Canine Hip Dysplasia

In this episode of Current Vet, Dr. Lottie talks about canine hip dysplasia, how genetics and growth combine to increase the risk of disease, the key clinical signs to recognise in young and older dogs, the main hip screening schemes, and the medical and surgical options available for treatment.

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Timeline:

00:00 Intro
00:31 Case
02:22 Aetiology & Pathogenesis
06:13 Clinical Signs
08:09 Diagnosis
14:55 Treatment
21:25 Prevention
22:29 Key Points
24:34 Outro

References

• Brass, W. (1989) ‘Hip dysplasia in dogs’, Journal of Small Animal Practice, 30(3), pp. 166–170. Available at: https://doi.org/10.1111/j.1748-5827.1989.tb01525.x.
• Fries, C.L. and Remedios, A.M. (1995) ‘The pathogenesis and diagnosis of canine hip dysplasia: a review.’, The Canadian Veterinary Journal, 36(8), pp. 494–502. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC1687006/ (Accessed: 2 October 2026).
• King, M.D. (2017) ‘Etiopathogenesis of Canine Hip Dysplasia, Prevalence, and Genetics’, Veterinary Clinics: Small Animal Practice, 47(4), pp. 753–767. Available at: https://doi.org/10.1016/j.cvsm.2017.03.001.
• Ginja, M.M.D. et al. (2010) ‘Diagnosis, genetic control and preventive management of canine hip dysplasia: A review’, The Veterinary Journal, 184(3), pp. 269–276. Available at: https://doi.org/10.1016/j.tvjl.2009.04.009.
• Schachner, E.R. and Lopez, M.J. (2015) ‘Diagnosis, prevention, and management of canine hip dysplasia: a review’, Veterinary Medicine: Research and Reports, 6, pp. 181–192. Available at: https://doi.org/10.2147/VMRR.S53266.
• Kirkby, K.A. and Lewis, D.D. (2012) ‘Canine Hip Dysplasia: Reviewing the Evidence for Nonsurgical Management’, Veterinary Surgery, 41(1). Available at: https://doi.org/10.1111/j.1532-950X.2011.00928.x.
• Fossum, T.W. (2019) ‘Chapter 34 – Diseases of the Joints’, Small Animal Surgery. 5th edn. Philadelphia, PA: Mosby, pp. 1209–1220.

Current Vet is an educational podcast intended for veterinary students, veterinary professionals, and individuals with an interest in veterinary medicine.

All content provided in this podcast and its associated materials is for educational and informational purposes only. It is not intended as, and must not be considered a substitute for, professional veterinary advice, diagnosis, or treatment.

Any clinical cases discussed in this podcast are fictional, and are designed to reflect typical or likely clinical scenarios for educational purposes. They do not represent specific real-life cases, clients, or animals.

While every effort is made to ensure accuracy and alignment with current evidence at the time of publication, veterinary medicine is a rapidly evolving field, and recommendations may change over time.

Creators and Guests

Host

Dr. Lottie Wilkinson

Creator and host of the Current Vet podcast

What is Current Vet?

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In each episode, Dr. Lottie breaks down clinical conditions, cases, and concepts across species, focusing on pathophysiology, decision-making, diagnostics, and what actually matters in practice. It’s the kind of context that makes your knowledge finally click.

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Canine Hip Dysplasia-Veterinary Vista
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[00:00:00] Hi everyone, and welcome back to a brand new episode of Current Vet, the podcast that makes veterinary medicine simple. I'm your host, Dr. Lottie, and today we are talking about canine hip dysplasia. So in this episode, we're going to focus mainly on developmental hip dysplasia in dogs, so especially those young large breed dogs. But we're also gonna talk about how these patients may present later in life with things like chronic osteoarthritis as well. So let's start with our case.

Five-month-old female entire German Shepherd called Nova is brought into your clinic because her owner has noticed that she seems a little bit odd in her behind. So Nova seems bright, playful, and she's growing really quickly. She's fed a large breed puppy diet, but her owner admits that she's also been getting a lot of extra food because she always seems really hungry. She lives in a busy household with some children, and she spends a [00:01:00] lot of time running around in the garden, chasing balls, and jumping on and off the sofa.

