Hip dysplasia is the abnormal develop of the hips while a dog or cat is growing.

The underlying cause may be a dysproportionate growth of the muscles that support the hip relative to the hip joint. The result is looseness of the socket and subsequent arthritis.

Treatment is dependant on the clinical stage of the disease and the size of the animal.

The prognosis generally is good with treatment.

What is it?

• Hip dysplasia is the abnormal development of the hip joints. The primary cause of this condition is laxity of the soft tissues that hold the hip joint together. In addition, when the hip muscles are not well developed, the result is inadequate compression of the hip into its socket.
• A loose hip results in abnormal wearing of the joint and arthritis subsequently develops (see photo of an arthritic hip and normal hip).
• Below left is a radiograph of a dog that has loose hips (left hip labeled H) as a puppy, which is the first phase of hip dysplasia. The right hip (R) in this dog could still potentially be treated with triple pelvic osteotomy, but the left hip (labeled H) needs to have total hip replacement surgery.
• The radiograph below right is the same dog as below left- take note of the advancement of the hip dysplasia and arthritis as the dog matured. This dog has severe arthritis of the hips and total hip replacement is the preferred treatment option. 

Clinical signs 

• Breeds: both small and large breeds are affected, however, large breeds are more commonly affected
  • Small and medium breeds: Pugs, Dachunds, Lhasa apsos, Cocker spaniels
  • Large breeds: Golden retrievers, Labrador retrievers, German Shepherds, Rottweilers and many others
• Age: as early as 4 months of age, however, many dogs are 8 to 12 months of age. Some dogs seem to experience signs of hip dysplasia when they are a couple of years old and others in the geriatric years.
• Signs clinical signs first start out as exercise intolerance or an awkward gait of the hind limbs.
  • bunny hopping
  • stiffness on rising after a rest; difficulty lying down gracefully
  • lameness
  • atrophy of the muscles of the hind limbs
  • narrow-based stance of th hind limbs
  • painful when hips are touched; painful when the hind end is brushed or combed

Diagnosis

• A diagnosis of hip dysplasia is based on a combination of
  • history
  • clinical signs
  • physical examination findings
  • radiographs (x-rays)
• NOTE: We do not base a decision to perform surgical treatment only on radiographs.

Treatments

• No treatment
  • Failure to treat a pet that is in pain is inhumane.
  • Many dogs that have radiographic evidence of hip dysplasia do not show any signs of pain and no treatment is needed in such cases
• Medical therapy - conservative Limited controlled physical exercise (swimming is excellent)
  • Provide a warm, soft bed
  • Avoid cement floors
  • Use prescribed medications
  • Use of aspirin should be stopped about 1 week prior to the surgery, as it will increase bleeding during surgery.
• Surgery
  • If your pet does not have arthritis in the joint and is young (less than 10 months is ideal), a reconstructive procedure (triple pelvic osteotomy) can be done to make the socket fit better over the ball of the femur bone.
  • If your pet already has arthritis one of two procedures is recommended: femoral head and neck excision or total hip replacement. The femoral head and neck excision involves cutting off the ball and neck of the femur so that it does not rub against the socket of the hip. In this situation, the body forms a false joint and the pain is relieved. This procedure is recommended for medium and small dogs and cats. Large and giant breed dogs may not do as well with this type of surgery.
  • Total hip replacement is recommended for the large and giant breeds of dogs. This procedure involves replacement of the hip socket with a polyethylene cup and replacing the head of the femur with a metal implant.

Prognosis

• Total hip replacement is about 90% successful.
• Femoral head and neck excision usually does not return the function of the limb to perfectly normal, but can significantly decrease the pain that the pet is experiencing. Cats and small dogs do very well with this procedure, but large breed dogs do not do as well.
• Triple pelvic osteotomy is about 90% successful, however, some arthritis may develop, as the pet gets older.

Complications

• HIP REPLACEMENT. Infection at the surgical site can occur soon after surgery or months to years later. If your pet gets an infection following total hip replacement, usually the implants will need to be removed. To prevent infection from developing, your pet should be administered antibiotics prior to and following any surgical procedure or dental work. This will help prevent bacteria from entering the blood stream and getting into the prosthesis. Following hip replacement, the prosthetic hip can become dislocated if your pet is too active during the healing phase. Too much activity can cause the cup or the femoral prosthesis to loosen from the bone, thus requiring a second surgery.
• FEMORAL HEAD AND NECK EXCISION. Infection is an uncommon, but potential complication. Second, if your pet does not get enough exercise after surgery the hip will lose mobility and the false joint does not form properly. This will result in poor limb function after healing has taken place. Therefore rehabilitation therapy is very important.
• TRIPLE PELVIC OSTEOTOMY. Infection is an uncommon, but potential complication. If your pet is too active during the first 2 months after surgery, the implants securing the pelvis can loosen and the repair may break down. Some hip arthritis will develop in most dogs receiving a triple pelvic osteotomy surgery, but usually does not cause pain or stiffness. If the hips develop debilitating arthritis total hip replacement may be needed.

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