Spotlight on...Canine Hip Dysplasia
What is Hip Dysplasia?
Hip dysplasia is one of the most common skeletal diseases seen in dogs. It is a life long condition affecting the hip joint and contributes to the development of other conditions such as osteoarthritis.
The hip joint is composed of a ball and a socket. In a normal hip the ball (the head of the thigh bone or femur) fits the socket (the acetabulum of the pelvis) and cartilage ensures that the joint operates smoothly over a wide range of motion.
Hip dysplasia refers to an abnormal formation of the hip joint. Commonly the ball only fits into the socket loosely or partially and the socket is misshapen. This results in the joint being unstable and movement creates an abnormal amount of wear and tear within the joint. This leads to inflammation of the joint and pain, and impacts the dog's quality of life.
The cause of hip dysplasia involves several factors, including breeding and environmental considerations (for example, excessive nutritional intake and excessive exercise during the growth phases, obesity, injury at a young age) and often begins while a dog is still a puppy. However, as hip dysplasia is a malformation of the hip joint, it can also develop later in a dog's life as a result of other conditions such as osteoarthritis. Over time the deformity of the joint in affected dogs may get worse or remain the same, and cases can range from being mild to severe.
A genetic predisposition to hip dysplasia has been recognized in several large and giant breed dogs including Labrador Retriever, German Shepherd, Great Dane, and Saint Bernard. However, it also affects some small to medium breeds. Breed Associations, Kennel Unions, and Veterinarians are working together to promote breeding which reduces the occurrence of hip dysplasia in pure bred dogs. If you are considering purchasing a medium or large breed puppy ask the breeder if the parents have been hip scored. A good score is A1 or A2.
Whilst hip dysplasia commonly begins before a dog is 18 months old, many dogs are only diagnosed in later life when the secondary problems related to this condition result in visible symptoms and recognizable signs of pain. However, as these dogs have been walking on deformed hips for most of their life it is important to recognise that they will have been living with chronic pain for a long time.
What are the signs and symptoms of Hip Dysplasia?
Many dogs show no clinical signs even when x-rays reveal hip dysplasia. The presence of the following signs and symptoms may be seen early in a dog's life (before 7 months) or in adulthood due to differences between animals, such as the abnormality of the hip joint, whether the deformity is stable or getting worse, the general condition of the dog (for example, weight), activity levels, and tolerance for pain:
•Reduction of movement of the hip through changes to their gait (for example, a bunny hop where both legs move together is typical of this condition and young dogs may have a waddling or swaying gait)
•Stiffness or soreness after rising from rest (often worse in the morning)
•Reluctance to exercise
•Lameness of the hind limbs (intermittent or persistent)
•Narrow stance in the hind limbs
•Reluctance to stand on hind legs, to jump up, or climb stairs
•Wasting away of the muscles in the hip area
•Over development of the shoulder muscles
•Partial or full dislocation of the hip joint
•A distinct clicking sound may be heard when the dog is walking or running
What treatments are available?
If you recognise any of the above signs or symptoms, or suspect that something isn't right with your dog, make an appointment to have your dog checked out by one of our vets. Diagnosing a condition such as hip dysplasia will involve taking x-rays, often not just of the hip, but also of the spine and the legs. Our vet will also conduct a thorough examination of your dog to help determine the cause of your dog's problem since serious pain can be present even with little x-ray evidence.
The treatment options for a dog with hip dysplasia can be medical, surgical, and physical rehabilitation therapy, and those prescribed by our vet will depend on the age and specific condition of your dog. The main goals of treatment will be to control pain, minimise instability, and aid your dog in regaining as normal function as possible whilst promoting quality of life. These various options will not cure hip dysplasia, but they will reduce the clinical signs.
Medical treatment aims at relieving pain and maintaining limb function and the options include:
•NSAIDS (anti-inflammatory drugs)
•Omega 3:6 supplementation and specific joint diets
•Neutraceuticals and chondroprotectants
Surgical options depend on the age of the dog and the condition of the hip joint. The options include:
•Triple pelvic osteotomy - this procedure can be carried out when a dog is between 5-12 months of age if no osteoarthritis is present and involves increasing the depth of the acetabulum (the socket) to promote greater coverage of the head of the femur (the ball);
•Total hip replacement - a procedure available to dogs over 10 months which involves the formation of a new hip joint using titanium implants;
•Femoral head amputation - this procedure is used on dogs greater than one year of age and is used in cases where physical rehabilitation has been unsuccessful or total hip replacement is not an option. It involves cutting off the head of the femur (the ball).
The options for physical rehabilitation therapy include:
•Veterinary or animal chiropractic
These options are complementary to the medical and surgical alternatives set out above, and in the latter case may be used to offer both pre- and post-operative support. Alternatively, use of appropriate physical rehabilitation techniques can make surgical intervention unnecessary and may lead to a reduction in medical treatments.
Acupuncture is used in conditions such as hip dysplasia to provide pain relief and often reduces dependence on medical treatments which can be used alongside this treatment. It can also be used to address muscle spasms associated with the condition. Therapeutic ultrasound uses sound waves to heat muscle groups, improve extensibility of connective tissue, reduce tension, muscle spasm and pain. This treatment also helps decrease inflammation, whilst neuromuscular electrical stimulation helps to address areas of muscle weakness and muscle spasm.
Hydrotherapy and therapeutic exercises are used to strengthen muscles, create stability, and address compensatory issues. In addition, hydrotherapy will also promote joint flexibility. Compensatory issues are particularly important in hip dysplasia as dogs adapt the use of their spine in response to their inability to make normal use of their hips and this often causes spinal, stifle (knee), or soft tissue problems. These compensatory issues may also be addressed through the use of massage therapy.
In order to create stability therapeutic exercises focusing on balance, spatial awareness (proprioception), and muscle strengthening are used to target specific muscle groups that will promote increased stability in the hip joint. The reduction of instability leads to a decrease in pain and, in turn, the reduction in pain promotes better hind limb extension which reduces the dog's need to compensate. Medical approaches such as the use of pain killers and anti-inflammatory drugs will help reduce pain but they will not create stability.
Alongside physical rehabilitation techniques employed by our vet or other trained professionals, you will be given a home exercise programme to assist in the process of treating your dog's hip dysplasia. In this programme general exercise will be strictly controlled and adjustments will be made according to your dog's strength and stability. Your compliance as an owner will be essential to the improvement shown by your dog.
The addition of physical rehabilitation therapy to the medical and surgical options previously available to veterinarians means that dogs diagnosed with hip dysplasia can have an improved quality of life.
What can I do at home?
Being overweight will add pressure to the weakened joint(s) and cause your dog more problems. So too, doing the wrong type of exercise, exercising on the wrong surfaces, or doing too much exercise, will all exacerbate your dog's condition. This means it is of vital importance that you follow our vet's instructions on nutrition and exercise.
Look at your environment, are there ways in which you can make life easier for your dog? Perhaps you can buy or make a ramp to relieve the work of climbing up stairs, and find something to cover slippery floors and surfaces. Another area to look at is where your dog sleeps. Providing a warm place, away from drafts will help, and there are many types of beds that seek to assist dogs by promoting even weight distribution.
Read more about physical rehabilitation, acupuncture and veterinary chiropractic for pets.