Pupscan Project

Tel: UK 0044 (0) 7500 311900
Tel: Ire 00353 (0) 86 2345460

WHAT IS PUPSCAN?

FAULTY JOINT DEVELOPMENT IN DOGS

    Breeders and lovers of large breed dogs know all too well the heartache of canine hip and elbow dysplasia. Dog owners see patellar subluxations, cruciate tears and osteochondritis dissecans (OCD) in young dogs at an alarming rate and they pay the price with expensive surgery, therapy and supplements. Why are dogs suffering from these diseases at such a young age? Many breeders and vets are quick to say that it is due to bad genetics – so good breeders screen their dogs for these diseases by way of X Rays before breeding, to make sure the problems are not passed down to the offspring. The problem is, this method of screening hasn’t really changed the incidence of most of these diseases.

A LITTLE HISTORY

Hip ‘dysplasia’ was first diagnosed in dogs in 1935 and over the next twenty years the number of dogs presenting with this disease prompted the Swedish Kennel Club to become one of the first to develop a program to reduce the incidence of hip ‘dysplasia'. The breeds in which this was noticed were Labradors, Retrievers and German Shepherds; however, this may simply be because they were the most popular breeds at the time. It is now thought that proportionately these breeds are no more susceptible to hip problems than any other breed given the numbers of popularity. 

It was believed at the time that if breeders took radiographs of their dogs and only bred those dogs that did not show evidence of hip ‘dysplasia’, they could eliminate it.  However, after ten years of selective breeding of German Shepherds, the incidence of moderate and severe cases of hip ‘dysplasia’ had not chanaged.  Dogs that did not show radiographic evidence of hip 'dysplasia’ were still producing puppies with the disease. In one study, over two thirds of dysplastic puppies were from normal parents.

This led researchers to conclude that hip 'dysplasia' was a polygenic disease (residing in more than one gene), meaning that the severity of the disease could be influenced by environmental factors such as diet and lifestyle.

    Over fifty years later, despite increased testing rates, the incidence of hip 'dysplasia' is not going down in most breeds. In fact, smaller breeds are now also showing an increased susceptibility to this disease which historically was limited to larger breeds of dogs

WHAT IS DYSPLASIA

The term ‘dysplasia’ sends shudders through any breeder, but it is important to understand that the word ‘dysplasia’ is NOT a pathological diagnosis. The word is derived from the Greek dys = bad and plasia = formation, and is a term frequently used to describe the general appearance of an abnormal joint (or any other tissue) but it is NOT specific to any single diagnosis. For example, an x-ray taken at skeletal maturity may show changes from conditions such as healed trauma, growth plate injury, Septic Athrisis and Perthes disease which can all look similar to possibly genetic disorders. These conditions are acquired after birth and the genetics are NOT proven, despite decades of research. The simple fact is that there has NOT been a link established between hip and elbow problems in humans, other than in dwarfism, let alone dogs. It is worth considering that dwarf breeds of dogs are generally not hip scored in many countries for exactly this reason!

Good Hips

Bi-lateral  'Dysplasia' - (Genetic)

Septic Arthrisis

(Not genetic)

Trauma

(Not Genetic)

Perthes Disease

(Genetic?)


    A great deal of published “research” material has been taken from X-Rays for ‘scoring’, not from diagnosis. For example, a diagnostic image will usually be acquired in two planes, not one (as required for hip scoring) and will not be distorted by traction or leverage designed to demonstrate “laxity”. Even the laxity images are difficult to compare as the amount or direction of traction is not specific for the breed, gender or size of the dog, therefore making scientific validation impossible.

    With more than 50 years of ‘scoring’ there has been no statistically significant reduction of ‘dysplasia’ in any breed studied either by imaging or, more recently, gene studies. The overwhelming evidence is that the current method of ‘scoring’ is not a valid health screening test. If it were, it would be repeatable, producing the same score time and time again, and robust. The fact is that there is so much variability between countries, vets, and opinion when scoring X Rrays that it is impossible for any breeder to have confidence when deciding which dogs to include or exclude from their breeding program.

