# Ortolani Test--Good Idea?



## tbliss (Mar 26, 2009)

This weekend our new puppy Maevis had her first vet check. The vet recommended that in the near future we have an Ortolani test performed on her to check for hip dysplasia. Apparently, the test requires the dog to be sedated, whereupon the vet manipulates her hip to see if it dislocates. If so, our vet said that the dog would be considered likely to develop hip dysplasia, and should undergo an orthopedic surgery that deepens the hip socket and generally prevents the dog from developing hip dysplasia later. We want to do what is best for our dog, but don't want to put her through unecessary procedures/sedation. Does anyone have any experiences with the Ortolani test and/or the procedure performed on dogs that "fail" the test? For what it's worth, we obtained Maevis from a reputable breeder and both of her parents and their lineages are free from hip dysplasia.


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## mylissyk (Feb 25, 2007)

This is my personal opinion, but unless your puppy is exhibiting problems I would not have this test done. Honestly it sounds like it could CAUSE the hip to dislocate in the future when otherwise it would not have. For certification Xrays for hip displaysia can't be done until the dog is two years old.


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## LibertyME (Jan 6, 2007)

Im curious to know why your vet made the suggestion - seems a bit odd to me...for such a young puppy...

Did you express deep concern for the health of her joints? - Was he making the suggestion as a wya to offer you some comfort and reassurance?
Did he manipulate and hear/feel a problem?
Did he suggest a timeline that the test be performed? for instance did he think it should be done soon...like in the next 6 months?...next two years?
Did he make the suggestion becuase you told him you are interested in breeding?
Does he do the testing? - Lordy I hope he does suggest this to all puppy buyers as a way to profit... 
Did he suggest a particular facility? (I would hope he doesn't have a vested interest in sending clients to a particular facility....but stranger things have happened...)


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## LibertyME (Jan 6, 2007)

Personally I don't believe in buying trouble...if the puppy or dog is healthy and active and you are not planning to breed...leave well enough alone.


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## Pointgold (Jun 6, 2007)

I've not heard of any vets suggesting this. OFA prelims, perhaps, if you are considering any venue of competition, but otherwise, unless there is reason to suspect a problem, I would wait until 24 months to take OFA radiographs.


From "Canine Hipe Dysplasia Part III by John Cargill MA MBA MS & Dr. Susan Thorpe-Vargas :

( http://www.siriusdog.com/dysplasia-hip-dog-chd-ofa-pennhip-3.htm )

*Palpation.* In humans, the most popular and reliable palpation maneuver used to identify congenital dislocation of the hip determines the presence or absence of the Ortolani sign. "A positive Ortolani sign confirms the diagnosis of coxofemoral subluxation in newborns prior to development of clinical signs or radiographic changes." 8 Many veterinarians feel that the techniques have too much subjectivity and variance to be of much use. Nonetheless, the Ortolani sign still figures prominently in the literature. 9-14 Animals to be examined must be anesthetized past the point where there is still a palpable response. Two basic approaches are used: dorsal recumbency and lateral recumbency, with dorsal recumbency being preferred for large dogs. Downward pressure is applied down the axis of the femur until the femoral head subluxates. The leg is slowly abducted while holding the stifle firmly. If the joint is loose, a distinct clicking may be felt and in some cases will be audible.
Other palpation methods have been proposed by Barlow and Bardens. 15,16 Barlow’s Sign is essentially the first half of the Ortolani Test. Downward axial pressure is applied on the femur without abducting the leg. The Bardens’ Test places the dog on its side, and the leg is held perpendicular to the spine. Lifting pressure is applied to the femoral shaft without abduction. The examiner’s finger is placed on the greater trochanter. Any movement of the finger by more than one-fourth inch is considered a positive sign for a loose joint. Palpation has shown diagnostic use in human neonates, but is controversial and may have little diagnostic or prognostic utility in the dog. A caution: In human infants, it has been suggested that repetitive Barlow tests, and presumably Ortolani and Bardens as well, are capable of making infant hips unstable, thus giving a false-positive result. 17"


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## tbliss (Mar 26, 2009)

Thanks Mylissyk and Liberty. We were sceptical as well, which is why I asked the question. The vet did not offer this information in response to anything she saw or felt (she did not manipulate her hips and did not mention anything to us). We also did not express any concern about the issue and we do not plan to breed her. The vet said the test is strong recommended for all very large dogs and GSDs. She said it was less of a necessity with goldens, but that since the surgery can prevent dysplasia from developing, the test to see if the surgery is required is probably worth it. The ve performs the Ortolani test, but does not perform the surgery itself.


