Hip Dysplasia in Dogs

I have been told that my dog has hip dysplasia, but she isn't lame. Is that diagnosis correct?

Hip dysplasia is a deformity of the hip that occurs during growth. The hip joint is a ball and socket joint. During growth, both the ball (the head of the femur, or thighbone) and the socket in the pelvis (acetabulum) must grow at equal rates.

In hip dysplasia, this uniform growth during puppyhood does not occur. The result is  looseness (laxity) of the joint, followed by degenerative joint disease (DJD) or osteoarthritis (OA), which is the body's attempt to stabilize the loose hip joint.

The dog’s degree of lameness is dependent on the extent of these arthritic changes and may not be correlated with the appearance of the hip joint on X-rays. Some pets with significant signs of hip dysplasia or osteoarthritis on X-rays may not exhibit any clinical signs, while others with minimal changes may experience severe pain and lameness.

What causes it?

Hip dysplasia is a genetic disease that is affected by factors such as diet, environment, exercise, growth rate, muscle mass, and hormones. As this disease is most commonly seen in large breed dogs, these puppies should be kept at a normal, lean weight during growth, not overfed or encouraged to grow big.

One study of puppies at risk for hip dysplasia found that, when they were fed as much as they wanted to eat, two thirds of the puppies went on to develop hip dysplasia. When they were fed measured meals, only one third of puppies developed hip dysplasia.

A study of German shepherds found that overweight puppies were almost twice as likely to develop hip dysplasia as their normal-weight counterparts. These studies have allowed food manufacturers to develop specially formulated diets for large-breed puppies.

Additional studies have shown that spaying or neutering at an early age may lead to an increased incidence of developing hip dysplasia in some dogs.

Are certain breeds affected more than others?

Yes; although any dog can be affected, hip dysplasia is predominantly seen in larger dogs such as German shepherds, Saint Bernards, Labrador retrievers, golden retrievers, Old English sheepdogs, and bulldogs. Large mixed-breed dogs are also at risk for developing it and should be fed a special large breed growth diet their first year.

What symptoms should I look for?

Weakness and pain in the hind legs are the usual clinical signs. The dog appears wobbly and is reluctant to rise from a sitting or lying position. Some dogs will limp or be reluctant to climb stairs. These signs can be seen in puppies as early as a few months old but are most common in dogs one to two years of age. Dogs with mild hip dysplasia on X-rays may develop minimal arthritis without clinical signs until they are older. In fact, although hip dysplasia begins in puppyhood, most dogs do not develop clinical signs until they are older. It often takes years of gradual bone degeneration until a dog becomes symptomatic.

How is it diagnosed?

A hip radiograph under general anesthetic is the preferred method for diagnosing hip dysplasia. Clinical signs and palpable joint laxity (positive Ortolani sign) may also indicate hip dysplasia. Any pet suspected of having hip dysplasia should be X-rayed as soon as possible. Research into genetic testing is ongoing, as the current available options are questionable in their validity.

What is the treatment?

Treatment depends on the pet's clinical signs and amount of discomfort. There are several effective, non-steroidal anti-inflammatory drugs (NSAIDs); speak to your veterinarian for options. The choice of medication is made on an individual basis, and various drugs may be tried before finding the most effective one. Additional medications that may be added include gabapentin, tramadol, or amantadine.

Most dogs with hip dysplasia should receive veterinary-approved joint supplements, including omega-3 fatty acid nutritional supplements. Many dogs with painful hip dysplasia will benefit from chondroprotectant (Adequan, Cartrophen) injections on a regular basis. Moderate daily exercise and avoidance of high-impact activities, such as jumping, may help keep the patient mobile and strengthen surrounding support structures.

"Physical therapy is highly effective at improving the quality of life for affected dogs and should be part of any treatment regimen."

Physical therapy is highly effective at improving the quality of life for affected dogs and should be part of any treatment regimen. Since excess weight puts undue stress on the hip joints, weight loss is strongly recommended in overweight dogs.

What if NSAIDs don't help?

The alternative to NSAIDs and medical therapy is surgery. There are several surgical procedures available to treat hip dysplasia. The two most common surgical techniques for hip dysplasia are total hip replacement and femoral head/neck ostectomy (FHNO). Other less common surgical procedures used to treat hip dysplasia include triple pelvic osteotomy (TPO), juvenile pubic symphysiodesis, and arthroplasty. The choice of surgery will be determined by your pet's age, condition, and lifestyle. Your veterinarian can provide the best recommendations for your individual pet.

What about alternative medicine treatments?

Physical rehabilitation, including therapeutic exercise, hydrotherapy, laser, and extracorporeal shockwave therapy (ESWT) can be beneficial in managing hip dysplasia. Acupuncture, stem cell treatments, cannabinoids (CBD oils), and traditional Chinese medicine have all been used to treat hip dysplasia with varying results. To date, rigorous scientific studies on these alternative therapies have been sparse, although some are very encouraging in small studies. More studies are ongoing. Speak with your veterinarian about their experiences and recommendations for complementary medical procedures to help your dog.