Helping a dog with hip dysplasia at home

Hip dysplasia tends to arrive with a lot of fear attached, usually because the word surgery comes up in the same conversation. For many dogs the day-to-day reality is different: a long condition managed with weight control, the right kind of exercise, pain relief your vet leads, and a house arranged so the hips are not fighting it every time the dog stands up. This page takes those in the order the veterinary sources give them, then goes room by room, then covers the surgery conversation and when to have it.

What hip dysplasia is, in plain words

The hip is a ball and socket. The AKC puts the problem simply: in a dog with hip dysplasia, the ball and socket "do not fit or develop properly", so they rub and grind instead of sliding smoothly. VCA explains why. The ball at the top of the thighbone and the socket in the pelvis have to grow at equal rates, and when they do not, the joint ends up loose. The American College of Veterinary Surgeons (ACVS) describes what that looseness does over time: the progressive loss of cartilage, scar tissue around the joint, and bone spurs around the ball and socket. In other words, arthritis in that hip.

Two points from the sources matter most if your dog is older. First, the condition starts during growth but often shows up late. VCA says that "although hip dysplasia begins in puppyhood, most dogs do not develop clinical signs until they are older," and the AKC notes that some dogs develop it "in conjunction with osteoarthritis as they age." Second, the ACVS names genetics as the biggest single risk factor and says it is most common in large breeds. So a dysplastic hip is mostly a big dog's problem, and that shapes almost every piece of gear further down this page.

If your dog has arthritis in other joints too, the general routine on our page about helping a dog with arthritis at home still applies, and if an arthritis diagnosis came with it, our first-month plan for a newly diagnosed dog is a calm place to start. This page is the hip-specific layer: what the hip dysplasia sources recommend, and the moments in a day that load the hips hardest.

What the veterinary sources recommend

We read the hip dysplasia pages from four sources: the ACVS, VCA Animal Hospitals, the AKC, and Cornell's Riney Canine Health Center. Their non-surgical advice overlaps far more than it differs.

Weight: the part that is entirely yours

The ACVS is unequivocal: "All dogs with CHD should be kept very slim from the outset, from very young to old age." The AKC gives the reason in one line: obesity puts a lot of stress on a dog's joints and can make an existing condition such as hip dysplasia worse. Cornell's version gives you a test you can do today: a dog at a healthy weight should "have a waist looking from the side and over the top."

For an older dysplastic dog there is a catch. The muscle over the hips and thighs is what steadies a loose joint, and both the AKC and the ACVS list loss of thigh or rear-limb muscle among the signs of hip dysplasia. So the aim is fat off and muscle kept, which means a vet-set target and a slow rate rather than simply cutting the food. Our page on keeping an old dog lean covers scoring your dog by hand and losing weight without losing muscle.

Exercise: controlled, not cancelled

None of the four sources says to rest a dysplastic dog. They say to change the shape of the exercise. The ACVS recommends a limited routine of "leash walks of a length the dog tolerates comfortably." VCA says "moderate daily exercise and avoidance of high-impact activities, such as jumping, may help keep the patient mobile and strengthen surrounding support structures." The AKC lists exercise restriction, "especially on hard surfaces," and Cornell recommends regular, low-impact exercise such as walking and swimming.

Translated into a day, that means on the leash rather than off it, grass or dirt rather than pavement where you have the choice, several shorter outings rather than one long one, and no ball games or jumping. Canine Arthritis Resources and Education (CARE), writing about arthritic dogs generally, sums up the pattern: dogs "should ideally do something every single day rather than be weekend warriors." Judge a walk by how your dog moves the next morning. Our guide to keeping a stiff dog moving gently covers how to read that.

Physical rehabilitation: worth asking about

VCA's hip dysplasia page is unusually direct here: "Physical therapy is highly effective at improving the quality of life for affected dogs and should be part of any treatment regimen." The ACVS says physical therapy can help dogs who lead a very sedentary lifestyle, and Cornell lists physical therapy "including muscle strengthening exercises."

This is where sit-to-stands come in. PetMD's overview of canine physical therapy lists sit-and-stand exercises among the therapeutic exercises dogs do in rehabilitation, and the same article is firm about doing them yourself: "Never look up exercises and attempt them on your own. Doing PT on your dog without veterinary guidance could cause injury." It suggests looking for a certified canine rehabilitation therapist (CCRT) or a veterinarian board-certified by the American College of Veterinary Sports Medicine and Rehabilitation. Ask your vet whether a referral makes sense for your dog, and let the therapist set the exercises, the number and the pace.

