- Canine hip dysplasia (CHD) is a very common musculoskeletal disease in purebred and mixed breed dogs, especially large breeds
- Symptoms of CHD include an abnormal gait, low exercise tolerance, and a reluctance to climb stairs
- CHD must be diagnosed and managed as early as possible to preserve dogs’ quality of life
- Five areas of focus for dogs with hip dysplasia are diet and weight management, exercise and preventing injury, physical therapy, pain management and joint support, and hormone replacement therapy for desexed dogs
Editor's Note: This article is a reprint. It was originally published November 15, 2021.
Canine hip dysplasia (CHD) is considered the most common-occurring musculoskeletal disease among both purebred and mixed breed dogs. The severe form of the disorder typically occurs in puppies under a year; the chronic form develops later.
In a dog with healthy hips, the ball (the head of the femur) at the top of the leg bone fits perfectly into the socket. In animals with CHD, the less-than-perfect fit causes the bones to separate. This separation is the result of abnormal joint structure coupled with weak muscles, ligaments and connective tissue that support the joints.
The result is a joint that chafes and grinds rather than slides smoothly during movement. Often the body tries to compensate for the poorly fitting joint by producing hard, bony material in and around it to try to stabilize it. This alteration can have the opposite effect, creating an even more unnatural fit.
The wear and tear on the joint from chafing and grinding eventually results in degenerative joint disease (DJD), which can be extremely painful and debilitating for the dog.
Symptoms and Diagnosis of Hip Dysplasia
Dogs with CHD often have one or more of the following symptoms:
- Low exercise tolerance
- Abnormal gait
- Reluctance to climb stairs
- Bunny-hopping when running
- Audible "click" when walking
- Thigh muscle atrophy
- Increased width between points of the hips
Canine hip dysplasia is what is known as a polygenetic multi-factorial disease, meaning there is a genetic component to the disorder, more than one gene is involved, and it is caused by several factors, not all of which have been identified. Dogs with genes for hip dysplasia may or may not develop the disease; a dog without CHD genes is in the clear.
A dog can have great OFA and PennHIP scores (which measure hip health) and still carry the genes for the disease, meaning future generations of puppies can develop CHD even if prior generations show no signs of it.
A dog is diagnosed with CHD if the ball and socket hip joint is malformed, causing separation of the two bones of the joint. In most cases, the socket is not deep enough for the ball to fit snugly into place.
Diagnosis is typically made either because a dog is showing symptoms, or as the result of a standard hip exam. Your veterinarian will perform a complete physical exam and take x-rays. He or she may also be able to feel looseness in your dog's hip joint and note pain when a rear leg is extended or flexed.
In dogs without symptoms, CHD is often diagnosed during the OFA and/or PennHIP certification process intended to establish the health of an animal's hips.
How to Give Your CHD Dog an Optimal Quality of Life
To give dogs with hip dysplasia the best chance for a long, fully mobile, and high-quality life, early identification of CHD is crucial. Especially if you have a large breed dog, I recommend taking the following steps from day one to lessen her chances of developing or suffering from hip dysplasia as she grows and ages.
If your dog has already been diagnosed with the condition, the following recommendations will alleviate the impact. The goal is to do everything possible to decrease the likelihood that CHD will create quality of life issues for your canine companion.
- Diet and weight management — The number of calories your dog consumes, especially from three to ten months of age, has been shown to have a significant impact on whether a puppy with CHD genes will go on to develop the disease. High calorie, high carb diets can cause frame growth that is too fast for the cartilage in the body to keep up with, especially in large breed dogs.
The goal for large breed puppies is slow, controlled growth with targeted (not generic) mineral ratios. The European pet food association (FEDIAF) differentiates puppies into early and late growth phases, with different calcium and phosphorus ratios for different periods of growth. We can only hope AAFCO (the American pet food association) may someday follow suit.
A portion-controlled, well-formulated, species-specific (aka low carb, for dogs) diet will provide your dog with the right nutrition in the right amounts throughout his life. Obesity can increase the severity of dysplasia and accelerate the degeneration of joints, so it's important to keep him lean.