    Furthermore, after over 15 generations of breeding surely the condition would have tremendously reduced as opposed to increased in 14 breeds and completely unchanged in 17 and only one or two points in the majority. (REF: Ruth Dennis. Interpretation and use of BVA/KC hip scores in dogs)

The ‘Dysplasia’ score given from x-rays does NOT include a diagnosis but despite this the consequences frequently lead to complaints against the breeder which may be unjustified. The traditional scoring method takes account of many factors without being breed specific. One of these factors scored is laxity, which breeders understand varies greatly between breeds and gender.

    In human studies, joint laxity following trauma is highly correlated with early onset of osteoarthritis. Non -traumatic laxity has NOT been correlated with premature arthritis except in very rare conditions.

    It is widely known that research for the benefit of humans has involved dogs; Norberg (not a vet, but a human radiologist who worked at the Karolinska Institute, Stockholm and famous for developing the Norberg angle for diagnosis and treatment of faulty hip development in babies) used his expert knowledge of human joint disorders, stating in his original published work with co-workers on hip ‘dysplasia’ in dogs from the early 1960s...

However, the Basic features are similar and for this reason one has the right to assume that the disease is basically the same in the two species.’  

REF: A Comparative Review B. HENDRICSON, * I. NORGERG AND S.-E. OLSSON. Royal Veterinary College, Stockholm, Sweden. 1966 (referring to dogs and humans) 

Sadly, this opinion has rarely been applied for the benefit of our dogs.   From 1957 to 2015 there was still a failure to learn from Norberg and his colleagues who believed that: ‘environmental factors are responsible for about 50 per cent of the variation of the severity of hip dysplasia.  REF: B. HENDRICSON, * I. NORBERG AND S.-E.OLSSON. Royal Veterinary College, Stockholm, Sweden.   

   Bearing in mind that the only in vivio investigations they could use at that time were X-Rays,  this was an important opinion. Since those days we have enjoyed the extra scientific evidence that can be obtained by CT, MRI and Ultrasound Scanning yet this does not yet appear to have been successfully incorporated into veterinary text books to differentiate between all the potential non-genetic reasons for faulty joint development.  It is therefore sad that X-Rays are still being used to make a ‘score’ but not a diagnosis. These films could not indicate if the abnormality was more probably genetic in origin than not. Furthermore, veterinarians all over the world have been taught that ‘dysplasia’ of hips is genetic in origin and, even more disturbingly that elbow dysplasia was similarly genetic when there is, in fact, evidence to the contrary REF: Hou Y, Wang. Etal P L oS one 2013 October 4; 8 (10) Monitoring hip and elbow dysplasia achieved modest genetic improvement of 74 dog breeds over 40 years in USA. 

   Indeed, one Elbow scoring system uses a single lateral view of the elbow joint to illustrate the Anconeus Process, suggesting that is the origin of dysplasia, while a standard and much respected Radiology text book shows that there is NO separate growth plate in the Anconeus and that all the evidence points to a fracture that has failed to unite properly or at all.  

By scoring rather than diagnosing there is therefore a huge amount of untreated disability in young dogs that could have led to a high or normal level of function in the dog’s advancing years had correct treatment been given. Would this be acceptable for humans?

Ununited Anconeal Process

   It is very important to recognise the wide-reaching implications of a scoring system based on a phenotype image alone. 

   A paper published, In The veterinary journal In Practice. By Ruth Dennis. 2012 (can be viewed on the BVA website) clearly demonstrates that the existing scoring method, when the figures are viewed closely, actually show an increase in the incidence of ‘dysplasia’ across many breeds and not a decrease as we are led to believe.

  So the questions remain....if the scoring method is designed to improve ‘canine hip dysplasia’ why after 50 plus years and up to 20 generations of dogs have we not seen a statistically significant improvement across all breeds? After all, its not as if it is a new study. Why are there such discrepancies? Why has it never been validated?

  In the very near future explanations of why a joint has developed badly will emerge. Some are likely to have a genetic origin, be it through gene mutations or SNIP (single nucleotide pleomorphisms) aberrations. But at least this will be observed against a background of confirmed normality in the first few weeks of life without pre-selection bias. We intend to provide information that is scientifically validated, that can be relied upon, be repeatable and be robust around the globe.

