Hip Dysplasia in dogs: an update
A couple of years ago, I wrote an article on here about hip dysplasia. But since it is such a hot topic in the Veterinary World right now I decided to write an update, with a bit more focus on a preventative surgery that is available (JPS –Juvenile Pelvic Symphysiodesis) and the current hip screening programmes available in Australia.
What is dog hip dysplasia?
Hip Dysplasia is a disease that results from abnormal formation of the hip joint. The ‘Dys’ in Dysplasia, comes from the ancient Greek meaning of ‘bad’ and this unfortunately sums up this disease as it relates to dogs. The abnormally formed hip can cause dogs pain, which is often worse in the growing phase of life, and then also later in life when it can result in debilitating arthritis. It is a complex disease and there are several possible causes. One of these causes is genetic, however it is not the only cause and diet, exercise and hormones may also be linked to development of the disease.
Abbie in her clinic
What types of dogs get hip dysplasia?
There are usually two groups of dogs we see presenting to the vet clinic with symptoms of hip dysplasia. There are the younger group of dogs where pain is thought to be a result of laxity in the hips. Essentially, the ball is ‘jiggling around’ in the socket. This can lead to micro-fractures within the cartilage. These dogs tend to present at around 5-12 months of age and can have a typical ‘bunny-hopping’ gait, swaying hips and a wide-based stance.
We also see mature/senior dogs that present with signs that can be attributed to the resulting osteoarthritis. These dogs often have more of a short, stiff gait. Other signs can include trouble getting in and out of the car, up and down stairs, stiffness after rest, exercise intolerance or reluctance to exercise or reduced/altered interaction with owners.
Diagnosis of hip dysplasia in dogs
Hip Dysplasia is diagnosed at the Vet Clinic using a combination of:
- History from you as an owner – when do you see the symptoms, what makes them worse, how much is it affecting your dog’s quality of life and ability to exercise.
- Clinical examination – this will focus on the hips but vets should also check the stifles (knees) and spine to rule out other causes of pain and lameness
- Radiographs – it is important to note that severity of disease on radiographs does not always correlate well with severity of disease in the dog. You could have quite good radiographs for a dog in a lot of pain and vice versa. This is why a combination approach must be used to diagnose and treat the disease.
Prevention of hip dysplasia in dogs
Although hip dysplasia is an undesirable thing, it is not all bad news. A lot is being done around the world to reduce the incidence of this disease. There are also several treatment options which will be discussed below.
One of the key focuses of prevention has been to try to reduce the incidence of the disease within the gene pool. The basic principle of this involves identifying affected dogs and attempting to remove them from the gene pool by not using them for breeding, and rather using dogs with good hips. Unfortunately, this is much easier said than done and the current hip screening programs are not 100% accurate in terms of their ability to identify the affected dogs. The current program used in Australia has been shown to pick up around 63-69% of affected dogs. This means that 31-37% of dogs that do have hip dysplasia can potentially remain as breeding dogs.
There are other hip programs being established (for example the PennHip programme) for which studies have shown superiority in terms of identifying affected dogs and removing them from the gene pool. This hip screening program is now used in New Zealand. I personally hope that Australia follows in adopting this more successful programme. Unfortunately, no programme is perfect, which is why even if you purchase a dog from an excellent breeder, the dog may still be affected by the disease. Some breeds are more affected than others, as I discussed in the last article.
Treatments for dog hip dysplasia
There are several treatment and preventative options for dogs affected with hip dysplasia.
Juvenile Pubic Symphysiodesis
There is a procedure now offered by some Veterinarians for dogs that are identified as being ‘at risk’ in puppyhood. This procedure is called Juvenile Pubic Symphysiodesis (JPS). JPS is a minimally invasive procedure with low morbidity (low risk of complications). There have now been several published studies looking at dogs diagnosed with canine hip dysplasia early in life, comparing treatment (with JPS) and control (untreated) groups. A 2010 study concluded that “JPS performed between 12 and 24 weeks of age was an effective pre-emptive bilateral treatment for mild-to-moderate hip dysplasia” (1). A separate study revealed that “the JPS procedure increased the odds of arresting or limiting the progression of canine hip dysplasia in mild to moderate grades” (2).
JPS works by slowing growth in one of the growth plates within the pelvis. This changes the conformation of the hip joint. The X in the photo below marks the centre of the growth plate. A cautery probe is slipped into the growth plate in this region every couple of millimetres. This results in better coverage of the acetabulum (marked with a star) over the ball of the femur. This has been shown to reduce hip dysplasia in later years.
JPS is effective and low risk, however the catch is that it must be performed ideally before your puppy is 20 weeks. It has been found to be less effective for very severely affected cases. If you are curious about the procedure, get information from you vet when your puppy is at first or second vaccination. The procedure is only performed on dogs that are at risk for developing the disease and suitability is determined by radiographic study.
There are other surgical procedures that can also help dogs diagnosed early, usually before 14 months. One such procedure is called a “double pelvic osteotomy”. This procedure is best discussed with a veterinary specialist and is more advanced/invasive than JPS, but can provide long term benefits.
In older dogs, the treatment usually focuses on resolving the symptoms of osteoarthritis. This can involve a pain relief protocol, an exercise and weight loss program, a possible diet change or dietary supplementation, or use of injectable agents such as pentosan polysulphate. Physiotherapy and hydrotherapy can also be useful. For refractory cases, total hip replacements or femoral head ostectomies can be useful salvage procedures.
For any further questions about hip dysplasia, as always, I am happy to answer them. Feel free to make contact via the contact form.
1 – R.T Dueland, WmM Adams, A. J Patricelli, K. A. Linn, P. M. Crump (2010) ‘Canine Hip Dysplasia treated by Juvenile Pubic Symphysiodesis’
2 – A Vezzoni, G. Dravelli, L. Vezzoni, M. Dehorenzi, A Corbari, A. Cirla, C. Nassuato, V. Tranquilla (2008) ‘Comparison of conservative management and Juvenile Pubic Symphysiodesis in the early treatment of canine hip dysplasia’.