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New Vet - New Diagnosis Hip Dysplasia please help read x ray

1800 Views 29 Replies 7 Participants Last post by  GoldenManila
Hello
I've been worried sick about our boy Milo who has had a mild limp off on his left side off and on since he took a tumble after jumping from my arms after I tried to get him off our bed.
As he was hobbling quite a bit we rushed him to emergency but by then he was weight bearing again with just a limp. At emergency they x rayed him and said his hips and knees looked great, no fracture visible. He was walking fine again the next day after going on anti inflam.
Anyway he then saw another vet 2.5 weeks later as he tumbled off the sofa awkwardly while we were away and our friend who was watching him said he started limping right away. When we got home he still favoured his right leg again so I took him to another vet who was apparently trained in orthopeadics. Milo's limp was barely visible at that stage and he again x rayed hips and knees and said both looked excellent. Probably a sprain as his left hock was swollen.
Anyway he went on more meds for a week and was great but as meds wore off his limp returned but not quite as severe.
I decided to take him to another vet today. She x rayed him again and this time she says he has hip dysplasia as she thinks she can see a bone spur. Personally I thought hip dyspalsia is the head not fitting well in the socket and decreased spacing. I'm just not seeing it at all when I compare his x rays to x rays of hip dysplasia I'm seeing on the net. She also did a check she said of his hips but couldn't find any abnormality or get him to express any pain. He doesn't bunny hop when walking his only real clinical symptom is a reluctance to put full weight on his left leg. I'm worried about two things.
a) If he has hip dysplasia what that means for his life. Milo is a support dog for my child who was diagnosed with an illness and he is her everything.
b) Can you diagnose off only an x ray when 2 other vets have said his hips were excellent including an orthopaedic vet only 2 weeks ago. This vet said the bone spur could have developed since then but surely there would have been signs on the earlier x rays (he has actually had 3 previous hip x rays and all 3 gave him the all clear saying his hips are excellent). I don't know if she is right and the other 2 vets are wrong (she did mistake a left leg limp for a right when I showed her a video of him walking, she also said his hock is normal when it is clearly larger than his right).

Sorry for the long post but I'm beside myself with worry. He has been an absolute angel for my daughter. If anyone knows anything about x rays I'll attach the picture here and I circled what she is calling an abnormal bone spur/growth. Milo is 2 years old and we are expats living in Manila, Philippines
Joint X-ray Medical imaging Radiography Medical
Joint X-ray Medical imaging Radiography Medical
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Disclaimer: not a medical professional

Hip dysplasia doesn’t need to be hips out of the socket, but you do see that most of the time. I am reticent to disagree with a veterinarian, but I do agree with the other two that this animal does not look dysplastic on this image. If I were you, I would send this radiograph to a radiologist or back to the orthopedist.
 

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Discussion Starter · #6 ·
Can you share the entire image?
sure, this is the picture I took with my phone but honestly the contrast is the same as the image I was seeing in the x ray room. I could be in complete denial as hip dysplasia was the thing I was most concern about in getting a GR and we checked the breeder and his clients as best we could given we are in the Philippines.

His hips were x rayed at 12 months as a screening, then at 19 months after what turned out to be a muscle strain then twice more after the fall from our bed when he developed his limp and 4 different vets including one specialising in orthopaedics said his hips looked great. This vet did only a quick hip flexing test and some palpation and elicited no sign of dysplasia. Her diagnosis is based on this x ray. He doesn't bunny hop when walking but when going down stairs since his injury he will hop down with his left leg raised on occasion. His symptoms are worse after his walk and he has lied down for 30 min on the tiled floor or couch. He will hobble for 10 or steps and then it becomes tough to see any limp. He has the same appetite, is still crazy playful and jumps around the place as normal including going up and down or 6 garden steps without incident. He sits normally and seems to lay a lot of his left hip which is supposedly the bad one. His other hip the vet said looks great. I worry that even if there is a bone spur there that it is not the culprit of his current limp and the real cause is still unknown because this seemed like a good explanation. Fact is his left hock is still swollen. When I pointed this out to her she said it's normal and looks like the other one. I've included a picture of his left and right hock. The swelling has come down a bit from a week ago but this picture is from today just before I visited the vet (you can just see as well how he is placing a bit more weight on his right side. I'm very lost at this point as I don't know who to believe. I'm going back to one of the 3 vets who cleared him of hip dysplasia on Monday to get a second opinion and possibly another x-ray, a proper physical exam and a better look at his hock. Any information/ reassurance of raising a dog with hip dysplasia would be much appreciated. I'd like to give my daughter as much hope as possible for our boys future. Thank you all so much

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Discussion Starter · #7 ·
sure, this is the picture I took with my phone but honestly the contrast is the same as the image I was seeing in the x ray room. I could be in complete denial as hip dysplasia was the thing I was most concern about in getting a GR and we checked the breeder and his clients as best we could given we are in the Philippines.

