Hip dysplasia is a common problem that occurs in large and giant breed dogs.  Hip dysplasia is an abnormal growth of the hip joints where essentially the head of the femur (thigh bone) does not fit appropriately into the socket of the hip joint.  The primary cause of hip dysplasia is genetic but diet and fast growth during puppyhood increase the risks of developing this disease.  Hip dysplasia can continue to develop in dogs until they reach 2 years of age.

There are two groups of dogs we see with symptoms for hip dysplasia:  young puppies 4-18 months of age, and elderly dogs that had not been diagnosed with hip dyspasia earlier in life that present with arthriti changes.  Symptoms of early hip dysplasia in puppies and adults include:

• Bunny hopping gait, or reluctance to use a full stride in the hips when running
• Reluctance to jump or stand on hind legs
• Pain in the hips when flexed or extended
• Lameness on one or both rear limbs

• Muscle wasting in the thighs

The symptoms of hip dysplasia in younger dogs arise from the instability of the hip joint.  Though these dogs have not yet developed clinical arthritis, because the femoral head does not rest tightly within the hip joint, these dogs have very unstable hip joints.  Pain is created when the bones rub together instead of the bones sliding against normal cartilage.  In addition, the muscles surrounding the hip joint will often be sore from trying to hold the hip joint in a more stable position.  Because of this unstable hip joint, dogs with hip dysplasia develop arthritis much earlier than dogs without this disease.

Hip dysplasia is diagnosed from hip x-rays.  We will often have to sedate your dog before getting x-rays because the manipulation of the joints causes too much pain when awake.  There are several grades of hip dysplasia, and various degrees of symptoms occur depending on how severe the dysplasia is.  Some will need to be treated surgically, but mild hip dysplasia can often be treated with medical management (listed below).

In at-risk large and giant breed dogs, we recommend not to breed before 2 years of age and to obtain OFA certified x-rays prior to any breeding.  OFA (Orthopedic Foundation for Animals) x-rays are taken only after a dog reaches 2 years of age (when the majority of hip dysplasia cases can be identified) and are certified as excellent, good, fair or poor.   Only dogs with good or excellent hips should be bred since this is a genetic disease.  In addition, if you are looking to purchase a puppy from a breeder, BOTH parents of the puppy you choose should have proof of OFA certified x-rays to decrease the likelihood of your puppy developing hip dysplasia.

With mild hip dysplasia, often we can treat these dogs medically with good results well into older age.  Exercise is very important to build up good hip muscles in order to protect the hip joint.  Swimming, walking and caveletti or hill work is good to build up these muscles.  Strenuous exercise such as agility and high impact running should generally be avoided as these can cause worsening symptoms.  Fatty acid supplements and glucosamine/chondroitin supplements help cartilage grow and decrease inflammation in the joints.  Dasuquin is the only glucosamine/chondroitin product we recommend for dogs.  It is FDA approved and has to have quality control batch-testing performed.  This means you get a good product that has the amount of active ingredient it promises, and therefore works better than human counterparts that do not have to be tested.  There are prescription and OTC diets that have these supplements added in, and we highly recommend these diets for dogs both at-risk or already diagnosed with hip dysplasia.  Another important aspect of medical treatment is keeping a lean body condition.  Overweight dogs will have clinical signs appear much faster and be more severe than lean dogs.  Finally, anti-inflammatories such as NSAIDs or steroids can help when pain becomes a problem.  Opiods and other pain medications are available as well.

When symptoms cannot be controlled with medical therapy alone, surgery will be recommended to alleviate pain.  There are several different options for surgical correction of hip dysplasia:

Triple Pelvic Osteotomy (TPO)
This surgery can be performed on young dogs without arthritic changes.  Three cuts are made in the pelvis and the hip joint is re-aligned over the femoral head for a tighter fit.  This surgery is performed by an orthopedic surgeon and requires about 3-4 months of aftercare and physical therapy.  One or both hips can be done, but often times when the worse hip is done first it leads to positive changes in the other hip and an additional surgery may not be necessary. 

Femoral Head Osteotomy (FHO)
This surgery is usually performed on smaller dogs under 50-60 pounds and can be performed by your regular veterinarian, so the cost is typically less than a TPO or total hip.   During this surgery, the femoral head is removed, muscle is packed into the joint and a false joint occurs from scar tissue formation.  This surgery is sometimes referred to as a salvage procedure because the hip will not be nearly as stable as with other surgeries, and persistent mild lameness may occur.  Usually the dogs do not want to use their leg for at least a few weeks after surgery, but after full recovery most dogs do well.  This surgery should probably not be done on dogs that need full range and motion in their hips (agility dogs, working dogs).  For most pet dogs though, the false hip joint allows them to do all the activities they will need to do and slows down the onset of arthritis. 

Total Hip Replacement
This procedure is done in dogs that already have arthritis formation or will need a truly stable hip joint to perform their jobs.  This surgery is done by an orthopedic surgeon.  The entire femoral head and hip joint are replaced with a prosthetic, and recovery typically takes about 3-4 months.  If no complications arise (infection is the most common leading to failure of the prosthetic implant) these dogs do wonderfully and arthritis is virtually eliminated. 

Since not everything is known about what exactly causes hip dysplasia, it is not possible to prevent this disease in all cases.  There are several things that we can do as owners to reduce the chances of getting a pet with hip dysplasia:

1. If buying a puppy from a breeder, follow the recommendations listed above and only purchase a puppy from certified parents.  Do not buy puppies from dogs that were bred before 2 years of age or from dogs that have known hip problems.
2. Keep your puppy lean!  It has been shown that keeping puppies underweight will reduce the chances of developing hip dysplasia.  NEVER allow your puppy to free feed.  In at-risk dogs, it is recommended to feed puppies a large breed puppy food and to switch them to an adult large breed maintenance diet at 4 months of age.
3. Don't over-exercise your puppy.  Joints and growth plates continue to develop until puppies are 10-12 months of age.  Hard exercise before this period of time (excessive running, jumping or other high impact activities) increase the stress on developing bones and can increase the risk of joint disease.
4. If you are breeding your dogs, please be a responsible breeder and get your dogs certified before breeding.  Wait until these dogs are at least 2 years of age to breed them.
   

The OFA website contains a current full list in order of breeds commonly affected with hip dysplasia.  Please visit this website to learn if your dog is at risk: