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* A CASE STUDY - MAX
Max is a gorgeous 10month old female pugle. We were dismayed when she waddled through the waiting room doors on only three legs, holding the fourth forlornly off the ground. Her owners reported that they had noticed some occasional mild lameness over the last few weeks but things had suddenly become much worse. It was evident that the muscles in her left hind limb were much thinner than usual and the leg rotated inwards as it was held up against the body.

X-rays were scheduled and revealed that the top of the femur (or thigh bone) was crumbling away and not forming a proper joint with the hip. This condition is called Legge Perthes disease and occurs when the cells at the end of the bone (femoral head) die off . We do not know exactly why this happens but it is suggested that hormonal influences, inherited factors, anatomical shape and an interrupted blood supply to the area may play roles in its cause. The end result is a weakened bone that is unable to withstand weight bearing causing collapse and fragmentation with associated pain and lameness.

Legge Perthes disease is seen most commonly in young small breed dogs between 3-12 months of age. It usually presents as slow onset lameness with reduced range of movement and muscle wasting around the hip joint but can suddenly cause severe lameness when the bone collapses. When the x-rays are examined the femoral head appears deformed with a reduction in the bone density.

Max was scheduled for a surgery in which the diseased femoral head is removed from the femur. The surgery involved approaching the site through the muscles around the hip, cutting away the affected bone and creating a smooth surface over which the muscles could be closed. In essence the hip joint is removed and fibrous tissue forms to create a false joint. Max coped very well throughout her stay in hospital and was sent home with a slow release pain relief patch to keep her comfortable for the next few days. She was encouraged to walk immediately after surgery to begin strengthening the weakened muscles and commenced physiotherapy 3 days later to ensure that the area retains flexibility. She is already putting weight on the leg and with time should regain almost normal function.

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