Canine Hip Dysplasia is a condition caused by a congenital instability or loose fit of the hip joints. As the condition progresses, osteoarthritis or "degenerative joint disease" of the hips occurs, leading to intermittent lameness, stiffness and pain. Hip dysplasia has a hereditary basis which is why it is more prevalent in certain breeds. The inheritance is influenced by multiple genes interacting with environmental factors, such as rapid weight gain as a puppy.

The clinical signs of hip dysplasia are lameness, reluctance to rise or jump, shifting of weight to the front legs, loss of muscling over the rear limbs, and pain when the hips are manipulated. Not all dogs with hip dysplasia visible on x-rays show clinical signs. Dogs may show clinical signs at any age or stage of development of the disease. Many dogs are painful at 6 to 8 months but recover as they mature. Some dogs with very dramatic changes on x-rays do not show any lameness or pain until later in life. As the arthritis progresses over time, dogs may show clinical signs similar to people with arthritis such as lameness after unaccustomed exercise, stiffness after prolonged confinement, and worsening with cold weather. Sedentary behavior can exacerbate the condition by contributing to the further muscle atrophy and increasing weight.

Recommended treatments for hip dysplasia vary with the age of the dog, condition of the hips, and severity of clinical signs. Treatment protocols involve surgical options, anti-inflammatory medications, weight-management, nutritional supplements, and physical therapy. Immature dogs (less than one year) with loose fitting hips, but no arthritic changes may be candidates for a Triple Pelvic Osteotomy or TPO. This procedure involves cutting the pelvic bone in three places and rotating it to stabilize the hip joint and in many cases prevents osteoarthritis. Immature dogs with osteoarthritis present have advanced disease and are treated medically as needed.

Mature dogs with hip dysplasia who are not showing clinical signs do not need surgical treatment. These dogs need to maintain an ideal body weight. The ribs should be easy to feel, and the dog should have an obvious waistline. In obese dogs, weight loss alone may alleviate clinical signs. Mature dogs with hip dysplasia may benefit from nutritional supplements for improving joint health. These products include glucosamine, condroitin, often along with magnesium and Vitamin C. Supplements available from veterinarians (such as Cosequin) are dosed and flavored for dogs. It is very important to encourage regular non-traumatic exercise to develop good muscle mass supporting the hips. Controlled leash walking and swimming are good choices.

Mature dogs with occasional lameness can be treated with anti-inflammatory drugs such as aspirin (preferably enteric-coated products such as Ascriptin) or prescription NSAIDS (such as Rimadyl). A veterinarian should be consulted regarding dosing, possible side effects, and any drug interactions. These should always be given on a full stomach and discontinued if there are any gastrointestinal problems (vomiting, diarrhea, or decreased appetite). After the lameness subsides, slowly increasing the exercise program should be attempted; if lameness recurs, exercise is decreased and the medications are administered again.

When medical therapy does not provide pain relief and reasonable function, the dog is a candidate for one of two surgical procedures to reconstruct the hip joint. The femoral head and neck osteotomy (FHO) involves removing the femoral portion of the hip joint. The joint heals with fibrous tissue and in many cases allows a more pain free existence. The total hip replacement involves replacing the hip joint with a metal and polyethylene prosthesis. This procedure results in the most normal limb function in large dogs. The procedure is expensive because of the implants and the technical requirements of the surgery. It also is subject to complications such as infection at the implant sight, and requires intense follow-up care.

Dr. Mary Welle is a Veterinarian at All Creature's Animal Hospital in Urbana, Illinois.

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