Hip Dysplasia in Dogs: Signs, Treatment Options and Costs

Hip dysplasia is a developmental problem in which the ball and socket of a dog’s hip don’t fit snugly, so the joint is loose and wears into arthritis. Most dogs can be managed with weight control, sensible exercise and pain relief, while young dogs and severe cases may need surgery that costs several thousand pounds or dollars per hip.

It is most common in large breeds, but the American College of Veterinary Surgeons (ACVS) notes that many affected dogs show no obvious signs at all. That makes early checks, and decisions made while your dog is still a puppy, unusually important.

What hip dysplasia is and why it happens

In a healthy hip, the head of the femur sits deep in the socket of the pelvis. In a dysplastic hip, the joint is lax. The ACVS describes how that looseness leads to cartilage loss, scar tissue and bone spurs over time.

The causes are mixed:

• Genes. The ACVS calls heredity “the biggest single risk factor.”
• Growth. Rapid weight gain and excess nutrition while growing make it worse, according to both the ACVS and the Merck Veterinary Manual.
• Exercise and body condition. The Orthopedic Foundation for Animals (OFA) says calorie intake and exercise can affect severity.

VCA Animal Hospitals lists German Shepherds, Saint Bernards, Labrador and Golden Retrievers, Old English Sheepdogs and Bulldogs among the breeds at higher risk, along with large mixed breeds. Small dogs can be affected too. If you share your life with a German Shepherd or a Labrador, assume hips are worth checking.

Signs to watch for

Hip dysplasia rarely looks dramatic at first, and the early signs are easy to mistake for a dog that is simply lazy or stiff.

The usual clues are:

• Stiffness or slowness getting up, especially after a rest
• Reluctance to jump into the car or onto the sofa, or to climb stairs
• A “bunny-hopping” gait, where both back legs move together when running
• A swaying or wobbly walk at the back end
• Shifting weight onto the front legs, so the shoulders look bulky and the thighs thin
• Lameness that is worse after exercise
• Pain or resistance when the hips are moved

VCA says signs can start at a few months old but are most common between 1 and 2 years, while many dogs show nothing until arthritis sets in later. Both VCA and Merck point out that how a dog moves doesn’t always match its X-rays: some dogs with ugly-looking hips cope well, and some with mild changes are sore.

Dogs are good at hiding discomfort, so it helps to know the quieter signs a dog is in pain.

See a vet now if:

• Your dog suddenly can’t bear weight on a back leg, or can’t stand up.
• There is swelling, a wound or a fall or collision before the lameness started.
• Your dog cries out when moving, or won’t settle because of pain.
• Back-leg weakness comes with wobbling, scuffing the toes or changes in bladder control, which can mean a spinal problem rather than hips.
• A dog on anti-inflammatory pain relief starts vomiting, stops eating or passes black stools.

How vets diagnose it

In puppies

The ACVS says laxity can be detected from about 10 weeks of age. A vet can feel for it with the Ortolani test, which is often done at the 10–16 week vaccine visits, usually under light sedation. A positive result usually means arthritis by one year. A negative one can be a false reassurance.

PennHIP, a stress X-ray method that measures how loose the hips are, is accurate in puppies from 16 weeks, according to Antech, which runs the scheme. The ACVS considers it the most accurate early test. It needs a vet trained in the method.

Screening schemes for older dogs

• OFA (US): grades hips into seven categories, from Excellent to Severe. Preliminary screenings are available from 4 to 23 months.
• BVA/Kennel Club Hip Scheme (UK): dogs must be at least a year old. Each hip is scored on nine features, up to 53 per hip, giving a total of 0 to 106. Lower is better. Submissions start at £82.50 including VAT, plus your vet’s X-ray costs.

The ACVS’s view is that X-ray schemes done at one to two years come too late for the early preventive surgeries. Merck adds that reviews have “failed to identify a gold standard” for screening, and genome testing may eventually help. For now, VCA describes genetic tests as still being researched.

Treatment without surgery

For many dogs, and especially middle-aged or older dogs with milder laxity, conservative care is the main treatment. The OFA says up to 76% of severely dysplastic dogs with arthritis can function with weight control and controlled exercise.

