You’ve likely heard of hip dysplasia, as it’s one of the most common orthopedic conditions in dogs, usually affecting large breeds. Unfortunately, dysplasia can have a significant negative effect on your pet’s quality of life. There are several options to prevent, screen and manage canine hip dysplasia, however—yet there is no definite cure. Here’s how to recognize this common issue, and if you see it, how to help your pet live its best life.
Hip dysplasia is defined as abnormal growth leading to insufficient coverage of the femoral head (highest part of the thigh bone) to the acetabulum (cup-shaped socket of hip, leading to laxity (looseness) of the hip joint.
Instability of one or both hip joints can lead to pain and devastating arthritis (degenerative joint disease causing inflammation of the joint). It can also lead to subluxation (partial dislocation) of the hip. Eventually osteoarthrosis (degeneration and irreversible deterioration of the joint) occurs, leading to loss of joint function. Cartilage then becomes damaged, and the protective cushion that surrounds the joint diminishes.
The canine hip is highly important, as it connects the femoral head to the pelvic acetabulum to support the dog’s weight while standing, walking and running—everything your dog wants to do when leading a playful, healthful life.
Canine hip dysplasia can be seen in almost any breed, but it is much more common in large and giant breed dogs. A 40-year study of over one million cases of canine hip dysplasia found the following breeds to be predisposed, along with many others: 
It has also been shown that male dogs are more frequently affected. The condition is polygenic, too, meaning it involves two or more genes. Hip dysplasia is also considered multifactorial, which means many factors such as nutrition, exercise and environment can also play a role in its development and severity.
Clinical signs of hip dysplasia are sometimes present in young dogs, and a diagnosis can even be made in puppies between three to eight months of age. Many dogs however live with hip dysplasia for years without showing any symptoms until they’re older. Symptoms may include:
- Hind limb lameness
- Bunny-hop gait, where both legs lift simultaneously like a jumping rabbit
- Muscle loss or poorly developed muscles in the rear limbs
- Wobbly gait
- Overuse of the front limbs causing enlargement in those muscles
Puppies can be screened for hip dysplasia at sixteen weeks—well before they develop any lameness or pain. Screening is painless, and involves checking for hip laxity. In fact, the University of Pennsylvania School of Veterinary Medicine has created a program called the “Penn Hip Improvement Plan (PennHIP)” which is a research-based procedure involving sedated x-rays and measurements.
In order to make a diagnosis, a veterinarian performs a thorough physical and orthopedic exam. Dogs with hip dysplasia will exhibit a decreased range of motion when the veterinarian puts the hips through extension. Joints may make a crunching or snapping sound due to roughened cartilage, x-rays might show less than 50% coverage of the femoral head to the acetabulum.
A veterinarian can also perform an Ortolani test (while the dog is sedated), which is also used to test for hip dysplasia in people. A positive result occurs when subluxation of the hip is possible, and a pop is felt when the femoral head returns to the acetabulum.
Hip dysplasia management depends on the severity of the condition and the effects it has on the dog’s quality of life. Options include conservative medical management, surgery and rehabilitation.
Conservative medical management:
This typically involves non-steroidal, anti-inflammatory drugs for pain relief and to decrease inflammation. Your veterinarian may use blood work to monitor organ function, as the medication can sometimes cause side effects with the liver, kidney and gastrointestinal tract. Supplements like glucosamine, chondroitin, glycosaminoglycans and fish oil can also help mitigate pain, inflammation and other problematic symptoms.
It is also crucial that dogs maintain an ideal weight. You may need to restrict exercise, though most veterinarians typically prescribe low-impact exercise such as slow walking and swimming to help maintain fitness. Adequate muscle mass and an ideal weight will ultimately put less pressure painful hips.
Medical management is the least costly treatment option upfront, however many years of medication and blood work can be costly—to the tune of several hundred to a thousand dollars per year.
