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Hip Dysplasia in Dogs

Explore physiotherapy rehabilitation for hip dysplasia. Understand its benefits, process, and key exercises for recovery.
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What is Hip Dysplasia in Dogs?

Hip dysplasia (dɪsˈpleɪzɪə) in Dogs is a disease of the hip in which the ball and socket joint is malformed. This malformation means that the ball portion and its socket don’t properly meet one another, resulting in a joint that rubs and grinds instead of sliding smoothly. This can cause crippling lameness and painful arthritis of the joints. It is a genetic (polygenic) trait that is affected by environmental factors.
Hip dysplasia is one of the most common skeletal diseases seen in dogs. Gender does not seem to be a factor, but some breeds are more likely to have the genetic predisposition for hip dysplasia than other breeds.
Your dog’s hip joint is constructed very much like the ball joints of your automobile. The bone of the thigh (the femur) ends in a ball that fits into a socket (acetabulum) formed by the pelvis. This type of arrangement forms a very strong joint that allows a great range of motion and weight-bearing. But for it to work properly, the ball must be held deeply and snuggly within the socket.
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What causes Hip Dysplasia and are there certain breeds at risk?

What is the cause of Hip Dysplasia

In canines, it can be caused by a femur that does not fit correctly into the pelvic socket, or poorly developed muscles in the pelvic area. Large and giant breeds are most susceptible to hip dysplasia (possibly due to the BMI of the individual animal), though, many other breeds can suffer from it. For a list of top 100 breeds affected, by percentage, visit the OFFA.
To reduce pain, the animal will typically reduce its movement of that hip. This may be visible as “bunny hopping”, where both legs move together, or less dynamic movement (running, jumping), or stiffness. Since the hip cannot move fully, the body compensates by adapting its use of the spine, often causing spinal, stifle (a dog’s knee joint), or soft tissue problems to arise.
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Signs and Symptoms of Hip Dysplasia in Dogs

Symptoms depend on the degree of joint looseness or laxity, the degree of joint inflammation, and the duration of the disease.
  • Early disease: signs are related to joint looseness or laxity
  • Later disease: signs are related to joint degeneration and osteoarthritis
  • Decreased activity
  • Difficulty rising
  • Reluctance to run, jump, or climb stairs
  • Intermittent or persistent hind-limb lameness, often worse after exercise
  • “Bunny-hopping,” or swaying gait
  • Narrow stance in the hind limbs (back legs unnaturally close together)
  • Pain in hip joints
  • Joint looseness or laxity – characteristic of early disease; may not be seen in long-term hip dysplasia due to arthritic changes in the hip joint
  • Grating detected with joint movement
  • Decreased range of motion in the hip joints
  • Loss of muscle mass in thigh muscles
  • Enlargement of shoulder muscles due to more weight being exerted on front legs as dog tries to avoid weight on its hips, leading to extra work for the shoulder muscles and subsequent enlargement of these muscles

Hip Dysplasia – The importance of a proper diagnosis process

The classic hip dysplasia diagnostic technique is with appropriate X-rays and hip scoring tests. These should be done at an appropriate age, and perhaps repeated at adulthood – if done too young they will not show anything. Since the condition is to a large degree inherited, the hip scores of parents should be professionally checked before buying a pup, and the hip scores of dogs should be checked before relying upon them for breeding. Despite the fact that the condition is inherited, it can occasionally arise even to animals with impeccably hip scored parents.
In diagnosing suspected dysplasia, x-ray is usually combined with an observation of the animal’s gait and posture. Evidence of lameness or abnormal hip or spine use, difficulty or reduced movement when running or navigating steps, are all evidence of a problem. Both aspects have to be taken into account since there can be serious pain with little X-ray evidence.
It is also common to X-ray the spine and legs, as well as the hips, where dysplasia is suspected, since soft tissues can be affected by the extra strain of a dysplastic hip, or there may be other undetected factors such as neurological issues (e.g. nerve damage) involved.
There are several standardized systems for categorising dysplasia, set out by respective reputable bodies (Orthopedic Foundation for Animals/OFA, PennHIP, British Veterinary Association/BVA). Some of these tests require manipulation of the hip joint into standard positions, in order to reveal their condition on an X-ray.
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What can you do for your pet with Hip Dysplasia

