Dog Hip Dysplasia Treatment: What Works Without Surgery

Most dogs with hip dysplasia do not need surgery, though surgical treatment benefits severely affected dogs and dogs that do not respond to conservative treatment.¹ Conservative care means weight control, controlled exercise, vet-directed pain relief, joint support and physical therapy, with surgery held in reserve. If your dog's back end is wobbly and slow to rise, that plan is where you begin.

If you are still getting your head around the condition itself, start with our overview of hip dysplasia in dogs and come back here for the treatment side.

What you are actually treating

With hip dysplasia you are managing the osteoarthritis (the wear-and-tear joint damage) that follows joint looseness, not just an oddly shaped hip, and your dog's pain and lameness depend on those arthritic changes rather than on how the hip looks on X-rays.² Hip dysplasia is an abnormal development of the hip joint characterized by looseness of the joint and the degenerative joint disease and osteoarthritis that follow.¹ The looseness comes first, and the arthritis that follows is the body's attempt to stabilize the loose joint.²

Although hip dysplasia begins in puppyhood, most dogs do not develop clinical signs until they are older, since it often takes years of gradual bone degeneration before a dog becomes symptomatic.² Weakness and pain in the hind legs are the usual signs: the dog appears wobbly and is reluctant to rise from a sitting or lying position.² Lameness can be mild, moderate or severe, and is more pronounced after exercise or, once osteoarthritis has developed, shortly after rest.¹ There is more detail in our guide to the early signs of hip trouble.

Making sure the hips are really the problem

Get the diagnosis right before you spend a year treating the wrong joint. In one large group of dogs having knee surgery for a torn cruciate ligament, the main stabilizing ligament of the knee, hip dysplasia was visible on X-ray in 36.3% of them.³ Lower back problems matter too: an abnormally formed vertebra where the spine meets the pelvis has been associated with canine hip dysplasia and with degenerative narrowing of the spinal canal in that same region.⁴ And problems that look musculoskeletal can also point to muscle disease, neurologic problems, hormonal or metabolic disorders and other illness, including infections, toxins, blood and vascular disorders, poor nutrition and birth defects.⁵

On the hips specifically, your vet is feeling for joint looseness (the Ortolani sign, a hands-on test for a loose hip), decreased range of motion, a grating sensation and pain when the hip is fully extended and flexed.¹ Sudden weakness, collapse or paralysis is different. That is an emergency, so go straight in.

How the diagnosis is made

Dogs suspected of having hip dysplasia are diagnosed by feeling the hip joints during a physical examination and with X-rays.⁶ A hip X-ray under general anesthetic is the preferred method.² Standard views of sedated or anesthetized dogs can be graded by the Orthopedic Foundation for Animals,¹ and the PennHIP method, which X-rays the hip under gentle stress, measures joint looseness to judge the risk of developing dysplasia and arthritis in future.¹ PennHIP can identify dogs susceptible to hip dysplasia as early as 16 weeks of age.⁶

Imaging matters because clinical signs vary and do not always match what shows on the X-ray, and the images show how much arthritis is present and help plan both medical and surgical treatment.¹ If your vet mentions the Morgan line on the report, we explain that term in our guide to that X-ray finding.

How to treat dog hip dysplasia without surgery

Conservative care rests on four things: weight reduction, activity modification with restricted exercise on hard surfaces, controlled physical therapy such as hydrotherapy and laser therapy to strengthen and maintain muscle tone and joint range of motion, and anti-inflammatory medication.¹

Weight is the piece you control every day. Weight management is an effective and important component of managing dogs with hip dysplasia and associated osteoarthritis.⁷ A large Swedish screening study found that higher body weight within a breed was associated with a more severe hip dysplasia grade,⁸ and the authors concluded that lower body weight might be a protective factor.⁸

Exercise is medicine at the right dose. Moderate daily exercise and avoidance of high-impact activities such as jumping may help keep the dog mobile and strengthen the structures supporting the joint.² On supplements, products containing omega-3 fatty acids have been reported as beneficial in dogs with osteoarthritis.¹ Let your vet choose and monitor any medication.

Be realistic about the goal. Canine hip dysplasia leads to hip arthritis causing pain, stiffness and diminished quality of life, and it has no medical or surgical cure.⁶ Dogs who do not have surgery may need long-term management of chronic arthritis pain, plus lifestyle changes, to live comfortably.¹

Dog hip dysplasia physical therapy: what rehab actually does

Rehab is not optional extra credit. Physical therapy is highly effective at improving quality of life for affected dogs and should be part of any treatment regimen.² Conservative rehabilitation is directed at decreasing pain, improving hip range of motion and building or maintaining muscle mass.⁹

In practice a rehab vet will combine hands-on work with water and machines. Therapeutic exercise, hydrotherapy, laser and shockwave therapy, which uses pressure waves applied through the skin, can all be beneficial in managing hip dysplasia.² Acupuncture, stem cell treatment, cannabinoids and traditional Chinese medicine have been used with varying results, and rigorous studies on these are sparse, although some small studies are encouraging.² Ask for a referral to a qualified canine rehabilitation practitioner rather than guessing at exercises yourself.

