Hip dysplasia is something that most people that are involved with dogs in any way have heard of even if they don’t know what it is exactly. It is the most common orthopedic condition affecting dogs sadly and many of us have heard of a dog that had to be euthanized as ‘his back legs went’.
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What is Hip Dysplasia?
Dysplasia means ‘abnormality of development’ and as the name suggests, in the case of hip dysplasia the hips are quite literally displaced to some degree. Canine hip dysplasia is a genetic condition (although other factors play a part too, which we will come to this later) where the joints are ‘lax’ or looser than normal during puppyhood.
All pups are born with normal hips but in a dysplastic pup, the soft tissues that should stabilize the joint while it develops do not do their job properly. This leads to the ball and socket developing incorrectly.
The socket becomes saucer-shaped rather than cup-shaped, and the ball becomes flattened rather than round. This leads to wear and tear within the joint capsule as the bone will be rubbing on bone and cartilage which leads to osteoarthritis manifesting as pain and lameness.
Hip dysplasia is more likely to occur in large or giant breeds that grow rapidly and is heard of in Standard Poodles more often than in the Miniature or Toy varieties.
How is it Hip Dysplasia Caused? What are the Signs?
There is no one specific cause of hip dysplasia, unfortunately. If it was that simple, we would know how to prevent it altogether. Although, it is common sense to avoid breeding from any dog with known hip problems in the line (pedigree). All responsible breeders should screen their potential breeding dogs for hip and elbow dysplasia prior to breeding.
The condition is believed to be primarily genetic although environmental factors must also be taken into consideration. There are estimated to be over one hundred genetic codes that influence whether a dog is predisposed to developing hip dysplasia which means it is very difficult to test for using DNA in the way that we can for many other genetic conditions.
Whilst there is no evidence to prove that exercise and the environment can also cause dysplasia, most breeders and many veterinary professionals believe this is the case. Breeders believe that slippery surfaces in the early days after birth can be partially to blame. For this reason, among others, most will line puppy pens with a vet bed or carpet to enable pups to grip when they crawl and start to walk.
Running on hardwood or tile floors that can be slippery are best avoided along with going up and down stairs and jumping on and off furniture. If you have ever adopted a puppy you will probably have heard of the ‘rule of five’. This means that you should not exercise your puppy for more than five minutes per month of age per day. This is to prevent the overuse of immature joints.
Many large breed owners, I included, have stair gates at the bottom of staircases in the home to stop their pups and large breed dogs from climbing the stairs and risking injury. Agility training should also not be allowed before a pup has reached twelve months of age especially jumping or weaving in and out of poles.
Obesity is also considered a risk factor for developing dysplasia and it is important not to allow dogs to become too heavy especially while they are growing. It is far better for your dog to be a little on the lean side.
Unfortunately, we are used to seeing overweight animals and many people worry that their pet is too skinny if they can see a little rib. I have even heard of people being accused of neglecting their animals because they look fit rather than fat. There is a worrying trend amongst large and giant breed owners of trying to have the heaviest dog possible. This is to the detriment of the dog’s health and must absolutely be discouraged.
Most dogs with hip dysplasia will start to show signs between the ages of six and twelve months but symptoms vary and can occasionally be missed until the dog is much older. Signs include but are not limited to stiffness or difficulty getting up, problems climbing stairs (although as already mentioned pups, in particular, should be discouraged from this), difficulty jumping up, hind leg lameness, or an unusual gait such as ‘bunny hopping’ and sitting with one or both hind legs extended out to the side.
Some juvenile dogs suffering from hip dysplasia may be reluctant to exercise or appear to tire easily. As the condition progresses you may notice a loss of muscle mass in one or both hind legs. Another thing to watch out for is over development of the shoulder muscles where the dog has been overcompensating for the problems with his hind legs by taking most of the strain on his front legs where possible. In mature dogs in some cases, you may even hear clicking noises from the joint, but this is usually in more advanced cases.
How is Hip Dysplasia Diagnosed?
If hip dysplasia is suspected due to yourself noticing any of the aforementioned signs or your vet noticing signs of pain or during routine examination your vet will probably suggest taking x-rays of the hips.
The images will show up any abnormalities of the joint and osteoarthritis if it is present. The radiographs will be carried out under sedation or general anesthesia and in some cases, MRI or CT scans will also be performed.
The x-rays and scans will be assessed by a specialist orthopedic surgeon or team who will also carry out a test known as the Ortolani test. This is an evaluation carried out by manipulating the dog’s hips whilst he is heavily sedated to see how much laxity there is in the joint.
