A dislocated hip in dogs is painful and stressful, but thankfully, the outlook is generally good with prompt veterinary care. Integrative veterinarian Dr. Julie Buzby explains the causes and symptoms of hip dislocations, and the surgical and non-surgical treatment options. Plus, she discusses what to expect during the recovery period.
Did you know that the hip is the most common joint to become dislocated in dogs? Falling, landing wrong from a jump, getting hit by a car, or other events can cause the hip to pop out of place. Unfortunately, the end result is one painful pup.
While you can’t go back in time and prevent your dog’s dislocated hip, you can equip yourself with information to make the path forward a bit smoother for your dog. Let’s discuss.
What is a dislocated hip?
Hip dislocation, or hip luxation, is the traumatic separation of the head of the femur from the acetabulum of the pelvis. In other words, the ball of the hip joint comes out of the socket.
Normally, the rounded head of the femur (the “ball”) sits in the cup-like pelvic acetabulum (the “socket”) to form the hip joint. Running from the head of the femur to the acetabulum is the capital ligament (round ligament).
The capital ligament, along with the half-moon-shaped bony rim of the acetabulum and the fibrous joint capsule, keeps the head of the femur from coming out of the acetabulum. In order for the hip to be dislocated, two of those main hip stabilizers must be damaged.
What causes a dislocated hip in dogs?
As you might expect, a dislocated hip doesn’t happen easily. Most commonly, it occurs as the result of trauma, including:
- Being hit by a car
- Falling from a height, such as down stairs, off a deck, or from the back of a moving vehicle
- Landing improperly after a jump, which could happen while playing or chasing a ball
Additionally, some dog breeds are predisposed to hip dislocation because of poor anatomic conformation. Large and giant breed dogs, including Great Danes, Labrador Retrievers, Rottweilers, Mastiffs, Bulldogs, and German Shepherds, have a hereditary tendency for hip dysplasia in dogs.
Hip dysplasia occurs when the hip joint is too shallow and/or the head of the femur is misshapen. As a result, the head of the femur doesn’t sit completely in the acetabulum and may partially dislocate (subluxate). In some cases, dogs with hip dysplasia may also suffer a full hip dislocation, especially after a jump or fall.
What are the symptoms of a dislocated hip?
Dogs who have a sudden hip dislocation usually have clear signs of an orthopedic issue, including:
- Pain: With a dislocated hip, you will generally see signs your dog is in pain, even if your dog is usually very stoic. He or she might whimper, shake, hide, or act uncomfortable.
- Lameness: Dogs may be limping on a back leg, toe-touching, or not bearing any weight on the leg at all. The severity of the limping depends on the degree and direction of the dislocation, and the dog’s pain tolerance.
- Leg length asymmetry: Most commonly, the thick muscles of the hip pull the femur forward and upward. As a result, the head of the femur rests on top of the pelvis (craniodorsal luxation). This type of luxation often causes the affected leg to appear shorter than the other three legs.
- Abnormal leg position: After a dislocation, the muscles around the hip and thigh tighten, holding the leg in an unusual position. The leg may stick out at an odd angle, often rotated outward. This prevents the toes from resting flat on the ground.
- Limited range of motion (ROM): Hip dislocation disrupts the normal ball-and-socket joint. Thus, your dog’s leg can’t flex, extend, or rotate at the hip like normal. If the dog is trying to use the leg, it will look stiff or awkward.
- Difficulty standing or squatting to use the bathroom: With the leg in an unnatural position, both male and female dogs may struggle to urinate or defecate comfortably.
- Secondary injuries: Dogs with a hip dislocation due to blunt force trauma may have other injuries such as broken ribs, ruptured bladder, bruised lungs, diaphragmatic hernia, etc.
If you think your dog has a hip dislocation, go to the vet
If you are seeing some of the symptoms above, it is important to seek veterinary care immediately. Hip dislocations are very painful, and the sooner the vet can reduce the dislocation, the better. Depending on the situation, your vet may have you make an emergency vet visit at an emergency clinic or the regular clinic.