Pain relief: your vet's department

The drugs that do most of the pain control for dysplastic hips are prescribed. VCA describes several effective non-steroidal anti-inflammatory drugs (NSAIDs), chosen for the individual dog, and notes that "various drugs may be tried before finding the most effective one," with other medications sometimes added and, for some dogs, regular injections. Cornell notes that NSAIDs require intermittent monitoring of blood work. Three things follow for you at home:

• Never use your own medicine cabinet. The FDA warns that "an NSAID meant for people may not be safe and effective in dogs," because in a dog the drug may last longer, be processed differently and reach higher blood levels.
• Expect blood tests. For a dog on an NSAID long term, the FDA advises asking about baseline blood tests before starting and repeating them regularly to check liver and kidney function.
• Know the side effects. The FDA lists vomiting, diarrhea, bloody or black stool, decreased appetite, decreased activity, and yellowing of the whites of the eyes or the gums. If you see any of them, call your vet.

Supplements, framed the way the sources frame them

All four sources mention joint supplements, and they disagree about them sharply. The ACVS: "Cartilage protective supplements are often recommended, however there is no evidence in peer reviewed literature that they provide any help." VCA: "Most dogs with hip dysplasia should receive veterinary-approved joint supplements, including omega-3 fatty acid nutritional supplements." Cornell lists cartilage protective supplements and omega-3 fatty acids among its management options, and the AKC lists joint supplements among its non-surgical treatments.

Our reading: a supplement is a reasonable addition if your vet agrees, and it is the least important item on this page. If you go that way, our comparison of which Cosequin suits an older dog goes through the Nutramax range formula by formula, and our joint supplements roundup covers the wider shelf.

The house, arranged around the hips

Most of the signs the sources list for hip dysplasia show up at particular moments in the day. VCA describes dogs that are reluctant to rise from a sitting or lying position or to climb stairs. The AKC lists difficulty rising, jumping, running or climbing stairs. PetMD adds trouble standing up, abnormal sitting positions, and "bunny hopping," particularly on stairs. Those moments are where the house can help.

Getting up from lying down

Every source we read lists difficulty or reluctance getting up among the signs, and it is easy to see why: the back legs have to push the whole back end up from a folded position. Three changes make it easier.

• A bed the dog walks onto rather than climbs into. VCA's guide to setting up a home for a mobility-compromised dog recommends beds your dog does not have to climb over or onto, ideally a recessed orthopedic bed.
• Grip where the dog stands up. CARE advises that "non-slick flooring should be under/ around the bed." A dog that pushes off onto bare hardwood slides as it rises.
• Enough foam that the hip does not sink to the floor. The AKC suggests orthopedic beds made from a thick, solid piece of polyurethane foam or memory foam. Press the heel of your hand hard where the hip lands; if you can feel the floor, it is too thin for your dog.

There is a trade-off worth naming. A thick foam slab holds a heavy hip up well, but it is also a step, and a dog that struggles to lift its back legs may balk at a tall edge. Match the depth to your dog's weight and pick the lowest entry that still keeps the hip off the floor. Put the bed where your dog already chooses to lie, too. Our hip dysplasia bed roundup ranks the options by depth against weight.

Sitting down and standing up

The sit-to-stand is the hip's other daily test, and PetMD lists abnormal sitting positions among the signs of hip dysplasia, so watch how your dog sits as well as how it gets up. Ask for a sit only where the floor grips, because a sit on tile turns into a slide. When your dog needs a hand to get up, help from a sling or harness under the hindquarters: CARE describes a two-handled support harness as the tool for dogs that need help getting up, and VCA suggests a harness that supports the hind end for dogs that struggle to hold a posture. If a rehabilitation therapist prescribes sit-to-stand repetitions, do them on the same grippy surface.

Slick floors

VCA's home guide is blunt: "hard flooring like hardwood, laminate, or tile is not good for dogs." Its fix is non-slip rugs and runners in the areas your dog uses most. CARE adds that a rug needs a non-skid pad underneath and suggests yoga mats or gym floor tiles as alternatives, and the AKC's list for senior dogs includes grippy dog socks, toenail grips and all-season boots. Before buying any of it, do the two free fixes that both VCA and CARE recommend: keep the nails short, trimmed at least monthly, and trim the fur between the paw pads.

For a dog whose back end is already the weak end, a slip on a hard floor is exactly the fall you are trying to prevent. Our guide to stopping a senior dog slipping covers which routes to cover first, and our page on nail length and grip explains the free part.

Stairs

Stairs ask for two things at once: pushing up with the back legs on the way up, and controlling the body on the way down. VCA notes that your vet may recommend avoiding all unnecessary stairs, and that baby gates may be the best solution when they do. CARE suggests gates at both the top and the bottom so the stairs are never used unsupervised. Our page on stair gates for an old dog covers which gate goes where. For the trips that still happen:

• Grip on every tread. CARE recommends carpeting or non-slip stair treads; VCA suggests a carpet runner or stick-down grip tape. Our stair treads roundup compares the options.
• A handle. CARE recommends a harness with a handle "to help support and slow down ascent and, especially, descent."
• Your vet's view on up versus down. CARE notes that walking up stairs can help range of motion and muscle strength in arthritic dogs, while going down can be more problematic, particularly for dogs with elbow and wrist arthritis. Whether that applies to your dog's hips is a question for your vet or rehabilitation therapist.

