How to Care for your German Shepherd with Hip Dysplasia

If you want a dog who’s loyal, courageous, and highly intelligent, look no further than a German Shepherd. 

The breed is known for its tall, graceful, muscular, and agile physical presence. German Shepherds enjoy learning commands and will pick them up quickly. As with any dog, but particularly large dog breeds, German Shepherds do need training and socialisation. It’s not a coincidence that they’re chosen as guard dogs - sometimes they can seem intimidating, because they will throw themselves in harm’s way to protect others. However, they’re also family dogs with a great capacity to love. This is why they generate such devotion in their owners.

German Shepherds do well on lots of mental stimulation - if a German Shepherd’s bored, they’ll let you know by barking a lot!  They also need good amounts of exercise and can run up to 30mph. Suitable activities for German Shepherds include agility, hiking, herding, and tracking. Some enjoy dock diving. Enrichment activities are also right up their street.

Germans Shepherds are predisposed to certain health conditions

Hip and elbow dysplasia feature very highly on the list. 

Hip dysplasia is one of the most pressing health issue concerns for German Shepherd owners. Figures from various studies done show that the proportion of German Shepherds affected possibly ranges from 18% to 49%. The breed seems to have a much higher risk of developing hip dysplasia even than other large breed dogs that are vulnerable to it, such as Dobermans, Labradors, and Rottweilers. 

Learning about German Shepherd hip dysplasia, and understanding how to identify the early signs of it, will help you catch it early should it develop, and therefore manage it more effectively.

They are also prone to suffering from degenerative myelopathy (DM) a terminal degenerative neurological disease that causes paralysis; exocrine pancreatic insufficiency (EPI) whereby the pancreas doesn’t produce enough enzymes, causing poor digestion and nutrient absorption; bloat (Gastric Dilation Volvulus) where the stomach fills with gas and twists on itself (GDV), Panosteitis (AKA growing pains, where the outer shaft or surface of the long bones of the legs becomes inflamed), allergies, hemangiosarcoma (cancer), and cauda equine syndrome (lumbosacral disease caused by narrowing of the spinal canal, resulting in compression of the spinal nerve roots).

If your Dog is Diagnosed with Hip Dysplasia, Your Priorities Are: 

• To slow the progression of the disease
• To help lessen the pain that hip dysplasia is causing your dog (osteoarthritis is an inevitable secondary condition of hip dysplasia, and also contributes to any pain your dog’s experiencing)
• To minimise the impact of the disease on your dog’s well being, mobility, and quality of life. The right strategies can, in most cases, help with all of these objectives. 

This Guide will take you through the condition, how to look out for it, what to do if your German Shepherd is diagnosed, and what steps to take to minimise the likelihood of your German Shepherd developing it.

Ensuring your German Shepherd has at least annual veterinary checks, or perhaps every six months as they get older, will help you to keep an eye out for any sign of hip dysplasia in your dog, or indeed any of these conditions.

German Shepherd Hip Dysplasia - Definitions and Causes

It’s important to understand hip dysplasia in German Shepherds, so that you’re able to recognise the symptoms of hip dysplasia in dogs should yours become afflicted by it. You’ll then know how to manage it if your dog does develop it.

By following the right strategy, even with hip dysplasia, your German Shepherd can still thrive and maintain a good quality of life.

So what is hip dysplasia?

Dog hip dysplasia is when the ball of the thigh bone (femur) doesn’t sit properly in the ‘socket’ of the hip joint. Usually they sit together very well to allow smooth and easy movement. 

With hip dysplasia however, the bones rub together painfully, instead of gliding smoothly against each other. This can happen because the hip ligament is too lax (loose), which means the joint is unstable and results in the hip and thigh bones meeting each other in the wrong place and with the wrong amount of pressure, resulting in the hip socket becoming deformed. Or it can happen because the hip socket is already abnormally formed e.g. too shallow or the ball of the femur not properly formed.

Either way, the hip joint ends up being loose and unstable. It moves too much. This ends up causing pain, swelling, and arthritis. It can also cause the hip cartilage to be damaged and deteriorate, making the situation even worse.