Note: Dogs who’ve experienced blunt force trauma that was significant enough to dislocate the hip can have damage to the soft tissues (skin, muscles, and internal organs) near the area of impact. This is another reason that seeking veterinary care immediately is so important.
How will the vet diagnose a hip dislocation?
The vet will start with a physical examination, which will often provide clues to whether or not your dog has a dislocated hip. However, to reach a definitive diagnosis, the vet will likely need to take sedated X-rays. The sedation helps minimize your dog’s discomfort during the process. And it allows the veterinary team to position your dog in such a way to obtain good-quality X-rays.
The X-rays can confirm a hip dislocation and provide other valuable information. In dogs who suffered blunt trauma, they may reveal fractures of the femur and/or pelvis. This is important to know ahead of time because fractures can affect the normal shape of the hip socket and prevent a simpler, non-surgical hip reduction. X-rays are also an excellent way to evaluate your dog for hip dysplasia and other hereditary conformational issues.
What is the treatment for a dog’s dislocated hip?
Once your veterinarian has diagnosed your dog with a hip dislocation, the next step is to get the hip back into the socket as quickly as possible.
Closed (non-surgical) reduction of hip dislocations
For some dogs, a closed reduction technique (meaning that no surgical incision is required) is appropriate. This involves manipulating the ball of the femur back into the hip socket while the dog is under general anesthesia. Then, the vet may recommend strict crate rest for dogs and/or placement of an immobilizing sling (Ehmer sling) for 10-14 days.
Recovery from closed reduction
After a closed hip reduction, you’ll need to closely monitor your dog’s comfort level at home. Also, it will be important to follow your vet’s instructions about pain medications, exercise restriction, and sling management (if applicable).
Monitoring the Ehmer sling should include regular daily checks for skin irritation (especially in the groin area). Plus, it is important to ensure the bandage isn’t wrapped too tightly around the foot. A poorly fitting or overly tight bandage can cause significant damage to the underlying tissue.
Safety note: Visible swelling, bluish nails, or toes that feel cold to the touch are all indications that your dog’s bandage is too tight. Contact your vet as soon as possible so he or she can adjust it. (Or head to the emergency clinic if your vet is closed.)
Some general practitioners will perform closed reductions in the clinic. But they may recommend referral to a board-certified veterinary surgeon when an open reduction or other surgical procedure is necessary.
Open (surgical) reduction of hip dislocations
In certain situations, dogs will need a surgical procedure to address the hip dislocation. The main reasons for surgical treatment of hip dislocations include:
- Fractures of the pelvis or femoral head/neck
- Hip dysplasia
- Degenerative joint disease in the hip
- Chronic hip dislocation
- Hip dislocation that reoccurs after closed reduction
Some dogs might need toggle pinning to reduce the dislocation. For others, a femoral head ostectomy (FHO) or total hip replacement (THR) is a better choice. The veterinary specialist will help determine which procedure is right for your dog.
Toggle pinning (toggle rod stabilization)
Toggle pinning or toggle rod stabilization uses a strong suture to mimic the function of the damaged capital (round) ligament.
Under general anesthesia, the vet drills one hole through the femoral head and neck, and one through the acetabulum. Then a heavy nonabsorbable suture, attached to a toggle pin or rod, is inserted through the acetabular hole. The remaining suture is then threaded through the hole in the femur and tied to another toggle or button on the outside of the bone to hold the femoral head in place inside the hip socket.
After toggle pin surgery, your dog will need to wear bandage tape hobbles, or a removable hobble system like DogLeggs™ to limit hindlimb movement and help the hip heal.
In a study of 58 dogs who underwent toggle rod stabilization for a hip dislocation published in the Journal of the American Animal Hospital Association, 90% of dog parents reported good or excellent satisfaction with the procedure. This helps confirm that toggle pins and rods are a good option for open reduction of hip dislocations.
Femoral head ostectomy (FHO)
FHO surgery in dogs involves surgically removing the femoral head and neck rather than attempting to get the femoral head back into the hip socket. During the healing process, the body forms scar tissue around the hip. This creates a false joint to replace the physical connection between the femur and the pelvis.
