Hip dysplasia in dogs: symptoms, tests and treatment

Overview

The hip joint consists of the head of the thigh bone and the hip socket in the pelvis. In hip dysplasia, the joint does not develop sufficient stability. Looseness and abnormal loading can damage joint cartilage and alter the surrounding bone. The resulting degenerative joint disease is called osteoarthritis.

The disease occurs particularly in large dogs, although small dogs are not protected from it either.

Hip dysplasia is the most common developmental bone and joint disorder in dogs. The hips look normal at birth, but changes begin within the first weeks of life.

Lameness can be mild, moderate or severe, and joint range of movement may decrease as the disease develops.

Causes

Several genes and environmental factors contribute. A puppy may not look abnormal at birth even if joint development later takes an unfavourable course. Feeding, growth rate and exercise also affect how inherited susceptibility is expressed.

When the femoral head does not stay securely enough in the socket, pressure is distributed unevenly across the joint surfaces. Alongside cartilage and bone damage, the joint capsule and other soft tissues change. Over time, the joint may stiffen and the hip's range of movement decrease. Looseness in a young dog and osteoarthritis pain in an older dog can therefore look different despite the same underlying developmental disorder.

Overfeeding and rapid growth can worsen the expression of disease in a susceptible puppy.

In a loose joint, the contact area between the femoral head and socket is small. High pressure concentrated over a small area can cause microfractures and make the hip socket shallower.

One disease mechanism is an imbalance between the muscle mass supporting the hip and the rapidly developing skeleton. The joint capsule may thicken with fibrous tissue, and the femoral head may move partly or completely out of the socket.

Risk factors

Large size and rapid growth are prominent risk factors. Affected breeds include Labrador Retrievers, German Shepherd Dogs, Rottweilers and bulldog-type dogs, for example. Relatives' hip results also provide information about susceptibility.

Excess weight increases signs in a dog already affected, and weight reduction alone may improve their condition.

Affected dogs occur in almost every breed. Normal hip X-rays in the parents do not remove the puppies' inherited risk. Family risk is therefore assessed using the pedigree and hip results of offspring from the same mating.

Inherited susceptibility is the most important single risk factor, although the growth environment and nutrition also affect whether disease develops.

Typical symptoms

Signs may begin in a young dog or only later as osteoarthritis develops. Some dogs initially appear almost symptom-free. Stiffness after rest and lameness after exertion are common observations.

• Your dog gets up slowly or with difficulty.

• The back legs move together in a bunny-hopping action when running.

• Lameness or stiffness affects the hindquarters.

• Your dog avoids jumping or moves less than before.

• Hindquarter muscles become smaller and weight shifts towards the front legs.

A young dog's signs may sometimes ease for a long period. This does not necessarily mean the structural developmental problem has disappeared.

Signs in a puppy may be noticed at 3–12 months of age. In a young dog, pain may come from inflammation of the joint capsule caused by looseness. A clicking sound may be heard when walking, or the hips may sway from side to side.

Complications and consequences

Osteoarthritis can cause long-term pain, restricted movement and reduced function. Reduced use of the back legs can also lead to muscle wasting. This changes how everyday loads are carried, and your dog may shift weight forwards.

Possible complications of total hip replacement include infection, dislocation, implant loosening, nerve damage and fracture.

The outlook depends on disease severity, other health conditions and the environment. Many dogs live well with treatment, and not every dog needs surgery.

JPS surgery narrows the pelvic canal. As a result, a female dog cannot give birth normally. Other risks of pelvic osteotomy include screws loosening and changes in hip range of movement.

Diagnosis at the vet

The vet asks when lameness began, how exercise and rest affect it, and about previous injuries. Your dog's movement is observed, and the joints and back are examined. The aim is to locate the source of pain, as back-leg signs do not always arise from the hip. The same dog may also have knee or back disease, for example.

Arriving at the practice may temporarily change your dog's movement: excitement or anxiety can hide lameness that is visible at home.

Hip X-rays are taken in appropriate positions, usually under sedation or general anaesthesia. The images assess structure and osteoarthritis changes, and help plan treatment. Joint looseness can also be investigated using specific hands-on tests or stress radiography.

Some breed-club skeletal health assessments are intended to provide screening information for breeding. They do not replace clinical examination of a dog with signs.

X-ray changes and the severity of signs do not always correspond. The vet may therefore recommend treatment based on pain despite mild imaging changes, or monitor a dog with few signs despite clear X-ray abnormalities.

Joint looseness can be assessed early using the Ortolani manoeuvre at 10–16 weeks of age. Some official hip screening schemes require a minimum X-ray age of 12 months, or 18 months for certain breeds. Breed-specific screening rules define these exceptions.

A standard hip X-ray taken with the dog on their back does not always reveal looseness, because fibres of the joint capsule tighten when the back legs are extended. Stress radiography measures joint looseness in a controlled way, helping assess the risk of later osteoarthritis.

