Hip Dysplasia
Hip dysplasia is an abnormal formation of the hip socket that, in its more severe form, can eventually cause crippling lameness and painful arthritis of the joints. It is a polygenic trait, that is affected by environmental factors in the production of the final phenotype. It can be found in many animals and occasionally in humans, but is most commonly associated with dogs, and is common in many dog breeds, particularly the larger breeds.
Causes and effects
In dogs, a femur that does not fit correctly into the pelvic socket, or poorly developed muscles in the pelvic area. Large and giant breeds are susceptible to hip dysplasia, and Cocker spaniels and Shetland sheepdogs are also known to suffer from it. Cats are also known to have this condition, especially Siamese.
To reduce pain, the animal will typically reduce its movement of that hip. This may be visible as "bunny hopping", where both legs move together, or less dynamic movement (running, jumping), or stiffness. Since the hip cannot move fully, the body compensates by adapting its use of the spine, often causing spinal, stifle (a dog's knee joint), or soft tissue problems to arise.
The causes of hip dysplasia are considered heritable, but new research conclusively suggests that environment also plays a role. To what degree the causality is genetic and what portion environmental is a topic of current debate. Environmental influences would include overweight condition, injury at a young age, overexertion on hip joint at a young age, ligament tear at a young age, repetitive motion on forming joint (i.e. jogging with puppy under the age of 1 year). As current studies progress, greater information will help provide procedures to effectively reduce the occurrence of this condition.
In dogs, the problem almost always appears by the time the dog is 18 months old. Richard Pitcairn theorizes that the hips of young dogs are weakened by heavy vaccination. The defect can be anywhere from mild to severely crippling, and can eventually cause severe osteoarthritis.
It is most common in medium-large pure bred dogs, such as German Shepherd Dogs, Labrador or Golden retrievers, rottweilers and mastiffs, but also occurs in some smaller breeds such as spaniels and pugs and occasionally (usually with minor symptoms) in cats.
Symptoms
Dogs might exhibit signs of stiffness or soreness after rising from rest, reluctance to exercise, bunny-hopping or other abnormal gait (legs move more together when running rather than swinging alternately), lameness, pain, reluctance to stand on rear legs, jump up, or climb stairs, subluxation or dislocation of the hip joint, or wasting away of the muscle mass in the hip area. Radiographs (X-rays) often confirm the presence of hip dysplasia, but radiographic features may not be present until two years of age in some dogs. Moreover, many affected dogs do not show clinical signs, but some dogs manifest the problem before seven months of age, while others do not show it until well into adulthood.
In part this is because the underlying hip problem may be mild or severe, may be worsening or stable, and the body may be more or less able to keep the joint in repair well enough to cope. Also, different animals have different pain tolerances and different weights, and use their bodies differently, so a light dog who only walks, will have a different joint use than a more heavy or very active dog. Some dogs will have a problem early on, others may never have a real problem at all.
Each case must be treated on its own merits, and a range of treatment options exist.
 
Long term pain
A dysplastic animal has probably lived with the condition since it was only a few months old, and has therefore grown up taking the chronic pain for granted and have learned to live with it. Dogs suffering such pain do not usually exhibit acute signs of pain. Sometimes, they will suddenly and abnormally sit down when walking, or refuse to walk or climb objects which they usually would, but this can equally be a symptom of many other things, including a thorn in the paw, or a temporary muscle pain. So pain recognition is less common a means of detection than the visible gait and other abnormalities described above.
Diagnosis
The classic diagnostic technique is with appropriate x-Rays and hip scoring tests. These should be done at an appropriate age, and perhaps repeated at adulthood - if done too young they will not show anything. Since the condition is to a large degree inherited, the hip scores of parents should be professionally checked before buying a pup, and the hip scores of dogs should be checked before relying upon them for breeding. Despite the fact that the condition is inherited, it can occasionally arise even to animals with impeccable hip scored parents.
In diagnosing suspected dysplasia, the x-ray to evaluate the internal state of the joints is usually combined with a study of the animal and how it moves, to confirm whether its quality of life is being affected. Evidence of lameness or abnormal hip or spine use, difficulty or reduced movement when running or navigating steps, are all evidence of a problem. Both aspects have to be taken into account since there can be serious pain with little X-ray evidence.
It is also common to X-ray the spine and legs, as well as the hips, where dysplasia is suspected, since soft tissues can be affected by the extra strain of a dysplastic hip, or there may be other undetected factors such as neurological issues (e.g. nerve damage) involved.
There are several standardized systems for categorising dysplasia, set out by respective reputable bodies (Orthopedic Foundation for Animals/OFA, PennHIP, British Veterinary Association/BVA). Some of these tests require manipulation of the hip joint into standard positions, in order to reveal their condition on an X-ray.
Treatment
There is no complete cure, although there are many options to alleviate the clinical signs. The aim of treatment is to enhance quality of life. Crucially, this is a congenital condition and so will change during the life of an animal, so any treatment is subject to regular review or re-assessment if the symptoms appear to get worse or anything significantly changes.
If the problem is relatively mild, then sometimes all that is needed to bring the symptoms under control are suitable medications to help the body deal better with inflammation, pain and joint wear. In many cases this is all that is needed for a long time.
If the problem cannot be controlled with medications, then often surgery is considered. There are traditionally two types of surgery - those which reshape the joint to reduce pain or help movement, and hip replacement for animals which completely replaces the damaged hip with an artificial joint, similar to human hip replacements.
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Hip Dysplasia
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