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Osteochondritis (OCD)
Osteochondritis Dissecans
by Joe Bodewes, DVM
Osteochondritis dissecans, commonly known as OCD and osteochondrosis dessicans,
is a disease of the cartilage that affects the joints in a dogs body. In any
joint in the body two bones come together and movement is allowed between them.
Where the two bones meet an exceptionally smooth area of cartilage covers their
surfaces. This acts as a cushion and protects the underlying bone. If anything
disrupts this smooth cartilage surface, movement of the joint becomes painful.
In a dog with OCD this cartilage is damaged or grows abnormally. Instead of
being attached to the bone it covers, it separates or cracks, causing great
pain. In some cases, small pieces of cartilage break off and float free in the
joint. These pieces of cartilage do not die, but rather continue to grow and
increase in size. These are known as joint mice. Approximately 15% of all dogs
will develop OCD. This article will cover the disease and its treatment and will
explore some of the suspected causes.
Who gets OCD?
OCD is primarily a problem in large or giant breed dogs. It has been reported in
small dogs and cats though it is not very common. It affects male dogs 2 to 5
times as frequently as females, most likely due to the males' larger size and
increased stress on the joint. It generally occurs when the animal is between 4
and 8 months of age though it can show up in older dogs. There are several
breeds that despite being larger breeds have decreased incidences of the disease
including the Doberman Pinscher, Collie, and Siberian Husky.
What are the symptoms of OCD?
The symptoms are lameness in the affected limb. Some dogs have a barely
noticeable limp and others are unable to bear any weight on the leg. The
lameness tends to worsen after periods of exercise and improves after rest.
Seventy four per cent of the cases of OCD occur in the shoulder joint, 11% in
the elbow, and 4% in the hock. When it affects the front shoulder a shortened
forelimb stride may be noted due to reluctance to flex and extend the shoulder
joint. Occasionally the disease will affect both limbs simultaneously and the
dog may be reluctant to move.
How is OCD diagnosed?
Diagnosis is based on history, physical exam, and radiographs (x-rays). On
physical exam we notice joint pain. For instance, most healthy dogs show no
resistance when their shoulder joint is fully flexed and extended. However if
they have an OCD lesion in their shoulder they may resist shoulder manipulation
and may even cry out in pain when it is attempted. In addition this flexion and
extension of the shoulder joint may worsen the lameness.
Radiographs of the affected joint are taken to confirm the diagnosis. The dog is
often sedated so that full relaxation of the joint can be obtained. Several
views of the affected joint and the healthy joint on the other side are taken
for comparison. The separations of the cartilage or joint mice are often
identified on radiographs. If the radiographs are not confirmatory but OCD is
still suspected, radiographs may be taken again in 2 to 3 weeks.
What causes the formation of OCD?
Trauma to the joint, hereditary factors, rapid growth, restricted blood flow to
the cartilage, and nutrition contribute to the formation of OCD lesions. The
cause of OCD is considered to be multifactorial. It is thought that there are
several factors that contribute to the formation of OCD lesions including trauma
to the joint, hereditary factors, rapid growth, restricted blood flow to the
cartilage, and nutrition.
Trauma, whether chronic or acute, may contribute to the formation of OCD
lesions. Injury to the surface cartilage may lead to the separation of the
cartilage from the bone or cause a decrease in blood supply that leads to
cartilage flap formation.
It appears that there is a genetic link between parents and offspring and the
formation of the disease. Certain breeds and genetic lines are much more likely
to develop the disease. Careful screening of parents against this disease is
recommended during the selection of all breeding stock.
The disease usually occurs during periods of rapid growth. Therefore it has been
suggested that nutrition that creates rapid growth may lead to the increase in
incidence of the disease. It has been recommended that animals that are
susceptible to the disease be fed a diet that is lower in protein and fat or
that they are fed in a limited manner to allow steady even growth during the
first year of life. This theory may have merits but more specific studies need
to be done before any general recommendations can be made.
How is OCD treated?
There are currently two ways to treat OCD, conservative medical treatment or
surgical removal of the lesion. Conservative treatment may be indicated for dogs
that have early mild symptoms of OCD or where a specific lesion cannot be
identified on radiographs. Conservative treatment consists of strict rest for 4
to 8 weeks. Leash walking is permitted but no running or playing is allowed.
Anti-inflammatories and painkillers such as buffered aspirin or carprofen (Rimadyl)
may be indicated. In addition, the use of glucosamine/chondroitin products has
been suggested yet there are no current studies that confirm their beneficial
use in this particular disease. Conservative treatment may be difficult in young
active puppies who may still need to undergo surgery if the symptoms don't
improve.
Surgery is indicated in animals that show severe symptoms, in cases where large
lesions are identified on radiographs or when conservative treatments fail. The
surgery is very straightforward. The affected joint is opened and the offending
flap, defect, or joint mouse is removed. There is a very high success rate for
surgery and most animals recover fully without any further problems.
How is OCD prevented?
Prevention consists of careful selective breeding that avoids the breeding of
animals with a history of OCD. Young large and giant breed dogs should not
undergo strenuous activity, particularly jumping activities. Housing on hard
concrete surfaces has been linked to increased OCD lesions in pigs and may also
contribute to problems in the dog. Providing a good balanced diet that promotes
even sustained growth is also recommended. There are currently many large breed
puppy foods on the market made specifically to help reduce the incidence of bone
formation problems. While there has been no evidence that these diets actually
reduce the incidence of this disease as compared to other commercial puppy
foods, future studies might support their use.
Summary
OCD is a cartilage problem that affects young large and giant breed dogs. It is
due to several factors including genetics, trauma, rapid growth and nutrition.
Treatment is either conservative including strict rest, or surgical removal of
the damaged cartilage. Prevention is aimed at good genetic selection, reduced
activity and careful feeding.
References
Brinker, W.; Piermattei, DL; Flo, GL. Handbook of Small Animal Orthopedics and
Fracture Treatment. Saunders, Philadelphia, PA; 1983
Compendium. "Osteochondritis Dissecans of the Canine Tarsal Joint," Compendium;
July 1994
Harari, J. The Veterinary Clinics of North America, "Osteochondrosis". Saunders,
Philadelphia, PA; 1998
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