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LEGG-PERTHES (LEGG-CALVE-PERTHES DISEASE)
Legg-Perthe's disease is a degeneration of the hip joint occurring
in young dogs. It is also known as Legg-Calve-Perthe's Disease,
Perthe's disease, Calve-Perthe's disease, or in medical terminology,
avascular necrosis of the femoral head and neck. The former
names recognize the original researchers in the disease as it
occurs in humans.
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Most of the time the clinical signs of this disease occur in 4 to
11 month old dogs and usually consist of lameness of one leg
only. Pain may be mild to very severe. Some dogs have mild
forms of this condition and do not require medical care. In other
dogs, the condition cause sufficient pain and deformity of the hip
joint to require surgical intervention. Atrophy of the muscles of the
affected leg is not uncommon. If this is severe it can slow the
recovery period considerably and may make medical therapy less
likely to work.

Definitive diagnosis is made by X-rays. As changes to bone occur
slowly, X-rays taken early in the course of the disease may appear
normal. Repeating the X-rays in 3 to 4 weeks will reveal the bony
changes. A dog affected with LPD suffers a loss of blood supply to
an area of the femur (thigh bone) known as the neck. Because the
bone loses its blood supply, it dies. As a result of the loss of bone
tissue, the neck of the femur collapses. The neck attaches the head
of the femur to the body of the femur. When the neck collapses, the
head of the femur is moved, and may also become deformed. These
changes are readily apparent in X-rays. The head of the femur is
the "ball" which sits in the "socket" on the pelvis, making up the
hip joint. Therefore, changes to the head result in disruption of
function of the hip joint which causes the pain and lameness.The
term "avascular necrosis" means death of tissue due to lack of
blood supply. In most dogs, only one hip is affected, and males
and females are equally affected.

Treatment of this condition varies according to the severity of
the signs seen. In mild cases, enforced rest may be sufficient to
allow healing of the damaged areas to occur. In some cases,
immobilization of the affected limb using an Ehmer sling may
be beneficial to recovery. Many dogs have advanced cases of
this disease by the time they are examined by a veterinarian and
medical treatment is not likely to work. In these dogs, excision
of the femoral head (ball portion of the hip joint) is often
beneficial. Removal of this section of the bone diminishes painful
bony contact in the hip joint. Recovery from this surgery can
be slow with recovery periods of up to one year sometimes
occurring before good use of the affected leg returns. If muscle
atrophy is not present at the time of surgery the recovery time is
usually much less. Pain relief and anti-inflammatory medications
may be beneficial.
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There is a stronger tendency to treat this as a medical condition
prior to surgery right now. A general rule of thumb is to allow
non-surgical therapy a month to show a beneficial response. If
one is not seen, surgical repair should be considered more carefully.
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Treatment of LPD usually consists of surgery to remove the
damaged femoral head and neck (femoral head ostectomy).
Mildly affected animals may recover soundness with only cage
rest. Affected animals will probably always have some gait
abnormalities, but make satisfactory pets after recovering
from surgery.
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Prevention of the disease is only possible through genetic means.
Affected animals should not be bred. Breeding stock should
have their hips X-rayed to insure that they are not affected
with mild LPD, the symptoms of which went unnoticed during
the dog's adolescence. Extreme caution should be used when
considering breeding animals that have produced LPD, or
have LPD affected littermates.