Hip Dysplasia

Hip dysplasia is a developmental condition where the ball-and-socket hip joint develops abnormally - the head of the femur (ball) doesn't fit snugly in the acetabulum (socket), leading to instability, cartilage damage, and eventually osteoarthritis. It has both genetic and environmental components: body weight, growth rate, and diet during puppyhood influence how genetic predisposition is expressed.

It is most prevalent in large and giant breeds, though it can occur in any breed. Signs may appear in puppies as young as five months (hip pain from laxity), or may not become apparent until middle age when arthritis has developed.

What to monitor

Gait. Hip dysplasia causes a characteristic "bunny-hopping" gait in puppies and young dogs - the rear legs move together rather than alternately. In adult dogs, a swaying or waddling gait, or a shortened stride in the back legs.

Rear limb lameness. Note which leg(s), when in the day (worse after rest or after exercise), and whether it's improving, worsening, or staying the same.

Exercise intolerance. Reluctance to jump, run, or climb stairs. Reduced willingness to exercise compared to normal.

Pain on hip manipulation. Note if your dog reacts when hips are touched, pressed, or extended. This should be assessed by the vet, but you may notice pain reactions during normal handling.

Morning stiffness. As secondary arthritis develops, stiffness on rising is common and tends to improve with gentle movement.

Muscle mass in hindquarters. Reduced exercise leads to muscle atrophy - compare hindquarter muscle bulk week to week.

Weight. Excess weight dramatically worsens hip dysplasia. Monthly weighing is essential.

Diagnosis

Hip dysplasia is confirmed by X-ray. The BVA/KC Hip Dysplasia Scheme scores each hip 0–53 (total 0–106 for both hips) - lower scores indicate better hip conformation. The breed median score provides a reference point; breeding animals should ideally score below the breed median.

For diagnosis in a symptomatic dog, X-rays are taken under sedation or anaesthesia for accurate positioning. The Norberg angle and degree of subluxation are assessed.

Management options

Conservative management (appropriate for many dogs):

• Weight management - the single most important modifiable factor
• Controlled, low-impact exercise (swimming/hydrotherapy is excellent)
• Anti-inflammatory pain relief (NSAIDs)
• Joint supplements (omega-3 fatty acids, green-lipped mussel)
• Physiotherapy

Surgical options:

• Triple pelvic osteotomy (TPO) or double pelvic osteotomy (DPO) - in young dogs with hip laxity but before arthritis develops; reshape the socket to improve femoral head coverage
• Femoral head and neck excision (FHNE) - removes the femoral head; creates a false joint; good outcomes in small/medium dogs
• Total hip replacement (THR) - the gold standard for advanced hip disease; replaces both the socket and ball with prosthetics; available in the UK at specialist orthopaedic referral centres

When to contact your vet

Contact your vet soon if:

• A large-breed puppy shows rear limb lameness or a bunny-hopping gait
• An adult dog shows declining rear limb function or increasing lameness
• Pain management no longer appears to be providing adequate relief

Schedule a routine appointment for:

• BVA hip score X-rays (for breeding dogs or at-risk breeds)
• Physiotherapy referral
• Surgical assessment if conservative management is inadequate

Frequently Asked Questions

Can hip dysplasia be prevented? The genetic component cannot be prevented, but expression can be influenced. Feeding large-breed puppies a diet formulated for large breeds (controlled calcium and energy), maintaining lean body condition, and avoiding repetitive high-impact exercise during the growth phase all reduce severity. Responsible breeding using BVA/KC hip-scored parents reduces prevalence in future generations.

My puppy has been diagnosed with hip dysplasia - does that mean they'll be crippled? Not necessarily. Many dogs with hip dysplasia live with mild to moderate disease that is manageable throughout their lives, particularly with weight control, exercise modification, and pain relief. The outcome depends on severity at diagnosis, management quality, and whether secondary arthritis develops.

Is swimming good for a dog with hip dysplasia? Hydrotherapy and swimming are among the most beneficial exercises for hip dysplasia. Water supports body weight, reducing joint load while allowing full range of motion and muscle building. Many specialist hydrotherapy centres in the UK work specifically with orthopaedic conditions.

At what age should a large-breed puppy be assessed for hip dysplasia? Preliminary screening can be done from 16 weeks using PennHIP assessment (measures hip laxity, a good predictor of later disease). Official BVA/KC scoring is performed from 12 months.

How much does total hip replacement cost in the UK? Total hip replacement typically costs £3,000–£6,000 per hip at specialist centres. Pet insurance with lifetime cover usually covers this if the condition develops after the policy inception. An estimate from the referral centre is always worth getting before proceeding.