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## LibertyME (Jan 6, 2007)

If I am understanding the procedure correctly....the Ortolani Test sounds quite subjective - which would in all likelihood lead to more testing......If I were going to have to deeply anesthetize my dog, I would do a PennHip which would at least give me a quantitative score...


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## tbliss (Mar 26, 2009)

Thanks Pointgold. I agree this sounds more subjective than we were led to believe. We will not be breeding/showing or doing any competitions with Maevis, so I think we will likely not have the test performed. We certainly don't want to put her through an unnecessary procedure(s) (especially one that sounds like it could be very painful)--or worse, a procedure that may actually cause future problems, i.e. dislocations.


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## LibertyME (Jan 6, 2007)

I'll be curious to hear more feedback from the board....if their vets have strongly recommended the test....
Not that it means anything, but mine never have....


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## Pointgold (Jun 6, 2007)

Honestly, I have NEVER heard of any vet recommending it. The op surprised me.


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## BeauShel (May 20, 2007)

I have not ever heard of a vet recommending it for a large dog. Personally I would not have it done.


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## cubbysan (Mar 13, 2007)

LibertyME said:


> I'll be curious to hear more feedback from the board....if their vets have strongly recommended the test....
> Not that it means anything, but mine never have....


My vet did recommend this to me too.

TBLISS and I come from the same town, so it was probably the same vet or something the vets in that region believe in. I will have to go through my old posts.


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## tbliss (Mar 26, 2009)

For what it's worth, we ended up switching to another vet. Our new vet has not mentioned the Ortolani test and we have not raised the issue.


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## AmbikaGR (Dec 31, 2007)

Is this an orthopedic specialist? To me it sounds as if he would have been doing moore damage then you could have ever imagined.
I see you have switched vets and I believe that to be a very good thing.


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## cubbysan (Mar 13, 2007)

I forget the details of the test, but it needs to be done before the dog is 18 weeks old, because if the dog does not pass the test, an orthopedic specialist in the greater Boston area does a very noninvasive and a lot cheaper procedure to the bones then the normal more invasive hip surgery.

If a puppy is already showing hip problems or the has family history of problems this procedure is a god send. It needs to be done before 18 weeks because of the growth plates. My vet was not seeing very many 
well bred Goldens, and a very high percentage of them were being diagnosed with HD.

She had given me the information for this specialist because one of Brady's parents tested as a Fair.

The procedure is quoted from peteducation:
*Juvenile Pubic Symphysiodesis:* A less invasive surgery for treating hip dysplasia is called Juvenile Pubic Symphysiodesis. This surgery prematurely fuses two pelvic bones together, allowing the other pelvic bones to develop normally. This changes the angle of the hips and improves the articulation of this joint, lessening the likelihood of osteoarthritis. Early diagnosis is critical, since the procedure must be done before 20 weeks of age, preferably 16 weeks, and before any signs of arthritis are evident.


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## tbliss (Mar 26, 2009)

The vet that wanted to us to let her perform the test is not an orthopedic specialist. If she determined that the test result indicated that the pup was predisposed to hip dysplasia, she told us she would refer us to an orthopedic surgeon who could perform an operation on the hip socket that would prevent the HD from developing. It also seemed to us like the procedure could cause problems, which is why we switched vets. Thanks to everyone who offered thoughts on this issue--this is such a helpful resource for a new golden owner.


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## jdloc (Nov 11, 2009)

*WASTE OF TIME Had to Reply*

I am from Franklin MA also and probably go to the same local vet that wanted to do this test. I asked them why they told me about JPS that it must be done within 16 weeks. Of course I want to give my do the best care. Here's the catch they told me my dog tested postive during this test and to go get A PENNHIP TEST (which they can't do) to see how severe it is and if we need JPS. I just wasted over $200.00 on this test when I could have just gone to a Pennhip certified vet in the first place but obivously they want MONEY for a useless test.


