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Legg-Calve-Perthes

Pug Dog Legg-Calve-Perthes 

Overview 

This a degenerative disease of the head of the femur bone on the hind leg (the ball that fits into the socket in the pelvis; which makes up the hip joint). 

Note that a loosening/slipping of where the head of the femur fits into the socket is associated with hip dysplasia, a separate and distinct issue. With Legg-Calve-Perthes (LCP), there is necrosis; the bone starts to deteriorate and die. This causes pain and mobility issues, and can be crippling. Dogs affected by LCP can have issues with osteoarthritis afterward. In most cases, it occurs in just one hip. 
x-ray-of-dog-Legg-Calve-Perthes

Occurrence Rate

This affects small dogs much more often than larger breeds, seen most often with dogs under 20 pounds (9 kg) and the Pug is moderately prone to this.  

Age of Onset

This most often manifests at a young age. Most cases are detected when a puppy is between 4 and 12 months, though it has been seen as early as 3 months or as old as 18 months. Both genders are equally affected. 

Causes

This is a genetic condition and while the exact cause is unknown, it does run in certain breeds and is thought to be connected to lack of proper blood flow to the area due to clots in the blood vessels. 

Symptoms

Signs usually include one or more of the following: 
  • Lameness in hind leg(s). This is the #1 sign of LCP and almost always affects just one of the hind legs. This usually begins gradually with progression over the course of several weeks although in some cases it happens over the course of just a few days. As it worsens, a dog can no longer place any weight onto the leg. 
  • Holding the affected leg in an odd way, limping
  • Signs of discomfort
  • Affected leg may appear shorter
  • Loss of muscle tone in the affected leg
  • Mobility issues (trouble rising, difficulty in maneuvering stairs, etc.) 

How this is Diagnosed

Diagnosis is usually made through physical examination and x-rays. Since this is progressive, a series of x-rays may be taken to identify changes over the course of time (several weeks). 

Treatment, Non-Surgical Vs. Surgical 

Cases of Legg-Calve-Perthes with Pugs can vary from moderate to severe. In moderate cases, non-surgical treatment may help. With severe cases, surgery is required to help offer some level of mobility and relief from pain. Since the development of arthritis is exceedingly common with dogs diagnosed with LCP, treatment almost always involves prevention or treatment of arthritis as well. 

Treatment, Non-Surgical 

When caught early, non-surgical treatment can be effective. This includes: 

• Very strict bed-rest. This involves a dog not putting any weight onto the leg whatsoever. A crate is used to prevent standing or walking. For bathroom needs only, a Pug can be carried out of the crate and onto grass, but on a very short leash so that there are no attempts to walk. Bed rest may last 4 to 6 months, with x-rays taken periodically to see if the area is healing. 

• NSAIDs (non-steroidal anti-inflammatory drugs, such as Rimadyl) are often given to help with discomfort and inflammation. The veterinarian will carefully monitor the dosing. 

• Corticosteroids such as prednisone may be given. Because of possible serious side effects including lowered immune system and increased thirst and/or appetite, this is usually only given short-term and dogs are gradually weaned off.
• A joint supplement like Doggie Dailies Advanced Hip & Joint Supplement for Dogs with combined glucosemine, chondroitin, MSM, and CoQ10 can help with pain and inflammation, help a Pug with mobility and plays a big role in helping to prevent arthritis which commonly occurs in dogs with this condition.  
• An omega-3 EPA and DHA should be given. This can also control inflammation, help with mobility, and are used to help prevent arthritis. One of the easiest methods of providing this is via a liquid fish oil, which most dogs love. Zesty Paw's Pure Wild Alaskan Salmon Oil is an excellent choice. 
• Additional treatment may involve laser therapy, acupuncture, massage, and/or non-weight bearing water therapy.

Treatment, Surgical

If non-surgical treatment options do not resolve pain issues or in very severe cases, surgery may be recommended. For larger dogs, total hip replacement is an option; however, smaller breeds like the Pug are usually not good candidates for this. Instead, surgery is performed to remove the head of the femur bone. Afterward, the body gradually repairs itself as tissue and muscle form in the area. In most cases, prognosis is very good; one-year post-surgery, many dogs are pain-free and there is improvement with mobility. 
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