Surgical options:
For young pets, surgery is considered to prevent arthritis associated with hip dysplasia, yet in older dogs, it’s often considered a salvage procedure for those who don’t seem to respond to medical management. It is important to understand that surgery will not cure hip dysplasia, but rather serve to manage painful symptoms. Some surgical options include:
Total Hip Replacement: The surgeon places a prosthetic femoral head and acetabulum, creating a new hip joint. It is the most successful of all treatment options, with a success rate of approximately 90%, however it is an invasive surgery. If successful, many dogs can live a normal life after the post-operative healing process.
Total hip replacement can be done when growth plates are completely closed, which generally happens by nine months of age, or at the latest, one year—depending on the breed. It is the most expensive of all treatment options, with costs ranging from $5000 to $6000, including hospitalization, anesthesia and medications.
Triple Pelvic Osteotomy (TPO) surgery aligns the femoral head and the acetabulum so that the head is forced deeper into the acetabulum. This provides more coverage when a dog walks, and decreases stress on the hip joint. TPO is performed by making three cuts into the pelvic bones and implanting plates and screws. The surgery can only be performed when the dog is six to 12 months of age, and before any arthritis has occurred.
Juvenile Pubic Symphosiodesis is a preventative surgery that is performed on dogs between 12 and 20 weeks of age. It cannot be performed on puppies that already have severe hip dysplasia. Compared to other surgical options, it is less invasive and less costly. The procedure stops the growth of the pubis (part of the pelvis), to increase coverage of the acetabulum.
Femoral Head and Neck Osteotomy (FHO) removes the top part of the femur. Scar tissue will form at the site creating a “ false joint” to allow pain-free mobility for most dogs. This is a good surgical option for smaller dogs who generally weigh less than 30 lbs. For dogs with severe hip dysplasia, FHO may be a better option than hip replacement.
Rehabilitation:
Physical therapy and rehabilitation can help with hip dysplasia. The goals are to decrease pain, improve range of motion and increase muscle mass. Laser therapy, massage, stretching and hydrotherapy (underwater treadmill) are all excellent modalities to help manage canine hip dysplasia, along with medications.
Physical therapy can also help with post-operative pain and inflammation. This can be done at a veterinary office that has certified veterinarians, technicians or canine physical therapists. Costs typically vary, depending on how many sessions are needed, but will likely run at least $2000.
The only true way to prevent canine hip dysplasia is through responsible breeding, since it’s a genetic disease. Overfeeding or not having a puppy on a balanced, puppy-specific diet can sometimes exacerbate or create symptoms, however. Orthopedists should perform testing on breeds that are predisposed to decrease the likelihood of passing on the condition. Two screening tests, Penn Hip and OFA (Orthopedic Foundation for Animals) hip, should be performed by a certified veterinarian prior to breeding high-risk dogs, and if the results are positive, the dogs should not be bred.
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Resources:
Dycus, D.L., et.al. “Physical Rehabilitation for the Management of Canine Hip Dysplasia.” Veterinary Clinics of North America: Small Animal Practice, vol. 47, no. 4, July 2017, pp. 823-850.
Harper, Tisha AM. “Conservative Management of Hip Dysplasia”. Veterinary Clinics of North America: Small Animal Practice, vol. 47, no. 4, July 2017, pp. 807-821.
“Small Animal Topics.” American College of Veterinary Surgeons, www.acvs.org/small-animal/canine-hip-dysplasia.
Syrcle, Jason, “Hip Dysplasia: Clinical Signs and Physical Examination Findings.” Veterinary Clinics of North America: Small Animal Practice, vol. 47, no. 4, July 2017, pp. 769-775.
Witsberger, Tige H., et al. “Prevalence of and Risk Factors for Hip Dysplasia and Cranial Cruciate Ligament Deficiency in Dogs.” Journal of the American Veterinary Medical Association, vol. 232, no. 12, 15 June 2008, pp. 1818–1824.
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