Canine Hip Dysplasia
By Emily Hoppmann, DVM
All pet owners should be aware of hip dysplasia since it is a serious disorder that affects thousands of dogs (large and small) and even some cats. It causes pain in varying degrees (some of which is acute and some is more chronic) and decreases your pet’s ability to move around normally. It often leads to osteoarthritis and, if left untreated, can lead to osteoarthritis at very young ages. It is mainly due to genetic issues that are passed down through the breeding line, but the course of the disease can be affected by many outside factors. These factors include obesity, nutrition, and types/intensity of exercise routines. This is why it is so critical to know if the breeding line your puppy comes from is prone to hip problems or have been diagnosed with hip dysplasia. If the history of your pet is unknown, it is critical to have him examined at a young age and throughout life. Also, this disease can skip generations so just knowing the medical history of the parents is not enough – it is best to be able to go as far back as possible with the family history. Hip dysplasia is a life-long disease and it can be a very expensive disease to manage and treat. By having your pet examined as a puppy (or kitten) and bi-annually throughout life, the problem is able to be identified earlier which allows more treatment options, prevention or delay of secondary issues, and can be less costly in the long-run. It also allows for a better quality of life for your pet and that is the most important thing to everyone!
Canine Hip Dysplasia (CHD) is a common condition caused by an abnormal developmental disorder that affects the hips joints of dogs (more specifically the coxofemoral joint). The hip joint is a ball and socket joint (just like in people) and in normal joints the ball and socket fit together tightly. In a dog with CHD, the ball does not fit into the socket tightly enough and can appear to rotate out, characterized by joint laxity in young patients and degenerative joint disease (DJD) of variable severity in both young and adult patients. In puppies that have a genetic disorder causing this disease the abnormal signs usually start to appear between three and eight months of age. However, the body is not fully developed at this point so the signs may seem to get better or worse with time, depending on how the body adapts. This disease is different than generalized osteoarthritis in the joint which can develop in the absence of hip dysplasia, but having canine hip dysplasia is known to be a contributing factor to the development of osteoarthritis (often at a younger age than it would normally occur). The development of osteoarthritis is due to the abnormal looseness of the joint leading to excess wear and tear on the joint.
The pain of both hip dysplasia and osteoarthritis greatly affects a pet’s quality of life, even if your dog does not seem to be painful while he is running like the wind when he is doing one of his favorite activities (chasing a squirrel or playing fetch, etc). This is why we examine all of the joints of your pet at every visit – to see if your dog has hip dysplasia, osteoarthritis, or a combination of both, regardless of whether your dog seems to be doing well at home. Some of the clinical signs you may see at home are: reduced activity level, becoming more tired than usual after exercise, an inability to walk as far as in the past, a reluctance to jump up or get up on furniture, not wanting to use the stairs or going up or down the stairs in a sideways fashion, “bunny hopping” (using both back legs at the same time) when running, hearing an audible clicking noise when rising or walking, lameness on any of the legs (but often the hind-limbs are more affected), swaying when walking, muscle loss in the hip area, and/or your pet having more difficulty when trying to stand from a seated position or after laying down for any length of time (or just not seeming to find a position to sit or lay down that is comfortable). While you can see any of the clinical signs listed above in both young and older dogs with this disease, in older dogs these signs may be more obvious after exercising. In young dogs you may notice that he prefers to play while in a seated or laying position instead of running around like you would expect a puppy to do. These are all ways your pet may behave when in pain and we never want our babies to be hurting! The good news is that there are a variety of treatment options, including medical and surgical options to help keep your pet more comfortable, avoid/slow the progression of disease, and/or eliminate the disease all together (though elimination of the disease is more rare and is achieved through surgical options).
Canine Hip Dysplasia is most common in large and giant breeds, including Labrador Retrievers, Golden Retrievers, German Shephards, Rottweilers, and Newfoundlands. All dogs are at increased risk if they are overweight, grow at too rapid of a rate as a puppy, or are exercised excessively on hard surfaces (such as pavement) while they are still growing. It is better to exercise on a surface with some give to it, such as a track or the grass, until your large dog is at least 18 to 24 months old. If your young dog is diagnosed with or thought to have hip dysplasia, then slowly walking him on a daily basis is recommended first over any intense exercise at all. Though hip dysplasia is thought of more as a disease in dogs, it can occur in cats as well. Maine Coon Cats are thought to be at higher risk than other cat breeds.
Hip dysplasia can be diagnosed through physical exam as well as with radiographs. During physical exams I observe how a patient stands and walks, the condition of the skeleton and muscles, as well as observing abnormalities in movement and/or pain level during manipulation of the joints. Sometimes sedation or anesthesia is needed to fully be able to palpate the joints to be able to diagnose early signs of hip dysplasia. Radiographs can provided conclusive evidence of changes in the skeletal structure of a pet, including changes in the hips indicative of hip dysplasia and those indicative of osteoarthritis. It does take more time to be able to appreciate changes on radiographs. For young dogs (as early as 16 weeks) the PennHIP approach uses a series of multiple radiographs to evaluate a dog’s hip disease and these radiographs help to determine how likely it is that the dog will develop hip dysplasia. For a dog to be “certified” as being free from signs of hip dysplasia a dog must be at least 2 years old to be included on the Orthopedic Foundation for Animals registry. However, a combination of radiographs and palpation can be useful at any age and should be done on all dogs that are at-risk for this disease if you plan to breed your pet.
As mentioned previously, there are a number of treatment options including both medical and environmental management and surgical options. Generally in less severe cases medical and environmental management is the first line of defense. The goal is to reduce pain through decreasing inflammation and prevent the progression of disease through a modified life style. This includes the use of a medication that both decreases pain and inflammation and there are several medications that fall into this group. It may take some trial and error to find which specific medication is most helpful for your pet and has the fewest side effects. Since these medications will most likely be used for life, having regular blood work done is critical. One of the medications used is a non-steroidal anti-inflammatory and the other provides an increase in the amount of Omega-3 Fatty Acids the pet consumes. A diet change that slows the growth and development of a puppy or helps to get an overweight dog to his ideal body weight is also critical. Not being at the ideal body weight is more detrimental to a dog than anything else when it comes to joint disease (along with a host of other diseases). Individualizing an exercise plan to both prevent muscle loss in the hind limbs, while not placing excess stress on the joints is also incredibly important. With dogs that have hip dysplasia it is important to encourage normal movement of the joints, but not cause unnecessary wear and tear on the affected joints, which can be accomplished by swimming and slow walks. There are also other measures that can be done to help keep your pet more comfortable, such as avoiding extreme temperatures, having extra cushion in bedding, performing massage, and incorporating acupuncture treatments. As a team, we will work with you to find an individualized plan for your dog based on the age, breed, weight, and severity of disease to give your pet the happiest, healthiest life possible!
In more severe cases where medical management is not an option or is not going to produce the long-term results that you want for your pet, there are a number of surgical options. Which surgical option is best for your pet depends mainly on age and severity of disease. The two most common procedures are a Triple Pelvic Osteotomy and a Total Hip Replacement. The Triple Pelvic Osteotomy is more suitable for young dogs that do not have any osteoarthritis or signs of degenerative joint disease and have more mild signs of hip dysplasia. A Total Hip Replacement is more suitable for hips that are showing moderate to severe damage or dogs that are too old for the Triple Pelvic Osteotomy. We are lucky enough to have Veterinary Orthopedic Specialists in the area that routinely perform these surgeries with great results! Regardless of the management your pet with hip dysplasia has, we are all here to help get your baby feeling good and able to enjoy the happiest, healthiest life possible!