Canine Hip Dysplasia

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Hip dysplasia is a very common disease in dogs. This orthopedic condition occurs as a result of abnormal development of one or both hip joints, leading to instability and degeneration of the joints. Hip dysplasia can affect one or both limbs and may range from mild to severe. 

What is Canine Hip Dysplasia?

The hip joint includes a ball at the top of the rear leg bone (head of the femur) and a socket in the pelvis (acetabulum).

When a dog has hip dysplasia, the connection of the ball and socket fits poorly. Typically, there is laxity (loose joint) and instability in the joint. Because of the abnormal connection, movement of the leg causes deformity of the joint. Over time, the cartilage in the joint wears down. Scar tissue and abnormal bony growths (osteophytes) develop. The damage in the joint makes it gradually more difficult for the dog to move the leg without pain and restricted range of motion.

Causes of Hip Dysplasia in Dogs

Several factors may contribute to the development of canine hip dysplasia. The primary cause is heredity (inherited trait). Several dog breeds are predisposed to hip dysplasia, most of them large breed dogs. The following are just a few of the dog breeds prone to hip dysplasia: 

Reputable breeders of these predisposed dog breeds will often have their dogs' hips screened and certified via the Orthopedic Foundation for Animals  or PennHip prior to breeding them.

Screening involves taking precisely positioned radiographs of the hips, usually done under sedation. Dogs can be certified after the age of two years. Radiographs taken as early as four months of age may reveal a dog's susceptibility to hip dysplasia.

A contributing factor to the development of canine hip dysplasia is rapid growth due to dietary factors.

This is part of the reason many owners of large breeds choose specially formulated large breed puppy food. Ask your veterinarian if large breed food is right for your puppy.

Although obesity does not cause hip dysplasia, it can significantly increase the symptoms. If your dog is predisposed to hip dysplasia or has been diagnosed, you should keep his weight under control in order to minimize symptoms.

Signs of Canine Hip Dysplasia in Dogs

The primary signs of canine hip dysplasia include hip pain, limping, trouble rising and jumping, difficulty with exercise, and muscle loss in rear limbs. Dogs with mild hip dysplasia may show no signs. As hip dysplasia progresses, signs may come on suddenly or gradually. Signs often continue to worsen over time as the disease progresses. Arthritis may occur secondary to hip dysplasia, especially in older dogs. 

Be aware that the signs of hip dysplasia may be similar to the signs of other health problems seen in dogs. if you notice these or any other signs of illness in your dog, contact your veterinarian for an appointment.

Diagnosing Canine Hip Dysplasia

When you bring your dog to the vet for signs of hip pain or hip dysplasia, your vet will begin by thoroughly examining your dog. This will include manipulation of the joints and observation of your dog's gait. Next, your vet will likely recommend radiographs (x-rays) of your dog's hips, back legs, and possibly spine. Proper positioning is extremely important in order to obtain an accurate diagnosis. This may be difficult for many dogs, especially those in pain. Be aware that your dog may need to be sedated for the radiographs. 

Both the examination and radiographs are essential in order to properly diagnose canine hip dysplasia. Be aware that other orthopedic issues may be discovered as the primary cause for your dog's signs. Hip dysplasia may be discovered incidentally, but there may be another issue requiring treatment, such as cruciate ligament injury or patellar luxation. This is why the examination is so important. 

In general, dogs with hip dysplasia fall into one of two categories: 

  1. Young dogs with significant hip laxity but no arthritis
  2. Mature dogs that have developed arthritis in the hips secondary to hip dysplasia

Once your vet has evaluated your pet, a diagnosis may or may not be made. Recommendations will be based on the severity of the disease plus your dog's age, size, and overall health. In some cases, medical treatment is the next step. Or, your vet may refer you to a veterinary surgeon for further evaluation.

Canine Hip Dysplasia Treatment

When hip dysplasia is mild to moderate, medical treatment and physical therapy can be very helpful. In most cases, mature dogs with secondary arthritis are more likely to respond to medical treatment than the younger ones without arthritis. 

The goal of medical therapy is to ease symptoms and slow disease progression. There is no medical cure for hip dysplasia.

  • Nonsteroidal anti-inflammatory drugs, fish oil supplements, and/or disease-modifying osteoarthritis drugs may help give your dog some relief.
  • Physical therapy has been known to help many dogs build muscle mass and improve range of motion. 
  • Regular low-impact exercise can also help your dog maintain muscle mass and decrease stiffness.
  • If your dog is overweight, weight loss can significantly improve symptoms. Gentle exercise and diet change are essential for weight loss.