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## cubbysan (Mar 13, 2007)

Out of curiousity was this vet in Bellingham?


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## Willow52 (Aug 14, 2009)

I believe I'd be changing vets. I've always had large dogs and never has this sort of test been suggested. Sounds like a procedure that you come to find out later on causes more harm than good.


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## tbliss (Mar 26, 2009)

Yes, the vet that was the subject of the original post is in Bellingham. We also thought that the test sounded like it was probably unnecessary or worse, might cause problems. As such, we started going to a new vet, with whom we have been very happy.


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## Pointgold (Jun 6, 2007)

I'd be very interested in seeing how the puppies in question might rate, at 24 months, with a standard OFA view radiograph. The entire thing smells funny to me... an ortho specialist who isn't doing PennHip? Doing Ortolani tests, sending them to another vet for PennHip to diagnose _severity, _then rx'ng JPS... this reminds me of a sort of "scam" (for lack of a better word) that was going on in southern CA in the late 80's, early 90's - one or two clinics there were doing the then relatively new TPO on pretty nearly every Golden that came through their doors - whether needed or not - the diagnostics were, shall we say, "questionable". We had a puppy that we'd sold to a couple who wintered there set up for the TPO - _double - _at 8 months old, after they took her in for a slight limp. The vet told the owner that because the dam was a Fair, this dog would be unable to walk at all before she was 2. The owners called me absolutely _screaming _at me for being such an irresponsible breeder, and for lying to them, and that I was going to have to pay th $6000 in surgery, etc etc. I asked that they take her to another vet for a second set of rads (the vet of a Golden breeder friend further north in CA), and that I would pay their expenses to get her there as well as the vet bill to do the rads. Her hips were beautiful. Her intermittent lameness was due to the fact that she'd jumped off their deck and torqued her knee. Huh. Imagine that.


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## jdloc (Nov 11, 2009)

Yes it was Bellingham I didn't post the whole story yesterday, when they recommended that my dog have the test of course I booked it. My dog had no problem walking, running or showed any signs of a problem.
I did some research on the internet before this appt and came across Pennhip testing and OFA testing. I called them back to question why I should bother having this test and not Pennhip or OFA. They said the Ortolani test was to check there hips and must be done before 16 week (put some fear in you) so I did it and they thought there might be a problem. Like I said before they are recommend I get my dog Pennhip tested which is the same test I asked them about but they ARE NOT CERTIFIED to preform that test. Pennhip & OFA will tell you everything an Ortolani test does and more. So basically I feel like I was taken advantage of becuase if they were HONEST with me they would have told me "Yes you are better off doing the Pennhip test" So I wasted over $200.00 on this useless test only to be told to go to a specialist and get Pennhip test which cost another $350.00. 
I would appreciate if you could please recommend another Vet in the Franklin area that you are happy with.


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## Pointgold (Jun 6, 2007)

jdloc said:


> Yes it was Bellingham I didn't post the whole story yesterday, when they recommended that my dog have the test of course I booked it. My dog had no problem walking, running or showed any signs of a problem.
> I did some research on the internet before this appt and came across Pennhip testing and OFA testing. I called them back to question why I should bother having this test and not Pennhip or OFA. They said the Ortolani test was to check there hips and must be done before 16 week (put some fear in you) so I did it and they thought there might be a problem. Like I said before they are recommend I get my dog Pennhip tested which is the same test I asked them about but they ARE NOT CERTIFIED to preform that test. Pennhip & OFA will tell you everything an Ortolani test does and more. So basically I feel like I was taken advantage of becuase if they were HONEST with me they would have told me "Yes you are better off doing the Pennhip test" So I wasted over $200.00 on this useless test only to be told to go to a specialist and get Pennhip test which cost another $350.00.
> I would appreciate if you could please recommend another Vet in the Franklin area that you are happy with.


So, has dysplasia actually been diagnosed in your dog??


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## tbliss (Mar 26, 2009)

jdloc said:


> I would appreciate if you could please recommend another Vet in the Franklin area that you are happy with.


 
We switched from our original vet in Bellingham to Dr. Daniel Castillo, who owns Franklin Veterinary Hospital. We chose him based on the recommendation of several friends and we have also been happy with him. We have also found their prices to be more reasonable.


