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Dog: Hip Dysplasia

General information

Other common/scientific names: HD

Hip dysplasia is the abnormal development of the hip joints. The hip joint consists of the head of the femur (thigh bone) and the acetabulum of the pelvis. It is a ball and socket type of joint with the ball portion of the joint being the rounded head of the femur which fits into socket portion of the joint or the acetabulum. The head of the femur and the acetabulum are coated with smooth cartilage which enables the bones to glide across each other’s surface.

When a dog has hip dysplasia, the ball and socket do not fit together tightly. The muscles, ligaments and connective tissue that normally hold the hip together are lax and the hip joint becomes loose. The acetabular socket can be shallow and the femoral head can be flattened. This joint instability causes abnormal wearing of the cartilage resulting in pain and arthritis. Dogs with more hind limb muscle mass seem to have less incidence of hip dysplasia such as Greyhounds.

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Abb. GG3W1R4L: This is an illustration of a normal hip joint on the left and a hip joint with dysplasia on the right.

Causes

Hip dysplasia has both genetic and environmental factors implicated in its cause. Hip dysplasia can affect all breeds of dogs; however, large and giants breeds are more prone to the disease. These breeds include German Shepherds, Labrador Retrievers, Golden Retrievers and Rottweilers. While hip dysplasia is known to be inherited from affected parents, breeding dogs with normal hips can sire pups with hip dysplasia. The most common environmental factors contributing to HD include feeding an excessive calorie diet, weight gain and excessive exercise.

Cardinal symptom

  • Lameness
  • Difficulty rising

Symptoms

Dogs as young as four months of age may show signs of HD while some dogs are much older before they exhibit any symptoms. Clinical signs of hip dysplasia include difficulty rising, intermittent or constant lameness, “bunny-hopping” gait, pain on palpation (feel) of the hips and atrophy of the hip muscles.

Diagnosis

A presumptive diagnosis of hip dysplasia can be made from history, clinical signs and physical examination. However radiographs are needed for a definitive diagnosis. When radiographing hips for dysplasia, the positioning of the dog is critical to properly evaluate the bones and joints. Because of this and to reduce any pain from manipulating the hip joint, general anesthesia is necessary when obtaining hip radiographs. Radiographs will provide information about the conformation of the hips joint and any associated arthritic changes.

The Orthopedic Foundation for Animals (OFA) was originally founded to standardize radiographic findings of dogs in regards to hip dyplasia and provide information to dog owners to assist them with the selection of good breeding animals. Hip radiographs are submitted to the OFA and evaluated by three diplomats of the American College of Veterinary Radiologists. The hip conformation is then classified as excellent, good, fair, borderline, mildly dysplastic, moderately dysplastic or severely dysplastic. Grades of excellent, fair and good are considered normal by the American Kennel Club (AKC) and are given a certification number from the OFA. This certification number is public knowledge and listed on the dog’s pedigree. Offspring of OFA-certified parents are less likely to develop HD. Dogs must be two years of age for OFA certification although a preliminary hip evaluation can be performed on dogs 4 months to 24 months of age. The OFA also provides evaluation and certification for other orthopedic and genetic diseases.

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Abb. GG3W8LUR: Normal hips.
This is a radiograph showing normal hips of a dog.

Treatment

The objective of treatment is to relieve pain, slow the progression of arthritis and maintain mobility. Treatment can be conservative management or surgery. The treatment option selected is based on the degree of lameness, age of the dog and the financial resources of the owner.

Conservative Treatment

  • Pain relief medication in the form of NSAIDs (non-steroidal anti-inflammatory drug). There are several veterinary manufactured NSAIDs available. Since every dog responds differently, your veterinarian may prescribe different NSAIDs based on its response. Other forms of pain medication include corticosteroids and analgesics.
  • Weight control to reduce mechanical stress on the hip joint
  • Massage, physical therapy and acupuncture
  • Chondroprotective supplements such as glucosamine, chondroitin sulfate and diets high in omega-3 fatty acids.
  • Moderate exercise (without causing pain) to build muscle such as walking, jogging and swimming
  • Warm, well-padded bedding

Surgical Treatment

  • A triple pelvic osteotomy (TPO) can be performed to reestablish joint stability and joint development. The pelvic bones are cut in three places to free up the hip socket and allow the femoral head to fit better. Plates and screws are used fuse the cut bones. This procedure is only be successful in young dogs (5-10 months) with minimal arthritic changes.
  • Total hip replacement (THR) is used on older dogs with severe arthritis. With this procedure, the femoral head and neck are replaced with a prosthesis made of cobalt chrome or titanium and the acetabulum is replaced with a plastic cup prosthesis. One or both hips can be replaced.
  • A femoral head ostectomy (FHO) is the removal of the femoral head or ball and the femoral neck. This eliminates the source of pain and creates a false joint consisting of a cushion of scar tissue between the cut bone edge and the hip socket. An FHO works well for dogs under thirty pounds and for owners who cannot afford a total hip replacement.

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Abb. GG3WHHAV: Total Hip Replacement (THR).
This is a radiograph of a hip of a dog which has undergone a total hip replacement procedure. Note the prosthetic femoral head, neck and acetabulum.

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Abb. GG3WLQBI: Post Surgery.
This is a photograph of a dog after FHO surgery. Note the incision over the hip joint.

Prognosis

Hip dysplasia can be treated successfully. Young dogs which are diagnosed and treated early with a TPO have a 90% chance of a successful recovery. THR can also be 90% successful, but many owners cannot afford this procedure. While a femoral head ostectomy does not restore the limb to function, it can significantly decrease the dog’s pain.

Prevention

Prevention is aimed at breeding individuals that have OFA certification. Dogs with even mild hip dysplasia should not be used for breeding. Breed organizations and breed clubs should recognize HD as a problem and encourage OFA certification. Prospective buyers should check pedigrees. If no documentation is available, the dog should not be used for breeding.

A balanced diet should be fed to all young dogs. Protein, energy, calcium or phosphorus should not be overfed. Reducing stress to the hip joints in young, growing dogs is important. This can be accomplished by maintaining a normal, healthy weight and avoiding excessive exercise. Older dogs should also be maintained at a healthy weight to decrease the stress on the hip joints.

Early diagnosis and treatment can prevent the debilitating arthritis caused by HD.

Tips

For dogs undergoing surgery, it is very important that the dog does not lick or pull at the sutures. A special collar (E-collar or Elizabethan collar) is worn by the dog to prevent this. Incisions should be observed daily for swelling, discharge or redness.

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Abb. GTCPKGYD: Elizabethan collar.

CAUTION

If you notice your pup or dog is lame or has difficulty getting up and this persists for more than three days, please call your veterinarian. Early diagnosis of orthopedic problems is the key to successful treatment.

Update version: 4/24/2014, © Copyright by www.enpevet.de
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