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Hip Dysplasia: The Definitive Guide
Hip Dysplasia:
The Definitive Guide
Hip dysplasia, also known as Canine Hip Dysplasia or CHD, is one of the most common skeletal disorders seen in dogs. The condition is characterized by a malformation of the coxofemoral (hip) joint.1 The hip joint is the connection between the head of the femur bone and the pelvis. The hip joint is a ball and socket joint that allows movement for walking and running. Normally, the joint is very stable and strong; however, dysplastic hip joints are weaker due to malformation of the ball and socket.
The hip is the joint most commonly affected by osteoarthritis in dogs. While traumatic causes such as hip subluxations and hip fractures can also cause arthritis, more commonly arthritis in the hip joint of the dog is caused by hip dysplasia.
Hip dysplasia is one of the most common skeletal diseases in dogs. Large breed dogs, such as German Shepherds, American Staffordshire terriers, Labrador Retrievers, Golden Retrievers, Rottweilers, and Saint Bernards are more often affected. Additionally, smaller dog breeds such as pugs and French bulldogs experience higher rates of hip dysplasia.²
Hip dysplasia is a genetic, heritable disease, so any dogs that are diagnosed with hip dysplasia should not be bred. It is important to note that smaller dogs can also develop hip dysplasia, but they are less likely to show signs of disease.
Take a look at the difference between healthy hips and dysplastic hips in these x-rays from the Orthopedic Foundation for Animals.
Puppies aren’t usually what you think of when you imagine a dog with hip dysplasia, but there are signs and symptoms that are important to know. Early intervention is key when it comes to treating hip dysplasia. In dogs less than one year of age, signs of hip dysplasia are related to the degree of looseness within the hip joint.
This stage is often the ‘silent stage’, where dogs won’t show any symptoms at all because nothing hurts...yet. If the joint is not loose but there is abnormal rubbing on the cartilage because the ball or socket of the joint is misshapen, then symptoms of pain will not occur until the dog is older.
Download your free Puppy Symptom Checklist
Some young dogs can be so severely affected that the head of the femur (the ball) may pop out of the socket, subluxating the hip joint. This may result in your dog crying out in pain or limping acutely on the affected leg. When this happens, a dog may be in so much pain that he refuses to walk on the leg completely, and instead, choose to hop around like a tripod. This is an indication that there has been trauma to the joint, and the best course of action is to call your veterinarian.
A sign of hip dysplasia reported by pet owners is a ‘swaying gait’, where the hips sway back and forth from side to side more than normal. If your dog looks like a runway model when he is walking, then have your veterinarian check for hip dysplasia.
Other signs in a young dog can include bunny hopping when he starts moving or when he is trotting or running. Imagine what a rabbit looks like when they move - dogs with painful hip dysplasia will look the same. Instead of having a normal gait, they will move both rear limbs together like a hopping bunny. Bunny hopping tends to get worse after exercise.
Dogs with hip dysplasia can exhibit general signs of joint pain as well, such as difficulty getting up, limping, increased irritability, sleeping more, stiff in the morning, restless sleeping, difficulty getting comfortable, decreased interest in exercise or getting tired sooner, as well as decreased willingness to jump or climb stairs. If your dog has stopped jumping in the car when you ask him to or doesn’t enjoy walks or fetch as much as he used to, hip dysplasia could be the culprit.
Some of the signs and symptoms between adult dogs and puppies overlap, but there are also many symptoms that stand out in older dogs. Unfortunately, many of these symptoms can be written off as simply part of getting older or slowing down, but if you’re seeing more than a few of these symptoms, you should talk with your vet.
Download your free Adult Dog Symptom Checklist
In older dogs, signs of hip dysplasia are correlated with the development of osteoarthritis within the hip joint or joints. Older dogs with hip dysplasia can have all of the same signs as younger dogs with hip dysplasia. They can also have signs associated with osteoarthritis, including decreased flexibility in the hip joints, and when the hips joints are moved, a grating sensation called ‘crepitus’ can be detected by feeling the joint with your hand. Crepitus is caused by abnormal wear, tear, and rubbing on the joint that causes rough cartilage or loss of cartilage resulting in bone rubbing on bone. That hurts!
Additional signs that your dog might have hip dysplasia include increased stiffness after sleeping or when it is cold outside, stiffness, limping, or holding a limb up after exercise, and bunny hopping, which looks like both of the back legs moving together when running, instead of independently. Here’s an example from Mansion Hill Vets that shows exactly what a “bunny hopping” gait looks like.
