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The Hip Health Project aims to improve outcomes in dogs diagnosed with hip dysplasia. Our goals are to
In particular, we are collating information around massage and exercise therapy programs in the management of hip dysplasia, alongside or in addition to conventional conservative and surgical management of the disease.
Canine hip dysplasia (CHD) is a disease of dogs that has been recognised since early in the 1900s.
Technically speaking, hip dysplasia means abnormal growth or development of the hip.
People also suffer from a similar condition, called Developmental Dysplasia of the Hip ( DDH). Babies are tested for ‘clicky’ hips before they even leave hospital, and during various stages of their development.
Hip dysplasia has two distinct phases.
The first phase of the disease can be recognised in puppies. In puppies, hip dysplasia is characterised by loose hips or ‘laxity’ in the hip joint.
The hip is comprised of a ball (the femoral head) and socket (acetabulum.)In a dysplastic hip, the ball doesn’t sit properly in the socket. During movement, the femoral head can become displaced or ‘subluxated’. Subluxation means partial dislocation.
When the femoral head reseats in the acetabulum, there are uneven forces centred on the joint, leading to cartilage wear and tear and the development of DJD or degenerative joint disease.
The second phase of the disease is the development of arthritis.
Once DJD is established in a dysplastic joint, inflammatory mediators produced by damaged cartilage set up a chain reaction that ultimately leads to the development of osteoarthritis or arthritis.
Arthritis is a painful condition. We can manage the pain of arthritis, we can slow its progression, but we cannot reverse arthritis once it is established in a joint.
As we mentioned before, the aims of the project are to improve outcomes for dogs diagnosed with hip dysplasia, at any stage of their life.
We will be working with local breeders and veterinary clinics to help identify dogs that may be included in our research project. We are looking to develop small group classes for puppies that may be predisposed, or are showing early gait abnormalities, to follow on from puppy preschool and into a class with specific strengthening exercises and strategies specific to strengthening the muscles of the lower back and hips.
If you are local to Newcastle, NSW, we can offer either individual appointments or small group classes (coming soon) for the delivery of the hip health project exercise program.
We also offer a completely online option…
If you are not local, we can offer you an online delivery system, where you can receive one-on-one coaching online and receive the complete program as ebook and video tutorial downloads.
If your dog is an adult dog, dealing with arthritis, and particularly hip arthritis, we can help.
Our program can help any dog, at any stage in their disease, to improve their function and mobility and decrease their pain levels. We have a particular sweet spot for the oldies.
We prefer to do individual programs for our older dogs because we often need to consider multiple issues. Rehab is never a one size fits all program! However, we are looking to develop a community around the Hip Health Project and have some picnic in the park fun days in the future, and we would love to see our oldies participating
Hip dysplasia is diagnosed in regular veterinary practices using a combination of history, clinical signs of soreness or lameness – such as pain on rising after rest, manual palpation of the joints and X-rays under sedation or anaesthetic.
Some of the things that we can look for to identify hip soreness include…
a ‘sloppy’ sit…
Since Hip dysplasia was recognised, the veterinary profession, along with breeders have been trying to reduce the severity and incidence of this disease.
Hip scoring systems have been developed on every continent to measure hip dysplasia in an effort to identify dogs that are considered appropriate for breeding.
In Australia, this method has traditionally been the hip extended view.
In more recent years, the PennHip method of identifying younger dogs with hip laxity has become more readily available. This technique measures the laxity or looseness of the hip joints in dogs as young as 16 weeks. This technique can help breeders identify dogs that are suitable for breeding at a younger age.
We know that dogs with loose hips and higher laxity scores are much more likely to go on to develop DJD and arthritis.
Sadly, however, the hip scoring systems are not perfect. Dogs with good hip scores can still have puppies with poor hip scores.
Further research into the dog genome has identified multiple genes, in different locations in the genome that code for aspects and elements of this disease. Some genes code for the shape of the joint, while other genes are more responsible for the propensity to develop arthritis. A combination of various genes means that breeding dogs without hip dysplasia is at best an extremely challenging goal.
There is also great variation between breeds. Some breeds have very low prevalence rates of hip dysplasia – such as the greyhound ( 3%) and other breeds such as the Pug have hip dysplasia prevalence rates as high as (71%)
The environment that puppies are reared in, also can have an impact on the development of the disease. Studies in northern European nations have shown that puppies born in spring and summer have a lower prevalence of hip dysplasia than puppies born in winter and confined indoors for the first 12 weeks of life. That would seem to indicate that early activity, rough and tumble play is important for development.
So, on reflection, it would be fair to say that there has been a lot of effort and energy directed to improving outcomes for dogs and reducing the incidence of this disease, with some fairly unsatisfactory results so far. There have been some improvements within breeds, and a reduction in severity of the disease across breeds, but there are still lots of dogs suffering with hip dysplasia.