Treatment

The vet prescribes pain relief and tailors other treatment to your dog. Conservative treatment, meaning care without surgery, may include weight management, suitable exercise and physiotherapy. The aim is to maintain muscles, joint movement and a comfortable daily life.

Non-steroidal anti-inflammatory drugs and other pain relief, when needed, are chosen according to your dog's health. Some medicines require blood tests to monitor safety. Do not give human painkillers or medicines previously prescribed for another patient on your own initiative.

Exercise can be regular, gentle and low-impact. Walking, water-based exercise and muscle-strengthening exercises may form parts of the plan. Rehabilitation exercises are taught so you understand their purpose and what pain response means the load should be reduced.

Surgery is considered, for example, for a dog with severe signs that other treatment does not relieve adequately. Total hip replacement replaces the joint components, while removal of the femoral head and neck aims to eliminate painful contact within the joint.

Juvenile pubic symphysiodesis, or JPS, uses heat to fuse the pubic growth plate and alter pelvic growth so the socket covers the femoral head better. It is performed early, at about 12–20 weeks and no later than before 5 months of age. JPS or pelvic osteotomy performed at the appropriate age may reduce joint looseness as growth continues. Some breed-club guidance nevertheless notes that reliable evidence of JPS effectiveness is still lacking.

Rehabilitation after surgery depends on the procedure. After hip replacement or pelvic correction, initial restrictions and follow-up are needed before activity increases. After femoral head removal, controlled joint use and physiotherapy are central to recovery.

In pelvic osteotomy, pelvic bones are cut and the socket is rotated into a more supportive position. The procedure suits young dogs before significant osteoarthritis develops.

Restrictions are usually needed for about 6 weeks after pelvic osteotomy and about 8 weeks after total hip replacement. Healing is confirmed by examination and X-rays before activity increases. During recovery, your dog must avoid stairs, slippery surfaces and boisterous play with other dogs.

After removal of the femoral head and neck, a so-called false joint forms around the hip. Muscles then transmit the limb's load to the pelvis. The procedure relieves pain, but does not aim to restore a completely normal joint.

Prevention

Because of the inherited background, home care alone cannot reliably prevent hip dysplasia. Breeding screening and consideration of relatives' results can reduce risk in future generations. However, healthy hip X-rays do not guarantee that a dog cannot produce affected offspring. When choosing a puppy, also ask about relatives' test results and the breed's health recommendations.

Avoid overfeeding a growing large dog and maintain a suitable weight. Provide a complete, balanced diet appropriate for the growth stage. Do not add calcium or vitamin D to an already balanced diet on your own initiative. A puppy with signs should also be examined promptly, rather than having all stiffness attributed to normal growth.

A practical weight-management goal is a visible waist when viewed both from the side and from above. A food calculator can help estimate food quantities. Choose a diet designed for the growth stage of a large-breed puppy.

In breeding, the BLUP index combines hip information from a dog and their examined relatives. It reduces the influence of environmental factors on the breeding assessment. Using the index requires enough dogs in the breed to have been X-rayed.

Important for dog owners

Watch how your dog gets up, walks, uses stairs and joins in ordinary activities. Record what exertion brings on signs and how rest affects them. Take comparison videos on the same surface if you can do so without straining your dog. Report changes in weight, medication and exercises too, so assessment of treatment response does not depend on a single day at the practice.

In some breed-club screening schemes, a dog operated on for hip dysplasia receives a separate result indicating surgery rather than a standard grade. These schemes prohibit breeding from a surgically treated dog. If surgery is being planned, ask about these consequences and submitting information too; your dog's welfare remains the aim of the treatment decision.

Frequently asked questions

Can hip dysplasia cause signs in a puppy?

Yes, and early signs deserve investigation. Not all stiffness in a puppy's back legs is part of normal growth. Some operations that influence development require early assessment before osteoarthritis, so do not wait solely for later official screening when signs are present.

Does every dog with hip dysplasia need surgery?

No. Many dogs benefit from weight management, tailored exercise, pain relief and rehabilitation. Surgery is considered according to the dog's circumstances and treatment response. The decision is based on clinical examination and imaging; an official letter grade alone does not determine it.

Can X-rays look severe when a dog moves well?

Yes. Imaging changes and signs do not always correspond directly. Even a dog that moves well is therefore assessed as a whole, while pain is treated even if X-ray findings are minor. Tell the vet about everyday observations that a brief appointment may not reveal.

Does an official hip score replace investigation of pain?

No. A breed-club hip assessment is part of breeding screening, while examining a dog with signs establishes the source of current pain and the treatment needed. The aims partly differ. Do not leave new lameness uninvestigated simply because your dog has a previous official assessment.

Does losing weight help?

Reducing excess weight can ease signs in a dog with hip disease and is often part of treatment. It does not change the inherited background or replace other necessary pain relief. Ask your vet for a suitable target and feeding plan that also supports muscle condition and nutrition.