Owner says Nova sometimes bunny hops when she runs. She's slower to get up after sleeping, and after longer walks, she seems a little bit stiff and reluctant to climb the stairs. On exam, Nova is friendly and excited, but when you watch her walk, you notice a subtle hind limb lameness. When you palpate her hips, she is tense and uncomfortable. You suspect there may be a little bit of pain on hip extension, but because she's quite anxious and wriggly, you can't properly assess it while she's awake.

So at this stage, your differentials might include, obviously, hip dysplasia, something like panosteitis in a young, growing, large breed dog, hypertrophic osteodystrophy, osteochondrosis, traumatic soft tissue injury maybe. We could have stifle disease, [00:02:00] lumbosacral pain, or then less commonly, we could have a neurological condition as well. But obviously, because Nova is that young, rapid-growing, large breed dog, the hind limb gait abnormalities, difficulty rising, and then possible hip pain, hip dysplasia is gonna be very high on your list.

So canine hip dysplasia is a developmental disease of the coxofemoral joint. The coxofemoral joint is the hip joint. It's formed by the femoral head, which is that femoral part of the word, and it's that ball at the top of the femur, and then the acetabulum, which is the socket in the pelvis. So in a normal hip, the femoral head sits really nicely and securely within the acetabulum, and the joint is then stabilized by firstly the shape of the bones, but then we also have the joint capsule, the ligament at the head of the femur, the surrounding muscles, and then other soft tissues as well.[00:03:00]

So in hip dysplasia, the hip does not develop with normal stability, and it's a lot more lax than it should be. This means that the femoral head is not being held tightly within the acetabulum, so instead it can move slightly too much within the socket, and this abnormal movement is called subluxation, when the femoral head partially moves out of normal alignment. So instead of smooth even loading over a well-fitting ball and socket, there is some abnormal pressure, some different forces, and then microtrauma can develop, which over time causes inflammation, cartilage damage, thickening in the joint capsule, remodeling of the acetabulum and femoral head, and then eventually osteoarthritis.

In young dogs with the condition, the pain is mainly gonna come from that joint laxity, stretching of the soft tissues, inflammation in the synovial capsule, so synovitis, and then those [00:04:00] microtraumas as well. But in older dogs, the pain is often much more related to osteoarthritis, chronic inflammation, reduced range of motion, muscle wastage, fibrosis, and ongoing inflammation in the joint.

Hip dysplasia is a multifactorial condition. So there is a really strong genetic component, which is why some breeds are much more predisposed than others. So large and giant breeds are over-represented. Breeds like German Shepherd dogs, Labrador retrievers, Golden retrievers, Bernese Mountain dogs, Newfoundlands. But environmental factors also influence whether a genetically predisposed dog is actually gonna develop clinically significant disease, and then obviously how severe that disease becomes. So important factors are gonna include a really rapid growth rate, excessive calorie intake, excessive body weight, inappropriate calcium or mineral balances in the diet, [00:05:00] and then high impact exercise, especially in that growth phase when they're young. One of the biggest points to remember is that overfeeding a large breed puppy is not necessarily gonna make them grow into a stronger, bigger adult dog. It can make them grow too quickly and carry too much weight through their immature joints, which is gonna increase mechanical stress on a hip joint that may already be genetically predisposed to that laxity and poorly fitting conformation. So this is why controlled growth is so important in large breed puppies.

And large breed puppy diets are designed to support this because they have that controlled energy density, and then also appropriate calcium and phosphorus and other mineral levels in the diet that these puppies need. Exercise also needs to be controlled and sensible. So obviously, puppies do need movement, they need play and normal activity for good healthy development, but repetitive, really [00:06:00] high impact forced running, excessive stairs, repeated jumping in a growing puppy is gonna increase stress on those immature joints as well.

Okay, so what clinical signs are we gonna see? The clinical signs largely depends on the age of the dog and then the stage and severity of disease. So in young dogs like Nova, signs often begin between around four and 12 months old. So we're gonna see things like an abnormal gait, bunny hopping, getting tired really quickly, reluctance to exercise, struggling to rise when they're sat down or laying down, sitting a bit awkwardly, and then seeming a little bit stiff after resting. Some puppies can be really stoic though, so owners may not notice obvious signs of pain. They may just say that the dog is a bit clumsy or a bit weak, a bit lazy, or not keeping up with other dogs. In adult dogs [00:07:00] with chronic hip dysplasia and osteoarthritis, the signs are gonna look more like classic osteoarthritis or also known as degenerative joint disease. So these dogs may be quite stiff after resting, slow to rise, reluctant to jump into the car. They're gonna be less willing to climb stairs. They might be a bit lame after exercising, less enthusiastic when they're out on walks and things. And then owners may notice that they lie down more often or lag behind or just become less tolerant of handling around the hindquarters because it may be painful for them.