Available Surgical Correction for Dogs diagnosed Hip Dysplasia in Singapore

There are several different types of surgery available here in Singapore to help dysplastic dogs. They are mostly expensive and the results are mixed. The fact there are so many dissimilar techniques being used on heavy breeds at the same time, suggests that none of them give as good a result and the pet owner will hope for.
This is because they all target the results of hip dysplasia – not the cause. The results of hip dysplasia are an improperly shaped hip. But the cause of hip dysplasia is weakness and looseness of the ligaments and cartilage that hold the hip together.
This older technique was popular in the 1970s. It involves cutting the pectinious muscle of the groin to lessen the pain of dysplasia. Cutting this muscle was said to decrease the normal pressure that presses the ball of the femur into the acetabular socket. Some veterinarians thought it might be helpful in certain cases of hip dysplasia. However, the relief provided was usually temporary and arthritic changes in the joint continued or possibly sped up. Few veterinarians still perform this surgery but it is no longer recommended by most veterinarians.
This older technique was popular in the 1970s. It involves cutting the pectinious muscle of the groin to lessen the pain of dysplasia. Cutting this muscle was said to decrease the normal pressure that presses the ball of the femur into the acetabular socket. Some veterinarians thought it might be helpful in certain cases of hip dysplasia. However, the relief provided was usually temporary and arthritic changes in the joint continued or possibly sped up. Few veterinarians still perform this surgery but it is no longer recommended by most veterinarians.
This older technique was popular in the 1970s. It involves cutting the pectinious muscle of the groin to lessen the pain of dysplasia. Cutting this muscle was said to decrease the normal pressure that presses the ball of the femur into the acetabular socket. Some veterinarians thought it might be helpful in certain cases of hip dysplasia. However, the relief provided was usually temporary and arthritic changes in the joint continued or possibly sped up. Few veterinarians still perform this surgery but it is no longer recommended by most veterinarians.
This older technique was popular in the 1970s. It involves cutting the pectinious muscle of the groin to lessen the pain of dysplasia. Cutting this muscle was said to decrease the normal pressure that presses the ball of the femur into the acetabular socket. Some veterinarians thought it might be helpful in certain cases of hip dysplasia. However, the relief provided was usually temporary and arthritic changes in the joint continued or possibly sped up. Few veterinarians still perform this surgery but it is no longer recommended by most veterinarians.
This older technique was popular in the 1970s. It involves cutting the pectinious muscle of the groin to lessen the pain of dysplasia. Cutting this muscle was said to decrease the normal pressure that presses the ball of the femur into the acetabular socket. Some veterinarians thought it might be helpful in certain cases of hip dysplasia. However, the relief provided was usually temporary and arthritic changes in the joint continued or possibly sped up. Few veterinarians still perform this surgery but it is no longer recommended by most veterinarians.
This older technique was popular in the 1970s. It involves cutting the pectinious muscle of the groin to lessen the pain of dysplasia. Cutting this muscle was said to decrease the normal pressure that presses the ball of the femur into the acetabular socket. Some veterinarians thought it might be helpful in certain cases of hip dysplasia. However, the relief provided was usually temporary and arthritic changes in the joint continued or possibly sped up. Few veterinarians still perform this surgery but it is no longer recommended by most veterinarians.
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The importance of Rehabilitation and Physiotherapy for Hip Dysplasia in Dogs

Conservative Management of Hip Dysplasia

Physiotherapy has an important role in the management of hip dysplasia. Whilst hip dysplasia is a progressive disease, the condition can be affected by external factors. The main feature of the disease is joint laxity which leads to changes in the joint, abnormal wear and subsequent osteoarthritis.