If your dog doesn’t want to jump into the car or go up or down stairs anymore that is also a sign that he might be suffering from hip dysplasia. Older dogs that have hip dysplasia usually have very small, bony back legs and beefed up front legs. Because the hips hurt, a dog doesn’t want to use the back legs, and that leads to muscle atrophy (shrinking). Instead, a dog will use his front legs to haul himself up, leading to excessive muscle development in the shoulders.
And, here’s an example of an altered stance. In this image, you can see a Labrador Retriever standing with his back feet close together to compensate for his hip dysplasia.
Other clues that your dog might have hip dysplasia is a general decrease in activity, not walking or playing as long, lagging behind on walks, needs excessive coaxing to get up, not enjoying the things he used to enjoy like fetch or tug of war, sleeping more, and increased irritability. Chronic pain makes people grumpy, and it does the same thing to dogs. Dogs that are in a lot of pain can become snappish and growly when their hindquarters are touched, and honestly, who could blame them?
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During your visit, your veterinarian will take a history from you and do a full examination of your dog. This will usually include you walking and trotting your dog around so the veterinarian can assess your dog’s ‘gait’. Your veterinarian will then feel all the bones, muscles, and joints. They will test for pain. They will move joints through their range of motion while feeling the joint for any swelling or crepitus. Then your vet will most likely check neurological reflexes as well.
When there is thickening, arthritis, or degenerative changes around a joint, your dog will show fairly predictable patterns with each joint.
Your veterinarian will feel for muscle mass on your dog while he or she is standing and compare muscles on each side. Arthritis anywhere in a leg will cause loss of muscle mass over the entire leg, not just around the affected joint.
Just because your pet has a bony hip does not automatically mean your pet has hip pain: it could also be knee or ankle pain. Also, loss of muscle mass can also be secondary to spinal or nerve dysfunction. Your veterinarian will determine whether the condition is musculoskeletal or neurological.
Diagnosis of hip dysplasia is mainly completed by a physical exam and X-rays. X-rays require special positioning and your dog may need to be sedated, especially if he or she is in pain or scared. X-rays will determine the level of arthritis in the joint and the severity of the malformation. Dogs typically cannot be diagnosed with hip dysplasia via X-ray until they are a minimum of two years of age, because the skeletons of larger dogs can continue to develop during the first two years of life.
The tricky part with hip dysplasia is that the disease doesn’t always play by the rules. A dog that has terrible hip dysplasia as seen on X-rays may not display any signs or pain. Conversely, dogs that have minimal changes on X-ray can be very painful. Some dogs will only be in pain as puppies and never show signs again. More commonly, dogs will skip the puppy stage of the disease and show signs associated with arthritis pain later in life.
Alternative causes of lameness in the rear legs of dogs include torn cranial cruciate ligament rupture: up to 1/3 of dogs referred for treatment of hip dysplasia are suffering from concurrent cranial cruciate ligament rupture in the knee. Other possible causes include panosteitis, degenerative myelopathy, stifle arthritis, or lumbosacral disease. Your veterinarian will want to rule out these other conditions before diagnosing your dog with hip dysplasia.
In young dogs, your veterinarian may check for an Ortolani Sign, a test that checks for subluxation of the hip joint. Depending on your dog’s level of pain and comfort, this test may need to be performed under sedation.
Here’s a quick video about the Ortolani Test:
Special note: The hip-screening procedure known as PennHIP (University of Pennsylvania Hip Improvement Program) has proven to be the most accurate and precise method to measure hip laxity and subluxation. This screening method can identify dogs that are susceptible to developing hip dysplasia as early as 16 weeks of age. Early identification benefits breeders and allows veterinarians to advise pet owners on lifestyle modifications and treatments before the onset of pain or arthritis. Unfortunately, this test may not be available in your area as veterinarians must receive specialized training and quality-control exercises before becoming certified to perform the PennHIP procedure.
While the exact genetic defects are not known, the main culprits of hip dysplasia are laxity (looseness) in the joint, and abnormal shapes of the bones that make up the ball and socket hip joint. In hip dysplasia, poor congruence, or poor ‘fit’ between the femoral head (the ball) and the acetabulum of the pelvis (the socket) creates abnormal forces across the joint, interfering with normal development and growth and leading to irregularly shaped surfaces. As the dog walks or runs, the head of the femur rubs abnormally on the cartilage of the pelvis, causing micro-tears in the joint cartilage. If the joint is loose, the hip joint can also pop out, subluxating and causing pain and limping.