His hips were x rayed at 12 months as a screening, then at 19 months after what turned out to be a muscle strain then twice more after the fall from our bed when he developed his limp and 4 different vets including one specialising in orthopaedics said his hips looked great. This vet did only a quick hip flexing test and some palpation and elicited no sign of dysplasia. Her diagnosis is based on this x ray. He doesn't bunny hop when walking but when going down stairs since his injury he will hop down with his left leg raised on occasion. His symptoms are worse after his walk and he has lied down for 30 min on the tiled floor or couch. He will hobble for 10 or steps and then it becomes tough to see any limp. He has the same appetite, is still crazy playful and jumps around the place as normal including going up and down or 6 garden steps without incident. He sits normally and seems to lay a lot of his left hip which is supposedly the bad one. His other hip the vet said looks great. I worry that even if there is a bone spur there that it is not the culprit of his current limp and the real cause is still unknown because this seemed like a good explanation. Fact is his left hock is still swollen. When I pointed this out to her she said it's normal and looks like the other one. I've included a picture of his left and right hock. The swelling has come down a bit from a week ago but this picture is from today just before I visited the vet (you can just see as well how he is placing a bit more weight on his right side. I'm very lost at this point as I don't know who to believe. I'm going back to one of the 3 vets who cleared him of hip dysplasia on Monday to get a second opinion and possibly another x-ray, a proper physical exam and a better look at his hock. Any information/ reassurance of raising a dog with hip dysplasia would be much appreciated. I'd like to give my daughter as much hope as possible for our boys future. Thank you all so much

View attachment 897889
oh and the x ray
X-ray Radiography Medical imaging Jaw Bone
 

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Discussion Starter · #9 · (Edited)
Yes that hock is quite swollen in that image. Did anybody X-ray the hock?
I would definitely see an orthopedist again and have a full lameness evaluation.
Thank you so much for the advice. I will do whatever it takes to get this guy back on his feet so to speak. If it is dysplasia we will deal with it. I've read some of the stories on here of others with dogs with that diagnosis and been heartened that he can live a good life even if surgery lies somewhere in his future. I'm concerned about the hock but I seem to be the only one. I worry that it is OCD or something even though he is quite old for that to suddenly reappear at 2 years old and the hock doesn't appear painful to him in the slightest (but then again nothing does including the hip). I asked the vet we saw to x ray the hock and she said she did and it was normal. To be honest I didn't ask to see it which I now regret as I have some doubt that they actually did x-ray it as she already pinned things on the hip. I'll pursue a second opinion as you suggest on Monday.

If I do a second opinion though, do you think it best that i stop the anti-inflammatories as I'm worried they may mask possible findings. I think I may just give him the Glucosamine Plus that was also prescribed. He has been on supplement chews for the past 7 days but they don't appear to have done anything as yet.
 

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I won't weigh in on the x ray because I don't feel qualified. But I do want to say that even if the dog is mildly dysplastic, that doesn't mean he can't still have a happy life.
 

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Discussion Starter · #14 ·
I won't weigh in on the x ray because I don't feel qualified. But I do want to say that even if the dog is mildly dysplastic, that doesn't mean he can't still have a happy life.
Thank you for the words of encouragement. He is a big part of our family in what he has done for my daughter so we will do whatever it takes to give him his best life
 

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Discussion Starter · #15 ·
Of course, good luck and I hope he feels better
Quick update. I did as you suggested and paid for an online consult. I sent the x ray image as well as videos of Milo taken today. He was quite certain that it is not hip dysplasia based on both the x ray and the way he moves in the videos He also said what the vet is saying is a bone spur is not obvious to him at all. He also said the hip socket and joint spacing look excellent in the x ray. He said it is definitely the left hock and said total rest and a round of NSAIDS for at least 5 days. I feel a bit better but now have to wonder what is going on in that hock? I'll also continue to brace it
 

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Quick update. I did as you suggested and paid for an online consult. I sent the x ray image as well as videos of Milo taken today. He was quite certain that it is not hip dysplasia based on both the x ray and the way he moves in the videos He also said what the vet is saying is a bone spur is not obvious to him at all. He also said the hip socket and joint spacing look excellent in the x ray. He said it is definitely the left hock and said total rest and a round of NSAIDS for at least 5 days. I feel a bit better but now have to wonder what is going on in that hock? I'll also continue to brace it
It is impossible to say without a diagnostic work up. If he injured something like a tendon or ligament, the length of time it takes to heal will be much longer and is at high risk for reinjury. Rest and NSAIDs will help, but if he starts limping again after being off crate rest, it would be worth an ultrasound of the hock if there is a veterinarian capable. It’s hard to see the soft tissue structure.
 

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Discussion Starter · #17 ·
It is impossible to say without a diagnostic work up. If he injured something like a tendon or ligament, the length of time it takes to heal will be much longer and is at high risk for reinjury. Rest and NSAIDs will help, but if he starts limping again after being off crate rest, it would be worth an ultrasound of the hock if there is a veterinarian capable. It’s hard to see the soft tissue structure.
Yep agree, thanks again
 

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Discussion Starter · #19 ·
I think you have your answer already based on the last couple posts, but gotta ask... do you have a full xray that shows the entire hip - ie like the below? (the hip xray was the first I grabbed from google).

I'm very curious what the 2nd vet saw as a bone spur.



View attachment 897895
This is the best I have but the one I say today is actually the 4th vet to look at x rays of his hips in the last 3 months. 3 so far have concluded that his hips look very good. She think there is a bone spur on the x ray at about 8 - 9'o clock on his left side (right when looking at the x ray). Before this diagnosis though this vet mis diagnosed his limp as right rather than left until pointed out how he was raising his left leg when standing. She also concluded that his hocks were the same size which I was staggered by. It is grayish in that region but not so different from the left and given they didn't sedate him to x ray and the blurry nature of the x ray I was very dubious. The other x rays we'd looked at of his hips had far clearer definition and contrast of the hip area including one just 10 days prior with supposedly the best orthopaedic surgeon in Manila who declared he had excellent hips. This new vet suggested this bone spur grew within those 10 days which I struggle to believe.
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I would not call these excellent hips from that xray... but I don't really see how you could identify a bone spur from that blurry spot. 🥴 How bizarre of that vet. I do not think you need to be concerned about HD....

It seems to me that you already know that it is the hock. From the picture the swelling appears to be high up and it could be the bone or the ligaments around there. I would have xrays done to rule out any fractures or OCD, but odds are very likely it is soft tissue and will just need rest.
 
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