As discussed above, hip dysplasia in German Shepherds has a genetic component. This means that in some cases it will develop whatever preventative measures are taken. However, if you know your German Shepherd is at risk, taking certain precautions can mean the development of hip dysplasia can be slowed down or, to a certain extent, controlled. Hip dysplasia is also irreversible, meaning it can’t be cured.

Signs of Hip Dysplasia in your German Shepherd

Some German Shepherds will display signs of hip dysplasia while they’re still growing and immature. Symptoms vary depending on the severity of the condition. Onset of clinical signs vary but it’s most commonly diagnosed between 6 and 12 months of age. These signs can start from as young as 4 months. So if you notice your puppy is displaying any of the below signs, take them for a veterinary check-up. 

In older German Shepherds, hip dysplasia is often diagnosed alongside osteoarthritis which inevitably develops as a secondary condition to hip dysplasia.

Hip dysplasia symptoms vary, depending on its severity. Inflammation levels, joint laxity, and length of time your dog’s been suffering from it, will also affect how symptoms present themselves.

The Most Common Signs of Hip Dysplasia in German Shepherds are:

• Being reluctant to exercise
• A wobbly or swaying gait, or back legs crossing over
• Bunny-hopping (using both hind legs together)
• Stiffness, lameness or limping, particularly in the hind legs
• Difficulty in getting up or lying down, as well as difficulty in going up or down stairs or jumping
• “Skinny hips”, a sign of a reduced thigh muscle mass and weakness in the hind quarters and/or noticeably enlarged shoulder muscles
• Pain or sensitivity in the hip area
• Audible clicking or popping sounds in the hip joint
• A ‘grating’ feel in the joint during movement
• Sensitivity to being touched in the hip region during grooming or bathing
• Reduced range of motion
• Signs of being in pain

If you see your German Shepherd displaying any of these signs, take them to the vet for a check-up. As with many conditions, the longer hip dysplasia is left untreated, the harder it is to manage and the worse it becomes. Prompt veterinary attention can make a significant difference.

What causes Hip Dysplasia in German Shepherds?

There are a number of causes of hip dysplasia, including genetic and environmental factors. These include rapid growth, excessive weight gain, poor nutrition, hormones and genetic factors. It’s currently estimated that there are roughly 100 gene codes for hip dysplasia.

Environmental factors on their own are less likely to cause hip dysplasia. However, they can influence the likelihood that it'll develop in genetically predisposed German Shepherds. 

These factors will also influence the level of severity at which it’ll develop. One very important factor is nutrition. A German Shepherd puppy's growth rate and weight have an effect on how the hip joints develop. So it's important to get nutrition right. While the exact cause of hip dysplasia is not fully understood, these are currently recognised as contributing factors:

Genetics:

• Genetics play a significant role in the development of hip dysplasia. Individual German Shepherds with a family history of the condition are more likely to inherit the predisposition. Most dogs who develop hip dysplasia inherit the condition from one or both of their parents.  It’s seen much more commonly in pedigree dogs than in cross-breeds. Cross-breeds from pedigree parents are also at risk. 

Breeds known for a higher prevalence of hip dysplasia include large and giant breeds such as Labrador Retrievers, German Shepherds, German Shepherds, and Great Danes.

Because of the known genetic link, it’s possible to screen for hip dysplasia before two dogs are mated. Parents’ hip (and elbow) scores are worth checking before buying a puppy. Parents with poor scores will likely produce offspring with an inherited predisposition to developing hip dysplasia.

Joint laxity:

• Hip dysplasia involves abnormal development of the hip joint, leading to instability and laxity. This laxity can result from a genetic predisposition that affects the formation and structure of the joint.

• Fast growth and excessive weight gain in puppies can contribute to the development of hip dysplasia. This is particularly relevant for large and giant breeds, as rapid growth can outpace the development of the joint structures.

• Poor nutrition during a dog's early development, including an imbalance of calcium and phosphorus, may contribute to the risk of hip dysplasia. Providing a well-balanced diet appropriate for the dog's age and size is crucial for skeletal health. Dogs which are overweight while young are at an increased risk of hip (and elbow) dysplasia.