 

THE PUPSCAN PROJECT

 

   Pupscan uses the most modern diagnostic Ultrasound technology to separate joint disorders at birth, from those that are certainly acquired later in life through environmental and nutritional factors.  PUPscan have established that there are significant differences in the development of puppy hips between breeds and even between the genders within each breed. This is the basis for the guidance that is being produced by breed experts on the best way to care for a new puppy. 

   The benefit to both the dog and breeder is that diagnostic images, incorporating new precise measurements which are being developed breed by breed, can be taken of hips and elbows from 14 days to 16 weeks of age to confirm normal development. The breeder therefore has as much information as possible about the joint development of each puppy within a litter.

   Ultrasound diagnostics supports both the breeder and the puppy and helps to defend against a future bad score that may result in allegations or claims of selling a ‘dysplastic’ puppy.

PUPscan Ultra Sound imaging is carried out without anaesthetic or muscle relaxation in a natural position of load bearing so that normal joint mechanics are not disturbed.

The PUPscan Project, working together with University College Dublin and supported by the Irish Kennel Club, is generating scientifically based data to highlight the importance of breed and gender specifics, husbandry, nutrition, exercise, and the conditions in which each pup was born. As with humans, the intra-uterine environment and birth process often give rise to conditions that are diagnosed soon after birth that may be entirely unrelated to the genetics of the puppy. An example is when the amniotic sac either leaked during pregnancy or had too little fluid in which the embryo could move, resulting in abnormal (arthrogrypotic) joints. There is no evidence to suggest puppies are immune for the same processes, why in large litters are puppies any different? we are all familiar with the term ‘runt of the litter’…is this runt sometimes the one that had too little room? 

Single Pregnancy

with lots of space

Multiple Pregnancy

with limited space


The PUPscan team will work with breed clubs and individuals to produce breed specific data giving clear guidance to new puppy owners on their breed. This information will reinforce the puppy’s new owners’ duties of care and responsibilities to their puppy with clear evidence based on holistic guidance to include advice about exercise and activity, breed specific health issues and nutritional advice.

  PUPscan trained Vets will be best placed to support not only the breeder but also the new puppy owner. They will have the training and equipment not only to scan for pregnancy but also carry out hip, elbow and knee scans that can be checked against the Pupscan database for breed- and gender- specific normal values.

  For the expert breeder the new knowledge that the whole litter has been scanned and shown to be free of genetic disease will give reassurance of genetic health for future litters from the same parents or others that have been confirmed to have produced normal litters in the past.  Within a very few years this new database, based on microchip and/or DNA identification, has the potential to register results from across the globe.

  At first glance there seems to be no justification for NOT scanning. Every breeder and owner will benefit. If a dysplastic puppy is found (so far our figures show one in a thousand of 61 breeds scanned) we can then carry out well targeted genetic screening with a far greater chance of finding the gene(s) involved. 

THE SCANNING PROCEDURE

  At 6 – 8 weeks of age when the hip (or elbow) is predominately cartilage an image is acquired by Ultrasound, a non-invasive imaging technique that and does not require any hair removal.    The scan is performed in real time, there is no ionising radiation and therefore there is no risk to ovaries or testes. The breeder can see the images immediately.

  Ultrasound imaging allows internal body structures to be seen by recording echoes or reflection of ultrasonic waves. No anaesthetic or sedation is needed. The image is taken while the puppy is in a natural load bearing position or cradled in the breeder’s or a team member’s arms. Both hips or elbows can be imaged in less than 15 minutes. 
  The Ultrasound conductive water based gel is applied to the puppy’s coat and leaves no residue when wiped away. The gel is non-toxic so has no impact on the coat. 
  Pupscan are working with a global supplier of Diagnostic Ultrasound equipment supported by specially developed software. This will ensure diagnostic quality images, supporting the scanning technicians in working to a satisfactory diagnostic standard. 
The Diagnostic Technician will scan the hip/elbow joints to produce quality images required for the PUPscan specialists to analyse.