Rehabilitation Aims

Initial symptoms that your dog may exhibit can be reduced exercise tolerance, problems going up and down stairs, difficulty rising and lameness after exercise. If your primary care vet or orthopaedic clinician should refer your dog to our rehabilitation service a full physiotherapy assessment is undertaken by one of our chartered physiotherapists. Findings might be – altered gait pattern, with or without lameness, reduced weight-bearing load on the affected limb, weakness of specific muscles (most commonly the gluteal muscles) pain manifested by intolerance to be touched in the affected area or during certain movements or postures and reduced range of movement (ROM). Your dog may exhibit all of or just a few of these clinical signs.
Rehabilitation aims to address the above findings and to maintain and/or prevent progression of the disease. After physiotherapy assessment is completed, a list of focus points is formed and a rehabilitation treatment plan is implemented.
Aims will include the following
  • Reduce pain
  • Strengthen the affected muscles
  • Improve and maintain soft tissue flexibility
  • Improve and maintain ROM
  • Enhance gait patterning

Rehabilitation Aims

Targeted exercises specifically for the gluteal muscles Balance and coordination exercises “Hands on” therapy such as massage and basic stretching for pain relief and improving flexibility Pain relief might be provided using laser therapy and ice.

Hydrotherapy Treatment Options

  • Hydrotherapy, particularly underwater treadmill, can be a useful tool for strengthening specific muscles and improving gait patterns. The buoyancy of the water provides support to the body which in turn reduces the load on the affected joints whilst exercising the necessary muscles.
  • Any physiotherapy program which is prescribed for your dog is constantly re-evaluated and progressed based on the response to treatment. Owner participation is key as so much of the therapy can be used on a daily basis and provided at home. Detailed instructions are always provided.
TimelinePhysiotherapy AimsRehabilitation Therapy options
Week 0 to 2Reduce post operative swelling• Game Ready (Ice Therapy) • Laser • Soft tissue massage
Reduce muscular guarding and maintain soft tissue flexibility• Laser • Soft Tissue Massage • Heat therapy • Careful stretches
Allow careful limb loading• Assisted active exercises
Week 2 to 4Progress limb loading and gait re-education• Home exercise program • Neuromuscular electrical stimulation • Hydrotherapy • Underwater Treadmill
Increase muscle massLow level exercise program and muscle stimulation
Maintain soft tissue length and flexibility• Passive joint range of movements and stretches
Management at home• Exercise restriction • Advice regarding flooring • Advice regarding assisted walking with harness and sling if required • Advice regarding cavaletti pole work, gradients, steps and different surfaces
Week 4 to 6Continue as above, include core stability exercisesProgression of home exercise program to challenge balance, body awareness and strength
Advice on maintaining controlled exercise when dog feeling better
Week 6 to 12Increase exercise toleranceIncrease exercise level, considering land and water based options.
Continue to increase core stabilityHome exercise program considering land and water based exercises
Week 12 onwardsReturn to full function or establish deficits and advise regarding long term management.Progress to off lead exercise and previous exercise level if appropriate.
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References

Darryl L. Millis, MS, DVM, DACVS, DACVSMR, CCRP Professor of Orthopedic Surgery & Director of Surgical Service
Robin Downing, DVM, MS, DAAPM, DACVSMR, CVPP, CCRP
Diplomate of the American Academy of Pain Management, is a a founder and past-president of the International Veterinary Academy of Pain Management.
Janet B. Van Dyke, DVM
Diplomate American College of Veterinary Sports Medicine and Rehabilitation, CCRT, CEO
Ludovica Dragone, DVM, CCRP
Vice President of VEPRA, Veterinary European of Physical Therapy and Rehabilitation Association.
Andrea L. Henderson, DVM, CCRT, CCRP
Resident, Canine Sports Medicine and Rehabilitation
Steven M.Fox, MS, DVM, MBA, PhD
President Securos. Inc
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