• Environmental factors, such as inappropriate exercise during a dog's growth phase, can contribute to the development of hip dysplasia. Over-exercising or doing activities that put excessive stress on the hip joints, such as jumping or running on hard surfaces, will either increase the chance of hip dysplasia developing, or exacerbate the condition.

• Hormonal influences, including sex hormones, can affect the development of hip dysplasia. For example, females may experience increased laxity in the hip joint during their estrous cycles.

Early detection, appropriate nutrition, controlled exercise, and regular veterinary check-ups are essential for managing and preventing hip dysplasia in dogs. 

Dog Hip Dysplasia Diagnosis

When your German Shepherd’s at the vet, they’ll undergo a physical examination and X-Rays will be taken. Your vet will also possibly recommend blood tests. Generally changes in the hip joint show up on the X-Rays, although that’s not 100% guaranteed.

It’s likely that your vet will refer your dog to a specialist Orthopaedic surgeon.  The Orthopaedic surgeon will carry out a thorough assessment, including the ‘Ortolani’ test - a manipulative test for evaluating hip joint laxity.  To do this, your dog will have to be heavily sedated or put under general anaesthetic.

The ‘Ortolani’ hip dysplasia test

The ‘Ortolani’ test started being used on human children in 1937. It’s considered the ‘gold standard’ early diagnostic test for hip dysplasia. Vets began using it on puppies in 1985. It’s been shown that if the Ortolani Sign is present, it confirms that the puppy will have hip arthritis by the time it’s 1 year old. This exam can be performed by many vets on puppies as young as 10 to 16 weeks of age.

Additional diagnostic imaging might be recommended. X-Rays, CT, and MRI scans are all done under general anaesthetic. At this stage, you’ll probably be given a provisional diagnosis.

When the Orthopaedic surgeon has gathered all the information needed, you’ll be able to discuss the right treatment for hip dysplasia in your dog.

What can you do once your German Shepherd is diagnosed?

The approach you take to manage your German Shepherd’s hip dysplasia will be determined by the severity of the condition, your German Shepherd’s age, and the Orthopaedic specialist’s guidance on whether or not surgery is appropriate.

There are broadly two routes:

1. Conservative Management
2. Surgery

Conservative Management

This means to manage hip dysplasia without surgery, including lifestyle adjustments and rehabilitation. Components of conservative management include:

• Pain management (including LED therapy wraps) and anti-inflammatories (NSAIDS)
• Supplements for joint health e.g. Winstons and Omega 3s 
• Appropriate levels of low impact exercise
• Appropriate nutrition
• Physiotherapy and Hydrotherapy
• Laser Therapy
• A hip brace for dogs
• A dog wheelchair
• Weight control
• Complementary treatments including stem cell therapy, extracorporeal shockwave therapy (ESWT), CBD oils, canine massage therapy, hyaluronic acid injections, PEMF bed, and acupuncture should be experimented with to see whether they improve symptoms and lessen pain. Ask your vet if you’d like more information, or their opinion on any of these options.

It’s worth noting that post-surgical care often looks similar to conservative management. 

Dog Hip Dysplasia Surgery

If your German Shepherd requires surgery for their hip dysplasia, then much of their ongoing care post-operatively involves the same treatments as outlined above. Limited and controlled exercise, physiotherapy, weight control, use of a supportive hip dysplasia brace for dogs, anti-inflammatory painkillers, and joint supplements to help support healthy joints and mitigate the onset of arthritis. 

• Juvenile Pubic Symphysiodesis (JPS)

Part of the pelvis is fused in order to alter growth, so that the location of the ball part of the ‘ball-and-socket’ hip joint is improved. Surgery is simple and involves electrical cauterization of part of the pubis (on the underside of the pelvis). Dogs must be a maximum of 5 months of age for the surgery to be effective. To be eligible, mild-to-moderate laxity will have been confirmed using manipulative and radiographic tests. Dogs usually develop clinical signs when they’re at least 6 months old, so JPS is usually a prophylactic (preventative) surgery. Dogs treated by JPS have to be neutered at the same time.

