If you have a large breed of dog that is showing signs of lameness or even perhaps unusual discomfort while walking or perhaps displaying the characteristic ‘bunny hop’, then there is a great chance that it might already have hip dysplasia. This abnormality of the hip joint is generally considered to be the single most important cause of canine hip arthritis. Some say that hip dysplasia can be due to bad pet parenting, although science says that the disease is mostly genetic with large and giant dog breeds being more vulnerable to its development. While it is true that canine hip dysplasia can be genetic in origin, it should be noted that multiple environmental factors can play a role in the expression of this particular trait.
What is Hip Dysplasia in Dogs?
Canine hip dysplasia is a condition characterized by a gross deformity or malformation in the ball and socket joint of a dog’s hip. More specifically, the hip joints fail to develop in a more normal manner. This leads to the gradual deterioration of the hip joint’s integrity and eventually leading to a complete loss of the function of these joints.
Normally, the head of the thigh bone or femur fits perfectly into the concave socket of the pelvis known as the acetabulum. The surfaces of both the acetabulum and the femur head are covered by cartilage to ensure smoother fit as well as allow for optimum range of motion.
In most cases of canine hip dysplasia, the acetabulum is rather shallow or not deep enough to allow for the more secure fit of the femoral head. As such the femoral head simply slides around the surface of the acetabulum. This leads to the two bony surfaces to grow and develop further apart. Bone spurs develop because of the misalignment of these two bony surfaces. These spurs are what produce pain especially when walking.
In other cases of canine hip dysplasia, the acetabulum is deep enough to accept and secure the femoral head. Unfortunately, either or both bony surfaces are grossly misshapen. This gross malformation in the hip joint leads to abnormal wear and tear as well as friction within the hip joint itself. When this happens, the joint will try to repair itself by producing new cartilage.
Regrettably, the speed at which the joint is able to lay down new layers of cartilage is slower than the speed of the damage to the cartilage. This is because cartilage doesn’t contain blood vessels upon which various reparative cells would have been mobilized. As such, while the hip joint attempts to repair itself, it is also suffering continuing degradation of the articular surfaces. This leads to inflammatory changes that lead to pain. Sadly, with each degree of damage to the hip joint there is a corresponding loss of ability to resist further degradation or damage brought about by inflammation.
What Breeds of Dog are More Prone to the Development of Hip Dysplasia
Experts now agree that canine hip dysplasia develops as a result of the interplay between genetic and environmental factors. While it is true that large and giant dog breeds have an increased risk of developing the disease, canine experts also maintain that other dog breeds can be affected as well. Scientists have yet to uncover the specific gene in dogs that code for the canine hip dysplastic trait. What is clear is that the propensity of the disease to affect large and giant dogs may be related to the higher body mass index of these dogs. In other words, it is believed that the overall body weight of these dogs is sufficiently greater than what their hip joints can support.
The Orthopedic Foundation for Animals has their top 100 breeds that are affected by this joint condition. Among the more popular dog breeds that have the condition include the following.
- Great Danes
- German shepherds
- Labrador retrievers
- Golden retrievers
- American Staffordshire terriers
Pugs are hardly considered as large or giant breed. However, because of their rather stocky built, scientists say pugs may also be at an increased risk for the development of the condition. This also underscores the importance of environmental or non-genetic factors in the development of the disease.
For instance, a dog’s nutrition is now widely accepted as a risk factor for the development of the disease. There are certain nutrients that are beneficial in the continued growth and development cartilage and bone in dogs. While calcium and phosphorus play a major role in bone development, protein is also needed in greater amounts to supply the structural proteins needed for cartilage development. Of course, there are also specialized diets for large and giant dog breeds that have hip dysplasia. While these foods don’t necessarily prevent the development of the disease, they can somehow limit excessive growth to minimize the long term effects of canine hip dysplasia.
In addition to your dog’s weight and nutrition, exercise also plays an important role in canine hip dysplasia development. Too much or too little exercise has been implicated in its development. Too much exercise can increase the wear and tear of the hip joint apparatus while too little exercise predisposes the pooch to obesity. Either way, the resulting physiologic changes can aid in the development of hip dysplasia in dogs.
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What are the Signs and Symptoms of Canine Hip Dysplasia?
It is quite easy to recognize the signs and symptoms of hip dysplasia especially if the dog has been with you since puppyhood. While the condition may not manifest until about adulthood, the mere fact that you can actually monitor the progression of your pooch’s symptoms is one good way to identify the existence of the condition. This means you will have to be very vigilant about the normal behavior of your puppy so that you can easily identify anything that is amiss as it grows old.
Another point you might want to look into is the dog’s family history. If you bought it from a breeder or perhaps adopted it from a shelter, it is crucial to look at the dog’s family history. If one or both of its parents have been diagnosed with hip dysplasia in dogs, then there is a 50 to 100 percent chance that your pooch will also have the disease. Alternatively, you can order for a DNA test on your dog so you’ll have an idea of the various diseases that it is most vulnerable to develop, not only canine hip dysplasia.
