Gold Bead Implantation In Small Animals (Hip Dysplasia )
This condition accounts for about 50% of the cases in which we implant gold beads. Our cases ranged from 4 months to 17 years of age. Most dogs were large breeds, or dogs >50 pounds body weight. We have treated 2 Pekinese dogs for hip dysplasia. The size of the dog does not have a bearing on the success of the gold bead implant. Age does have the greatest effect on the success of gold bead implant. We break the age group into 3 classes. Under 7 years of age we have a 98% success rate. From 7 to 12 years of age we have about 80% success rate and from 12-17 years of age we have about 50% success rate. The number one cause for our failures in hip dysplasia is secondary degenerative myelopathy.
Degenerative myelopathy is considered by most experts to be a totally separate condition, but I have never seen it show up as a condition by itself. There has always been another concurrent problem. In my opinion, degenerative myelopathy begins as a localised alkalosis in the hip joint. In a small percentage of the dysplastic dogs, the localised alkalosis starts to involve the local nerves and eventually spreads to the spinal cord. The alkalosis of the cord eventually causes demyelination of the cord. At some point we are unable to reverse the alkalosis and demyelination of the cord. When this happens, there is a progressive, irreversible degenerative myelopathy and the dog cannot walk. The gold bead implant will reverse the degenerative myelopathy in about 50% of the cases. We are not able to look at these dogs before the implant and know which ones we can help. We cannot help dogs if they are unable to support their weight and the rear legs are basically reduced to skin and bone with very little muscle. If the dogs still have some muscling and can intermittently get up, we can help about 50% of them.
An apparent but temporary success may follow gold bead implantation in a small group of dogs with degenerative myelopathy. They seem to be good for 3-9 months, but then they deteriorate. All such dogs have been about 9 years old. I have spent much time on degenerative myelopathy, but this is a major problem in small-animal practice. Let it not deter you from doing gold bead implants.
When implanting gold bead for hip dysplasia, we begin with 4 basic points: GB29, BL54, GB30, and GB33. These points need treatment in all dysplastic dogs. Other points that need to be implanted fall into 3 Zones. Zone 1 is dorso-anterior to GB29. Zone 2 is dorso-anterior and dorso-posterior to BL54. Zone 3 is dorso-posterior to GB30. GB31 and GB32 are the main exceptions to the rule; they need to be treated in some dogs.
The next set of points to be implanted are in 1-2 of three Zones around the hips. These points usually are Ahshi / trigger points. Zone 3 needs treatment least frequently. One rarely must use all 3 Zones. To find the next point, draw a line midway between GB29 and BL54 and go dorsal 0.5-1.0 inch. If a point is sensitive, place gold beads into it (A). Then search for point tenderness midway between BL54 and GB30. Go dorsocaudal to this area 0.5-1.0 1 inch. Implant gold beads into any sensitive point there (B). If point (B) does not show up, then there usually are no more points in Zone 3.
Then search for two sensitive points ventral and dorsal to point (A). Go halfway between GB29 and point (A) and search anteroventrally. Place gold beads in any sensitive point found. If there are no more sensitive points, move halfway between point (A) and BL54 and search anterodorsally. Implant any sensitive points found there. Implantation of the hips is complete when one can find no more sensitive points in the area.
When implanting gold beads for hip dysplasia, both hips should be treated at the same session. However, a single hip can be implanted in special cases. For example, some dogs have one normal hip and one bad hip. The bad hip may look like a dysplastic hip, but such hips were usually have been traumatised by their dam shortly after the birth of the pups. In those cases, only the bad hip needs treatment. Traumatic injury of one hip that has resulted in a femoral head resection or a hip replacement surgery may need to be treated with gold bead implant similar to hip dysplasia.
When we treat hips with gold bead implants, we see mostly local effects, and very little systemic effect. GB29, GB30, and BL54 work locally on the joint and the other trigger points work mostly on the surrounding muscle.
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