Total hip replacement (THR)
During a total hip replacement for dogs, the surgeon will replace the femoral head and the acetabulum with prosthetic implants. A new titanium femoral head is seated securely into the femur. And a surgical-grade plastic acetabular socket takes the place of the damaged bony acetabulum. The smooth surfaces of the titanium and plastic closely mimic the movement of a natural, bony hip joint.
Recovery from hip surgery
Following surgery, your dog may need to stay in the hospital for a couple of days. During that time, the veterinary team will manage your dog’s pain and monitor the surgical site for swelling or signs of infection. Then your dog can head home and continue to recover there.
What does recovery involve after a hip dislocation?
When the vet or surgeon discharges your dog, you’ll get instructions to follow at home.
Pain management
Your vet will probably send your dog home with pain medications such as carprofen for dogs (or a different non-steroidal anti-inflammatory), gabapentin for dogs, and/or tramadol for dogs. It is important to let your vet know promptly if your dog’s pain doesn’t seem to be under control.
Exercise restriction
Most of the time, your dog will need restricted activity for at least three months. This tends to entail starting with just leash walks for elimination purposes and not allowing your dog to run, jump, or play. Then, gradually, your vet may have you work up to a bit more walking time. However, this can vary between dogs and procedures, so it is best to ask your vet for recommendations specific to your dog’s situation.
Getting the green light to return to regular activity depends on the healing process and which procedure your dog had. Typically, your vet will release your dog to return to regular activity after about four months.
Rechecks with the vet or surgeon
It’s common for the vet to perform regular rechecks to assess your dog’s gait and comfort level. If your dog had a closed reduction, the vet may also want to verify that the Ehmer sling isn’t causing any issues.
Rehabilitation therapy
Due to the length of the exercise restriction, your dog may experience a loss of muscle mass in the affected leg. This can make it appear smaller or weaker than the other leg. Starting rehabilitation exercises can be helpful in combating this and helping your dog heal.
There are many good rehabilitation options, including hydrotherapy in a pool or underwater treadmill for dogs, or gentle physical therapy. Rehab is a great way help your dog strengthen the leg under the careful supervision of a veterinary rehabilitation team.
Providing traction for your dog
While your dog is recovering, the last thing you want to have happen is for him or her to slip and reinjure the leg or suffer a new injury. Thus, thinking about traction is important. Using carpet runners or yoga mats in your dog’s main living areas is one potential solution.
You could also consider applying Dr. Buzby’s ToeGrips® dog nail grips. These little rings go on your dog’s toenails and act like soccer cleats to give your dog added traction. The nice thing with ToeGrips is that they go everywhere your dog goes. That way, you don’t have to worry about what happens when your dog leaves the yoga mats or carpet.
What is the prognosis for hip dislocations in dogs?
Thankfully, with early diagnosis, prompt treatment, and careful adherence to the recovery plan, the prognosis is favorable for dogs with a hip dislocation. Many dogs are able to return to regular activity with minimal long-term complications. However, there is the possibility that the dog could develop arthritis in the joint. If you begin to notice your dog looking stiff, limping, or not wanting to be active, make an appointment with your vet.
Of special note, dogs who have hip dysplasia do have a greater risk of reinjury of the same leg or compensatory injury to the good leg. An FHO or THR can help decrease the risk of reinjury by addressing the abnormal anatomy.
You can help your dog heal
It is scary to find out that your dog dislocated a hip (or to watch it happen). However, the best things you can do are to stay calm and work with your veterinarian to help your dog heal. It is important to get your dog to the vet promptly so the vet can reduce the dislocation. But that’s just the start.
What you do at home matters a lot, too. Ensure you follow your vet’s discharge instructions, especially as they pertain to monitoring the Ehmer sling (if the vet applied one) and exercise restriction. That can make a big difference in your dog’s recovery.
While the idea of facing several months of recovery may feel daunting, chances are it will be over before you know it. And your dog will be back to running, playing, and having a grand old time!
Has your dog suffered a hip dislocation?
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