Once these assessments have been carried out the vet will be able to confirm or rule out hip dysplasia, diagnose the severity of the condition and advise on the appropriate treatment plan for your dog going forward.
The dog must be sedated or anesthetized to enable the veterinarian to extend the hip as correct positioning is crucial when assessing the joint for signs of dysplasia. In a dysplastic dog, the radiograph will show increased laxity of the joint which causes the femoral head or ball of the hip to separate from the socket. As the condition progresses arthritis will form along the femoral neck.
What are the Treatment Options for Hip Dysplasia in Poodles? Holistic? Medicinal? Surgical?
Being told that your dog is suffering from hip dysplasia is devastating. None of us like to think of our beloved pet being in pain and hip dysplasia is a condition that left untreated will get progressively worse and can severely impact your dog’s quality of life. Indeed, in the very worst-case scenario, it can lead to euthanasia.
The good news is that there are many treatment options available and the course of action you take may depend on your dog’s age and mobility as well as the severity of the disease. Let’s look at some of these options in starting with the most conservative route.
It can be a good idea to avoid surgery or long-term strong medication for as long as possible and if your vet agrees you can go down the holistic route first. The very first thing to consider is your dog’s weight. In the case of our Poodles, they do tend to be on the light side for a large dog which is a good thing as common sense tells us that the less weight an imperfect joint is carrying the better.
If your dog is overweight the very first thing to do is put him on a diet. We all know that if you eat less you lose weight, but we don’t want our dogs to be hungry so as well as cutting portion sizes and limiting treats you might want to consider changing his food. Raw food is a great option as it does not contain unnecessary fillers or carbohydrates. However, if this isn’t an option for you there are low-calorie or light versions of many of the better dry food brands available.
Raw vegetables such as carrots can be used as healthy treats. There are also many joint supplements available without prescription such as Glucosamine, chondroitin, and MSM. Fish oil and fatty acids are also available in capsule form and these are believed to help with joint problems.
Hydrotherapy is highly recommended as a great form of exercise for dogs with hip dysplasia as swimming can help to build the muscles surrounding the hip joint without putting strain on the hip. There are many specialist centers that you can take your dog to where he can be assisted to swim and exercise in water sometimes including the use of underwater treadmills that your veterinarian may be able to recommend or refer you to.
It is particularly important to restrict exercise that impacts the joints excessively such as jumping or twisting so chasing a ball or going up and downstairs must be avoided completely if your dog has been diagnoses with hip dysplasia.
Medical management of hip dysplasia is also an option and, in most cases, even your dog requires surgery, or you have elected to try holistic treatment first he will need treatment using medicines at some stage.
Anti-inflammatory drugs are usually prescribed and could be needed for the whole of the dog’s life. There are many non-steroidal anti-inflammatories available for dogs and your vet will prescribe the one that is most appropriate for your dog.
These are prescription-only, but your vet may issue you a repeat prescription which gives you the option to purchase the medication online which can work out cheaper than directly from the veterinary surgery.
Sadly, many dogs with hip dysplasia will require surgery sooner or later but once fully recovered, surgery can be a great option. After successful surgery, most dogs can lead a pain-free, relatively normal life.
There are a few different surgical options depending on the age of the dog and the degree of damage present. For young dogs, typically those that are diagnosed between six and twelve months of age that have hip laxity but no significant arthritic changes, triple pelvic osteotomy may be considered.
In this procedure three cuts are made through the pelvic bones and the pelvis is rotated and plated in a new position. The aim of this procedure is to slow down the progression of arthritis and reduce pain. This procedure has excellent long-term results and whilst no surgery is risk-free, post-surgical complications are rare with many patients going on to have a normal life.
If your dog is older when diagnosed or arthritis is already present repair of the hip rather than prevention of progression will be necessary. One way of salvaging the hip joint is with a femoral head and neck ostectomy.
During this surgery, areas of bone are removed from the joint eliminating pain however the outcome can vary and in some cases, the dog will have an abnormal gait even though he is no longer in pain. This surgery is more likely to be recommended in smaller dogs. Physiotherapy is essential after FHO.
More often if your dog is suffering from hip dysplasia your vet will recommend total hip replacement and although this is major surgery (and very expensive) this is a well-established procedure and offers an excellent outcome.
Cemented and cementless options are available and your vet will advise which is best for your dog. There are many implant sizes available, and this is the best option for adult dogs suffering from moderate to severe dysplasia.
THR can only be performed on one hip at a time so your vet will replace the most severely affected joint first with the second being replaced at least two months later. The downside of this is the double recovery period but, in some cases, replacing just one hip is enough to give your dog a perfectly acceptable outcome.
