Introduction
While there is no cure for hip dysplasia in dogs, there are treatments available to help alleviate the animal's pain and manage its quality of life. The overall goals of therapy are to relieve pain and stabilize the hip joint to return the dog to normal or nearly-normal function. Depending upon the severity of the condition, the veterinarian will recommend a treatment plan that may contain both surgical and non-surgical options.
Non-Surgical Options for Treating Canine Hip Dysplasia
Dogs with mild cases of hip dysplasia may respond well to conservative medical (non-surgical) management on an outpatient basis. Of course, which treatment protocol to adopt depends on the patient’s age, size and intended function (companion, hunting, show, etc), the severity of joint laxity, the existence and degree of osteoarthritis, the veterinarian’s personal treatment preferences and the financial considerations of the owners. Non-surgical options include physical therapy, swimming, dietary weight control, exercise restriction and use of oral anti-inflammatory and pain management medications. Corticosteroids normally are not recommended as part of a treatment plan for dogs with hip dysplasia, because despite their beneficial anti-inflammatory effects they also can cause cartilage damage with long-term use. A number of oral supplements are available to help protect and lubricate the cartilage in the hip joint as well. In many cases, weight loss alone can dramatically reduce the pain and clinical signs associated with hip dysplasia in overweight dogs. Reasonable and regulated exercise can stimulate cartilage growth and reduce degeneration, while long controlled walks in early or mild cases of dysplasia may help prevent loss of muscle mass.
Surgical Options for Treating Canine Hip Dysplasia
There are a number of surgical options for treating hip dysplasia, if less intrusive methods do not accomplish acceptable results. Depending on the severity of the condition in a given dog, the veterinarian may attempt to modify the existing hip joint, or instead may opt for a total hip replacement.
Hip Modification
Hip modification surgery can be effective but may not be adequate for older or heavier animals. Hip modification surgeries include:
- Juvenile pubic symphysiodesis – electrocautery is used to fuse the pubic symphasis in immature dogs (3 - 4 months of age), causing the head of the femur to be more completely covered by the “hip socket.” This is not a complicated procedure and is very effective if done in very young dogs.
- DAR arthoplasty – a technique available in young dogs to augment the outer rim of the hip socket.
- Excision arthroplasty, also called femoral head and neck ostectomy (FHO) - the head and neck of the femur (the long bone in the upper thigh that joins with the hip socket to create the hip joint) are removed to alleviate joint pain. The resulting scar tissue essentially replaces the hip joint. Following this surgery, the dog’s weight must be managed throughout its life in order to maintain mobility, and a total hip replacement cannot thereafter be done. This is primarily a salvage procedure for dogs whose dysplasia has deteriorated to severe osteoarthritis, when medical management cannot control the pain or when a total hip replacement is financially unavailable. Excision arthroplasty is most successful in small, light dogs with good pelvic muscle development. However, it can lead to complete freedom from pain and return to almost-normal function even in giant breed dogs (some minor gait abnormalities may exist and owners will often see muscle atrophy in the pelvic area post-operatively).
- Triple pelvic osteotomy (TPO) – a corrective procedure involving surgical rotation of the pelvis to improve coverage of the head of the femur. It is best done in young animals (6 – 12 months of age), before degenerative joint disease develops.
- Intertrochanteric osteotomy (ITO) – possible in immature dogs with abnormal femoral neck angles, but not commonly performed.
Total Hip Replacement (THR)
Total hip replacement, while expensive, has the highest surgical success rate especially in large or severely-dysplastic mature dogs that do not respond adequately to medical therapy. Pain-free hip joint function is reported in more than 90% of cases; even replacing only one hip joint can restore pain-free mobility.