Case Histories July 1998 Issue

Alternatives to Canine Surgery

A Dane owner tries a drug and nutritional therapy for OCD – with success!

I have a young Great Dane named “Bugsy.” I acquired him from a Dane breeder with a good reputation when he was four and a half months old. My only misgiving about the handsome pup was the discovery he had been raised on a terrible food, a brand made with poor quality ingredients and way too much protein and fat for a growing Dane puppy. Though many people think that big dogs must require lots of protein and fat to “grow so big,” giant breed dogs should be fed lower percentages of these nutrients.

Overly rapid growth of the long bones, brought on by too much protein, can bring on all sorts of growth-related problems. Research has shown that a lower protein/fat food slows the growth of the long bones, significantly reducing the possibility of common bone problems such as osteochondritis dessicans (OCD), panosteitis, and hypertrophic osteodystrophy (HOD) in giant breed dogs. I have always tried to feed my giant breed puppies a diet with between 20 and 23 percent protein and 13 to 15 percent fat.

Also, puppies who eat foods with poor sources of protein and fat within the first six months of life tend to have more growth-related bone problems. Higher quality ingredients assure faster absorption and better utilization of the food.

Only a month after the author bought Bugsy,
he began limping and holding up his right
front paw. Radiographs revealed severe OCD
in both shoulders.

But Bugs was so gorgeous! Pushing aside my misgivings about his early diet, I bought him toward the end of last November. I immediately but slowly began replacing his old food with a new and better food. The effects of poor food are cumulative, and I hoped that the change would be early enough in his life to protect him from any bone problems.

The breeder had told me that Bugs had an elbow injury sometime in the middle of October, about a month before I purchased him. In December, when he began limping on the right front foot, I felt that the limp might be a recurrence of his old injury. But in January my worst fears were realized: radiographs revealed OCD in both shoulders.

A Crippling Disease
OCD is characterized by degeneration of the bone that lies under the articular cartilage of joint surfaces anywhere in the body. The most commonly affected joints are: the stifle, hock, elbow, or shoulder, with the latter being most prevalent. The cartilage covering the joint ends of the bones thickens, and begins to die and crack. As it dries up, little pieces of cartilage can chip off and float freely in the joint, causing pain and inflammation. In medical reference books, the causes are listed as genetics, rapid growth and/or feeding poor quality food.

Ten months: Bugsy’s shoulders lack muscles,
but he moves without a trace of a limp. Vets
who treat OCD only with surgery thought he
would be crippled by now.

In the short term, Bugsy’s treatment was limited to completely restricted exercise. My veterinarian suggested that he walk – only on a leash – and for outdoor necessity. As I had intended Bugs to be my next obedience prospect, this put a serious crimp in my plans. I also had Bugs neutered right away, a tragedy as far I was concerned, since Bugs is a lovely specimen of the Dane breed. But because OCD can be passed along to future generations, both my veterinarian and I agreed the surgery should be done.

The next task was to decide how we were going to treat Bugs’ condition. My veterinarian was strongly in favor of surgery for this condition, and felt there as little in the way of alternative treatment. I called two orthopedic surgeons to learn a bit more about the surgery and its outcome.

OCD surgery is very traumatic. The muscles must be separated, the shoulder joint “popped” apart, and any areas that have been chipped or pitted must be smoothed out. In severe cases of OCD, the head of the long bone must be scraped to stimulate growth of good tissue. Finally, the whole joint is washed out with saline solution to remove any debris.

Frankly, the financial prospect of this surgery was enough to scare me (a minimum of $1,500 PER shoulder), not to mention the trauma and risk of such radical surgery and anesthesia, twice! Danes are extremely sensitive to anesthesia, and I’ve heard that many die on the table due to heart or breathing problems while they are anesthetized. Plus, there are no guarantees that, once the surgery is performed, the dog will recover completely; he may always limp, though the gait may not worsen.

The recovery period, too, looked difficult. Following joint surgery, the dog has to be judiciously and carefully exercised for about three months – judiciously, because the dog has to exercise enough to keep the joint moving, which stimulates the production of the lubricating joint fluids, and carefully, because you don’t want the dog to strain or damage the newly healing tissues. The dog is supposed to be walked – no trotting! – in straight lines, to keep the gait as even as possible.

Needless to say, I was not thrilled about this surgery. But the pressure was on; many veterinarians, including my own, warned that if the surgery didn’t take place by the time Bugs was a year old, he could be crippled for life.