Our guide to helping an old dog up and down the stairs covers the technique.

The car, the couch and your bed

CARE puts it plainly: "Jumping down from a bed or out of an SUV puts a lot of force on the joints." For the car it recommends some form of ramp or step, potentially with the help of a harness or sling. VCA suggests folding car ramps and support harnesses, and encouraging your dog to lie down during the drive to reduce swaying. Indoors, CARE says a dog should not be jumping off a high bed, but using stairs or a ramp instead. Our car ramp roundup, our page on ramps and stairs for large dogs and our guide for the dog that can no longer jump onto the bed cover the options.

The same rear sling does most of the lifting jobs on this page: the car door, the stairs and the bad mornings. The GingerLead listing names hip operations (TPO, total hip replacement and FHO) among the surgeries it is sold to help dogs recover from, and says its medium/large size typically fits female dogs over 45 lbs and male dogs over 60 lbs, so measure against the maker's chart before ordering.

What about a hip brace?

None of the four hip dysplasia pages we read lists a brace among its management options. Braces sell on compression and warmth, and some add a lift strap. Our hip braces page covers what that can and cannot do. If your dog needs help bearing weight, a sling is the tool built to take the load; a brace is not.

Signs it is getting worse

The symptom lists in the sources double as a watch list. Keep a short note and bring it to every appointment. Changes worth reporting:

• Taking longer, or more attempts, to get up, or refusing to (VCA, AKC, ACVS)
• New reluctance on the stairs, into the car or onto furniture (VCA, AKC, ACVS)
• Bunny hopping, with both back legs moving together, especially on stairs (AKC, PetMD)
• Shrinking thigh muscles; the ACVS and AKC both list loss of rear-limb muscle
• Shifting weight onto the front legs (ACVS), and noticeably bigger shoulder muscles (AKC)
• More limping or stiffness, or shorter walks before your dog wants to turn for home
• On an NSAID: any of the side effects the FDA lists, above

VCA makes a point worth holding onto: how bad the X-rays look and how much pain a dog shows do not always match. Some dogs with significant changes on X-rays show few signs, while others with minimal changes are in real pain. Go by the dog in front of you, not the last X-ray. Our pages on the quieter signs of pain and the stages of mobility loss help with what to watch for.

When to have the surgery conversation

VCA frames it simply: "The alternative to NSAIDs and medical therapy is surgery," and "the choice of surgery will be determined by your pet's age, condition, and lifestyle." The ACVS describes one procedure, FHO, as an option for dogs that "do not respond satisfactorily to medical treatment alone." So the practical trigger is not a particular X-ray. It is a dog whose pain and mobility are not controlled by weight, exercise, rehabilitation and medication together. That is the point to ask your vet whether a surgical referral makes sense.

For an adult or older dog, the list is shorter than the internet suggests. Two procedures you will read about are for young dogs only: the ACVS describes juvenile pubic symphysiodesis (JPS) for puppies under 18 weeks, and double or triple pelvic osteotomy (DPO/TPO) for immature dogs, ideally under 8 to 10 months old, with no arthritic changes yet. The two the sources describe for grown dogs are these.

• Total hip replacement (THR). The AKC calls it "the most effective surgical treatment for hip dysplasia in dogs": the surgeon replaces the whole joint with metal and plastic implants. Cornell notes it costs more than an FHO and is more common in large breeds. The ACVS lists its potential complications, including infection, dislocation, loosening of the implants, nerve injury and a fractured femur, and says activity is limited to leash walks outdoors and a small area indoors until it has healed, generally about eight weeks.
• Femoral head ostectomy (FHO). The ball of the joint is removed and the body forms a "false" joint. The AKC says it does not recreate normal hip function but can be a successful pain management strategy. Cornell says it is more common for small to medium-sized dogs, and the ACVS says it can give enough comfort in a dog weighing less than 60 to 70 lbs. Afterwards, the ACVS calls aggressive physical rehabilitation and controlled exercise "essential for an optimal outcome."

Which, if either, suits your dog depends on things only an examination can answer. What you can bring to that conversation is your notes on how your dog manages at home, and an honest sense of what weeks of restricted activity would ask of your household. Our guide to slings and harnesses after surgery was written around cruciate repair, but the confined weeks after a hip operation raise the same question of how to get a dog outside and back without a slip.

Where to start this week

1. Book the vet conversation if the pain plan is not keeping up: diagnosis, pain relief, and whether a rehabilitation referral makes sense.
2. Check for a waist from the side and from above, and agree a target weight if there is weight to lose.
3. Put grip where the hips work hardest: around the bed, on the routes your dog walks, and on the stairs. Trim the nails.
4. Take the jumps out: a ramp or step for the car and the bed, and gates on the stairs.
5. Swap the long walk for shorter leash walks on soft ground, every day.
6. Only then, if your vet agrees, think about a supplement.