A Vet’s Guide to Hip Dysplasia in Dogs


Hip dysplasia (HD) is an inherited, painful joint condition in dogs that can affect their quality of life. Fortunately, a good understanding of the condition can go a long way towards its management. Here we look at what HD is and some of the things you and your veterinarian can do to help your dog live with this joint problem.

What is Canine Hip Dysplasia?

Hip dysplasia is a developmental abnormality of one or both hip joints, most commonly seen in large breed dogs. The hip is a ball and socket joint: the head of the femur (the ball) fits into a socket in the pelvis.

Affected dogs are born with normal hips but develop a laxity (looseness) in the ligaments and joint capsule that hold the ball in the hip socket. Instead of sliding smoothly over each other, the ball and socket rub and grind together. This abnormal movement damages the joint cartilage, causing pain, arthritis, and loss of function.

Causes of Hip Dysplasia

Hip dysplasia in dogs is caused by a combination of genetic and environmental factors. We know that genetics play a role as some breeds are particularly prone to hip dysplasia. These are mostly large breed dogs like German Shepherds, Labrador Retrievers, and Rottweilers.

Risk factors associated with the development of HD in genetically predisposed dogs include:

  • Early neutering (before 6 months)
  • Housing on a slippery floor up to weaning age (such as newspaper)
  • Access to stairs in the first 3 months of life

Signs of Hip Dysplasia

Hip dysplasia is often detected between 5 months and 1 year of age. However, the severity and signs of the condition vary, meaning that dogs may not be diagnosed until they are a little older, when the changes in the hip joints are more advanced. Common signs include:

  • Hind leg lameness
  • Reluctance to exercise
  • Reluctance to run or jump
  • Stopping to sit down on walks
  • Hip swaying
  • Bunny hopping

As the condition progresses and arthritis develops, affected dogs typically become stiff after rest, and lose muscle in their back legs. Conditions that can resemble HD include other causes of arthritis, and cranial cruciate ligament disease.

Osteoarthritis

Osteoarthritis, also known as “degenerative joint disease” or “arthritis,” is an inflammation of the joint that causes pain, discomfort, and stiffness. Arthritis is caused by damage or changes to the cartilage that make it less smooth and increase friction in the joint.

Arthritis can appear at any age and in any joint subject to ligament damage, trauma, or abnormalities in development. Hip dysplasia is just one of many causes of arthritis.

Anterior Cruciate Ligament Disease

Anterior cruciate ligament (ACL) disease (sometimes called ‘cranial’ cruciate ligament disease) is another common cause of hindleg lameness in dogs that can sometimes resemble HD. ACL rupture often occurs very suddenly (unlike HD), but it can sometimes be more gradual. Clues your dog may have cruciate disease rather than HD are:

  • Sudden onset lameness
  • Single back leg affected
  • Pain and instability when manipulating the knee

How is Hip Dysplasia Diagnosed?

Your veterinarian will start with a full health check, including an assessment of your dog’s joints. Any decreased movement or pain when manipulating your dog’s hips may make your veterinarian suspicious of HD, but a diagnosis requires x-rays and palpation of the hips (Ortolani test), usually under sedation or a full general anesthetic.

Some of the changes in the hip can take a while to develop, so x-ray findings may be quite subtle, particularly in young dogs. In older dogs, the x-ray changes may be more pronounced, but this doesn’t always mean their problem is worse.

An x-ray diagnosis of HD can sometimes be a red herring as it may be present but not causing a problem. Your veterinarian will probably want to rule out other causes of hindleg lameness, even if they have already diagnosed your dog with HD.

Treatment and Prevention

There are several treatment options for HD, ranging from lifestyle changes to surgery. Treatment choice depends on the dog’s age, severity of clinical signs, and response to any initial therapy.

Exercise

Regular controlled exercise helps to maintain muscle mass and support the hips. High-impact activities like chasing after frisbees and balls should be avoided. Dogs are very individual, so you will need to get a feel for what works best for your dog.

The Best Types of Exercise for Dogs with HD

Swimming/HydrotherapySwimming is an excellent activity that allows your dog to build muscle without the added stress of weight on their joints. 
Hydrotherapy (in a pool or on a treadmill), under the guidance of a physiotherapist, is a great year-round way to exercise and treat dogs with HD. 
WalkingModerate exercise on soft ground is usually well tolerated. The ideal walk length is very individual, but the key is always slow, steady, and regular. 
Scent trailsScent trails are a great way of exercising your dog’s mind and body in a slow and controlled manner. Try to lay trails on flat, soft ground and avoid obstacles.
Puzzles and ToysMental stimulation can tire a dog as much as physical activity. Dog puzzles and toys are excellent ways of exercising the mind and supplementing physical exercise. 

