Hip Dysplasia in Dogs: Signs, Diagnosis and Treatment

When that even growth does not happen, the joint is left loose, and degenerative joint disease or osteoarthritis follows as the body tries to stabilise the loose hip.¹

That second part matters. Most of what you see, the stiffness, the wobbly back end, the trouble rising, tracks with the arthritic changes in the joint rather than with how the hip looks on X-rays, since some dogs with severe-looking hips show no signs while others with minimal changes are painful and lame.¹ Pain from osteoarthritis is linked to cartilage damage, bone exposure, friction, bony change and inflammation within the joint.² If you are still working out what is going on with your dog's back legs, start here, then take your notes to your vet.

What owners usually notice first

The early signs are subtle and easy to blame on age. Weakness and pain in the hind legs are the usual signs: the dog appears wobbly and is reluctant to rise from sitting or lying down, and some dogs limp or avoid stairs.¹ Slowness to rise after a long rest, difficulty going up or down stairs, and less jumping or playing are also common.³ A stiff hind limb gait, a waddle or sway through the back end, an unwillingness to jump into the car, and sitting with a leg straight out or rolled onto one hip are all typical.²

Owners often describe a "bunny hop", both back legs swinging together at a trot. Pain and lameness develop secondary to joint dysfunction or to muscle wasting and disuse of the affected limbs, and the weight shifted onto the other legs leads to progressive disability.³

Which dogs get hip dysplasia, and at what age

Hip dysplasia is seen predominantly in larger dogs such as German shepherds, Saint Bernards, Labrador retrievers, golden retrievers, Old English sheepdogs and bulldogs, although any dog can be affected.¹ It can affect both hips at once, which is covered in our guide to hip dysplasia on both sides.⁴

They can appear in puppies as early as a few months old but are most common in dogs one to two years of age.¹ Because the disease begins in puppyhood but often takes years of gradual bone degeneration to cause symptoms, many dogs do not show signs until they are older.¹ It is a genetic disease affected by factors such as diet, environment, exercise, growth rate, muscle mass and hormones.¹

How a vet confirms it

A hip X-ray, preferably taken under general anaesthetic, is the preferred way to diagnose hip dysplasia, and clinical signs plus looseness the vet can feel in the joint during a hands-on exam (a positive Ortolani sign) may also point to it.¹ Formal hip screening is available too, with preliminary evaluations between 4 and 24 months and certified grading from two years of age.³

Do not be surprised if the pictures and your dog do not match. Some dogs with obvious hip dysplasia or arthritis on X-rays show no signs at all, while others with only minimal changes have severe pain and lameness.¹

Things that look like hip dysplasia but are not

A cranial cruciate ligament tear, a tear of a stabilising ligament in the knee, is the big one, since it is the most common knee injury in dogs.⁵ Signs include sitting with the back legs off to one side instead of squarely, hesitating before stairs, muscle loss in the affected leg and shifting weight off it, and if the ligament ruptures completely a dog may suddenly become very lame.⁵ In one study of dogs having cruciate surgery, 36.3% also had hip dysplasia on X-ray.⁶

In its early stages it resembles the arthritis that follows hip dysplasia in large breed dogs, which makes diagnosis challenging.⁷ Early signs include knuckling, where the hind paws turn under so the dog walks on its knuckles, especially when turning, and the hind feet scraping the ground.⁷ Most affected dogs do not seem in pain, just very weak.⁷

See a vet promptly for knuckling, dragging toes, a dog that feels nothing when you touch the back feet, or weakness that appears suddenly. Sudden hind leg weakness or paralysis is an emergency.

Treatment, and why there is no dog hip dysplasia cure

Treatment depends on your dog's signs and how much discomfort they are in.¹ Physical therapy is highly effective at improving quality of life and should be part of any treatment plan, and weight loss is strongly recommended in overweight dogs because excess weight puts undue stress on the hips.¹ Moderate daily exercise and avoiding high-impact activity such as jumping may help keep a dog mobile and strengthen the support structures around the joint.¹ Rehabilitation, including therapeutic exercise, hydrotherapy and laser therapy, can be beneficial.¹ Pain relief and joint support are your vet's call.

When anti-inflammatory painkillers (NSAIDs) and other medical treatment are not enough, surgery is the alternative.¹ The two most common procedures are total hip replacement and femoral head and neck ostectomy (removal of the ball of the hip joint), with pelvic osteotomies (reshaping of the pelvic bones) also used, and the choice depends on your dog's age, condition and lifestyle.¹ Medical management will allow most dogs to live a long and active life, whereas surgical management could be curative.² More on that in whether hip dysplasia can be cured.

Home care, footing and dog hip dysplasia massage

Small changes at home protect the hips every day. Use rugs, carpets or yoga mats on hardwood and tiled floors, add ramps or steps where needed, and use a sling or harness to help with standing and walking.⁸ Replace running and jumping with controlled activity such as leash walks, because low-impact, consistent exercise builds the muscles around the joint and promotes joint stability.² Ask a veterinary rehab professional to show you exactly where and how to work, so you are not pressing on a painful hip.

When a rear support wheelchair helps

A cart is worth considering when a dog still wants to walk but the back end gives out partway, when rising is a struggle, or when muscle is melting away because the walks stopped. The OldPal Rear Support Dog Wheelchair supports the hindquarters while the front end works normally. The padded harness carries weight through the hips and chest rather than the spine, the frame is set so the back legs hang free or lightly brush the ground, and dogs can squat and go to the bathroom in the chair. It supports mobility; it does not treat the hips.

Sizing uses one measurement: rear leg height, from the top of the hip straight down to the toe pad, with your dog lying on its side. Take it with our size guide and fit finder, or email a photo and the measurement to help@oldpalpets.com. If the size is wrong, our Fit Guarantee lets you exchange the frame for the size that fits. Start with five or ten minutes on flat ground and build up. Our guide to using a wheelchair with hip dysplasia and arthritis covers introduction in more detail.

Outlook, and dog hip dysplasia prevention next time

Appropriate management of osteoarthritis or its underlying cause can result in a good quality of life.² Dogs with common orthopaedic conditions vary widely in pain and quality of life scores, so management should be tailored to your own dog rather than to the average for the diagnosis.⁹

For a future puppy, growth matters. In one study of at-risk puppies, two thirds of those fed as much as they wanted developed hip dysplasia, compared with one third fed measured meals.¹ Overweight German shepherd puppies were almost twice as likely to develop it.¹ Growing too quickly can stress developing bones and joints.¹⁰ Puppies raised on slippery surfaces have a higher incidence of hip dysplasia and osteoarthritis.² So feed a large-breed growth diet in measured meals instead of free choice, keep your puppy lean rather than pushing fast growth, and avoid high-impact activities such as jumping.¹

Frequently asked questions

Related guides

• Dog back leg problems: the full picture
• Hip dysplasia in both hips
• Hip dysplasia in boxers
• Can hip dysplasia be cured?
• Wheelchairs for hip dysplasia and arthritis

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