Chronic or severe cases in adult dogs may also have muscle wasting, crepitus, pain on manipulation, and a short-strided gait. A lot of these dogs are still weight-bearing, and the signs can be really subtle because when both sides are painful, there's not gonna be a really clear limp on one limb, [00:08:00] so they may just be moving differently and owners can confuse it as a sign of just general aging.

Diagnosis of canine hip dysplasia is based mainly on the clinical presentation, a good physical exam, and then some imaging. So for Nova, she is a young, rapidly growing large breed dog. She has those hind limb gait abnormalities. She's getting stiff after exercise, possible hip pain. So all of this is gonna be really suggestive of hip dysplasia. For a physical exam, the first step is always gonna be observation. Watching the dog, how they get up, look at their posture, watch them walk and trot if possible. Basically, any movement that you can observe, just watch them. And then we wanna do a thorough orthopedic exam. So making sure we assess all the way down the spine, around the pelvis, checking the stifles, hocks, and paws, as well as the hips, just to [00:09:00] make sure that the signs and pain are localizing to the hip, or that there's not other areas that are also inflamed or injured.

So when you assess the hips, you're looking for pain, range of motion, crepitus, muscle mass around the joint, and then any joint instability as well. Hip extension is typically quite uncomfortable for these pets, and you may also find reduced overall range of motion in the joint when you manipulate it.

The Ortolani test is one of the classic tests to assess hip laxity. So this test basically assesses whether the femoral head can be subluxated, which we said earlier is basically does it move outside of normal alignment within the joint, and then can it be reduced back into the acetabulum. So pressure is applied along the femur to push the femoral head dorsally, and then the limb is abducted.

If the hip is lax, the femoral head may reduce back into the [00:10:00] acetabulum with a palpable or like audible little clunk. And that is gonna mean that the test is positive, so it suggests hip dysplasia. The Ortolani test can be very useful, but tense muscles can mask joint laxity because it temporarily supports around the joint, and then pain can also make the dog resist any movement, so it may not be an accurate test to perform in an awake, anxious puppy. So laxity testing is often performed under sedation, and this is obviously gonna be better for accuracy and much better for patient comfort as well. The other thing to note with the Ortolani test is that a negative sign does not completely rule out hip dysplasia. So in very chronic cases, for example, with capsular thickening, osteoarthritis, and remodeling, these can all reduce the ability to elicit the sign even if the dog does have significant disease. So a negative sign doesn't necessarily mean that there is no hip disease.

The next step [00:11:00] is going to be radiography, and ideally this is with good station or general anesthesia. And this is gonna be important for two reasons. So first up, positioning needs to be really accurate. Poor positioning can make the hips look a bit better or worse than they really are. And the second reason is, again, that muscle tension can affect accuracy. So a relaxed patient allows much more reliable positioning and better assessment. The standard radiographic view used is gonna be a ventrodorsal extended hip view. So the dog is lying on their back, the pelvis is straight, and then the femurs are pulled and extended back.

Radiographic signs of hip dysplasia and secondary arthritis that we're gonna be looking for in these radiographs are poor coverage of the femoral head by the acetabulum, so it's showing that the femoral head isn't sitting nicely within that joint. We might be able to see subluxation of the femoral head and [00:12:00] noticeably shallow acetabulum, flattening or remodeling of the femoral head, thickening of the femoral head. We may see osteophytes forming around the joint, and then just general reduced joint congruity as well. In our younger dogs, like Nova, the radiographs are more likely to show laxity or poor congruency before that significant osteoarthritis has developed. But in the older dogs, the radiographs are more likely to show osteoarthritis as well.

Okay, I'm just gonna take a moment to talk about different screening schemes. So hip screening can be used for two slightly different reasons. So the first one is we're gonna be assessing an individual dog because they have signs or because we want to understand their specific risk of developing significant disease. And the other reason is gonna be breeding. We're trying to reduce incidents of hip dysplasia in future generations by selecting breeding animals with better hip conformation and making sure that their [00:13:00] offspring aren't also predisposed to hip disease. So there are a couple of screening systems that are used.