As I watched over an increasingly sore Dane pup, I voraciously researched everything I could get my hands on. I read books, magazine articles, and spent hours on the Internet, asking everyone about non-surgical options for OCD treatment. The University of Pennsylvania and University of Ohio, where extensive canine research is conducted, were particularly helpful.

Finally, a friend referred me to Dr. Cindi Bossart at the Animal Hospital of Fort Lauderdale, Florida. I was told Dr. Bossart was having “some” success with drug therapy for OCD, but when I spoke with Dr. Bossart directly, she told me her treatment had been almost 90 percent effective! Of course, she could offer me no guarantees, but I felt a bit more hopeful after speaking with her.

A Minority View
Contrary to what other veterinarians had told me, Dr. Bossart thought I had until Bugs was two years old to work on the problem without risk of crippling him. Her reasoning was that in Danes and other giant breeds, the long bone growth plates take almost twice as long to close as in average-sized dogs. The growth plate closure time is the window in which they feel the OCD surgery must occur to have the best chance of succeeding.

Dr. Bossart agreed to discuss Bugsy’s case with my veterinarian, and offer her opinion and treatment protocol for OCD. My veterinarian was willing to “try” the alternative plan, with much trepidation; I think his actual words were, “I have a great deal of doubt about this treatment plan.”

The plan called for ½ doses of injectable Adequan twice weekly, supplemented by the addition of Cosequin (and/or glucosamine and chondroitin taken orally). A full dose of Adequan is normally given at a rate of 2mg/pound animal weight, intramuscularly (IM), once a week for six to eight weeks. The protocol we followed was 1mg/pound body weight, IM, twice a week for six to eight weeks. We then gave a full dose once a week for two weeks.

The active ingredient in Adequan and glucosamine is polysulfated glycosaminoglycans (PSGAG), which is derived from bovine tracheal cartilage. Chondroitin has a similar active agent. The mechanism, or how these substances work is mostly unknown. PSGAG is characterized as a disease-modifying osteoarthritis drug. Studies have shown that PSGAG inhibits certain catabolic enzymes which have increased activity in inflamed joints.

My veterinarian started giving Bugs the Adequan shots and Cosequin (glucosamine hcl and chondroitin sulfate) in late January. I also added vitamins C and E supplements to the medical treatment. I feed all of my dogs Super Blue Green Algae (SBGA), so after three weeks, without seeing much improvement in Bugs’ movement, I began to increase his SBGA intake, too.

Around this period of time, I was also led to a certified homotoxicologist, Marina Zacharias, of Jacksonville, Oregon. Zacharias carries a variety of holistic, herbal, and homeopathic remedies, and she suggested that I add a couple more things to Bugs’ diet. She sent me some Traumeel (a homeopathic preparation thought to provide anti-inflammatory action), and two natural supplements. Bone Stim Liquescence is specifically for bone-related problems. Zacharias uses it to speeds healing of fractures, and for OCD, as it seems to help the body regulate calcium metabolism and heal bone.

Arth 9 is supposed to be in similar in action to Cosequin, but more comprehensive. Arth-9 has additional nutrients to stimulate healthy cartilage and aid in tissue repair. The added bromelain decreases inflammation, and boswellin and circumin promote joint healing, increase synovial fluids, and speed the healing of cartilage. Vitamin C, zinc, and copper provide nutritional support for the other ingredients. Overall, the product is supposed to help promote complete joint-ligament support. Poor Bugs got it all!

A Fading Limp
In early March, I began to see some improvement, a slight increase in his use of his right front leg. At Dr. Bossart’s suggestion, my veterinarian raised the dosage of glucosamine and chondroitin and continued the shots of Adequan until the first week of April. Then we discontinued the Adequan.

Our story is still in progress, but Bugs continues to show improvement. As of late May, he has not limped in about six weeks. I continue to feed Bugs his algae (I always will), and we will probably continue the chondroitin, glucosamine, Bone Stim Liquescence and Traumeel for another month or so.

I know that this isn’t how real research is done. Because I’ve given Bugsy so many different things, there is no way of knowing which one or ones might be contributing the most to his recovery. My veterinary friends think that the Adequan is probably the most active agent in Bugs’ rehabilitation, since it has been used with such positive results by Dr. Cindi Bossart in the past. I’m just happy that something is working!

State of the art surgery is a wonderful, valuable tool in our arsenal against pain and illness in our dogs, and there’s no telling whether Bugs might need it someday. But like good craftsmen, we all need more than a couple of tools in our tool boxes. Go out and research, study and discover all that alternative medicine has to offer!

-By Lyn Richards

Lyn Richards is a dog trainer and Dane lover living in Manchester, NH. See Resources for contact information for others mentioned in this article.

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