Dog hip dysplasia home treatment: the setup that does the heavy lifting

Home treatment is mostly about traction, rest and short frequent outings. None of this is fancy, and all of it takes pressure off a sore, loose hip:

• Runners and rugs on every slick floor, and a mat at the water bowl. Scrabbling on tile is what frightens dogs into stopping.
• A firm orthopedic bed in a warm spot, away from drafts and off cold hard floors.
• Ramps for the car and the couch, and a baby gate at the stairs.
• Raised bowls so your dog is not bracing on the front end to eat.
• Nails trimmed short, because long nails change how the foot lands.
• A padded support harness or sling with a handle over the hips, for getting up, out the door and back in again.
• Short, flat, frequent walks on grass or dirt instead of one long weekend hike.
• Paw protection if the back feet scuff or drag. Check the tops of the toes for worn hair, scrapes and filed-down nails, and tell your vet what you see.

Surgery, and who it suits

Surgery benefits severely affected dogs and those that do not respond to conservative treatment.¹ Options include removing the head and neck of the thigh bone to decrease pain, cutting and repositioning the pelvis (triple or double pelvic osteotomy) to improve coverage of the ball of the hip, a procedure in young puppies that alters pelvic growth (juvenile pubic symphysiodesis) to stop the hip slipping partly out of its socket, and total hip replacement for optimal restoration of joint and limb function.¹ Timing separates them: pelvic osteotomy and juvenile pubic symphysiodesis must be performed early in growing dogs, before degenerative changes develop.¹

For a dog that already has severe osteoarthritis from hip dysplasia, total hip replacement is the big one, since it replaces both the ball and the socket with artificial parts and about 90 to 95 percent of dogs end up with excellent function.¹⁰ The skeleton must be mature, which typically happens between 9 and 12 months of age and sometimes later in giant breeds.¹⁰ Roughly 80% of dogs with arthritis in both hips need only one hip replaced to enjoy good comfort and function.¹⁰ Recovery is structured: rehabilitation with a qualified practitioner starts shortly after surgery, and strict activity restriction at home is very important,¹⁰ with most dogs ready for full activity within 3 months.¹⁰ Prognosis overall is highly variable and depends on the dog's general health and environment.¹

Puppies and young dogs versus seniors

The two ends of life need different plans. In a growing dog, food is a lever: in one study of at-risk puppies fed as much as they wanted, two thirds developed hip dysplasia, compared with only one third of puppies fed measured meals,² and overweight German Shepherd puppies were almost twice as likely to develop it as normal-weight puppies.² Large mixed-breed dogs are at risk too and should be fed a large-breed growth diet in their first year.² The young-dog window is also when X-rays taken under gentle stress can gauge future risk, and when the growth-stage surgeries above can still be done.¹

For a senior, the job is pain control, muscle maintenance and mobility support.

How to help a dog whose back legs are giving out

When a dog is still willing but the back end cannot hold up for a walk, wheeled support keeps them upright and moving. The OldPal Rear Support Dog Wheelchair carries weight through the hips and chest with a padded harness rather than through the spine, and the frame sits so the back legs hang free or lightly brush the ground. Dogs can squat and go to the bathroom in it. The frame is lightweight aluminum with all-terrain wheels, and every strap adjusts.

Many owners use one part time: chair for the walk, rehab exercises and normal pottering without it. Introduce it in the house for a few minutes at a time with treats, then a short familiar route.

Sizing is one measurement, the rear leg height from the top of the hip straight down to the toe pad, taken with your dog lying on their side and the leg at its natural bend. Measure your dog with the size guide and fit finder, or email a photo and your measurement to help@oldpalpets.com. Five sizes cover 3 to 27 inches. If the size is wrong, our Fit Guarantee lets you exchange the frame for the size that fits. There is more in our guide to choosing wheels for an arthritic dog.

What not to do

• Do not crate-rest for weeks on end. One goal of rehab is to build or maintain muscle mass, alongside easing pain and improving joint range of motion.⁹
• Do not do hard-surface fetch, frisbee or jumping. Restricting exercise on hard surfaces is part of standard management.¹
• Do not let weight creep up, for the reasons above.
• Do not buy internet supplements instead of seeing the vet.
• Do not let rear paws drag unprotected.

Tracking progress and when to escalate

Keep a simple weekly diary: how long to stand up, how far before the wobble starts, stairs yes or no, and any night-time restlessness. Photograph your dog from behind once a month so you can see thigh muscle loss you would otherwise miss, and run your hands down both back legs to compare them.

Escalate if pain relief stops holding, if your dog is worse on the same routine, or if one leg is shrinking. Medication choice is individual, and various drugs may be tried before the most effective one is found.² Ask for a rehab or orthopedic referral sooner rather than later.

Frequently asked questions

Related guides

• What hip dysplasia is and how it develops
• Living with a dog who has hip dysplasia
• Whether hip dysplasia can be cured
• When both hips are affected
• Hip dysplasia in Australian Shepherds
• Hip dysplasia in Bernese Mountain Dogs
• Hip dysplasia in Boxers

Good days ahead.

Sources

Related guides

• Dog Hip Dysplasia Stance: What It Looks Like at Home
• Dog Joints Hurt: Signs of Joint Pain and What Helps
• How to Know If Your Dog Has Hip Dysplasia Before the Vet Visit
• Dog Dislocated Hip: Signs, First Aid and What Treatment Involves
• Dog Back Leg Joint Problems: Joints or Nerves, and What Helps