Do take note that the clinical manifestations of hip dysplasia in dogs are quite benign or are usually mild. Many dog owners simply brush these aside as nothing more than nuisance. Unfortunately, these otherwise benign symptoms grow worse over time. That is why vigilance is required every time you notice something ‘wrong’ with your pooch.
The following clinical manifestations are typical of a dog with hip dysplasia. Remember that not all of these manifestations will be present all at once at any given time.
- Decreased level of physical activity
- Reluctance to walk, run, jump, hop, or even climb the stairs
- Hind legs are unusually drawn closer together, creating a narrower hind leg stance
- Difficulty rising or getting up from a lying down or even a sitting position
- Lameness of the hind legs which can occur intermittently or persistently; this is often made worse by exercise or activity
- Looseness of the joints, otherwise known as joint laxity
- Reduced range of motion of the dog’s hip joints
- Reduced mass in the thigh muscles
- Swaying gait which may or may not be associated with bunny-hopping
- Pain in the dog’s hip joints
- Grating sensation which can be either felt or heard on the hip joints as the dog is walking or simply moving its hip joints
- Enlargement of the muscles of the shoulder as a compensatory mechanism for the loss of strength and mobility in the hind legs.
It should be understood that the earliest signs of the disease is associated with joint laxity or joint looseness. You may not see any significant changes in your dog’s mobility yet except that there will be occasional lameness or difficulty standing up. The problem is that these seldom occur that when they do, most dog owners won’t be there to see it. Or, they may have seen it, but since the behavior was only observed once, they will typically brush it aside as nothing significant.
In the late stages of the disease, the manifestations will already be more related to degeneration of the hip joints coupled with osteoarthritis. This is where pain, bunny hopping, loss of muscle mass, and decreased joint range of motion, among others, will set in.
Unfortunately, by this time, it may already be too late as the disease has already advanced too far. As such, the treatment will be more aggressive.
How is Hip Dysplasia in Dogs Diagnosed?
A thorough physical examination is needed to check the patency and integrity of the hip joint apparatus. This will help establish any changes in the joint’s range of motion and to check whether there are any signs of muscle atrophy related to disuse. The joints will also be evaluated for the presence of grating sensation while the dog’s overall mobility is assessed.
In addition to the thorough physical examination your vet will also order a complete blood chemistry test including an electrolyte panel, urinalysis, and complete blood count. If there will be inflammation in your dog’s joints, this will appear in its complete blood count.
Moreover, a comprehensive health history will be conducted which can include a survey of the symptoms, when these were first observed or noted, and any incident or circumstance that may contribute to the appearance of these symptoms. If you have a dog DNA test done, the results can be examined by your vet, too.
Imaging tests, particularly x-ray, will help visualize the extent of the hip dysplasia. It is possible to visualize the presence of degenerative states in the dog’s spinal cord, bilateral stifle disease, lumbar vertebral instability, and any other structural abnormality that may be present.
How is Canine Hip Dysplasia Managed?
Depending on the state upon which your dog was brought to the clinic, whether it is still in the early stages or already in the advanced stages of the disease, the treatment options are usually two-pronged. One is to correct the actual cause of the problem and two is to manage the accompanying symptoms. Symptomatic treatment, it should be clear, does not solve the root cause of the problem. What it does is that it only attempts to eliminate the symptoms so that the dog will be able to function as close as possible to its normal state. However, once the symptomatic treatment has been withdrawn, the symptoms will reappear; unless the root cause has already been managed by that time.
Here are some of the most common treatment approaches to a dog with hip dysplasia.
This is one of the most definitive treatment options when it comes to solving the issue of hip dysplasia. Regrettably, it is quite expensive and can entail a host of side effects from the drugs administered before, during, and after the surgery as well as potential complications from the surgical procedure itself. As such, surgery is best reserved as the treatment of last resort, and when the hip dysplasia is already so severe that there’s no chance it will respond to more conventional treatments. Just be ready to pay about $1,700 up to $4,500 and possibly even more just for the surgery alone.
Depending on the case of your dog, your vet may have to perform any of the following surgical procedures to correct the hip dysplasia.
- Juvenile pubic symphysiodesis
This surgical procedure is the treatment of choice for dogs that are not older than 5 months. The surgery requires the fusion of the two pelvic bones, allowing the rest of the pelvic bony structures to develop in a more anatomically correct manner. The procedure technically changes the angle of the dog’s hips to allow for more efficient and more variable range of motion at the hips.
