Hip Dysplasia is defined as a deformity of the Coxofemoral (hip) joint that occurs during the growth period. Hip Dysplasia is a hereditary condition that creates a poorly fitting hip joint. As the dog walks on this joint, arthritis will eventually develop, causing pain in the joint. The degree of lameness that occurs is usually dependent upon the extent of arthritic changes in the hip joint.

Is this found in certain breeds of dogs?

Most breeds of dogs can be affected with hip Dysplasia although it is predominantly seen in the larger breeds of dogs, such as the German Shepherd, St. Bernard, Labrador Retriever, Pointers, and Setters. There is equal distribution of the disease between male and female dogs.  Unfortunately Epagneuls Bretons are not free of the problem either, but their smaller size often allows the condition to go undetected, and why so many that are affected can lead a relatively normal life.

What are the clinical signs, and when do they occur?

The typical clinical signs of hip Dysplasia are rear leg pain, in-coordination, restriction in the movement and a reluctance to rise. Wasting of the large muscle groups in the rear limbs may eventually develop. Most owners report that the dog has had difficulty in getting up from a lying position for a period of weeks or months; lameness and pain subsequently develop. Again, the severity of signs and progression of the disease usually correlate with the extent of arthritis in the joint. There are two major groups of dogs that are presented to a veterinarian for dysplastic changes, even though Clinical signs can occur as early as 4-6 weeks of age :

The young dogs often have difficulty rising (especially in the morning), and may show gait problems when walking, running or using stairs. Their pain comes from many sources; tiny fractures where the loose femur hits the rim of the acetabulum, torn muscles, and torn joint capsule.

SIGNS OF CHD IN YOUNG DOGS: What you will see first is a pup that runs with both back legs nearly together, almost like a rabbit would run. After exercise the pup will be reluctant to rise, will sit back as if unsteady and will have difficulty climbing stairs or inclines. The pup might look slightly underdeveloped in the rear quarters. When it stands the rear legs may not be parallel, but rather too near each other at the hocks (ankles) called "cow hocked".

You might notice a boniness to the pelvic area from lack of good muscle development. Another hint of trouble is an inability to extend the leg backward very far (decreased range of motion). Note: Many pups rest or sleep in a frog-like position with knees extended out to either side - this is a good sign and shouldn't alarm you.

In severe cases of Dysplasia, the young dog will rock forward to support more weight on the front legs (which can create trouble in the shoulders and elbows). When dogs do this it seems as if they are tip-toeing or walking very lightly on their rear legs. A dysplastic pup will be reluctant to jump or "stand up" on its hind legs. Signs usually being between five and eights months of age. But remember, some dogs do not show any signs at all of hip joint degeneration until mature adults.

How is it diagnosed?

Tentative diagnosis of hip Dysplasia is made on the basis of history, breed, and clinical signs.  A large breed dog that has been slow to rise for several months and now is lame is highly suspect for hip Dysplasia; a dog which refuses to rise should also be considered a candidate. Because the clinical signs may mimic other diseases, final diagnosis of hip Dysplasia can only be made on the basis of specific radiographic (x-ray) findings. To obtain the proper radiographs, dogs must be carefully positioned on the radiographic table. This procedure may require the use of a short-acting anesthetic or sedation. The radiographs are evaluated for abnormal shape of the hip joint and for degenerative changes (arthritis).

How is it treated?

The degree of clinical signs and arthritic changes in the joints determine the specific approach to therapy. Treatment of hip Dysplasia may involve the use of drugs or surgery, or both. The options are as follows:

 l. Anti-inflammatory drugs. Several drugs will give relief from pain. Aspirin or acetaminophen may work well in some dogs. Other steroidal (cortisone) and non-steroidal drugs may also be used. Most have some side-effects and most require administration once or twice daily. Many dogs have severe stomach irritation to ibuprofen, so this drug is not recommended. Unfortunately, it is not possible to predict which dog will respond to which drug. Therefore, a series of trials may be needed to find the most effective one for your dog. Extreme caution is advised when these drugs are given to dogs with a history of kidney disease or with marginal kidney function. Many of these drugs have an adverse effect on blood flow to the kidneys and can lead to kidney failure. This does not appear to be a concern if kidney function is normal. As alluded to above, dogs with a history of ulcers are also at risk for complications. Your veterinarian can determine the risk for your dog. Anti-inflammatory drug therapy is most often used in older dogs, in dogs that did not get good relief from surgery, or in dogs for which surgery is not feasible.

