Managing Your Dog's Hip Dysplasia
Hip dysplasia is a common and painful orthopaedic condition that often leads to the development of osteoarthritis. It is most commonly associated with medium to large breeds, but can affect all breeds of dogs. With appropriate treatment and management plans in place, affected dogs can live happy lives for years.
What is Hip Dysplasia?
Hip dysplasia (HD) is a developmental condition that affects the bones of one or both hip joints. The hip joint consists of two bones, the pelvis and femur, which form a tight ball and socket joint. When affected by HD, bone growth is abnormal and the two bones do not fit together as they should do, causing the joint to be loose. This looseness and the associated instability leads to further damage as the two bones rub together, which damages the articular cartilage (tissue covering the bone ends). The joint capsule (tissue covering the whole joint) and surrounding ligaments also become damaged through abnormal stretching and twisting of the joint, which then leads to further joint laxity.
The changes to the hip joint usually occur when the dog is still young and growing, with symptoms appearing from as early as 6 months old. Whether an individual gets HD depends on their genetics and it is inherited from at least one parent, which is why health screening is so important when making a decision to breed dogs. The dog's environment can also affect the onset and severity of HD.
Symptoms & Diagnosis
The main indicators of hip dysplasia (HD) include groaning and difficulty settling down or getting up (one of the earliest signs of HD), difficulty going upstairs, stiffness after rest, lameness and poor gait. However, these can also indicate other medical conditions, so it is important to discuss them and any other concerning issues with your vet.
Your vet is the only person who can legally diagnose medical conditions, including HD, which they may do through behavioural observations, assessment of the dog's physical condition and palpation of the joints. However, the only definitive way to diagnose HD is via an x-ray. The x-ray would indicate abnormal or incorrect development of the hip joint and if later in the dog's life, can reveal deterioration of the joint.
Treatment & Management
There are a few treatment methods for hip dysplasia, as well as various ways to manage the condition. Treatment often involves surgery, with total hip replacement and femoral head and neck excision being the most common surgeries. However, new treatments, such as platelet-rich plasma therapy and stem cell therapy, are alternatives that have recently gained popularity.
Alongside treatment or in place of treatment (if not suitable), adjustments to the dog's environment and lifestyle are key to managing their condition and slowing deterioration of the joint. Appropriate lifestyle management during the young dog's life may also slow the onset and severity of hip dysplasia.
Medications & Supplements
In most cases, the use of pain relief and non-steroidal anti-inflammatory drugs is highly beneficial for dogs who are suffering with hip dysplasia. They can help a dog live more comfortably, allowing them to have a better quality of life. Supplements may also be beneficial for the health of the joints, however there are very few studies, particularly in dogs, to prove their effectiveness.
As with all things, there are side effects to medications and supplements that need to be fully researched and considered before making a decision. Also, it should be noted that not all dogs are the same and it may take some time to get a combination/dosage that is suitable for the individual dog, so do not give up on pharmaceutical intervention quickly.
There are a variety of physical therapies that can help dogs with hip dysplasia and each type of therapy has it's own benefits and outcomes. Often using multiple therapies, either simultaneously or interchangeably, is favourable as it allows multiple people to assess the dog, which can be useful for picking up things that the other may have missed. Different therapists and/or therapies will also treat areas that another may not treat. Therapies that are beneficial for a dog with hip dysplasia include myotherapy, physiotherapy, hydrotherapy, heat treatment and laser therapy.
How Myotherapy Can Help:
Specialised massage techniques relieve muscular tension
Overtime dogs with HD will seize up as their body attempts to protect the hip joint and prevent any pain associated with movement
Rehabilitative exercises promote appropriate use of muscles
Dogs with HD will have abnormal movement patterns, which uses muscles incorrectly, leading to compensatory issues in other muscle groups and weakness in the muscles that normally aid forward motion
Treats the whole dog, alleviating compensatory issues and chronic pain
For dogs with HD, this can be beneficial as they will often develop discomfort and compensatory issues in the front limbs due to changes in their posture and movement patterns. Treating the front limbs, as well as the neck and body has a positive effect on the whole dog and their condition
Massage leads to a release of endorphins (feel-good hormones)
Dogs who have had untreated HD for some time can become grumpy and/or depressed and the release of endorphins can help relax and calm their mood, which is highly beneficial for their overall wellbeing
Aids recovery from surgery and/or limited exercise routines
Vets may advise limiting the amount of exercise a dog with hip dysplasia gets or if the dog has had surgery, cage rest may be used to allow for healing. Myotherapy can keep the muscles stimulated, thus can prevent muscle stiffness
Image credit to Galen Myotherapy (www.galenmyotherapy.co.uk)
Excessive exercise or high-impact exercise during growth, as well as in adulthood can increase the wear and tear of joints, further damaging the joint. Rough play and highly active games (e.g. throwing toys and chasing) are common ways people play with puppies, often in an attempt to tire the puppy out (plus it's fun and exciting). These activities, if repeated and excessive can have an affect on the development of joints. Therefore, low-impact activities, such as playing scent games, hide and seek or allowing them longer to sniff on walks are great ways to interact and mentally stimulate puppies and dogs whilst reducing wear and tear of the joints. Due to the mental stimulation, these activities can also help burn excessive energy that puppies and dogs can have.
It is common to hear that excessive exercise is bad, however research has also indicated that there is a possibility that not enough exercise may also lead to the development of HD. The lack of exercise affects muscle development, which is a key component of a strong and stable joint. Appropriate muscle mass and usage is also required for good movement and normal use of the hip joint.
There is no hard and fast rule of how much exercise to give a dog, although several suggestions have been made, such as the '5 minute puppy walking rule'. However, this 'rule' should only be used as a very loose guideline. When exercising puppies or older dogs the key thing is to ensure the exercise is appropriate and not excessive. For dogs with HD, splitting a big walk into two shorter walks reduces the risk of inflammation and discomfort of the hip joint, which occurs when the dog is walking/running for a long period of time without being able to rest or lie down.
Nutrition & Feeding
Food quality and quantity during puppy-hood can have an affect on the onset of HD. Feeding a good quality diet with appropriate levels of minerals and vitamins is highly important during the individual's growth stage. For example, calcium is a mineral that aids strong bone growth and it is easy to understand that not enough calcium can lead to poor growth. However, research has also shown that too much calcium can lead to over growth of the bones, which creates an abnormal hip joint. Ensuring not to over-feed or under-feed is also important in allowing for appropriate mineral and vitamin intake.
Weight management is also a crucial element to prevent extra pressure on joints. Dogs that are at a healthy weight have less pressure on their joints, thus reducing the wear and tear of the joints. For puppies, feeding a diet suitable for their breed and age is advantageous in providing correct nutritional levels and allowing them to gain weight slowly and appropriately, which can be valuable for reducing the severity of HD.
In order to effectively manage the compensatory issues and chronic pain of a dog with hip dysplasia, multi-modal treatment is highly recommended alongside environmental and lifestyle adaptations. When using multi-modal treatment it is important that all those involved (you, your dog's vet and each therapist) are in communication with each other to ensure your dog is getting the best treatment.
It is also essential to have regular check ups/ins with those involved to ensure treatment is still working effectively for the dog. Sometimes it may be necessary to change and/or add medication/treatment to your dog's management plan.