Hip Dysplasia in Puppies: Top 10 Prevention and Management Recommendations

Here’s an interesting fact: all (or nearly all) puppies are born with normal hips. So how does hip dysplasia in puppies develop?

Hip dysplasia timeline

Radiographs taken of their hips appear normal for the first few weeks of life.

Puppies with hip dysplasia will start showing changes in the shape and congruity of the hip joint as early as 2 weeks of age.

From 2 to 5 months further changes are seen, including more luxation, roughening of the top rim of the socket and flattening of the ball (femoral head).

Beginning about 4 months, puppies with hip dysplasia begin to show the first outward signs of hip dysplasia.

Signs of hip dysplasia

• stiffness rising from the floor
• lameness with running, jumping, going up/down stairs
• reduced muscle development in the hips and thighs
• a bunny-hopping pattern of running.

Regular walking will still usually look normal at this stage.

By the time a puppy with hip dysplasia reaches 11-12 months of age, they start to display forward weight shifting, to take the weight off their hind limbs.

The hind limbs may be held narrowly together and the pelvis waddles from side to side during gait. The young dog may appear hesitant to run, slow to stand, and painful when attempts are made to pull the hips backward, into extension. The gait pattern shows short, choppy stride lengths.

It all sounds pretty depressing, right?  But wait, didn’t we say above that pups start out with normal hips?

Doesn’t that mean that there might be a chance in the very early stages of life to make a positive change?

Can you prevent hip dysplasia?

Here’s what Piermattei, Flo and Decamp say in their 2006 publication:  “The disease CHD (Canine Hip Dysplasia) is preventable if hip congruity is maintained until ossification makes the acetabulum less plastic and the surrounding soft tissues become sufficiently strong to prevent femoral head subluxation. Under normal circumstances, tissue strength and ossification progress sufficiently to prevent the disease by 6 months of age”.

In other words, you have time to do something to help prevent CHD before the growth plates start to close and bone maturation occurs.

This concept was not at the forefront of veterinary medicine until very recently.

I took a course this past spring at STAAR (Symposium of Therapeutic Advances in Animal Rehabilitation) taught by superstar canine physical therapist  Laurie Edge-Hughes, who broke it down for us.  Super cool information!

What is the effect of exercise?

As recent as 2012, Krontveit et al found a reduced rate of CHD in puppies allowed to have daily walks and exercise on soft ground and moderately rough terrain.

Puppies born on a farm and those with off-leash exercise outdoors, between birth and 3 months, had less CHD. But they also found puppies allowed to walk on stairs 0-3 months had an increased risk of developing CHD.

In 2013, Green et al found that longer daily exercise duration is associated with lower lameness scores in dogs with CHD.

I can hardly contain myself!

Here’s one more:  Smith et al, in 2006 found that limiting a dog’s diet yielded radiographic signs of hip arthritis that came on much later in life ( 12 vs 6 years of age) affecting far fewer of the littermates, as compared to dogs fed ‘at liberty’.

Back to the conference: at this point, Ms. Edge-Hughes separated us into small groups and gave us the task of making a list of things breeders and puppy owners (especially during the 2-5 month period) can do to help prevent or reduce CHD, based on these findings.

Top 10 recommendation to preventing hip dysplasia in puppies

1. Diet and weight management

I will not pretend to be an expert in this area! You already know by past lessons that Jana Rade shared with us about looking at your dog’s waistline and feeling the ribs to determine if they are overweight, etc. If they are overweight, adjust their food intake and increase exercise and activity to reach ideal body condition. Your vet can help determine weight range.

There is a formula to help determine daily calorie intake to maintain ideal weight: start with the ideal/target weight your dog has attained in kg (divide pounds by 2.2). Next, multiply this weight times 30. Add 70 to this value and you will have the number of kcal per day needed to maintain weight. Your dog food manufacturer can tell you the number of kcal per serving measurement.

2. Restrict access to stairs

Puppies clumsily climbing and slipping up and down stairs may look cute, but it is risky business!

Keep pups off stairs and carry them up/down stairs and steps for the first 3 months of life. At four months, they can start to be trained to climb steps and staircases only if carpeted or have non-slip tread runners or pads. Use a leash with the training initially.

3. Coordination and body awareness

Get early starts by having puppies experiencing physical challenges and activity that help the firing of joint sensory receptors such as walking on packed or wet sand, moving around obstacles such as chair legs, vertical cones, and cardboard boxes; climbing over low soft objects such as sandbags, pillows, beanbags. Stimulate their balance by standing atop an uneven surface like a rocker board (non-skid on top).

4. Joint stimulation and compression exercises

Have the puppy standing on a rubber or yoga mat, and gently bounce them on it, pushing lightly down and up on their shoulders and hips. Gently roll them from side to side, and onto their back and play a game of ‘push-a ways,’ by placing your palms against their paw pads, pressing their legs toward their belly in a bent position, and the puppy will respond by pushing their limbs against you. Another method is moving their limbs in a reciprocal ‘bicycling ‘motion with the pup on their back or side.

5. Strengthen specific muscle groups such as the gluteals (‘butt muscles”)

Stand the puppy with one side to a wall, then lift their outer rear leg and hold it up 1-2 seconds. Repeat 4 times, and then place the pup with their other side against the wall, etc.

You can also add backward stepping by placing a small treat under the dog’s chin and moving toward them, forcing them to look down and step backwards. Strengthen further by doing ‘sit to stand’ exercises (and can advance this by placing the front paws up on a small box or stool). Core strengthening is also helpful.

6. During the puppy’s first few weeks of life, allow them to move in a non-slippery, indoor mini-arena with side walls and rubberized floor.

7. Once a pup is weaned, allow supervised activity and exercise on level non-skid terrain

Let puppies have access to free-range play, walking and movement on grass, sand, packed dirt or straw/hay. Avoid wet grass, mud, rocks or any slippery uneven surface.

8. Elongated Stretch on a step or on the stairs

Place the dog with the rear legs on floor or lowest step, and the front paws on a riser few steps above, so the spine and hind limbs are elongated. Keep them there for a minute, coaxing them to look up for a treat or pat on the top of their head. Do this daily if possible.

9. Perform circular, flat- hand massage over the hips and pelvis, 5 minutes each side, three to four times per week.

10. What about swimming?

Swimming is not recommended for puppies as the buoyancy will not provide needed stimulation on the joints. However, for older dogs with advanced CHD and degenerative arthritis, it is highly beneficial.

Related articles:
Physical Therapy for Hip Dysplasia

Further reading:
The 10 most important things to know about canine hip dysplasia