There has been some good pain relief achieved with a period of using Adequan injectable for cartilage preservation, and regeneration, with Canine Hip Dysplasia and other arthritis conditions of joints.  To this same end many have reported good results with oral supplementations such as Synoflex.

2. Surgery: There are four main procedures: pectineal myotomy (muscle cutting surgery), femoral head ostectomy (ball removal), triple osteotomy, and hip joint replacement. Pectineal myotomy is a relatively minor procedure that involves cutting a small muscle that puts pressure on the hip joint. It results in no loss of leg function and gives good to excellent relief in 80-90% of dogs. If both hips are abnormal, both hips may be operated on at the same time. The dog recovers from surgery in one to two days. However, this procedure does not stabilize the hip joint or prevent progression of arthritic changes. Within a few months to several years, pain and lameness will return. This procedure is especially recommended in older dogs. Femoral head ostectomy (FHO) is another choice. The hip joint is a ball and socket joint. FHO is the removal of the ball part of the joint. This gives excellent results in small dogs because a functional "false joint" forms. However, some large dogs may not form this "false joint" very well. This procedure is usually used in large dogs if arthritis is very severe, if the hip dislocates, or if the expense of the other procedures is prohibitive. Triple osteotomy is a procedure in which the pelvis is cut in three places around the hip joint. The bone is rotated to create better alignment with the femoral head (the ball). It is reattached so that the joint functions in a more normal fashion without looseness and pain. This should only be performed in a dog with no arthritic changes in the joint, and most successful when done in very young dogs if detected early. It is an expensive procedure. Hip joint replacement is possible, as is done in humans. A stainless steel ball and socket are attached to the pelvis and femur in place of the abnormal ones. It is another expensive procedure, but it may give many years of pain-free use of the hips. Although the intent is for the transplant to be permanent, the new joint may loosen after a period of time.

I am considering breeding my dog. Can anything be done toprevent hip dysplasia in the puppies?

Research has shown that the cause of hip Dysplasia is related to a combination of genetic and environmental factors, the term "polygenic" is used.  The disease is known to be an inherited condition and the genetics of hip Dysplasia are extremely complicated. In addition, environmental factors such as overfeeding, poor nutrition and excessive exercise can predispose a dog (especially growing puppies) to developing hip Dysplasia if they already have the genetic makeup for the disease. Because the inheritance of the disease is so complicated, many questions remain regarding eradication of the disease. Here are some practical suggestions:

1. Have your dog radiographed before breeding to be sure the hips are normal. If they are not, this dog should not be bred.         

2. Consider a feeding program to keep growth to a moderate rate. There is a growing body of evidence indicatingthat dogs that grow very rapidly are more likely to have hip Dysplasia. Many authorities recommend feeding an adult-type food to puppies of high risk breeds so their growth is slower. They will still reach their full genetic body size, but just not as rapidly. Some dog food manufacturers are now making puppy foods for large breed dogs. This is essentially the same approach as feeding an adult food because these puppy foods are formulated for slower growth.

3. Avoid excessive exercise in a growing puppy. Any abnormality in the structure of the hip joint is magnified if excessive running and jumping occur. It is not necessary to treat your puppy as it were handicapped, but long sessions of running or chasing thrown objects can be detrimental to joints genetically predisposed to Hip Dysplasia.  Do not expect your puppy to hunt for the same periods as and adult dog, especially over rough terrain when not fully mature.

4.  All puppies are born with normal hip joints.  It is around 60 days of life that the normal joint starts to develop abnormally.  Good traction in the whelping box may prevent excessive wear and tear early on, and good traction thereafter can do no harm as they are going through the rapid growth phase up to about 5 months of age. Most Epagneul Bretons reach full growth at 18 months of age.

What does it mean to have the hips certified as normal?

