Dog Hip Dysplasia

The hip joint is a ‘ball and socket’ joint, this normally fits together perfectly to enable easy and smooth movement. However, when a dog has hip dysplasia their ball joint (head of the femur) and socket joint (socket of the pelvis) have developed incorrectly and don’t fit together as they should. It may be that the socket is too shallow or the ball is not fully formed or a combination of the two, meaning the joint is too loose.

This in turn causes the joint to be unstable and move excessively, leading to pain, swelling and inevitably arthritis. Hip dysplasia can occur in any dog; however it is most commonly seen in larger, pedigree breeds such as Labradors, Rottweilers and German Shepherds although it can also affect smaller dog breeds such as Pugs and French Bulldogs.

Some dogs respond very well to non-surgical treatments through weight, controlled exercise, and a hip brace. If your dog improves with treatment, it’s possible for them to live a long and happy life.

Early Signs and Symptoms of Hip Dysplasia

Symptoms of hip dysplasia in dogs usually start while they’re growing. These can vary depending on the severity of the condition. Recognising the early signs of hip dysplasia means prompt intervention and improved quality of life for your dog.

Onset of clinical signs vary but it’s most commonly diagnosed between 6 and 12 months of age. Symptoms can start from as young as four months of age. So, if you notice your puppy is displaying any of these symptoms, take them for a veterinarian check-up.

Older dogs may develop it simultaneously with osteoarthritis as they get older.

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 dogs are:

• Being reluctant to exercise, or a wobbly or swaying gait
• A bunny-hopping gait (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
• 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
• “Skinny hips”, a sign of lack of weakness and reduced thigh muscle mass and/or noticeably enlarged shoulder muscles
• Signs of being in pain

What should I do if I think my dog has hip dysplasia?

Taking prompt action is key when you suspect hip dysplasia in your dog. Your vet will do 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. Your vet will then likely refer your dog to a specialist Orthopaedic surgeon.

The Orthopaedic surgeon will carry out a thorough assessment. This includes the ‘Ortolani’ test - a manipulative test for evaluating hip joint laxity. Your dog will likely be heavily sedated, or even put under general anaesthetic, for this.  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 a treatment plant.

There are a number of causes of hip dysplasia, these include rapid growth, excessive weight gain, poor nutrition and genetic factors.

The reason for most dogs developing hip dysplasia is due to inheriting the trait from one or both of their parents. It is seen much more commonly in pedigree dogs than in cross-breeds, although cross-breeds from pedigree parents are also at risk. Because of the known genetic link, it is possible to screen for hip dysplasia before two dogs are mated and is something which you should check for before buying a puppy.

Over-exercising or doing activities which cause strain on joints, such as repetitive jumping when your dog is young and developing, will also increase their chance of developing hip dysplasia. Similarly, dogs which are overweight while young or fast-growing dogs are at an increased risk.

Hip dysplasia causes instability in the hip joint, so it moves excessively. This leads to pain, swelling, and, inevitably arthritis. Inside the joint, there could be microfracturing of bone and cartilage surfaces, because they’re rubbing past each other. The hip stabilisers, which are too lax, could also cause repetitive strain injuries. Cartilage starts eroding, ultimately resulting in the development of Canine Osteoarthritis. This makes movement in the hip joint very painful.

Genetics:

• Genetics play a significant role in the development of hip dysplasia. Dogs 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, Golden Retrievers, and Great Danes.

Because of the known genetic link, it’s possible to screen for hip dysplasia before two dogs are mated. It’s something to check for before buying a puppy.

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.
• Rapid growth and weight gain:

Fast Growth/Excessive Weight Gain:

• 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.

Nutrition:

• 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:

• 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 factors:

• 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. 

Can I do anything to prevent my dog from developing hip dysplasia?

Preventing hip dysplasia in dogs is possible in some cases. Preventative measures should be started as early as possible in a puppy’s life to be effective. While not every case can be prevented, certain measures can minimise the risk:

• Healthy & Appropriate Nutrition for Puppies: A balanced diet supports proper bone and joint development in growing puppies. One study showed that two thirds of puppies in a high-risk group, who were allowed to eat as much as they wanted, went on to develop hip dysplasia. By comparison, in another group only fed measured meals, only one third of the puppies went on to develop it. 

A separate study of German Shepherds found that the puppies who were overweight were twice as likely to develop hip dysplasia than the puppies who were a healthy weight. 

Make sure your puppy’s getting the right balance of calcium and phosphorus. Consult with your vet if you’re not sure. 

Proper nutrition allows your puppy’s skeletal system to grow in a healthy and balanced way, and is the foundation for healthy bone and joint development.

• 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.
• Regular Exercise: Low-impact activities, such as swimming or leash-walking, can maintain muscle strength without putting excessive strain on joints.
• Orthopaedic Bedding: Providing comfortable and supportive bedding helps reduce pressure on joints during rest.
• Regular Vet Check-ups: Early detection and intervention can make a significant difference in managing hip dysplasia.
• Genetic Screening: When considering getting a puppy from a high-risk breed, ask your breeder if the puppy’s parents have been screened for the condition. You could also consider getting X-Rays to screen your dog for Hip Dysplasia. The British Veterinary Association (UK) and Kennel Club (KC) run the Hip Dysplasia Scheme to assess these X-Rays, which is overseen by a central body. Your vet can organise your participation in this scheme if you’re in the UK.  You should also enquire if your breeder is part of it.
• Supplements: Joint supplements, particularly those which contain glucosamine, can be used for dogs that are from high-risk breeds as part of a programme to keep joints healthy. 

