out of socket: dislocated hips in pets
Updated February 21, 2019
Though nearly perfect in design, the hip joint is not without its weaknesses – especially in dogs predisposed to hip dysplasia and those with shallow sockets. Even the strongest ligaments and muscles can’t keep the joint in place when there's enough force, causing dislocated hips in pets.
The hip joint is a “ball and socket” type joint. The ball is the rounded head of the leg bone (or femur), and the socket (or acetabulum) is located in the pelvis and cups around the ball. The round ligament of the femoral head holds the ball in the socket, and the surrounding hip muscles help support the joint.
Signs of hip dislocation in dogs and cats
A dislocated (or luxated) hip occurs when the ball part of the joint comes out of the socket. Blunt trauma – like being hit by a car – can cause this type of injury.
Dogs and cats with a dislocated hip can’t bear weight on their back leg, and the affected leg may appear shorter than the others. Dislocated hips in pets are extremely painful and should be tended to as quickly as possible.
Diagnosing hip dislocation in pets
Pets who suffer trauma or begin limping, and who are suspected to have dislocated a hip, are X-rayed to check the positioning of the hip. Most often, the leg bone slides up and forward, but in some cases the opposite can happen.
Knowing where the ball of the joint is located helps the vet correct the problem. X-rays also reveal if there are fractures in the pelvis or leg that could interfere with correction.
How to correct a dislocated hip
There are two approaches to correct a pet’s dislocated hip: closed reduction and open reduction.
In a closed reduction, the vet tries to manually re-place the hip joint in its proper location without surgery. Pets are anesthetized because the procedure is painful and the leg muscles need to be relaxed.
Once the joint is back in place, the leg is placed in a sling to prevent weight bearing and encourage the joint to stay in place. Unfortunately, closed reduction can fail as often as it resolves the problem; there’s generally a 50% recurrence of dislocation (although that also means 50% stay put!). Most vets almost certainly attempt a closed reduction before discussing open reduction (or surgical repair).
There are several ways to surgically correct a dislocated hip, but they all have one goal in mind: to reduce the hip back to a normal position and keep it there. Options include reconstructing the round ligament, adding prosthetic joint capsules and using toggle pins to hold the ball in the socket.
For pets with existing arthritis or shallow hip sockets (like those with hip dysplasia), these types of surgical corrections are generally not recommended. For these pets, and for those with chronic hip dislocations, a femoral head osteotomy (FHO) is likely recommended. In this surgery, the ball of the joint is removed, resulting in a false joint supported by soft tissue to relieve painful bone-on-bone contact. FHO can also be considered for small dogs and cats, regardless of whether fractures or chronic problems exist.
For other pets, a total hip replacement is the right choice. In this procedure, the ball and socket are replaced with prosthetic implants to return pets to a pain-free life.
Your vet will talk with you at length about what surgical procedure is right for your four-legged family member. Patients who have an open reduction for dislocated hips stand a better chance of keeping their joint in place—about 85% are successful.
Post-operative care varies depending on how the pet’s injury was managed, but recovery almost certainly involves some period of reduced activity. For the first couple of weeks after surgery, the main concern is getting the hip and surrounding structures to heal from surgery.
Immediate post-operative care involves anti-inflammatory medications to reduce pain and swelling, as well as in-depth instructions for applying cold packs initially and warm packs later. Specific plans vary from vet to vet and pet to pet, but for all cases, it’s imperative to restrict activity as the hip heals—use a towel under the pet’s belly to help them walk, and avoid slippery floors.
As the hip joint starts to heal, the focus shifts to rehabilitating the muscles of the affected leg. Hydrotherapy (swimming, underwater treadmill) or physical therapy may be recommended. Other therapies may also be recommended, including alternative treatments like acupuncture and laser therapy.
For pets under restricted activity, meals should be decreased by about 10%. The last thing pets need is added weight stress on their healing injury.
Risk of re-injury
When a hip dislocates, the surrounding structures are severely damaged, so it’s important to remember that whether a closed or open reduction, failure of the joint to stay put is not a failure on the part of the pet or veterinarian.
After a closed reduction, the chances that the hip stays put are the same as the chances that it doesn’t, and while re-injury is frustrating, it’s common. The risk of the hip dislocating again after an open reduction is much lower, but unless there’s an underlying condition that warrants open reduction, the less-invasive closed reduction is almost always attempted first.
Whatever the case, dogs or cats who experience a hip luxation are more likely to experience arthritis in that hip with age. Keep pets at a proper weight, as any extra pounds can exacerbate the problem, and consider starting supplements, like glucosamine and fatty acids, for joint support.
Prevention of hip dislocation in pets
Most dislocated hips are the result of a traumatic accident, like being hit by a car, so the best thing you can do to prevent a dislocated hip is to keep your pet safe. But as much as we’d like to, we can never ensure our pets’ safety at all times. Whether it’s chasing after cars or falling into backyard holes, sometimes our pups have a way of finding danger. Luckily dog insurance can cover most or all x-rays, surgery and medication costs that come from unplanned trips to the vet. Unexpected injuries are painful enough for your entire family, so pet insurance helps make it easier.
Less frequently, luxated hips can occur in pets with severe hip dysplasia. Canine hip dysplasia is a chronic condition requiring life-long therapy. If your pet has hip dysplasia, discuss treatment options with your vet to ensure maximum quality of life for your pet.
Greta, 13-year-old Bichon/Poodle mix
Reimbursed $2,588 for FHO surgery
For an older lady, Greta is extremely hyper and active. “When she’s excited, she jumps up and balances on her hind legs. She looks like she’s trying to dribble a basketball,” says mom Dana. One day on their walk, she jumped up to bark at another dog and didn’t quite stick the landing – she immediately stopped barking and fell down. “Her rear leg was shaking. At first I thought she was having a muscle spasm.”
Dana immediately took her to the vet, where an X-ray revealed a dislocated hip. Greta spent the night and had FHO surgery the next day. “The surgery went well, and after a few weeks she even had physical, water and laser therapy, all of which were covered by Petplan,” says Dana. After six weeks of down time, she hasn’t had any hip issues since!
A pet that is non-weight bearing should always be seen by a veterinarian as quickly as possible. Luckily, whether a dislocated hip, fractured limb or ligament injury is to blame, a pet health insurance plan can help pay the vet bills – from the correction of the dislocated hip to therapy sessions and management of secondary conditions like arthritis – as long as the condition is not pre-existing.