Vets can be our best friends - just imagine trying to raise healthy dogs without the advice and expertise of a trusted veterinarian. But they can also be our worst enemies if we don't use our own common sense and filter their sometimes-biased advice through our own and others' experience.

This is most telling when it comes to diagnoses of CHD - canine hip dysplasia. Because of its prevalence in the giant breeds, vets often rush to judgment when presented with a Newf who displays even the slightest - or no - symptoms. And inexperienced or frightened owners often find themselves pushed into surgery that isn't necessary.

Case in point. A couple took their 7-year old Newf to the vet because she was "acting weird." A very active dog who walked several miles a day, she suddenly no longer wanted to exercise. She also would not eat, was staring into space, she seemed stiff, and her head was tilted to the side. All the symptoms were vague, but they knew she was not herself. The dog's rear movement had always been somewhat stiff, and X-rays at the age of three had showed very mild arthritic changes. This vet, without examining the dog except to look at her rear movement, pronounced her dysplastic, scheduled hip replacement surgery in ten days, and sent the owners home with a prescription for Rimadyl. The owners saw no improvement after three days; in fact, the dog was deteriorating rapidly. Repeated calls to the vet were no help; they were told only that the dog was obviously in extreme pain and the surgery would relieve it. Days later, the dog began urinating in the house and finally went into seizures. She was rushed to another veterinarian who recognized the symptoms of meningitis, but it was too late to save the dog. She died. Antibiotics and steroids a week earlier might have saved her.

Just because it's a Newfoundland doesn't mean that any sign of lameness is because of hip or elbow dysplasia!

There are, of course, an unfortunate number of Newfoundlands who are dysplastic - on X-ray. This is discovered, if at all, when the dogs are X-rayed at the age of two for OFA. Owners go to pick up their dogs, who have been active and non-symptomatic, in the afternoon and are told by a concerned veterinarian that the dog's hips are bad and surgery is recommended "to save the dog from pain." Except there is no evidence of pain. This kind of diagnosis has sent hundreds of concerned owners into an emotional tailspin that can be physically and financially devastating. The implication is that if you don't fix your dog, he or she will be crippled in a few months or maybe a year. Without first considering medical instead of surgical options, many dogs are subjected to unnecessary surgery. But many of these dogs, whose owners opt (guiltily?) to not do surgery, go on to live long, happy and pain-free lives.

The moral of the story is to look at the dog, not at the dog's X-rays. If you take your Newf to have diagnostic X-rays for OFA and the news is not good, remember that the dog you walk out with is still the dog you walked in with. If your dog is asymptomatic, an X-ray will not change that. CHD is not necessarily crippling, nor is it a death sentence, as some would have us believe. It depends on the individual dog, lifestyle, nutrition, and exercise.

If you take your dog for X-rays because of symptoms, it might be a different story. But once again, rushing to fix something with surgery isn't always the answer.

Second case in point. An owner takes in an 8-month old Newf puppy for a routine exam and weigh-in. The vet notices rear lameness and suggests taking a look for pano. The dog has severe hip dysplasia - radiographically severe. There is a shallow acetebellum on one side and none on the other. In this case, the deformation is bad enough that the "usual" surgical procedure - TPO (triple pelvic osteotomy) can't be performed because there isn't enough bone. The suggestion is to wait and see if there is enough bone to do a total hip replacement when the dog is grown (because only a dog who is full grown is a candidate for total hip replacement). The prognosis, however, says the vet, is grim. The dog will probably have to be put down in a few months.

This dog is taken to an orthopedic surgeon three months later because there is evidence of pain - refusal to move, whining and restlessness. Diagnosis is the same - TPO can't be done, wait and see about total hip replacement. Suggested palliative measures are glucosamines, buffered aspirin when the pain is evident, mild exercise for muscle strengthening, more X-rays in two months.

During that two-month period the dog gets better, begins running, starts jumping up on the bed, stops crying. The dog is X-rayed again, and this time the orthopedist reports that the head of the femur is completely out of the shallow joint and is, instead, held in place only by ligaments. The dog is no longer in pain because there is no longer bone rubbing on bone. When asked if the dog is a candidate for total hip replacement, the vet said that yes, it could be done, but why should it? "This is how I make my living," he said, "and maybe it's not smart to tell people that the surgery I do isn't necessary, but in this case, it's not. Nature fixed the problem, at least for the moment, and maybe for the rest of the dog's life. If the clinical picture changes, we can talk about it." He went on to outline the medical alternatives that should be used before any surgical procedure is performed. "First there's keeping the weight down and exercising sensibly. Swimming is great. You have to remember that it's only muscle and ligaments holding that leg in place, so strengthening the muscle is imperative." This is the kind of veterinarian we should all hope to have!

Keeping that "clinical picture" in perspective and understanding that there are alternatives to surgery is the responsibility of any caring owner.

Before rushing any dog into surgery, first consider glucosamine and chondroitin supplements, exercise, weight control, and occasional aspirin. If your dog has radiological evidence of degenerative joint disease - without symptoms - it is often enough to supplement with glucosamines and control weight. Surgery might be necessary, but it should be for the dogs who are in terrible pain, can no longer walk, and whose owners are prepared to undergo the long rehabilitation necessary for recovery. It is not something to be entered into lightly, and it is not a sign of negligence to explore medical treatments before opting for what should be a last resort.

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