The Orthopedic Foundation for Animals (O.F.A.) is an organization established for the purpose of standardizing the evaluation process of canine hip radiographs. The O.F.A. consists of a board of certified veterinary radiologists who are skilled in detecting hip Dysplasia. If the radiographs submitted to the O.F.A. are declared normal, the dog is issued an O.F.A. certificate number indicating that it has normal hip confirmation. The O.F.A. requires that dogs must be a minimum of two years of age to be certified. Many dedicated breeders require that a dog must have an O.F.A. certificate before breeding is allowed. Another hip evaluation program is called the PennHip method. Radiographs are made of the anesthetized dog in such a manner as to place outward force on the hip joints. This can reveal looseness in the joints that may elude detection by the more standard radiographic methods. It is also useful in identifying hip Dysplasia in puppies as young as four months of age. Although any veterinarian can make the appropriate radiographs and submit them for O.F.A. certification, the PennHip method must be performed by a veterinarian specifically trained and certified in this procedure.  There is considerable scientific research about Canine Hip Dysplasia and anyone can find just about any documentation on which method is better than another, but it still remains that the only real way to identify the condition is with some form of radiograph.

How does OFA know that the hip radiographs belong to my dog?

The radiographs must be imprinted with identification information about your dog at the time they are made and developed. This procedure creates a permanent mark on the radiograph.               In addition, OFA now requires that certified dogs be permanently marked with either a tattoo or a microchip implant, or have a DNA profile on file. The microchip implant process is simple and very effective. A tiny microchip is implanted under your dog's skin through a special injection needle. A special scanner can detect these chips through the skin. They can identify the dog and its owner through its code number and a registry system. This is also an excellent means of getting lost dogs back home because the registry system is national in scope. Most dogs imported from European countries are also permanently identified with a tattoo and this number is also often recorded on the radiograph as well.

How are the ratings defined and what does it mean to me?

Categories in blue boxes under OFA are issued certificates that hips are within normal limits, those also listed with and asterisk are acceptable for CEB-USA ratings at this time; categories under SCC in blue boxes are those that are considered acceptable for CEB-France breed title & ratings, not all breeders follow the recommended guidelines. Most all systems agree on the Excellent, Good, Moderate, and Severe categories,  There is a fine line between Indeterminate (no arthritic changes) and Fair (joint is not perfect but shows no degeneration) and is often a judgment call by the radiologist, and is one reason OFA elects to recheck this category 6 months later often calling it "borderline".

Understanding the ratings will help breeders make informed decisions with regards to breeding partners.  Not all systems are equal to each other, the intent is the same to find those affected.  Evaluating pedigrees of prospective stock is done on 2 levels:

1. Pedigree depth - how many generations of normal dogs are found in a pedigree.  OFA suggests that pedigrees with more generations of normal dogs lessens the risk of the new generation having affected.  It is no guarantee that there will be no affected but offers some hope.  A 3 generation pedigree of all clears has shown significant risk reduction, according to OFA.

2. Pedigree breadth - the number of related dogs to those listed in the pedigree are also normal.  Knowing the littermate information of the dogs listed in the pedigree tells you how consistent a pedigree is for passing on sound hips.  Unfortunately in the early days in the USA, this information was unavailable, but now with the posting of litter number registration you can track dogs with the same litter number under OFA.  You can also track information if provided on the newer OFA forms by Sire or Dam registration numbers as well to give you this breadth information on production.

3.  A system is only really valuable if all information is submitted both normal and affected.  Sadly in the USA the OFA charges for both normal and abnormal submissions and because of this most affected are not reported.  Dedicated breeders submit affected as well to make a true tracking of genetic information available for all to succeed.  We urge all to submit every evaluation to the OFA and to have it listed in the Open Registry format.  It is not a crime to have an affected dog and it does not mean that an entire family of dogs should be condemned if an individual is found to have a problem, the information can benefit all breeders in retaining individuals within a line that appear to reproduce better than themselves, even if it means starting with affected stock.

4.  When investigating potential purchases inquire as to whether or not hip evaluation has been done on parents and then grand parents.  If the breeder cannot provide you with parent information and a registration number to investigate on the OFA web site then you would have to assume there is no rating or worse that the dog is affected.  In many Epagneul Breton pedigrees in the USA there is very limiting information on hips available as many early breeders did not do evaluations erroneously believing that the breed had no such problems.  American Brittany breeders took advantage of OFA services when they were started in the 1960's and have made great strides in their stock and have some valuable data for their gene pool.  We have a long way to go with the Epagneul Breton but hopefully we will be as successful in our attempts.