Dogs born with genes that make them prone to hip dysplasia, if allowed to grow overweight, will be at much higher risk of developing the disease, and subsequently, arthritis as well.
- Exercise and preventing injury — Focus the exercise your dog gets on activities that work the rear-limb muscles, for example, sit-to-stands and walking uphill, along with running and swimming (hydrotherapy). The goal is to safely maintain excellent muscle mass, which can decrease the incidence and severity of CHD.
This also takes a commitment on your part to a daily, focused exercise plan. Without concerted daily effort, muscle mass wanes, atrophy sets in, and weakness and degeneration are inevitable.
To minimize the potential for traumatic injury, avoid activities that require jumping (especially from high places) or sudden stops or changes in direction. Also, don't allow your dog to exercise or spend significant time on slippery surfaces. Cover slick floors with runners or area rugs, and if she has difficulty getting up on your bed or couch for a snooze, consider adding a ramp or stairs so she doesn't have to jump.
- Physical therapy — The most important aspect of managing CHD is building excellent muscle mass, as well as maintaining tendon, and ligament health throughout your dog's life.
Toward that end, physical therapies such as chiropractic, massage, stretching, laser treatment, acupuncture, pulse electromagnetic therapy, shock wave therapy and aquatic therapy are extremely beneficial at maintaining quality of life, reducing pain, increasing mobility and slowing the rate of joint degeneration. Regenerative therapies, including stem cell therapy and platelet-rich plasma injections can also be beneficial.
- Joint support immediately, pain management when needed — It's very important to provide both joint support (chondroprotective agents, CPAs) immediately upon diagnosis, and pain management when needed.
I start my large and giant breed dogs on chondroprotective agents at three years of age, regardless of whether they have genetic predispositions for joint disease or not, because they fair better with less degeneration down the road.
If pain is also present at the time of diagnosis, begin both protocols simultaneously, recognizing pain management (natural or drug) does nothing to slow the degenerative process leading to arthritis and cartilage-protecting supplements do nothing to manage pain. Each protocol serves very different purposes but are equally important.
Do not wait to begin an arthritis-slowing protocol if your dog has been diagnosed with hip dysplasia, start now. Talk to your integrative veterinarian about supplements that can provide the raw materials for cartilage repair and maintenance, including:
- Glucosamine sulfate
- Eggshell membrane
- Collagen supplements
- Perna mussel
- Hyaluronic acid
- Chondroitin sulfate
- Adequan™ injections
By blending natural pain control, including curcumin, PEA (palmitoylethanolamide), boswellia and proteolytic enzymes (Wobenzym™, etc), I have been able to successfully delay the use of non-steroidal drugs with potential side effects for years, and even surgery, in some cases.
- Hormone replacement therapy — If your dog with hip dysplasia was desexed (neutered or spayed) at a young age, he or she has lost both muscle tone and bone density over time, which exacerbates CHD. For these dogs (both males and females), testosterone replacement therapy can be extremely beneficial.
Earlier this year, I interviewed veterinarian Dr. David Bieber, owner of the Sheridan West Animal Clinic in Cooper City, FL.
Dr. Bieber has developed a one-of-a-kind hormone replacement program called Dogosterone for desexed dogs that replaces the testosterone their testicles or ovaries (the gonads) would have provided naturally had they been left intact. When the gonads are removed, sex hormone production ceases, and sooner or later desexed dogs wind up with endocrine imbalances that create all kinds of health problems.
Dr. Bieber has seen improvement in a variety of conditions once testosterone replacement therapy is initiated, including hip dysplasia and arthritis. Unfortunately, Dogosterone therapy hasn't yet caught on with veterinarians.
The good news, however, is that Dr. Bieber is now offering online hormone replacement therapy certification to his colleagues through his Dogosterone website for veterinarians who would like to offer testosterone replacement therapy to their patients in a safe and effective manner.