What age does a dog get hip dysplasia?

Dogs with hip dysplasia usually begin showing symptoms while they’re growing. It can often show up in young puppies between 5 and 12 months old, but sometimes even as early as 4 months old. 

In other scenarios, clinical signs won’t be obvious until a dog’s older. Some dogs with a mild form of the condition, won’t show signs until they’re much older however, and have developed arthritis of the hips. Bone gradually deteriorates over the years, until a dog is obviously symptomatic.

What Dog Breeds Suffer from Hip Dysplasia?

Hip dysplasia can develop in any breed of dog but large-breed and large mixed-breed dogs are more statistically predisposed to it.  Bernese Mountain Dogs, Great Danes, German shepherds, Saint Bernards, Labrador retrievers, Golden Retrievers, Old English sheepdogs, Newfoundland, Rottweilers, and bulldogs are all high-risk breeds.

Treatments for Dog Hip Dysplasia

Dog hip dysplasia treatment options vary depending on the severity of the hip dysplasia and the level of pain your dog is experiencing from it. Sadly, once a dog has developed hip dysplasia, it cannot be reversed and so treatment and management is either surgical or non-surgical (conservative).

Non-surgical treatment for hip dysplasia in dogs includes:

• Weight Management - By keeping your dog slim and at a correct healthy weight, this reduces strain on the affected joint(s). 
• Limiting Activity - By limiting the kind of activities your dog’s doing - for example, short, regular walks on the lead. Try to minimise as much as possible the amount of jumping your dog does. For example, on and off the sofa, in and out of the car, or up and down the stairs, etc.
• Hip Dysplasia Braces for Dogs - Supporting your dog with a hip brace such as the Orthodog Hip Brace. These orthopaedic braces for dogs are designed to hold your dog’s hips firmly together, reducing pain and improving mobility. They give your dog the support and confidence they need in their everyday lives, as well as when out for a walk. Hip braces can help align the joints properly and control excessive range of motion which might be worsening damage to the joints.
• Anti-Inflammatories & Painkillers - They can help reduce the pain which your dog might be experiencing with hip dysplasia. Gabapentin, Tramadal, or Amantadine may all be prescribed as dog hip pain relief. Dogs who are in severe pain may be given polysulfated glycosaminoglycan injections regularly. 
• Joint Supplements - Giving your dog a joint supplement, such as YuMove, to help slow the progression of arthritis and reduce any joint pain resulting from this. Omega 3 supplements have anti-inflammatory properties.
• Physiotherapy & Hydrotherapy - A treatment plan will be designed for your individual dog, and will take into account any future problems that might develop. It will likely include exercises for your dog at home. Hydrotherapy means that the hips aren’t weight bearing and helps rebuild the weakened hind leg muscles. It also maintains cardiovascular health.
• Alternative Treatments - Stem cell therapy, laser therapy, extracorporeal shockwave therapy (ESWT), CBD oils, canine massage therapy, and acupuncture can all be tried to see whether they help manage your dog’s hip dysplasia. Ask your vet if you’d like more information or their opinion on any of these options.

Post-surgical care often looks similar to conservative management.

If your dog does require surgery for their hip dysplasia, then much of their ongoing care post-operatively involves the same treatment as outlined above. Limited and controlled exercise, weight management, use of a supportive brace, anti-inflammatory painkillers and joint supplements to help support healthy joints and mitigate the onset of arthritis.

If your dog requires surgery, there are different types of operations. Some modify the hip anatomy. Some are to arrest the damage being done and are known as ‘salvage’ surgeries. Your dog’s age, condition, and lifestyle will determine what type of surgery is undertaken.

• 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.

The technique has recently been 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.

How to help around the house

There are a number of ways in which you can help your dog manage their hip dysplasia on a day-to-day basis when at home.

• Getting your dog some rubber anti-slip socks or boots will prevent your dog from slipping, giving them support and traction, especially on wooden or slippery floors.
• Try to keep your dog’s bed at a low height, so they don’t need to climb into or out of it. Similarly, minimise doing up and down stairs or jumping on and off the sofa too much. Ramps can be helpful.
• A rear lift harness can help you help your dog get in and out of the car, reducing pressure on the hip joint.
• If your dog needs stimulation but exercise is limited, then something like a snuffle mat

Conclusion

Hip dysplasia can pose significant challenges for dogs, affecting their overall well-being and mobility. However, treatment, either surgical or conservative, can keep dogs with hip dysplasia comfortable into old age. 

Recognising the symptoms, seeking appropriate treatment, and implementing preventive measures are essential for managing this condition. Conservative management, including orthopaedic hip braces for dogs as a non-invasive pain relief solution, will improve the quality of life for a dog with hip dysplasia. 

Working closely with your veterinarian and staying proactive in your dog's healthcare will make a meaningful difference in preventing or managing hip dysplasia.