Legg-Calvé-Perthes disease

What is Legg-Calvé-Perthes disease?

Legg-Calvé-Perthes disease (LCPD) is a non-inflammatory and non-infectious disease of the hip joints characterized by ischemia (reduced blood supply) of the femoral head. This leads to necrosis (death) of the bone tissue and collapse of the femoral head and neck. This leads to deformation and osteoarthritis of the hip joint, causing severe pain and lameness.

LCPK usually occurs in dogs between 3 and 13 months of age, with small breeds such as Yorkshire Terriers, West Highland White Terriers, Toy Poodles and Maltese being affected more frequently than large breeds. The disease can occur unilaterally or bilaterally. The exact cause of LCPK is not known, but it is thought that hormonal factors, limb malpositions or hereditary factors may play a role.

How do I recognize Legg-Calvé-Perthes disease?

The first signs of LCPK are often non-specific and can easily be overlooked. Possible symptoms are

• Decreased appetite
• Gnawing or licking at the affected hip
• Unwillingness to play or walk
• Limping or non-weight bearing on the affected limb
• Muscle atrophy (wasting) in the thigh area
• Sensitivity to pain when touching or moving the hip
• Limited mobility of the hip joint

If you notice one or more of these symptoms in your dog, you should definitely consult a vet to diagnose the condition and initiate appropriate treatment.

How is Legg-Calvé-Perthes disease diagnosed?

The diagnosis of LCPK is based on a clinical examination in which the vet assesses the lameness, pain and mobility of the hip joint. However, X-rays are necessary to confirm the disease and determine its severity. Typical changes in the head and neck of the femur can be seen, for example:

• A flattening or crumbling of the femoral head
• A shortening or thickening of the femoral neck
• A widening of the joint space
• Formation of bone spurs or cysts in the joint area

How is Legg-Calvé-Perthes disease treated?

In most cases, treatment of LCPK consists of surgical intervention to remove the diseased femoral head and neck. This procedure is called femoral head and neck resection (FHR) and aims to eliminate the pain and create a new articular surface of connective tissue. FHR is the treatment of choice for small dogs (< 10 kg) as it usually results in good limb function and a satisfactory quality of life.

An alternative treatment option is total hip arthroplasty (TEP), in which the entire hip joint is replaced with an artificial prosthesis. TEP can be considered in larger dogs (> 10 kg) or in dogs with bilateral LCPK, as it results in better joint stability and mobility. However, TEP is also associated with a higher risk of complications such as infection, loosening or dislocation.

Surgical treatment of LCPK requires intensive post-operative care, which includes appropriate pain management, limited activity, physical rehabilitation and adapted nutrition. Physical rehabilitation is particularly important to strengthen muscles, promote mobility and accelerate healing. Physical rehabilitation can include various measures, such as

• Massage
• Passive movement exercises
• Heat or cold therapy
• electrostimulation
• hydrotherapy
• Underwater treadmill
• Balance or coordination exercises

Nutrition also plays an important role in the recovery of dogs with LCPK. A balanced diet with high-quality proteins, fats, vitamins and minerals supports wound healing and immune function. In addition, the dog's body weight should be controlled to avoid overloading the operated joint. A special diet for dogs with joint disease can be helpful as it contains anti-inflammatory omega-3 fatty acids and joint nutrients such as glucosamine and chondroitin.

How can I support my dog with Legg-Calvé-Perthes disease?

If your dog has LCPK or has had surgery, there are a number of ways you can help them improve their quality of life. Here are some tips on how you can support your dog:

• Follow your veterinarian's instructions regarding your dog's medication, activity restriction and physical rehabilitation.
• Provide your dog with a soft and warm place to lie down that is easily accessible and allows him to get enough rest.
• Avoid climbing stairs, jumping or running with your dog until he is fully recovered.
• Walk your dog on a lead and keep him away from other dogs that may encourage him to play.
• Encourage your dog to do gentle exercise such as short walks or swimming to maintain his muscles and mobilize his joints.
• Reward your dog for his progress with praise, cuddles or healthy treats.
• Be patient and understanding with your dog as he may be frustrated or anxious.