One of the most common conditions seen in large breed dogs as they age is evidence of hip dysplasia. When you are taking a history for an exam appointment (especially for older pets), don’t forget to ask how they are getting around. Ask the owner if their pet is slowing down, reluctant to jump up, is less active, or is having problems getting up off the floor. Some owners assume that these symptoms are just part of aging (sometimes they can be); but if the pet is having trouble, the veterinarian should address these issues with the owner and discuss management of arthritis.
What is it? Canine hip dysplasia is a progressive and multifactorial disease. It is usually genetic and caused by abnormal formation of the hip joints. This malformation leads to muscle and ligament laxity which means that the hip joint is not properly held in place. The dyplasia leads to chronic inflammation and pain in the hips.
Symptoms can include:
- Difficulty rising from the floor (tile floors make it especially difficult)
- Difficulty laying down and getting comfortable
- Reluctance to use the stairs (going up or down)
- Not wanting to go for walks or chase the ball, etc.
- A bunny hop type of gait
- Sometimes the dog shifts weight on the pelvic limbs
- Reluctance to be brushed or pet in the hind end or crying out when handled or picked up
- Not being able to jump up anymore (often noted that they can’t jump into the car anymore)
Risks for hip dysplasia:
- Large and Giant breed dogs (smaller breeds like Bulldogs are also at risk)
- Sub-optimal diet
- Genetics (offspring of a dog that had hip dysplasia)
Diagnosis: Diagnosis is made by a combination of things. Physical exam and poor range of motion in the hips is suggestive; pain on hip extension, or Ortolani sign on exam (posterior dislocation) may also be seen with sedated exam. X-rays are very helpful in diagnosis. The head of the femur should be more than 50% covered by the acetabulum, poor coverage (<50%) in the hip joint is seen with dysplasia. The appearance of the joint can be affected by positioning. It is important to keep the legs parallel with the table and not frog-leg the patient for positioning. Because dogs with hip dysplasia are painful, sedation is often needed for good hip extension and positioning for x-rays. For younger dogs that are going to be used for breeding or owner is concerned about risk, Penn Hip evaluation can be performed under anesthesia to determine risk for future development of dysplasia based on hip laxity (best at 1 year of age, can be done as early as 16 weeks). OFA HIP x-rays are more subjective and based on a grading system (need to be at least 2 years).
Treatment: Treatment may range from controlled exercise, weight loss, and management with joint support medications (such as glucosamine and fatty acids) or NSAID therapy. For more severe cases or those that cannot be controlled with medical management alone, surgical options include total hip replacement (with an artificial hip), femoral head osteotomy (to remove the head of the femur, usually for one hip), or triple pelvic osteotomy (for young high risk patients and performed between 6 to 12 months of age). Treatment depends up on each individual patient, pain level, and financial considerations.