Veterinarians were asked for their opinions on how to manage one of two orthopaedic cases which were having trouble getting up, had restricted movement in both hips, and acute pain in one hip. In fact both case histories were exactly the same except that one was a 4 year old black Labrador, the other was a 14 year old black Labrador. One of 4 main options were proposed by the veterinarians, as shown in the following figure :

Key 

N-X  Give a non-steroidal anti-inflammatory drug (NSAID) followed by XRay if no improvement

X-N  Take XRays followed by NSAIDs

S-X-N  Conduct blood screening, followed by XRays followed by NSAIDs

S-N-X Conduct blood screening, followed by NSAIDs, followed by XRay

Surgery was an additional option mentioned by 8 veterinarians - but only for the 4 yr old dog

There is a clear difference in the way in which veterinarians decided to manage these cases simply based upon the age of the dog, even though they should be probably be managed in exactly the same way from a scientific and clinical point of view. The key differences were as follows :

• Older dogs were more likely to be given NSAIDs as a first line of treatment than young dogs

• Young dogs were more likely to have XRays taken to confirm the diagnosis before treatment is administered. 

• Young dogs were unlikely to have blood screening performed either before anaesthesia for XRay or prior to the administration of NSAIDs

• Surgery was considered as a treatment option only for the young dog. 

It is a matter of concern that a large number of veterinarians did not consider blood screening as being necessary for the 14 year old dog either prior to anaesthesia for XRay or prior to NSAID administration

Updated January 2016