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## cubbysan (Mar 13, 2007)

tbliss said:


> We switched from our original vet in Bellingham to Dr. Daniel Castillo, who owns Franklin Veterinary Hospital. We chose him based on the recommendation of several friends and we have also been happy with him. We have also found their prices to be more reasonable.


 
I know many people that are happy with Dr. Castillo, too. They can't say enough about him.

I feel very bad about the vet in Bellingham. I no longer go there because I just moved out of state, but have been bringing my pets their since 1976, and have always trusted all the vets and help there. One of the vets there just recently bought the practice from the owner who retired, and I know she is changing a lot of the practice - but I thought for the good.


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## Pointgold (Jun 6, 2007)

Please, can any of you who were asked to do the Ortolani test tell me if your dogs have actually been diganosed as having hip dysplasia?


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## jdloc (Nov 11, 2009)

Hip Dysplasia happens overtime not in 16 weeks so basically the JPS surgery is supposed to prevent it. So there will be puppies that under go JPS surgery who would never develop hip Dysplasia. I sent my x-ray to someone who is a breeder (not the breeder of the dog) and has been Pennhip testing all his dog and is very familar with what he sees. This is his response to the X-ray they gave me. 

*Total scam







, you should report them to whatever authority oversees such things where you live.*
HERE I'LL BREAK IT DOWN FOR YOU REAL SIMPLE.
1st whoever took the x-ray had no idea of taking a good film







, *or they were really good at it.* I think #2 comes into play in this money making scam.
The growing pups bones are soft and pliable much like a babies. Making it more able to survive unscathed the rigors of growing up without permanent _(most times fatal in the wild)_ damage. Hips tighten as they mature, in Dave Farnetti's film with, he (DF) talks about a dog he ruined having hip surgery too early to tighten the sockets, (I think at Cornell).
*The X ray film is shot with the tail to the left side (on purpose) thus rotating a loose puppy hip girdle to the left elongating the socket on the right.* 
My vet wont even shoot a hip film without sedating the dog, to ensure 100% proper placement, I've been using the same guy for over a quarter century

I don't like this x-ray and I sure wouldn't use it to determine anything about my dog. I don't see very deep sockets but that doesn't mean a whole lot being that the dog is so young and the positioning of the pup in the x-ray is horrible. This vet is obviously preying on your fear and love for this pup to squeeze you for money. As I said before when we talked. I wouldn't worry until the pup shows signs of pain and then I would get a PennHIP evaluation. It is a non-subjective test that will tell you if there is signs of degenerative joint disease and the #1 cause of HD/DJD which is hip joint laxity. You can learn what you need to know from this test. However, if your not going to breed the pup I wouldn't worry about taking a hip x-ray until or if the pup shows signs of pain or limping. I definately wouldn't do a preventitive surgery on a pup that isn't showing any signs of pain. The % of good things coming from this surgery are extremely low. I would switch vets first thing and then wait and see how my pup does before I did anything else.


Above are a few people opinions that have over 25 years experiance with the breed.


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## Pointgold (Jun 6, 2007)

jdloc said:


> Hip Dysplasia happens overtime not in 16 weeks so basically the JPS surgery is supposed to prevent it. So there will be puppies that under go JPS surgery who would never develop hip Dysplasia. I sent my x-ray to someone who is a breeder (not the breeder of the dog) and has been Pennhip testing all his dog and is very familar with what he sees. This is his response to the X-ray they gave me.
> 
> *Total scam
> 
> ...


 
Thanks - this is exactly what I was getting at. It would appear that this is a very similar situaton to the one in SoCal years ago.


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## jdloc (Nov 11, 2009)

I am not saying that my dog is or isn't at risk for HD. I just wanted to post to let everyone know that you are wasting your money on an Ortolani test. If you are concerned about your puppy then you should get the most accurate nonsubjective test which is a Pennhip or OFA.

I called the specialist and guess what they do their own diagnostics $179.00 min for x-rays sedation etc, etc. I hope with these posts I prevent at least one person from being taken advantage of. Like I said I questioned them on why I should be having them preform this test and not have a Pennhip elsewhere.


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