Caring for dogs with hip dysplasia is much like caring for those with arthritis. You may wish to ​make certain accommodations for your dog to improve ​his quality of life. The following adjustments to your dog's environment can be helpful:

  • Place mats on slick floors. These can help your dog gain traction. Consider interlocking exercise mats or yoga mats.
  • Try an orthopedic dog bed. Consider a heated bed during cold weather. Make sure the bed is supportive and soft, but not too difficult to get in and out of. Memory foam beds are a great option.
  • Keep your dog's nails short. Long nails may make it even more difficult for dogs to gain traction on slick surfaces. Regular nail trims are essential. Better yet, consider filing down nails with a rotary tool.
  • Use ramps where needed. Placing a ramp in place of steps or to help your dog get in the car will decrease the painful impact and effort of climbing stairs and jumping up.
  • Use assistance devices. If your dog is weak in the rear end, look for a sling of some type to place around the rear  limbs. Some people use a rolled up sheet or blanket. If the problems persist, you may wish to buy a special product

If your dog is diagnosed with severe hip dysplasia, the above tips may be helpful. However, surgery is often considered the best treatment option for severe hip dysplasia, especially in younger dogs without arthritis.

Surgery for Hip Dysplasia in Dogs

There are several surgical options for the treatment of canine hip dysplasia. Your veterinarian will most likely have referred you to a veterinarian who is board-certified through the ACVS. This surgeon will talk with you, examine your dog, and review the radiographs. In some cases, additional radiographs or other diagnostic tests will be recommended. Then, the surgeon will consider several factors, such as size, age, severity of disease, and risk factors, before determining the right course of treatment for your dog.

If surgery is recommended, one of the following surgical procedures will most likely be performed:  

Juvenile Pubic Symphysiodesis: This procedure is performed on very young puppies (ideally younger than 18 weeks) who show very early signs of hip dysplasia as confirmed by specially-positioned radiographs. JPS is intended to alter the shape of the pelvis and stop the growth of the pubis (a part of the pelvis). This should decrease joint laxity by allowing better coverage of the ball portion of the joint and allow the hips to develop more normally as the puppy grows. JPS is a fairly minor procedure that only requires a short hospital stay (some dogs can go home the same day).

Pelvic Osteotomy: Double or triple pelvic osteotomy (DPO/TPO) surgery is an option for younger dogs with hip dysplasia but no arthritis. During a DPO or TPO, the pelvic bone is cut in two to three places. The surgeon rotates the segments of the pelvis and may secure them with plates and screws. The result is a better ball-in-socket fit, decreasing hip laxity. If hip laxity is severe, this is likely not the best surgical option.

Femoral Head Ostectomy: During an FHO, the surgeon removes the head of the femur, including the ball portion of the hip joint so that there is no longer painful movement of the abnormal joint. The FHO leaves no joint at the hip; instead, it is designed to allow the muscles in that area to adapt and support the leg. During recovery, the muscles in the hip area change the way the leg and pelvis function during movement. The FHO will not result in a completely normal hip function, but it will greatly reduce the pain caused by hip dysplasia. However, FHO is generally not recommended for larger dogs due to the fact that there is no longer an actual joint. Increased weight makes it more difficult for the muscles in that area to form the support needed without a hip joint.

Total Hip Replacement: THR is a major surgery that involves removing the deformed ball and socket and replacing it with implants (made from metal and plastic). The implants are designed to fit just like a normally functioning hip and generally allow full range of motion. Successful THR surgery cures hip dysplasia, eliminating hip pain and allowing the hip joint to function normally. THR cannot be performed on younger dogs as they are still developing. If you have a young dog and your surgeon recommends THR, your dog will be medically managed until he is mature enough for the surgical procedure. Because THR is such a major surgically procedure, it is usually only recommended for the most severe cases.

After Your Dog's Hip Surgery

Your dog will need to recover after surgery so he can heal properly and regain the best function possible. Recovery time depends on the type of surgery done and your dog's individual rate of healing. Exercise restriction will be required, but your dog will also need to move the hips in a controlled manner. Physical therapy is an important part of the recovery process, whether you do it at home with instructions from your vet, or you take your dog to a canine rehabilitation practitioner.

Which Option is Right For Your Dog?

Talk to your veterinarian or veterinary surgeon about the expected risks, recovery times, success rates and expense of the recommended options so you can make an informed decision. When in doubt, consider seeking a second opinion. Surgery is a serious step which one should not take lightly. Consider all factors before jumping in. You dog will thank you for it.