PennHip is a method that measures passive hip laxity using a distraction view. So it gives a value called the distraction index, or DI, and the distraction index estimates how far the femoral head can be displaced out of the acetabulum. So a lower DI means tighter hips, more normal hips, while a higher DI means greater laxity and higher risk of developing hip osteoarthritis. One of the big advantages of this screening scheme is it can be performed from around 16 weeks old by vets, and it can identify puppies at risk while early intervention options may still be available. This means that procedures like juvenile pubic symphysiodesis are time-sensitive, so if you wait until the dog is obviously lame or, like, eight to 10 months old, over a year old, you're gonna miss the treatment [00:14:00] window, which means that they're no longer good candidates for this treatment.

In the UK, the BVA or Kennel Club hip scoring scheme is often used for breeding assessments. So radiographs are gonna be assessed, and then each hip is given a score based on a couple of features. And each hip can score from zero to 53, given a possible score from zero to 106 overall. Lower scores are gonna be better, and this system is mainly used to help breeders make good breeding decisions and reduce the risk of hip dysplasia in their future generations.

And then in the States, we have the OFA system, and this evaluates hip radiographs and grades hips as excellent, good, fair, borderline, mild, moderate, or severe. Excellent, good, and fair are within normal limits, and then mild, moderate, and severe indicate dysplasia and hip disease.

Okay, next we are going to talk about treatment. So we can kind of [00:15:00] divide treatment into three separate pieces. So conservative or medical management, we then have early preventative or corrective surgery, and then the third is gonna be salvage surgery for painful hips with quite advanced disease. But it's important to know that kind of there's no single treatment that's right for every dog with hip dysplasia, so we're gonna talk through each of the options.

So first of all, conservative management. It's gonna be useful for a lot of dogs, either as the main treatment or alongside surgery and alongside corrective treatment. A key part of this is weight control, and excess body weight is gonna increase a load on already abnormal painful hips, so therefore weight loss or maintaining a lean body condition can significantly improve hip function, even in dogs with incurable disease. So for puppies like Nova, the aim is controlled steady growth and maintaining a lean body condition. But for adult dogs, [00:16:00] the aim is gonna be maintain a healthy body condition in general. The next part is exercise. So complete rest is not helpful in the long term because muscle is really important for good joint stability. But then at the other end of the spectrum, uncontrolled high impact exercise can worsen the pain and overload the joint. So you wanna make sure we've got controlled, regular, low impact exercise. So you're thinking about maybe lead walks, controlled strengthening exercises, avoiding things like repetitive chasing, jumping, making sure that floors aren't really slippery so they're not sliding around everywhere, or avoiding really long, intense walks.

Physiotherapy and rehab are also extremely useful, and these can include things like those strengthening exercises, improving range of motion exercises, controlled walking, hydrotherapy, or underwater treadmill work [00:17:00] The third key thing here is gonna be pain relief. So NSAIDs are a common option, and other analgesics may be used, for example, like paracetamol in dogs in some areas. But remember, it is toxic for cats. And then gabapentin, amantadine, or a couple of other adjuncts can also be considered in these cases. There are joint supplements like omega-3 fatty acids. There's also things like glucosamine, chondroitin, then nutraceuticals like green-lipped mussel extracts. But the evidence varies between different products, and they're not gonna be a good substitute for weight loss and exercise management, good analgesia, and definitely not a substitute for surgery if that is a possible option.

And then a couple of things owners can do at home as well is modifying that home environment using things like non-slip flooring, ramps instead of stairs, soft, deep bedding, just making sure that dogs are really comfy at home.[00:18:00]

So our first surgical option is gonna be juvenile pubic symphysiodesis, or JPS. So JPS is for puppies with hip laxity, and the procedure is gonna close the pubic symphysis early, which changes the way that the pelvis then continues to grow. So as the puppy develops, the acetabula are gonna rotate slightly to provide better coverage of the femoral heads. It can reduce the risk or severity of later osteoarthritis, but there is a main limitation of timing, so it has to be done very early, around 12 to 16-weeks-old, before most of that pelvic growth has already happened. So it's not gonna be a useful option in older puppies or dogs, especially not those with established arthritis. The next option is a double or triple pelvic osteotomy, often known as a DPO or TPO, and these are joint-preserving surgeries for young dogs with hip laxity, but [00:19:00] they have either little or no osteoarthritis. So the surgeon is going to cut the pelvis and rotate the acetabular segment so the socket covers the femoral head better, which improves the joint stability and then reduces subluxation. The advantage of this is gonna be that the dog's actual hip joint is preserved, and it can give really good results, but the downside is it's a pretty major surgery. It's a lot more expensive, and it only works well before significant arthritis has developed. Once the joint is already remodeled and arthritic, rotating the socket is unlikely to solve the problem because we've already got other sources of pain and degeneration within the joint.