Hip Dysplasia can start when a dog is very young. Dogs as young as 4 months of age can demonstrate problems with hip dysplasia. The signs of hip dysplasia depend on the severity of disease. Hip dysplasia is a two-part disease. In very young dogs, pain is associated with subluxation of the joint. A subluxated hip joint is extremely painful as it causes tearing and stretching of the soft tissues associated with the hip joint. Over time, the joint can “scar down,” reducing the pain and subsequently the signs associated with hip dysplasia. As young dogs grow, they can appear to improve, even with severe disease.
The second phase of hip dysplasia involves arthritis of the joint. Even though the joint is no longer subluxating, the joint abnormally flattens and over time wears down cartilage, causing pain associated with arthritis.
Making some changes around your home can make a huge difference to your dog’s comfort level.
Now that you know the signs, symptoms, and causes of hip dysplasia, let’s dive into the treatment options. There are two main types of intervention:
Surgical Treatments & Corresponding Aftercare
Non-Surgical Treatments, which include:
Quality of Life Improvements
Alternative Therapies
Your veterinarian will recommend treatment based upon several factors, including:
There are several surgical options available for dogs that are under 1 year of age. The goal of surgery is to improve stability within the hip joint and reduce the likelihood that arthritis will develop.
Dogs under one year of age are less likely to show signs or symptoms of hip dysplasia unless the disease is severely painful, making the detection of the disease difficult. Puppies susceptible to hip dysplasia, such as Labradors, German Shepherds, Rottweilers, Golden Retrievers, and large breed mixes should be tested at 4 months of age using the PennHIP technique.
If your veterinarian does not provide this service, ask for a referral to an orthopedist who does.
Here are the 4 major types of surgery aimed at treating hip dysplasia:
Juvenile Pubic Symphysiodesis (JPS)
Double or Triple Pelvic Osteotomy (DPO / TPO)
In puppies who are exhibiting signs of hip dysplasia, a surgery called juvenile pubic symphysiodesis can improve the hip joint and decrease risk of arthritis. This surgery should be performed in puppies that are at least 4 months of age, but no older than 5 months of age. This surgery is minimally invasive, and your dog should go home the same day as surgery is performed.
During this surgery, the dog is put under general anesthesia. A small incision in between the hind legs is made to expose the pubic bone in the pelvis, and the surgeon will cauterize the growth plate of the pubis. This stops the cells from growing any further on this part of the pelvis. When the growth from the center of the pelvis is stopped, the other parts of the pelvis continue to grow, and subsequently rotates the hip socket to cover more of the ball on the top of the femur. The result is a more stable hip that is less likely to develop painful arthritis.
This surgery is about 85% successful. Potential complications include failure to completely cauterize the pelvis, resulting in normal growth of the pelvis, infection, fluid accumulation at the surgery site (can be prevented by keeping the dog quiet after surgery), urinary problems, and narrowing of the pelvic canal. This does not cause any problems except with birthing, however, dogs with hip dysplasia should not be bred.
Complications are rare when the surgery is performed by an experienced surgeon, so if your veterinarian recommends this procedure, ask who will be performing it, their rate of complications, and how many of these surgeries have they done. Even though it will be more expensive, it is recommended to ask for a board-certified surgeon to perform the job. Board-certified surgeons have 4 years of advanced surgical training beyond DVM degree, they are experienced in new techniques, and they are tested by the American College of Veterinary Surgeons (ACVS) to ensure competency.
To see if you have a board-certified surgeon near you, check out the ACVS’s database.
Juvenile Pubic Symphysiodesis After Care
As with all orthopedic surgeries, the aftercare and convalescence is as important to healing as the surgery itself. Surgeries have often been ‘ruined’ in the post-operative period, so it is of utmost importance to follow your surgeon’s discharge instructions closely. Restrict your puppy’s activity for 2 weeks following surgery, give all pain medications as prescribed, and inspect the incision site daily for signs of infection, including redness, swelling, heat, or discharge.