I certainly feel, considering the complex nature of hip dysplasia, including genetic and environmental elements, it is an unfair burden for breeders to shoulder the responsibility of this disease in our much loved dogs. They have a role to play…but can we be doing something more?
There are a collection of factors that can predispose to the development of hip dysplasia, but it is important to remember that the development of the disease is a complex process. Just because there are some risk factors in a young dog, doesn’t mean that dog will go on to suffer debilitating hip arthritis.
Think Labradors, German shepherds, Golden Retrievers, Saint Bernards, Mastiffs.
Why? – because growth is often rapid, and bones elongate before the development of muscles and soft tissues to support them.
Size and weight are known to contribute to the development of arthritis.
We know that weight management is one of the keys to reducing arthritis and the pain associated with it.
Why? : Because we know that there are numerous genetic markers involved in the disease and importantly, laxity is heritable – passed onto puppies from the parents.
Why? : Exercise has been thought to predispose to joint problems in the past. Many breeders of large dogs often advise new puppy owners to restrict their puppy’s activity as it grows. During COVID lockdowns, we have seen a lot of dogs, sharing an increasing proportion of indoor time with their owners – regardless of our mild weather patterns.
It is true that excessive exercise, or intense exertion can often uncover a subclinical joint problem. But remember that puppies that have outdoor play time with their litter mates during development have a lower incidence of hip dysplasia.
My feeling is that a lack of exercise during development leads to less muscle development and a less balanced body composition. You could postulate that rapid growth of long bones without muscle development does increase the strain on connective tissues such as ligaments and tendons.
In addition, poor muscle development in the gluteal group is associated with increased hip laxity in growing dogs.
It is the laxity that leads to cartilage damage and arthritis later, so I feel that appropriate muscle development is important to protect or mitigate hip dysplasia and the lack of exercise could be a contributing factor to disease.
And once obesity sets in, it is hard to move and arthritis spins out of control.
One if the impacts of COVID has been the rapidly increasing demand for puppies. As demand increases, so has the price of puppies. In particular, some breeds have become extremely popular. Poodle crossbreeds in particular can fetch a purchase price of $5000 and more.
Aside from the growing population of ‘oodles are the fancy variations of all of the breeds.
We can miniaturise, change coat length and coat colour and breed a range of different variations on a theme. Not all of these variations are genetically sound, and the incidence of hip dysplasia in small breeds and crossbreeds is increasing as rapidly as the number of new colours available.
The other aspect of the growing popularity of crossbreed puppies is that there are no ‘breed standards’ for diseases such as hip dysplasia to be scored using traditional methods.
Our human desire for the rare and fancy may outweigh our desire for healthy and well put together.
If this is the case…we will need to learn to live with hip dysplasia in small dogs as well as our large breeds.
Over the last decade, my interest and passion for physiotherapy in the veterinary space, and rehabilitation techniques has grown, with one eye on the human space.
One of the great initiatives I have been involved (as a parent and observer) has been the skills acquisition program that my son has participated in through soccer. Part of the program involved a physiotherapy appointment.
Sports specific professionals consult with the kids, and look at the ‘way they are put together’ . For example some postural variations include being flat footed, pigeon toed, sway backed etc. Knowing the muscle groups that help support those bones, and the muscle development crucial to the sport, the physiotherapists put together individual strengthening programs for the kids as they develop…with the goal of minimising the risk of injury.
Pre-hab is a proactive approach to avoiding pain and injury.
One of the goals of the Hip Health Project is to collect information from puppies undergoing pre-hab for hip dysplasia to analyse the benefit of exercise therapy programs.
Perhaps the answer to this problem isn’t in breeding and genetics and hip scores and finding some magical genetic combination.
Maybe the solution is much simpler.
If you are planning to desex your puppy, you can ask your regular vet to screen them for hip laxity while they are under anaesthetic. We are happy to talk with your regular vet about our project.
Puppies with loose hips can then be x-rayed under anaesthetic (at the time of desexing) to help to reduce the costs and inconvenience of a second anaesthetic.
We accept standard hip extended views if your local vet doesn’t do PennHip X-rays.
Older dogs may have already been x-rayed and diagnosed with hip dysplasia.
We would like to work with your regular vet and may ask them for your dog’s relevant history and X-rays with your consent.
We would also like your vet to assess your dog’s mobility and pain levels at the conclusion of the program.
We would also be excited to hear from any breeders who would like to participate in the collection of data.
Analysing whole litters, and having some in the litter complete the program will allow for the most statistically significant data generation.
Breeders would be able to obtain the results of any PennHip scoring for their litters which will help them to evaluate their breeding combinations.
We are looking for participants that will help us to evaluate the benefits of exercise therapy and massage in hip dysplasia patients, as well as puppies in breeds that are predisposed to hip dysplasia.
We need to collect information from you at regular intervals.
This will be in the form of a questionnaire which will be required to be completed online.
Predisposed puppies have the option of completing PennHip X-rays to further enhance our analysis.
Follow up with a text message instead of voicemail