• Double or triple pelvic osteotomy (DPO/TPO)

Young dogs less than 10 months old (clinically immature) are usually the most suitable recipients of this surgery. The objective of the operation is to improve the function of the ball and socket joint by selectively cutting and modifying the pelvic bone and rotating the segments. As a result, the ‘capture’ of the ball by the existing socket is improved. A custom plate and screws are then used to fix bone segments into their new position. Healing of the bone takes approximately 4-6 weeks. TPO is only effective in dogs that have hip laxity. There can’t be any osteoarthritis or secondary bone remodelling. Suitability for this operation is assessed by a specific series of manipulative tests and radiographs. These tests are  performed by both experienced orthopaedic surgeons and advanced diagnostic imagers. Pre-surgery, it’s also recommended that arthroscopic examination confirms there’s no cartilage damage to the joint. This technique has been recently refined so that the pelvis is only cut in two places (double pelvic osteotomy) rather than three.

• Femoral head ostectomy (FHO) 

It’s possible for both young and mature dogs to have the FHO operation, which is a salvage procedure. The “ball” of the femoral head is cut off. The body then creates a “false” joint and the pain associated with hip dysplasia is significantly reduced. This operation won’t restore normal hip function. Rather, its objective is pain management, because painful contact between the bones of the “ball” and the edge of the hip socket is removed. An FHO is often done when a THR isn’t possible, either for financial reasons or because an individual dog’s makes them ineligible as a candidate for the surgery. Clinical outcome isn’t assured and can be unpredictable. This is especially true for bigger dogs. Intensive physical rehabilitation is essential after this surgery to make it worthwhile, so that your dog’s able to return to a meaningful level of mobility and activity.

• Total hip replacement (THR) - 

This is the most effective canine hip dysplasia treatment. The entire diseased hip joint is cut out and replaced with plastic (“the socket”) and metal (the “ball”) implants. Hip function returns to a more normal range. This surgery also eliminates most of the pain and discomfort of hip dysplasia, because bony surfaces are no longer in contact with each other. There’s a high success rate for THR - up to 90-95% of dogs. Most will return to full levels of activity.

Other considerations

As part of managing your German Shepherd’s hip dysplasia, it’s worth addressing their diet and nutrition to ensure that they’re at the right weight and get the right food to ensure that they’re getting the right nutrition. Consult with your veterinarian and physiotherapist about an appropriate exercise routine. Any high impact exercise, such as jumping or twisting to catch balls, should be avoided. German Shepherds generally love to swim, and hydrotherapy is one way you can maintain your German Shepherd’s cardiovascular fitness and start re-building any lost muscles, without putting undue pressure on their hip joints. It’s likely your physiotherapist will give you exercises that your dog can do at home under your supervision, to keep their core muscles activated and engage the correct muscles to support the biomechanics of the hip. 

Living with a German Shepherd with Hip Dysplasia

• Quality of life - It’s essential your German Shepherd’s quality of life is good. In particular, the osteoarthritis that accompanies German Shepherd hip dysplasia, can be excruciatingly painful. If your German Shepherd’s mobility is being compromised, it might be time to consider a wheelchair. German Shepherd wheelchairs take the weight of a dog’s pelvis so that it’s not having to bear too much weight, while still allowing the rear leg muscles to activate. This allows dogs to regain their mobility and independence, without putting stress on the hip joints. Being mobile will contribute to your German Shepherd’s well being and overall enjoyment of life.

Generally, well managed hip dysplasia shouldn’t impact your German Shepherd’s life expectancy. German Shepherds with hip dysplasia can generally expect to live long and happy lives. However, if you’re worried about quality of life, discuss everything with your vet. This questionnaire asks the right questions to help you assess your German Shepherd’s quality of life.

• Emotional support for owners (facebook sites) - Many dog owners are caring for German Shepherds with hip dysplasia. Support groups online can provide a wealth of information and support. You’ll find people who’ve already been through what you’re going through and will have ideas, tips, and tricks on how to deal with the challenges. 

• https://www.facebook.com/groups/dogswithhipdysplasia/ - run by a physiotherapist and focused solely on conservative management

• https://www.facebook.com/groups/caninehipdysplasiasupport/ - run by a physiotherapist and focused solely on dogs recovering from hip dysplasia surgery

• https://www.facebook.com/groups/1412067702452517/posts/3736108743381723/?notif_id=1709402693464654&notif_t=group_post_mention&ref=notif - is a general support group run by owners of dogs with hip dysplasia.