In dogs 6-12 months of age with hip dysplasia and without arthritis, a double or triple pelvic osteotomy is recommended (DPO or TPO). When done correctly, this surgery has a 90% success rate in preventing painful arthritis. This surgery is done under general anesthesia, and involves cutting the pelvis and rotating it to correctly align the ball and socket joint of the hip to reduce pain and decrease arthritis later in life. The places where the pelvis is cut are held together by screws. A DPO is preferred to a TPO because there is less pain during post-op as there are fewer cuts in the pelvis.
Complications from this surgery usually arise if the dog is too active within the first 2 months of surgery. This is because the bone has not yet healed and if the dog is running or jumping, the screws and plates used to hold the bone in place can loosen or break. Other potential complications include sciatic nerve pain, urinary problems, infection, and progression of arthritis. These complications are all very rare.
TPO/DPO After Care
Oral Pain medication will be prescribed following the surgery. Give the medication as prescribed, and do not stop the pain medication early, even if you think your dog is not in pain. Dogs will hide chronic discomfort, and it is well known that pain delays healing. If your veterinarian prescribes any other forms of pain control, give as prescribed. Antibiotics will also likely be prescribed - give all antibiotics until gone as prescribed to prevent infection.
If your dog has a bandage, that bandage must be kept clean and dry until you are instructed to remove the bandage. If the bandage loosens or becomes dirty or wet, call your veterinarian.
Your dog will have sutures or staples in the skin. Check the skin daily for signs of infection until the staples or sutures are removed. Signs of infection include redness, heat, swelling, or discharge from the incision. It is very important that you prevent your dog from licking the incision - use an anti-licking cone if needed, or ask your veterinarian for cone alternatives.
For the first two weeks after surgery, you will need to sling your dog to prevent slipping or falling when going outside. Place the sling (or a towel) under the belly, just in front of the hind legs. For the first two months after surgery, the dog will need a non-slip surface on which to walk, and the dog will only be able to go outside on a leash for urination or defecation. After the first 2 months, the length of leash walks will be gradually increased back to normal.
You will need to restrict your dog’s activity for 3 months after surgery to allow for bone healing. No running, jumping, or off-leash outside for 3 months. In puppies, this is easier said than done! You can talk to your veterinarian about prescribing a sedative if needed.
Your dog will be scheduled for a couple of follow-up exams. At the second exam, which will be scheduled 6 weeks after surgery, your dog will be x-rayed to determine healing. Dogs should be back to normal or better by 3-4 months after surgery.
If a dog is greater than 12 months or already has painful arthritis with hip dysplasia, and weighs 40 pounds or less, then a surgery called femoral head ostectomy (FHO) can help. The procedure is done under general anesthesia and the hair will be clipped over the entire leg and hip.
During surgery, an incision is made over the hip area. In this procedure, the femoral head (the ball) is removed surgically, thus removing the connection between the leg and the pelvis and the source of pain, which was bone rubbing on bone. The joint stabilizes by scarring down over the course of several months. This scarring creates a “false joint” between the acetabulum and femur and provides a cushion between these two structures.4
Femoral Head Ostectomy After Care
Pain medications will be prescribed — follow all prescribed instructions closely and do not stop pain medication early. Dogs hide discomfort, and they will recover more slowly if you stop the pain medication too soon. If antibiotics are prescribed, give them until they’re gone.
In contrast to other hip surgeries, activity is encouraged after a dog undergoes an FHO. A proper exercise program after surgery will help the joint scar down faster, and will help maintain a good range of motion in the joint. Swimming is the best exercise after the incision has healed.
Most dogs will start bearing a small amount of weight on the limb within 2 weeks after surgery. You will notice it as ‘toe touching’. Within 4 to 6 weeks after surgery, the dog should bear more weight on the leg, and the dog should be recovered and normal by 2-3 months, depending on their age. Dogs that undergo this procedure tend to do best if they have physical therapy and rehabilitation after the surgery. Dogs who have this procedure performed usually have permanent, non-painful changes to their gait and some muscular atrophy, and the operated leg is slightly shorter than before surgery, however, this does not appear to cause any problems.
Dogs that weigh less than 40 pounds do well following femoral head and neck excision surgery. Larger dogs can also do well, but some weakness on that limb frequently can be seen. This is due to the muscles supporting the region of the hip instead of the actual joint. As a result, heavy exercise can cause the pet to become stiff or lame. A total hip replacement is recommended for larger dogs.
