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Effect of dorsal hip loading,sedation, and general anesthesia on the dorsolateral subluxation score in dogs
Authors:Todhunter Rory J  Bertram John E  Smith Scott  Farese James P  Williams Alma Jo  Manocchia Adriano  Erb Hollis N  Dykes Nathan L  Burton-Wurster Nancy I  Lust George
Institution:Departments of Clinical Sciences and Population Medicine and Diagnostic Sciences and the James A. Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
Abstract:OBJECTIVE: To determine whether dorsal loading of the pelvis and type of chemical restraint affected the dorsolateral subluxation (DLS) score of dog hips. STYDY DESIGN: In vivo testing of diagnostic method. ANIMALS: Labrador retrievers, Greyhounds, and crosses between both breeds (n = 119 dogs). METHODS: Dorsal load was applied to the hips through a strap that was placed over the hips, and the peak vertical and steady-state vertical, ground-reaction forces exerted on the stifles were measured in the DLS position. The DLS score was measured with their hips under dorsal load and compared with the DLS score without load. For 24 dogs, the DLS score was measured both under chemical restraint (medetomidine) and under general anesthesia. Wilcoxon-signed rank test and paired t test was used to compare effects of dorsal load and restraint method on the left and right DLS hip score, and P <.05 was considered significant. RESULTS: Both stifles together accepted median 15% body weight in the vertical plane in the unloaded steady state. Loading the hips increased the steady-state, vertical ground-reaction force to 34% body weight. At 8 months of age, loading significantly decreased the DLS score from 65% +/- 11% (mean +/- SD) to 60% +/- 12% for left hips and 66% +/- 11% to 63% +/- 13% for right hips. The left hip DLS score was affected by load more consistently than the right hip. In general, loading the hips decreased the DLS score in all breeds by 4% to 6% except for the greyhounds, in which the DLS score was unchanged by dorsal loading. When grouped by their DLS scores, load significantly decreased DLS scores in dogs with unloaded scores greater than 55% (nondysplastic), whereas DLS scores of dogs with unloaded scores between 55% and 45% (dysplastic) and less than 45% did not change significantly with load. Unloaded scores did not change significantly when compared under sedation versus general anesthesia. However, load significantly decreased the DLS score under general anesthesia for the left hip but not for the right hip. CONCLUSIONS: Less than half of the vertical ground-reaction force normally exerted by the hindlegs of a standing dog was sufficient to induce hip subluxation in the DLS position. Although dorsal loading approximately doubled the steady-state, vertical ground-reaction force, the decrease in the DLS score under load was never greater than 6%. Furthermore, the DLS scores of dogs most likely to be dysplastic (based on DLS scores <45%) were not affected by load, whereas load slightly decreased DLS cores of dogs with DLS scores greater than 55%. CLINICAL RELEVANCE: External influences can change the DLS score significantly, but the magnitude of change is unlikely to be of clinical importance, making the method useful as a field screening test for both dysplastic and nondysplastic hips in young dogs.
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