Weight Management

Being overweight increases the clinical signs and progression of HD, so weight management is a priority. Low-calorie prescription diets are a good choice for weight management, in combination with moderate, suitable exercise.

Medical Management

Various medications, diets, and supplements are available to help manage dogs with hip dysplasia. Your veterinarian can advise you on which combination of these options will best suit your dog.

Commonly Used Medications, Diets, and Supplements for Dogs with HD

Non-steroidal anti-inflammatory drugs (NSAIDs)These anti-inflammatories are commonly used to help manage short and long-term pain in dogs with HD. 
Pentosan polysulfateThis drug is administered as a course of once-weekly injections under the skin by your veterinarian. Pentosan can help with arthritis by encouraging new cartilage formation, lubricating the joint, and improving blood supply to the area.
BendinvetmabThis relatively new antibody treatment is injected under the skin once a month. Bendinvetmab blocks a protein involved in transmitting pain, making dogs more comfortable and increasing their mobility. 
Omega -3 fatty acidsThis dietary supplement can help reduce inflammation and lameness in HD and may reduce the amount of pain relief your dog needs. 
Glucosamine and ChondroitinIt’s currently unclear how beneficial these supplements are for dogs with HD, but they are often used because they are generally considered not to do any harm.
Prescription DietsA high ratio of omega-3 to omega-6 fatty acids can help reduce inflammation and improve signs of HD. Prescription diets that specifically target this ratio are an excellent way to supplement omega-3. 

Surgery

Surgical treatment is not always necessary and is usually only considered when medical management and lifestyle changes fail to work. The most common surgeries for HD are:

Double or triple pelvic osteotomy (DPO/TPO)

This surgery involves cutting and rotating the pelvis to improve the function of the ball and socket in the hip and is usually performed in young dogs (under 10 months of age). 

Femoral head ostectomy (FHO)

In this surgery, a false joint is created by cutting off the femoral head (the ball of the hip). Although hip function will not be normal, this procedure helps reduce HD pain. 

Total hip replacement (THR)

Hip replacement is the most effective surgery for hip dysplasia in dogs. The entire hip joint is replaced with plastic and metal implants that allow a more normal function with minimal discomfort. 

The cost of HD surgery varies depending on the country and procedure being performed. Prices range from $2500 USD for DPO, TPO, and FHO, and from $3500 to over $7000 USD per hip for total hip replacement.

Braces

Hip braces can help support dogs of any age with HD and keep them mobile. Ask your veterinarian if they think your dog might benefit from a brace.

Dog with hip dysplasia waring a brace

What Happens if Hip Dysplasia is Left Untreated?

In dogs with clinical signs of hip dysplasia, a lack of treatment will lead to severe pain, stiffness, and loss of function, compromising their quality of life.

How Long Can a Dog Live With Hip Dysplasia?

The prognosis for dogs with HD is generally good once appropriate treatment is started. If the clinical signs of HD can be managed, dogs can have a reasonably normal life expectancy.

Preventing Hip Dysplasia

Screening schemes for selective breeding, are aiming to reduce the genetic causes of hip dysplasia. Dogs from breeds where hip dysplasia risk is high should undergo x-rays before breeding, and the x-rays sent to experts for grading. They should only be bred from if their hip scores are lower than the average score for the breed. When buying a puppy you should ask to see hip scores from both parents.

Early life management can help reduce the risk of hip dysplasia in dogs. Slippery floors and stairs should be avoided both at the breeder and when you first bring your puppy home. As they age, early neutering (less than 6 months of age) and excess weight should ideally be avoided.

Living with a Dog With Hip Dysplasia

Top tips for making your dog with hip dysplasia comfortable are:

  • Discuss treatment options with your veterinarian to find the best solution for your dog
  • Invest in a good quality orthopedic bed
  • Take them to regular hydrotherapy sessions
  • Keep their weight down – your vet can help you calculate an ideal weight for your dog
  • Feed a diet with a high omega-3 to omega-6 ratio
  • Decrease their exercise intensity, but keep them moving
  • Avoid stairs – this might mean using ramps in the house or car

Conclusion

Hip dysplasia is a common, painful condition in dogs. However, the good news is that with the help of lifestyle changes and a range of treatment options, dogs with hip dysplasia can often live comfortably into old age.

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