Pet owners with very large dogs with severe hip dysplasia and arthritis can also elect to pursue a total hip replacement (THR). This is considered a “salvage procedure” in mature dogs with severe arthritis that is not adequately responsive to medical therapy. One joint is operated on at a time.
To prepare for a total hip replacement surgery, it is recommended to bathe your dog the day before, completely dry your dog, and do not allow your dog to get dirty or go outside other than for elimination purposes. THR surgeries have a higher rate of infection, so every precaution needs to be taken.
The procedure generally requires a one or two night hospital stay. The procedure is done under general anesthesia, and the entire leg will be shaved. Your dog may receive an epidural for pain. The incision is made over the hip region, and the ball and socket are removed surgically. After the surgical sites are cleaned out, a plastic cup is cemented into the acetabulum (the socket) and a steel implant is cemented into the head of the femur (the ball).
Total Hip Replacement After Care
Pain management will be a critical part of your dog’s after care. Oral pain meds in the form of non-steroidal anti-inflammatories and Tramadol will likely be prescribed - give as instructed. Your dog will also be given antibiotics - give as prescribed until gone.
Most dogs will start to bear weight within a couple of days after surgery. For the first two weeks, examine the incision daily for signs of infection, including redness, heat, swelling, or discharge. The staples will be removed 2 weeks after surgery. For the first two months after surgery, the dog will need a non-slip surface on which to walk, and the dog will only be able to go outside on a leash for urination or defecation. After the first 2 months, the length of leash walks will be gradually increased back to normal.
You will need to restrict your dog’s activity for 2 months after surgery to allow for bone healing. No running, jumping, or off leash outside for 2 months. Dogs who have had a THR tend to lose muscle mass in their pelvic limbs. It’s important that we do everything we can to preserve and increase muscle mass, which is why physical therapy is recommended after surgery.
Dogs will be examined 4 months after surgery and x-rayed to ensure complete healing has taken place, the hip is stable, and the implants are in place.
90% of dogs that receive a THR become pain-free. 80% of dogs only need one hip replaced, though 50% of dog owners that elect to have a THR now choose to have both joints replaced, one after the other.5
Complications include luxation of the joint, implant infections, and nerve damage. Dogs with hip replacements need to be carefully monitored for any type of infections, as bacteria from other sites (mouth, bladder, skin) can migrate into a hip replacement. Dental infections, skin infections, and urinary infections need to be addressed by a veterinarian and treated immediately in dogs with hip replacement implants.
Oftentimes, whether it is due to cost, the advanced age of the dog, or other chronic disease, surgery is not an option. In these cases, medical treatments are pursued to maintain the best quality of life possible for the pet. It is important to note that without surgery, the joint will remain unstable and arthritis associated with hip dysplasia will progress, which is why it is so important to get affected dogs diagnosed and treated as early as possible.
The goals of non-surgical treatments are as follows:
If you choose the non-surgical therapy route, then a multi-modal approach will give you the best results. A multi-modal approach simply means combining two or more therapies that provide a synergistic effect. The combination of therapies should work to provide great pain relief, mobility, etc. than if the therapy was applied solo. Your veterinarian will work with you to determine the best combination of treatments to minimize pain and maintain mobility and muscle mass in your dog. We’ve broken out these therapies into two sections: Quality of Life Improvements and Alternative Therapies.
1. Weight Management
Keeping your dog at or even just below their recommended weight is the first defense against joint issues. To check on your dog’s weight at home, you can use the hand test.
To learn about how extra weight can affect your dog’s joint health and how to develop a weight loss plan, watch our Weight Management interview with Dr. Sarah Wooten, DVM.
2. Proper Nutrition
There are a few ways to go about ensuring your dog is getting proper nutrition. The first way is to simply talk with your veterinarian. They’ll be happy to work with you to come up with a diet designed for your dog.
If you’d like to do some research on your own, the first step is to make sure that any food you’re feeding your dog is compliant with the Association of American Feed Control Officials (AAFCO) standards. Dog foods that meet AAFCO standards are considered to provide a complete and balanced diet. You can also use a dog calorie calculator to make sure your pet is getting the right amount of food. There are lots of calculators available online, but we prefer the Pet Nutrition Alliance’s calculator.