• https://www.facebook.com/groups/1746052355456532 - a general support group for dogs with arthritis, which commonly accompanies hip dysplasia as a secondary condition

• https://theGerman Shepherdforum.com/threads/hip-dysplasia-any-advise.23836/  - a breed specific forum

• Further Reading:

• Dog Owner’s Guide to Hip Dysplasia

• My Dog Has Hip Dysplasia but Lives Life to the Full

• Hip Dysplasia in Dogs: A Comprehensive Guide for Dog Owners

• The Canine Rehab Hub website

Adapting your German Shepherd’s environment

There are adaptations you can make to your home to ensure that your German Shepherd with hip dysplasia is as comfortable as possible, and minimise the likelihood of any injuries associated with the hip dysplasia occuring.

• Orthopaedic dog bed - Keep your German Shepherd comfortable while they’re resting or sleeping, by ensuring that their bed provides good joint support

• Non slip socks or put down floor rugs - If you have wooden or slippery floors it makes it harder for your German Shepherd with hip dysplasia to get up because they have less purchase. As the hip dysplasia weakens the muscles of their rear end, they also have less control over their back legs. This means their rear legs can also slide and splay out sideways, potentially causing them pain and discomfort.

• An adjustable dog ramp - If your German Shepherd is keen on being on the sofa, or sleeping on your bed, a ramp means that they can get on and off easily without the impact on their hip joints of jumping up and down.

• A rear-lift harness - Lifting a German Shepherd with hip dysplasia in and out of the car is so much easier on both you and your dog with a rear lift harness. They’re also useful for helping your dog up if they need to go outside to do their business but find it a struggle to get up from lying down. The Help ‘Em Up Harness is particularly popular.

• Snuffle mats - If your German Shepherd is used to being more active and is finding life a little boring because of exercise limitations that come with hip dysplasia, try a snuffle mat or other enrichment toy to keep them mentally stimulated.

Prevention of hip dysplasia in German Shepherds?

As German Shepherd hip dysplasia is often an inherited genetic condition, it can sometimes be impossible to prevent. However, limiting the factors (e.g. overexercising, obesity etc) that contribute to its development can make a significant difference to the level of severity with which hip dysplasia presents.
In particular, consider:

• Screening - If you’re thinking of buying a German Shepherd, ask to see the hip and elbow scores of both parents. In the UK, A hip score is when the hips have been x-rayed and graded by a panel of expert BVA vets. The lowest score is 0 and the highest is 53 - so for both hips the lowest score is 0 and the highest score is 106.  The lower the score, the better. Parents with poor hip scores are likely to have offspring with joint issues. You should get a puppy with parents who’ve got good scores, according to the breed-specific statistics. The mean score of a German Shepherd tested at 5 years of age is 13 and the median score is 11.

• Rate of growth in puppies - Controlling how fast your German Shepherd puppy grows can mean the difference between them developing hip dysplasia or not. When a German Shepherd puppy grows too fast, it means bones can develop at different rates. If different bones grow at different rates out of sync, that’s when problems occur (such as the ‘ball’ of the thigh bone not fitting properly into the hip socket). So German Shepherd puppies should be fed an appropriate diet and kept at a lean weight during their growing years. Don’t give in to the temptation to overfeed your German Shepherd puppy so that they become ‘big and strong’. Studies have shown that 70% puppies who were overfed then developed hip dysplasia. 

• Weight control - From puppyhood onwards, keep your German Shepherd at the right weight. A lean German Shepherd means that there’s no extra stress or pressure being put on the hip joints. Extra stress on the hip joints is closely connected to the development of hip dysplasia.

• Appropriate exercise - It’s generally understood that overexercising a puppy can lead to hip dysplasia. Not every vet agrees with this theory, citing a lack of evidence to prove it, but what is certain is that exercising your puppy the right amount is important for their health and wellbeing. Ask your vet for guidance on how much exercise your German Shepherd needs at each stage of their life, particularly as German Shepherds are energetic and playful characters.

