Adequan for hip dysplasia.

As soon as the orthopedic surgeon walked into the room, I knew the news wasn't good. The cold look in his eyes was a dead giveaway.Shuffling through the X-rays just taken of Misty, my 2-year-old Golden Retriever, he picked the most definitive one, slid it onto the light screen and pointed to the left hip joint with his pen.

The words were a blur, but the diagnosis confirmed that of my veterinarian: a moderately severe subluxated left hip - in simple terms hip dysplasia. And, the prognosis was poor. In his opinion, total hip-replacement surgery was necessary, and even then, it was extremely questionable that Misty would ever work again as a gun dog. It was a crushing feeling, one that mixed equal doses of anger and hurt, because Misty had exhibited more pure talent than any of our goldens since her late grandfather.

Hip dysplasia, a genetically inherited skeletal problem, has become the insidious scourge or a growing number of both working and non-working dogs, mostly the larger breeds. Basically, it is a matter of poor fit between the hip socket and the had of the femur, or upper leg bone. Any condition in which less than 40 percent of the femoral head rests within the acetabulum (hip socket) is considered dysplastic. What results is a gradual wearing down of the separating cushion of cartilage and synovial fluid (a gel like substance that provides lubrication for movement). Eventually, direct contact is made between the two bones and the dog begins to suffer severe pain from both the contact and the inflammation that comes with it. The deterioration is usually progressive, until it eventually cripples the dog completely.

Depending upon the degree of severity and the amount of work a dog does, dysplasia can rear its head from as early as 6 months to well into retirement age. One of the problems with detecting it early in gun dogs is that they all tend to possess an inherent gut-it-out toughness , a dedication to purpose that would enable them to ignore pain that would floor the normal pet. My goldens work hard, but considering the care we take in breeding, Misty's problem came as a shock. As I've subsequently learned, no matter how select the breeding of dogs with certifiably good hips, dysplasia still can occur. That's not to say that dogs with bad hips should be bred. They shouldn't. It's not only unethical and immoral, but the suffering that the individual animals go through, especially after they become a part of your life, is hard to take.

The next morning, I informed my vet, Dr. Tim Jones, that the university had confirmed the diagnosis, and that they suggested major hip replacement surgery. Before I could get out a dozen words, Tim stopped me and handed me his just-delivered copy of the August 1987 Veterinary Journal. "Read this before you say any more."

"What's it about?"

"Just read it closely before you ask questions."

"It" was a brief article titled "Adequan - Alternative for Canine DJD" by Drs. Timothy Koby and Nell Tillis of the Lake Harbin Animal Hospital in Morrow, Georgia. What it dealt with was their experimental use of an equine drug named Adequan for the treatment of canine hip dysplasia. Some of the medical terminology was difficult to grasp on first reading, but the essence of the article detailed a treatment program that, unlike surgery, put virtually no physical stress on the dog, yet had resulted in exceptional, positive results in 12 out of 12 cases. For someone who abhors surgery and considers it only a last resort, this alternative treatment was like the flickering glow of a candle in the dark.

While Tim investigated the Adequan treatment further, Misty's deterioration was frighteningly quick. Within two weeks, she could not walk 50 yards without pulling up three-legged lame. The muscle mass and tone in the affected leg disappeared almost before your eyes. If you listened closely while she walked, you could hear a distinct "click" emanating from the hip joint as the two bones made contact.

When the information was finally in, including a long-distance consultation with Drs. Koby and Tillis, we decided to give it a try. What sold them, and us, was the lack of contraindications (those things that are the downside of most drugs). With Adequan - polysulfate glycosaminoglycan in 50-cent terms - there are none. Because it is a naturally occurring body substance, only that which is necessary is sued. The rest is cast off.

Because of the severity of Misty's condition, her program consisted of the maximum series of six injections, one per week, with the 125 milligram-doses given intra-muscularly.

The first three weeks proved uneventful - disheartening, really, because there were no observable changes. She still limped severely; the "click" from the join was still there; and the only way the we could keep even a semblance of muscle tone was by swimming her daily in the river behind the house. After the fourth injection, however, we began to notice subtle changes. The "click" began to soften, and she started to use the leg a tiny bit more. By the day of the fifth shot, the "click" was gone. And after the sixth, the changes were dramatic. He leg still was very weak because of the lack of muscle, but the pain obviously was gone. In order to rebuild the muscles, she was placed on a controlled exercise program. Two months after the last shot, she worked a late-season upland-bird hunt, running hard and retrieving a full limit.

The acid test was a late-season duck hunt in brutal conditions. Any healthy retriever, except maybe a raw-boned Chesapeake, would have had a tough time with the ice and cold, so I was prepared for the worst. Misty broke ice on the first retrieve, crawled out of the water and had her coat turn into icicles in seconds; then, she stoically sat out an hour of no birds. My endurance gave out before hers. The only visible negative effect of her hip was a slight limp for a brief time, and that was treated by a single aspirin tablet.

How the Adequan works is simple. In medical terms, it "stimulates chondroblast activity and increases the production of synovial fluid." For us laymen, that means it stimulates the production of cartilage (the cushion) and synovial fluid (the lubricant) in areas where they're needed. In dysplasia, that would be the affected hip joint. It has no effect in normal joints, so there's no worry about overloading and creating problems. As Dr. Koby put it, "Essentially, the end results of the drug's application is a total 'repaving' of the joint with new cartilage and synovial fluid." The worst side effect thus far encountered is a simple "pain syndrome", mostly in cold weather. When treated with aspirin, it disappears within a few days.

Since their first experiment in August '86, Drs. Koby and Tillis have treated approximately 30 dogs. The results have been positive in all hip and stifle (knee) cases. Re-treatment two shots only) has been necessary only once, in a basset hound with extremely sloppy hips.

As with any other medical treatment, though, there are always qualifications. "Success", for example, is relative. For a dog that can barely move and needs assistance in rising, success is the ability to rise, walk, and function on its own again. For one just beginning to exhibit problems, success can be a return to virtually near-normal performance. In Dr. Koby's words, "You have to understand the mode and mechanism of the drug in order not to expect more from it than it can deliver." And, you have to fit the cure to the case. They don't use it exclusively in their practice, because sometimes the case, for certain specific reasons, doesn't fit their established criteria.

A precise diagnosis is important, and quality X-rays are necessary. If bone fragments are found in the joint, surgical removal is required. Plus, the inflammation has to be reduced to tolerable levels. Beyond that, it has to be determined by the owner what is expected. You may not get a total return to 100 percent performance, but for me, anyway, something very close was good enough. In the real world, there are no miracles.

The dysplasia itself, because it is skeletal, always will exist. No medical technique can correct that. But Adequan has fulfilled every reasonable expectation. It goes beyond treating the symptoms and gets right to the root of the problem. As Dr. Koby says, "Adequan becomes an avenue to bypass further symptomatic improvement to get true clinical improvement."

If hip dysplasia has cursed your dog, question your veterinarian about this treatment. Don't be surprised if he knows little or nothing about it. Because it is so new, very few do. But, don't hesitate to bring it up. If the vet is as curious and conscientious as most are, he'll investigate it thoroughly. If he's "too busy" or unwilling to investigate, get another vet.

The treatment is not cheap. Figure on roughly $20 to $30 per shot. But, it's well worth it, from the standpoint of minimal stress, end results, and most of all, the reward of seeing a good dog work without suffering a pain that its heart and courage could not overcome. One look at Misty, who once again can do what she was born to do, tells it all. Even if treatment someday proves necessary, the Adequan alternative is the best news to come along for dogs and their owners in a long, long time.