3. Exercise
Your veterinarian will be essential in helping you create your dog’s exercise plan, either by helping you directly or by referring you to a physical therapist who can create a regimen specifically designed for a dog with hip dysplasia. Any good regimen will include a mix of range of motion exercises and weight-bearing exercises.
Range of Motion Exercises
For range of motion, swimming is a wonderful exercise for dogs with hip dysplasia. If you don’t have access to a pool, underwater treadmills are another low impact exercise option that can be found at canine physical therapy centers.
Here's Wolfgang the Obese Beagle using his underwater treadmill!
If you can’t make it to a physical therapy center, there are lots of exercises you and your dog can do from home. Stretching exercises and short slow walks on the grass are also good ways to exercise your dog with hip dysplasia.
Weight-Bearing Exercises
Weight-bearing exercises are an important part of mitigating muscle wasting that can result from hip dysplasia, but be sure to check with your veterinarian before starting a new program. Once you get the go-ahead, try out some of these with your dog.
Here’s a very simple yet effective weight-bearing exercise from Home Vet:
Use a training treat to lure your dog to move their head from side to side. This promotes weight shifting and weight-bearing. When they lift their head upward, there is a natural tendency to place more weight on to the rear legs. This is a very beneficial exercise for dogs with hindlimb problems like canine hip dysplasia. 6
If you’re more of a visual learner, you’re in luck! Big Barker recently partnered with Philly Unleashed to create a 30-minute class that teaches gentle exercises designed for older dogs or those with mobility issues.
4. Provide a Supportive Rest Area
One of the simplest things you can do to help your dog with hip dysplasia is to provide them with a supportive sleep area. The Big Barker has been helping dogs with hip dysplasia since 2012. To see how a supportive bed can make all the difference, read this case study about a labrador named Motley who suffered from hip dysplasia.
5. Oral Pain Medication
There are a variety of oral pain medications that your dog may be prescribed to help them maintain a better quality of life either as a post-op patient or simply as a dog who suffers from hip dysplasia. PetCareRx has a great breakdown of medication types:
NSAIDs
These non-steroidal anti-inflammatory drugs include Metacam, Piroxicam, Rimadyl, Novox, Deramaxx, Etodolac and Previcox
Note: If your dog is on Rimadyl, be sure to take advantage of their Rewards Program!
Opiates
These strong narcotics intended for short-term use include Buprenorphine, Morphine, Paregoric, and Codeine
Steroids
Steroids are used to control inflammation which can cause severe pain. Examples include Prednisone, Dexamethasone, and Corticosteroids
Nutraceuticals
Omega-3 Fatty acids, MSM, and Glucosamine are all supplements that can be used in conjunction with other pain medications.
Antidepressants
In some cases, antidepressants like Tofranil and Elavil can be used as pain medication.
In addition to these medications, CBD oil is also being used more frequently to help dogs suffering from joint pain.
6. Joint supplements
The right supplements can help your dog’s body by protecting their cartilage and reducing their inflammation. You’ll want to look for high-quality, bioavailable joint supplements. Glucosamine hydrochloride, ASUs, chondroitin sulfate, and high quality omega-3 fatty acids all protect cartilage and reduce inflammation.
Here’s a list of the top 20 joint supplements, but talk with your veterinarian before starting something new.
In addition to quality of life improvements, there are also a number of non-surgical therapies that may help you manage and reduce the pain and suffering your dog may be experiencing from hip dysplasia. Your veterinarian will likely want to restore full function, or as close to full function as possible, to your dog.
It is important to be in continual communication with your veterinary care team so that you are all on the same page. This will allow you to clearly communicate your expectations, your financial limitations (if any), your concerns, and also allow your veterinarian to adjust therapies as needed.
Finding the best combination of therapy, also known as a multi-modal approach, may take some trial and error, as what works well for one dog may not work as well in another. The goal is to find the right combination that works for you and your dog. This usually involves some combination of the following therapies:
Watch Dr. Brunke explain why a multi-modal approach is so effective.
Phototherapy
If you’re looking for a non-invasive pain-reducing treatment option, you may want to explore phototherapy. Phototherapy, also known as laser therapy, photobiomodulation or Low-Level Laser (Light) Therapy (LLLT) is thought to reduce inflammation and swelling while boosting anti-inflammatory enzymes and natural endorphins that reduce pain.⁶
Here’s what an example of an at-home laser therapy treatment might look like:
Acupuncture & Acupressure
Acupuncture and acupressure can provide a myriad of benefits for a dog with hip dysplasia. It not only improves blood flow and increases oxygenation of tissues, but it also relaxes muscles both where the needle is inserted and muscles located elsewhere in the body.
