Imagine that you’ve just heard the news; your young dog, only ten months old, has hip dysplasia. You haven’t a clue what this is, but it sounds serious, and you’re distressed. You love your dog. Is this a life-long sentence? Will he need an operation?
Let’s go through the many questions that run through the mind when we hear the words, “Your dog has hip dysplasia.”
What is hip dysplasia?
It is a condition in immature dogs where the tissues surrounding the hip are unable to offer the support needed to keep the head of the femur inside its socket.
This creates an unstable joint and irregular motion. Irregular motion stretches the fibrous joint capsule and the soft tissues surrounding it, resulting in inflammation and pain. Gradually the joint cartilage wears down, starting the arthritic cycle of inflammation, deposition of bone and pain.
What causes hip dysplasia?
There are two main causes; genetics (30%) and environmental factors (70%). We have no control over the former but we do have some control over the latter; these may include trauma, excessive nutritional intake resulting in too-rapid growth, and excessive exercise. With hip dysplasia, our focus is on prevention and management.
Why would a young dog get hip dysplasia?
Dogs are born with healthy, normal hips, but we can see changes in the tissues from as early as one week old. Symptoms are often subtle and go unnoticed until the problem is quite advanced.
Hip dysplasia is common in large-breed dogs, where we normally see two groups showing clinical signs of lameness: patients five to ten months old, and older patients with chronic degenerative joint disease. Be careful of over-exercising a young dog. It is best to wait until the growth plates have closed (after 18 months of age).
How would I know my pet has this condition?
Look for the following signs:
- lameness or decreased weight bearing on one or both hind limbs;
- reluctance to rise or jump;
- shifting of the weight to the forelimbs, which may cause forelimb lameness;
- loss of muscle mass on the hind limbs;
- pain when the hips are extended (pulled backward);
- ‘hip dysplasia waddle’ ∼ walking with a swagger, waddling from side to side;
- running skew; not being able to hold a straight line.
What can I do to help?
There’s a lot we can do – properly managed, hip dysplasia need not negatively affect your dog for life. We need to consider and treat three aspects of the condition:
- Pain control: We use acupuncture, massage and medications, both conventional and natural.
- Muscle strengthening: For long-term joint stability, it is essential that the muscles which support the joint are strengthened. Here’s where the underwater treadmill and various therapeutic exercises make the difference.
- Maintenance of joint integrity – through proper diet, supplements and regular, moderate exercise.
What movements are most painful?
Any extension of the hind legs will be painful. Unfortunately, extension of the hind legs comes into almost all movement, as this is how a dog propels his body forwards. Rising from a sit to a stand will cause extension of the hips, as will jumping over an object; all may cause pain.
To compensate for the pain, a dog with hip dysplasia shifts his weight onto his front legs, often avoiding using his hind legs and overusing his back in movement. This results in the classic ‘hip dysplasia waddle’. This compensation has disastrous consequences, causing wastage of the extensor muscles.
Why is muscle wastage so disastrous?
The extensor muscles are the weight-bearing muscles, needed for standing and walking. They span the hip joint and offer dynamic joint stability. When the extensor muscles are flabby or poorly developed, the hip has little support, which makes it less stable. The more unstable it is, the more the pain and the compensatory action, and the less your dog uses his extensor muscles ∼ which causes them to waste away.
By strengthening these muscles, we build up a firm support structure for the unstable hip joint, which reduces the pain. As pain reduces, the range of motion of the joint improves. Your dog will compensate less and will start to use his body correctly. This will help to maintain the extensor muscles, offering support and stability for the hip.
But I take my dog for a walk every day. Isn’t this enough exercise?
Moderate daily exercise on a lead is beneficial for your dog, but will do nothing to correct muscle imbalances because as your dog walks he will be compensating. Once hip dysplasia exists, it sets up a pattern of incorrect muscle usage, which gets engrained into the pet’s brain as being the normal way of moving. The more your dog compensates, the more entrenched these incorrect patterns become.
We need to build the correct muscles through therapeutic exercises and then continually remind the body to activate these muscles. If we are unable to strengthen the muscles around the hip, the hip will remain unsupported and unstable, and the muscle wastage will continue.
Why can’t I just give anti-inflammatories and painkillers?
The long-term use of anti-inflammatories has side effects such as gastric ulceration, and alterations in liver and kidney function. These tablets “put out the fire” and will give some short-term help, but they’re not a long-term solution. If we do not address the muscle weakness and muscle imbalances, the dog will continue to compensate. Correct muscle strengthening is the long-term solution.
How do we activate the right muscles?
We activate the right muscles through the underwater treadmill and therapeutic exercises.
Exercise on the underwater treadmill is excellent for hip dysplasia, because water results in decreased weight bearing. When water is at shoulder level, the dog’s weight is reduced by 62%. While walking on the underwater treadmill, the hip is extended in a decreased weight-bearing environment, making it less painful but still activating the extensor muscles.
The pressure of the water on the legs and muscles activates the extensor muscles to contract. This muscle activation occurs both while the dog is on the treadmill and for some time when he is off it. These activated muscles will kick in during your dog’s next walk, and as long as the underwater treadmill course is maintained for the recommended period, the compensatory movements will be suppressed. It is remarkably effective.
My dog swims in my pool ∼ will this help?
It will help with overall fitness, but it will not isolate the correct muscles we are trying to strengthen. Swimming is particularly good for the flexor muscles. In order to strengthen the extensor muscles, we need weight-bearing exercise.
Will my pet be able to go for long walks again?
Yes, but only once he has improved muscle strength.
What other options exist for hip dysplasia?
With most conditions, there are a number of options available. Let’s review them all:
- Conservative or medical options ∼ painkillers and anti-inflammatories.
- Natural pain management ∼ acupuncture, gold beads, homeopathy and herbs weight control.
- Joint supplements and special diets
- Moderate exercise
- Changes to the environment
- A long-term therapeutic exercise plan.
- Lastly, we have the option of surgery:
For dogs under one year of age with no osteoarthritis, a triple pelvic osteotomy may be done. This procedure involves cutting the pelvic bone in three places and rotating it to stabilize the hip joint and in many cases slow the progression of osteoarthritis. It is seldom done these days.
In mature dogs, a femoral head amputation may be done. This procedure involves removing the head of the femur and all the cartilage. The vet essentially forms a false joint. Fibrous tissue forms around the area and creates support for the leg.
It is important for dogs undergoing femoral head amputation to use the leg as soon as possible after surgery. If they don’t, their ability to move the leg is hindered and their gait will be altered, causing secondary arthritis and problems elsewhere in the body. Femoral head amputation is a salvage procedure and should only be done when all other conservative treatment options have not yielded results.
Lastly, there is the option of total hip replacement. This procedure replaces the cartilage of the socket with a polyethylene socket and the femoral head with a metal prosthesis. Most patients have an excellent return to function. This procedure is very expensive and is only indicated if the patient has continuous lameness where rehabilitation and conservative treatments have not been successful.
What is the first step?
Your first step, once you notice signs of hip dysplasia, is to find a veterinary rehabilitation practitioner who is qualified to give you advice and administer treatment. He or she will do a full orthopaedic and rehabilitation examination, including muscle mass measurements. They will then give your pet a tailor-made rehabilitation program, possibly including acupuncture, time on the underwater treadmill, therapeutic exercises and suggested alterations to your pet’s environment. Ask your vet for the contact details of veterinary rehabilitation practitioners in your area.
In the meantime, why not access my 7-minute doggie workout, seven easy exercises to do with your dog for improved muscle and core strength.
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