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Summary
In osteochondritis dissecans (OCD) of the knee, ankle and spine, small cracks in the cartilage lead to a lifting or separation of the cartilage into the joint, thereby compromising the ultra-smooth, gliding movements we expect from our dogs' joints.
Pain from the rubbing caused by the presence of this abnormal cartilage is the inevitable result. The joints of the knee and ankle are most commonly affected, though lesions like this have been seen in other joints as well--most notably at the lumbosacral joint in the spine.
Although OCD has been seen in cats and small dogs, it is almost always diagnosed in young, large and giant breed dogs (4-8 months is most typical).
Symptoms and Identification
Limping in one or both hind limbs is the most common sign. Affected dogs may not always appear terribly painful--though some undeniably are. They may only have trouble upon rising or appear stiff when they walk. A characteristic, "slinky" gait has been described for some hind limb OCD dogs.
Diagnosis is best achieved through X-rays, though some dogs may require CT (computed tomography) scans, bone scans or even surgery for a more accurate diagnosis.
Affected Breeds
Osteochondrosis of these joints is seen in a wide variety of dogs, though most often in large and giant breed dogs.
In the ankle or "hock" (the most commonly affected joint after the shoulder and elbow), Rottweilers and Labrador Retrievers account for over 70% of cases.
For the knee form, Great Danes, Labrador Retrievers, Golden Retrievers, Newfoundlands, and German Shepherd Dogs are the most commonly affected.
In the lumbosacral version, German Shepherd Dogs, Boxers and Rottweilers are overrepresented, as are males of these breeds (by a four to one margin).
Treatment
The treatment of OCD lesions almost always involves surgery. But surgery is not always completely curative in these cases. Knee sufferers, in particular, tend to do less well than others, especially if the disease is diagnosed later (over 12 months of age).
Surgery happens either through arthroscopy of the knee (visual and instrument access to the joint through a small camera and tiny incisions) or through a variety of open joint techniques for all affected joints.
Conservative management through non-surgical means is only advisable if the dog is not persistently uncomfortable. In these borderline cases some dogs may do well on pain medications (like NSAIDs), exercise restriction (until the symptoms completely subside), nutraceuticals (such as glucosamine) and appropriate weight management.
Veterinary Cost
The expense all depends on the severity of the disease. For dogs with no noticeable pain, the costs are usually limited to joint supplements, which larger breeds of dogs should arguably receive, anyway.
If, however, the disease process leads to lameness, pain relief through drugs is in order. This can be expensive over the long haul ($30-$100 a month), and they carry some risks, but their benefits are currently considered to be worth the significant expense and potential side effects.
Surgery, as is indicated in most cases, is expensive. $2,000 to $4,000 is pretty typical, though I've seen some surgeons cut these lesions for less if they're very straightforward. Board-certified surgeons should always be sought out for these procedures.
Prevention
Prevention of OC is primarily achieved through genetic management. In other words, affected dogs should be spayed and neutered so as not to risk passing down the genetic traits that may lead to this condition.
Additionally, owners should understand that slower growth rates may mean a lessened risk. That's why veterinarians now recommend lower-calorie diets for large breed, growing dogs. Eschewing additional calcium supplementation is also advisable, as is the provision of softer surfaces for puppies of susceptible breeds.
Some veterinarians may also recommend nutritional supplements that target the joint (such as glucosamine) to help support normal cartilage and attempt to ward off any future arthritis. This is currently considered advisable, with or without surgical intervention.
References
Brinker, W.; Piermattei, DL; Flo, GL. Handbook of Small Animal Orthopedics and Fracture Treatment. W.B. Saunders Co. Philadelphia, PA; 1983.
Compendium. 'Osteochondritis Dissecans of the Canine Tarsal Joint,' Compendium; July 1994.
Harari, J. The Veterinary Clinics of North America, 'Osteochondrosis.' W.B. Saunders Co. Philadelphia, PA; 1998.
Hanna FY. Lumbosacral osteochondrosis: radiological features and surgical management in 34 dogs. J Sm Anim Pract 42: 272, 2001.
Johnson AL, et al. Osteochondritis dissecans of the femoral head of a Pekingese JAVMA 187: 623, 1985.
Peterson CJ. Osteochondritis dissecans of the humeral head of a cat. N Z Vet J 32: 115, 1984.
Smith MM, et al. Clinical evaluation of dogs after surgical and nonsurgical management of osteochondritis dissecans of the talus. JAVMA 187: 31, 1985.
van Bree H. Evaluation of the prognostic value of positive-contrast shoulder arthrography for bilateral osteochondrosis lesions in dogs. Am J Vet Res 51: 1121, 1990.