Femoral head and neck excision it's also called FHNU or FHO, is a salvage procedure. So in this surgery, the femoral head and neck are completely removed, and this is obviously gonna remove that painful contact between the femoral head and the acetabulum, [00:20:00] and then over time, a fibrous pseudo-joint forms instead. So the main advantage of this is gonna be pain relief. It can be a really good option when the hip is painful and a total hip replacement is not possible or not affordable for the owner. But it does not restore a normal hip joint, and the outcome is mainly gonna depend on the dog's body size, their muscle mass, and then good rehabilitation after the surgery. Smaller dogs tend to do much better, but larger dogs can still improve, but they may just have a less normal gait after the surgery.

And then our final salvage option is total hip replacement But in this one, instead of removing the joint and then relying on that pseudo joint, the joint is gonna be removed and the diseased hip is replaced with an artificial ball and socket joint. So it provides really good pain relief and function in suitable candidates, especially those with [00:21:00] severe hip osteoarthritis. And the pros are gonna be it restores pretty much the normal mechanics of the hip, and it gives really good long-term outcomes. But it is very expensive, it's a specialist surgery, and there are risks of complications like luxation, infection, or the implant itself loosening and becoming a bit dysfunctional.

Okay, let's finally talk about prevention. So because hip dysplasia has that genetic component, responsible breeding is gonna be really key for prevention. Breeding dogs should be screened, and then dogs with poor hip scores or significant dysplasia should not be bred because that is gonna increase the risk of passing that predisposition onto offspring.

For owners of large breed puppies, there are management and environmental changes to consider to reduce the risk of genetically predisposed puppies from developing significant disease. So [00:22:00] feeding that properly formulated large breed puppy diet, avoiding excess calories, keeping that puppy lean, avoiding unnecessary mineral supplementation, and encouraging sensible controlled exercise so we're not overloading those joints. And making sure that we educate owners about healthy growth in these breeds is gonna be really key for preventing chronic problems throughout the dog's life as well.

Okay, so if you remember nothing else from today's episode, make sure you remember these key points. So first, canine hip dysplasia is a developmental disease of the coxofemoral joint, where hip laxity is then going to lead to abnormal loading of the joint, subluxation, cartilage damage, remodeling, and then eventually osteoarthritis.

It is multifactorial with a genetic predisposition, but those environmental influences like rapid growth, [00:23:00] excessive calorie intake, high body condition, poor nutrition, and then really intense exercise are gonna increase the risk of predisposed dogs developing significant disease. Young dogs often present with that bunny hopping gait, difficulty rising, exercise-related stiffness, and then reluctance to jump or climb stairs or other signs of pain. And older dogs present with those chronic arthritis signs, so that stiffness after rest, reduced activity, difficulty jumping or moving around as much, hindlimb muscle wasting, and then reduced range of motion in the hips.

Diagnosis is based on the history, the signalment, a good clinical exam, and then radiography to visualize the hip joint. And then conservative management is gonna include weight control, good exercise therapy, physiotherapy, analgesia, and long-term monitoring. [00:24:00] There are a couple of surgeries available, and we can do that juvenile pubic symphysiodesis for very young puppies, that double or triple pelvic osteotomy in young dogs. Femoral head and neck excision and total hip replacements are available as salvage procedures. Screening and then not breeding high-risk or clinically affected dogs is gonna be key for prevention, as well as making sure that we provide the appropriate diet and good exercise routine in our growing large breed puppies.

And that is canine hip dysplasia. Thank you so much for listening to this episode of Current Vets. If you found it helpful, follow or subscribe wherever you get your podcasts and share it with a friend or colleague who needs to hear it as well. As always, if there's a topic you'd like to hear covered in a future episode, make sure to let us know in the comments or come find us on Instagram or TikTok at VeterinaryVista.

See you next [00:25:00] time.