More good news is that post-surgical complications occur in less than 10% of dogs with many being able to walk on the affected leg the day after surgery with total recovery taking around eight weeks.
How can Hip Dysplasia be Prevented?
Prevention is always better than cure so how can we stop our dogs from developing hip dysplasia? In short, we can’t, or rather we can’t completely but there are steps that can be taken to lessen the chances of dogs being born that are genetically predisposed to developing hip dysplasia. Beyond this, there are ways that we can minimize the risk.
Let’s start before our dogs are even born. This responsibility lies with the breeder and while no breeder can ever guarantee that they won’t breed a dog that goes on to be dysplastic there are things that all responsible breeders can and should do to limit the chances.
You will most likely have heard of hip scores and perhaps you will have seen adverts for available puppies that include the hip scores of one or preferably both parents and often the grandparents as well. But you might not know what a hip score is or what these numbers mean.
As we have already discussed there is no singular factor that means a dog will or won’t suffer from this condition. However, over many decades’ breeders have been working hard to try to prevent hip dysplasia by only breeding dogs that have normal hips.
This is done in the form of hip scoring. When a breeder has a dog or bitch that he hopes to breed from he will make an appointment with a specialist vet to have the dog’s hips x-rayed and assessed by a veterinary panel to evaluate the joint and predict whether the dog is likely to develop dysplasia later in his life.
The x-rays are usually taken when the dog is between 12 and 24 months of age with many preferring to do this at around 18 months. This is so that the joint is fully developed but before age-related wear and tear could affect the result.
Just as when hip dysplasia is suspected the dog must be under anesthetic or complete sedation and correct positioning is essential. The x-rays are then sent to a specialist panel of orthopedic surgeons who will ‘score’ each hip.
There are a few different panels that score in slightly different ways. The BVA, AKC, and ANKC all favor the same system which involves each hip being given points for signs of abnormality. Each hip is scored between 0 and 53 with 0 being the best (no abnormalities detected at all) and 53 the worst. The score for each hip is combined to give the result out of 106. This score is compared to the breed median or average (in Poodles this is a total score of 15) with only dogs scoring below this being recommended for breeding.
Several factors are considered such as the ‘tightness’ of the joint, how deep the socket is, and how well the ball fits into the socket. The angle of the hip and signs of degeneration or wear on the bones.
The OFA has a slightly different system which is perhaps a little easier to understand for the layman. Rather than giving a number, they grade hips in seven categories these are:
- Excellent – superior conformation with the ball fitting tightly into a deep socket
- Good – slightly less perfect than excellent but still well-fitting with good coverage of the head by the socket
- Fair – minor irregularities with a slight movement of the ball from the socket
- Borderline – pretty self-explanatory, bordering on dysplastic
- Mild – increased space within the joint with subluxation present
- Moderate – ball barely seated within the socket with arthritis already present
- Severe – evidence of hip dysplasia showing
Only dogs with excellent, good or fair hips must be considered for breeding.
Pennhip is another slightly different system that is now available in the USA. This differs from the others as rather than measuring changes that have already taken place it is a predictive screening test that aims to assess the dog’s risk of developing hip dysplasia in later life.
Pennhip can be carried out on much younger puppies often as a preliminary examination prior to hip scoring in adulthood. This system works by measuring the laxity of the hips again while under anesthetic or sedation.
By breeding only from dogs with good results breeders can minimize the genetic risks. However, as we know there is no single cause of hip dysplasia as environmental factors must also be considered. As we talked about causes of hip dysplasia earlier, it is important to provide young puppies with good traction underfoot and to limit jumping and slipping on immature joints.
How can Hip Dysplasia be Managed?
Referring back to the section on treatment, hip dysplasia can be managed conservatively using weight control, physiotherapy such as hydrotherapy, and joint supplements in mild cases however the majority of dogs will go on to need medicinal or surgical treatment to manage their condition.
Is Hip Dysplasia Curable?
Unfortunately, hip dysplasia is not curable as such. However, its progression can be slowed or even halted with surgical intervention. If your dog does end up needing a total hip replacement, he will technically be cured as his dysplastic hips have been replaced.
Does Hip Dysplasia Impact Life Expectancy?
The good news is that with successful treatment a diagnosis of hip dysplasia does not always mean your dog’s lifespan will be shortened. After successful treatment and management by the owner, many dogs with hip dysplasia live well into their teens.
As with humans, arthritis and limited mobility come with age sadly and quality of life is always the most important consideration. With or without a diagnosis of hip dysplasia if your dog is no longer mobile and is in constant pain it is time to show him the final act of love and to let him go peacefully.