year sometimes occurring before good use of the affected leg returns. If muscle atrophy is not present at the time of surgery the recovery time is usually much less. Pain relief and anti-inflammatory medications may be beneficial.

It is also important to remember if you have a dog that has had Legg-Calves-Perthes disease then you should not breed it. If any family member of the animal has had the disease then they should not be used for breeding so the disease is not passed on to other generations of dogs, since it is believed to be hereditary.

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