A 6 week old Belgian Shepherd 

A 6.5 week old Golden Retriever

A 4 week old Great Dane

Once images, measurements and other data is collated against a puppy and only when all data is signed off will a certificate be produced to confirm normal development. These Certificates can be passed to the new owner at the point of sale or at the breeder’s discretion. This will form part of the Puppy Contract confirming that the hip (or other relevant joint) is developing normally for age, gender and breed.

 Because there will be a permanent record by Microchip and / or DNA identification from birth or within the first few weeks of life any disorders arising in a scanned/x rayed joint later in life can be correlated against the early images so that any disorder or disease progression can be properly assessed and investigated.   This will separate genetically acquired ‘Dysplasia’ from all the other processes that can lead to the appearance of ‘Dysplasia’.

  As larger and larger numbers of litters are entered into the database we expect that new disease processes will be clarified, especially on a breed by breed basis, so that early detection can lead to early treatment. Prompt removal from the breeding gene pool will therefore be based on sound scientific evidence rather than the current system that has failed to resolve the problem of faulty joint development in over 50 years.

"The greatness of a nation and its moral progress can be judged by the way in which its animals are treated".....Mahatma Ghandi
 
 
 
 
Over fifty years later, despite increased testing rates, the incidence of hip 'dysplasia' is not going down in most breeds.

..

 
 
 
 

The fact is that there is so much variability between countries, vets, and opinion when scoring X Rrays that it is impossible for any breeder to have confidence when deciding which dogs to include or exclude from their breeding program.

..

 
 
 
 

Furthermore, after over 15 generations of breeding surely the condition would have tremendously reduced as opposed to increased in 14 breeds and completely unchanged in 17 and only one or two points in the majority. 

REF: Ruth Dennis. Interpretation and use of BVA/KC hip scores in dogs)
 
 
 
 
 
In human studies, joint laxity following trauma is highly correlated with early onset of osteoarthritis. Non -traumatic laxity has NOT been correlated with premature arthritis except in very rare conditions.

..

 
 
 
Since those days we have enjoyed the extra scientific evidence that can be obtained by CT, MRI and Ultrasound Scanning yet this does not yet appear to have been successfully incorporated into veterinary text books to differentiate between all the potential non-genetic reasons for faulty joint development.  It is therefore sad that X-Rays are still being used to make a ‘score’ but not a diagnosis.

..

 
 
 
 

By scoring rather than diagnosing there is therefore a huge amount of untreated disability in young dogs that could have led to a high or normal level of function in the dog’s advancing years had correct treatment been given.

..

 
 
 
 

if the scoring method is designed to improve ‘canine hip dysplasia’ why after 50 plus years and up to 20 generations of dogs have we not seen a statistically significant improvement across all breeds?

..

 
 
 
 
PUPscan have established that there are significant differences in the development of puppy hips between breeds and even between the genders within each breed.

..

 
 
The PUPscan Project, working together with University College Dublin and supported by the Irish Kennel Club, is generating scientifically based data to highlight the importance of breed and gender specifics, husbandry, nutrition, exercise, and the conditions in which each pup was born.

..

 
 

As with humans, the intra-uterine environment and birth process often give rise to conditions that are diagnosed soon after birth that may be entirely unrelated to the genetics of the puppy.

..

 
 
 
 
If a dysplastic puppy is found (so far our figures show one in a thousand of 61 breeds scanned) we can then carry out well targeted genetic screening with a far greater chance of finding the gene(s) involved.

..

 
 
 

 Ultrasound imaging allows internal body structures to be seen by recording echoes or reflection of ultrasonic waves. No anaesthetic or sedation is needed. The image is taken while the puppy is in a natural load bearing position or cradled in the breeder’s or a team member’s arms.

..

 
 
 
any disorders arising in a scanned/x rayed joint later in life can be correlated against the early images so that any disorder or disease progression can be properly assessed and investigated.  This will separate genetically acquired ‘Dysplasia’ from all the other processes that can lead to the appearance of ‘Dysplasia’.   

..