Because this pain relief occurs naturally within the body it may lead to a decrease in the amount of pain medications needed to treat your dog.⁷
Therapeutic Massage
Canine massage therapy can provide many positive health benefits to your dog⁸, including:
Watch Victoria Stilwell learn canine massage.
Hydrotherapy
Hydrotherapy helps with dogs who have hip dysplasia by using the controlled aquatic exercise to build weakened muscle in the hind legs without having to put any pressure on them. It encourages joint mobility, endurance, and cardiovascular fitness that maintains the health of the cartilage around the joints.
Consistent, gentle, and regular swimming is key in managing hip dysplasia along with natural supplements and if needed, medication. Water therapy has been proven to be the most successful therapy in helping dogs with almost any degenerative disease, especially those that occur in the hips, joints, and legs.⁹
Benefits include:
Therapeutic ultrasound
Therapeutic ultrasound is typically a pain-free treatment method that in most cases does not require sedation. Many patients find the therapy pleasantly warming, but to achieve good contact between the ultrasound probe and the skin, fur will usually need to be clipped away. The probe is applied for 10 - 20 minutes at a time, usually with the probe moving in gentle stroking sweeps or small circular movements over the affected area. Therapeutic ultrasound is a treatment that requires multiple visits, usually 2-3 times a week.
A big benefit of therapeutic ultrasound is that it’s drug-free, which means there aren’t any side effects to worry about. However, this treatment isn’t usually the only treatment that a dog will need and should be thought of as a piece of the puzzle.¹⁰
Here's what a therapeutic ultrasound appointment may look like:
Stem cell therapy and Platelet-rich plasma therapy
A relatively newer method of treatment for joint disease in animals is stem cell and platelet-rich plasma therapies. In this therapy, stem cells are usually taken from the animal’s fat tissue or blood plasma. They're then separated out from other cells and put back in the animal, usually by injecting them directly into the arthritic joints. This procedure, both extracting the fat tissue or blood plasma and reinjecting it require sedation.¹¹
While there’s a fair amount of anecdotal evidence, there aren’t lots of peer-reviewed studies to prove stem cell therapy for hip dysplasia. For the latest information, speaking with your veterinarian is the best bet!¹²
TENS therapy
If your dog does end up having surgery, it’s likely that at some point they’ll have TENS therapy as a part of their rehabilitation plan. TENS or Transcutaneous Electrical Nerve Stimulation works by stimulating the muscle which helps to retrain that muscle to better support their joints. It’s most often used to help dog’s recover from TPLO, Total Hip Replacement and other orthopedic surgeries. Additionally, dogs who suffer from arthritis may also be good candidates for TENS.¹³
Another similar therapy is Electrical Stimulation, E-Stim or EMS. Both use electrical stimulation, but with TENS, the nerves are being stimulated to prevent pain signals from reaching the brain. Whereas EMS contracts the muscles to replicate the body's natural pain relief mechanism.¹⁴
Here’s an example of what a typical TENS or E-Stim visit may look like for your dog. There are also newer TENS handheld tools that always require shaving part of your dog that have been successful in trigger point therapy applications. As with any new treatment, be sure to know all your options.
Heat and Cold Therapy
Simple, easy to do at home and inexpensive, heat and cold therapy is a great additional therapy for a dog recovering from surgery or suffering from joint pain or hip dysplasia. It’s important to know when to choose heat therapy or choose cooling therapy.
Cold Therapy
If your dog is recovering from surgery, you’ll likely be instructed to use cold therapy for the first 72 hours.
Heat Therapy
On the other hand, if your dog is suffering from pain due to hip dysplasia or arthritis, you’ll want to use heat therapy, especially if they’ve just gone swimming in cool water or have been for a walk in cold weather. When possible, moist heat therapy is preferred over dry heat.15 To provide moist heat therapy, you can use a steamed towel, a warm bath, or use a rice-filled heat pack.
With proper heat therapy, you can get a 1-2ºC increase in tissue temperature within 10 minutes. This increase in temperature can increase local tissue metabolism by 10-15%, which increases blood flow and promotes tissue healing by supplying proteins, nutrients, and oxygen.16
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References