- Triple pelvic osteotomy
TPO, as triple pelvic osteotomy is fondly called, is perfect for pooches that are suffering from subluxation of the hip joint. For this procedure to have the best favorable outcomes, the dog must be less than 10 months old. This greatly increases the chance of better and faster healing since the surgical procedure is quite extensive, expensive, and very painful. More importantly, the hip socket is not yet damaged so it provides a much better chance of your dog leading a more normal life. The procedure requires breaking the pelvis in an attempt to realign the femoral head with that of the acetabulum or the hip socket. This effectively restores the full functionality of the hips.
- Femoral head and neck excision
This procedure is typically indicated for the management of hip dysplasia in dogs that are not really that heavy or dogs that are already in their senior years. The downside to this surgery is that, while it alleviates pain, it does not return the optimum range of motion of the hip joint. Neither does it correct the issue of hip instability. In femoral head and neck excision, the neck and head of the femur is removed and replaced with a fibrous joint. It’s more affordable than total hip replacement but it’s not often recommended to most dogs.
- Total hip replacement
Despite its prohibitive price and rather complicated nature, total hip replacement surgery is simply the best for dogs older than 10 months old that are suffering from hip dysplasia. As the name suggests, the hip joint is completely removed and replaced with a synthetic or artificial joint. It is similar to a transplant procedure except that the replacement body part does not come from the dog itself but rather from a synthetic device. This is actually what renders the procedure exceptionally costly. As such, total hip replacement is reserved for mature dogs that already have very advanced hip dysplasia that is no longer responding to conventional management. The good news is that this procedure can guarantee the complete elimination of pain and the return to optimal functioning of the joints for the rest of the dog’s life.
- Weight management
Reducing the body weight of your dog can do to help in its dysplastic hips. It can help lessen the load or pressure on the hip joints. This minimizes tissue damage and promotes tissue repair and regeneration. Do take note that managing your pooch’s weight will not cure or treat the dysplastic tissue. Instead, it will only bring relief to the overloaded hip joints so that they don’t unnecessarily begin grinding against each other again, further damaging the joint apparatus. Your vet can give you advice on what food to give to a pooch with dysplastic hips.
- Supplements for hip and joint health
While the scientific community is actually divided on the actual clinical benefits of providing dogs with joint health supplements such as glucosamine, chondroitin sulfate, and methyl sulfonyl methane or MSM, many dog owners are nonetheless providing these supplements to their dogs with dysplastic hip joints. Many veterinarians also recommend giving these supplements to dogs with such conditions including arthritis. These substances help provide the necessary raw materials needed by the joint capsule to produce cartilage and synovial fluid. Fish oils especially those rich in eicosapentaenoic acid (EPA) are also given for their anti-inflammatory benefits.
Do take note that these will hardly matter in the advanced stages of the disease since the degenerative changes would already be too far advanced for these substances to make any significant improvements in the condition. As such, these are best given as promotive and preventative agents, but never as treatments.
- Pain medications
As we have already pointed out above, hip dysplasia in dogs can be outright painful because of the resulting inflammation. As such nonsteroidal anti-inflammatory drugs like carprofen as well as acetylsalicylic acid or aspirin are often recommended. Unfortunately, aspirin and NSAIDs can upset the stomach as well as increase the risk of bleeding. As such, veterinarians will typically look for other ways to manage the pain.
- Anti-inflammatory drugs
Most veterinarians would rather give medication that has both anti-inflammatory and analgesic effects. For instance, it is not unusual for veterinarians to prescribe deracoxib or carprofen in the management of inflammation and pain brought about by canine hip dysplasia. Like dedicated analgesics, however, these can have serious side effects so your vet’s advice should always be sought before giving your pooch any of these drugs.
- Physical therapy
One of the hallmarks of canine hip dysplasia is the impairment in the dog’s mobility, typically brought about by pain and inflammation. Physical therapy is an excellent consideration since it helps optimize the return to normal functioning of the muscles through the use of exercises. The thing about hip dysplasia is that your dog will try to limit its movement as much as possible. As such, this can lead to muscle disuse atrophy.
Exercise can have a host of benefits especially in aiding the healing process. To aid in the exercise component of physical therapy, the dog may be subjected to hydrotherapy to lessen the impact of gravity on its hip joints. This makes it a lot easier for the dog to perform the necessary physical therapy exercises.
Physical therapy works best as a complementary treatment to the management of canine hip dysplasia. Conventional treatment modalities can help address some of the issues associated with the disease, especially pain and inflammation, while physical therapy can help improve overall range of motion of the hip joint and enhance overall mobility.
Hip dysplasia is never fatal. Unfortunately, the quality of life of your dog will be substantially affected that it won’t really be able to enjoy all the things that make a dog the most treasured pet in the world. It is thus, critical to become knowledgeable about what hip dysplasia is, what causes it, its manifestations, how it is diagnosed, and the treatment options available. Hopefully, with your vigilance, you can help your pooch lead a much better, more mobile life.
- Tammy Hunter, DVM, Hip Dysplasia in Dogs, VCA
- Nick Trout, Total Hip Replacement in Young Dogs, The MSPCA–Angell