• Spaying / Neutering - Consider waiting to neuter your dog until they’re fully mature. Evidence suggests that spaying or neutering at a young age might lead to a higher incidence of hip dysplasia. This might be because hormones, or lack of, may influence ligament laxity.

Zoomadog Case Studies:

Zoomadog has helped many dogs with hip dysplasia, including a number of German Shepherds. The following products are all helpful for German Shepherds with varying levels of hip dysplasia. If you’re unsure about what your dog needs, please contact us by phone or email us at woof@zoomadog.co.uk

• Non Slip Socks - These will give your German Shepherd purchase on slippery floors. Anti Slip socks will help your German Shepherd get up from lying down and will also prevent their back legs from splaying out and potentially causing more injury to the dysplastic hip.
• Supplements - There are many joint supplements on the market. Zoomadog stocks those that contain premium ingredients and have successful track records.

• Winstons Joint System 100% Natural Dog Joint Repair is a popular supplement made of natural ingredients. 

• Winstons Pain Formula is a natural formula that can be taken alongside prescription pain medication and then, as it starts to take effect - because it’s natural it can take a few weeks for visible improvement in pain - you can then start to taper off the prescription medication. 

• YuMove Joint Care + is a higher strength formula of YuMove’s best selling joint supplement. This strength supplement isn’t available to buy on Amazon or other retailers. 
• Flexerna Omega 3s Omega 3 oil are anti inflammatory, as well as being good for your dog’s coat and skin. Flexerna Omega 3s use green lipped mussel oil for full efficacy.

• Glycan Aid HA Glucosamine and Hyaluronic Acid for dogs: Trials have shown that Glucosamine can positively affect dogs with joint pain and osteoarthritis. This supplement has both glucosamine and hyaluronic acid, another substance that’s believed to help with joint pain through lubricating and cushioning the joint.

• Hip Dysplasia Brace for dogs - Dog hip braces are designed to draw and hold the femurs back into the hip sockets, as well as giving support to your dog’s lower back. They’re helpful as part of a conservative management plan, or pre- and post-surgery. If your German Shepherd’s having hip surgery, consult with your vet about when’s the appropriate time for your dog to start using a hip brace.
• Balto Life - Dog Hip Dysplasia Brace This dog hip brace is suitable for all degrees of hip dysplasia, and can also help with osteoarthritis in the hips. The brace is designed to reduce pain by exerting compression on your German Shepherd’s hips. Made of breathable, washable material.
• Orthodog Dog Hip Brace This hip brace for dogs stabilises your German Shepherd’s hips and lower back area. If your German Shepherd likes swimming, as many do, they can swim wearing this brace. Just make sure you rinse it afterwards with lukewarm water and a gentle detergent, and drip dry it (don’t put it in the dryer).

• Wheelchair - wheelchairs are amazing for giving your German Shepherd back their independence and mobility. As long as your German Shepherd has two strong, good front legs, and a desire to keep seeing the world, then a wheelchair can be transformative for a German Shepherd with severe hip dysplasia. 

German Shepherd Wheelchair You will need to give us your German Shepherd’s weight, back leg length (measured as if your GSD is standing normally - not fully extended - this measurement can be taken with your German Shepherd lying down) and your German Shepherd’s ATR (armpit to rump measurement). See the diagram below:

Dotty the German Shepherd: “Our 14 year old German Shepherd who has arthritis in his spine and is losing the use of his back legs, took to it very quickly.  We have been walking him using a harness for the last year so he is very strong in his front end which I think has helped…We are building up to a 10 minute walk slowly, but signs are good that it will help him walk a bit further and help our backs too!”

Conclusion

Seeing your beloved German Shepherd in pain, and losing their usual energetic, athletic, and graceful manner all because of hip dysplasia, can be stressful and upsetting.  However, taking the correct steps, with a focus on reducing pain, halting the progression of the condition, and maintaining your dog’s mobility and quality of life, means that you can make a significant difference to your German Shepherd’s experience of hip dysplasia. Even simple changes, like ensuring your German Shepherd is at the right weight, and getting non-slip socks if you have slippery floors, can make life much easier for a German Shepherd with hip dysplasia.