The pieces that matter most:

• Keep your dog lean. This is the one thing every source agrees on. Extra weight loads sore joints, and in a long-running study of Labradors, dogs fed 25% less than their littermates for life developed hip arthritis later. A summary of that study (Smith and colleagues, 2006) reports that half the normally fed dogs had hip arthritis by age 6, against age 12 for the restricted group. Our dog food calculator gives a starting point for portions.
• Controlled exercise. Lead walks rather than ball-chasing, and avoid long sessions on hard surfaces, as Merck advises. Moderate daily activity keeps muscles strong.
• Physiotherapy and hydrotherapy. VCA strongly recommends physical therapy as part of most plans; Merck lists hydrotherapy and laser therapy.
• Pain relief, only under your vet’s direction. NSAIDs are the backbone of treatment. The ACVS notes they need blood monitoring because of kidney and liver risk. Vets may add other drugs such as gabapentin or amantadine.
• Monthly injections. Librela (bedinvetmab), a monthly injection given by a vet, was approved by the US FDA in May 2023 for osteoarthritis pain. In January 2025 the FDA wrote to US vets about reported adverse events, including neurological signs and increased thirst and urination, and the label was updated in February 2025 with a client information sheet. Ask your vet to talk through the risks before starting.
• Supplements. Omega-3 fatty acids have some support. The ACVS says there is no peer-reviewed evidence that cartilage supplements protect or repair cartilage.

Surgical options

Which operation makes sense depends mostly on age, how much arthritis is present and the dog’s size.

Source: ACVS. Ask your surgeon how these apply to your dog.

A few points from surgeons that are easy to miss:

• Timing is everything for JPS and DPO/TPO. The ACVS suggests hips are checked when a puppy is neutered at around 6 to 8 months, because that is close to the end of the window.
• FHO suits smaller, lighter dogs best. The ACVS says it works best in dogs under about 60–70 lb (27–32 kg), and dogs must stay lean and give up athletic work.
• Not every dog is a hip replacement candidate. Mississippi State’s vet school says only about one in ten dogs it evaluates turns out to be a good candidate. Iowa State reports good to excellent function in 95% of its THR cases.
• One hip is often enough. Iowa State says about 80% of dogs with arthritis in both hips need only one replaced.

How much hip dysplasia treatment costs

Prices vary hugely by country, city, clinic type and the size of the dog. These are published examples, not averages, and they exclude ongoing medication and physiotherapy.

All UK prices above include VAT. On Iowa State’s figures, our own arithmetic puts one hip replacement with consult and recheck at roughly $8,700 to $11,100, before any complications. Iowa State adds about $1,000 if a femur fracture has to be repaired during surgery.

For a sense of more everyday bills, Animal Friends says its average 2025 claim for hip or elbow dysplasia surgery was £1,578, and its average hip dysplasia claim for giant dogs (over 50 kg) was £2,330. Those figures mix many types of treatment.

We could not find published university or regulator prices for Canada, Australia or the EU. Ask for a written, itemised estimate wherever you are.

Insurance and hip dysplasia

Hips are where the small print bites hardest.

• Pre-existing signs. If a vet has noted stiffness, laxity or a limp before cover starts, expect the hips to be excluded.
• Bilateral exclusions. Some policies treat conditions that affect both sides of the body as one, so a problem in one hip before cover can exclude the other. Look for the word “bilateral” in the wording.
• Long orthopaedic waits. Some US policies apply a hip dysplasia wait of 6 to 12 months, and at least one only covers hips if the dog is enrolled before age 6.
• Hereditary conditions. Check that inherited and congenital conditions are covered at all, and on what terms.

Our guide to pet insurance waiting periods explains how these clauses work in different countries.

Lowering the risk in a puppy

You can’t change your puppy’s genes once they’re home, but you can choose a litter carefully and manage growth.

• Check the parents. The BVA advises breeding only from dogs at or below the breed median score and asking to see both parents’ results. It also says good scores lower risk without removing it.
• Grow slowly. VCA recommends measured meals rather than free feeding and a large-breed growth diet in the first year.
• Keep them lean. Overweight puppies are at higher risk, according to VCA.
• Ask about neutering timing. VCA says early neutering may raise the risk in some dogs, so discuss it with your vet.
• Ask for a hip check early. For high-risk breeds, mention hips at the puppy vaccine visits.

The bottom line

Hip dysplasia is common in big dogs, often quiet for years and very manageable when caught and handled well. Keep your dog lean, choose steady exercise, use pain relief under your vet’s direction, and ask about hips early if you have a large-breed puppy, because the cheaper preventive surgeries have a short window. If surgery is on the table, get an itemised estimate and read your policy’s orthopaedic clauses before you book.