Hip dysplasia

What it is

Hip dysplasia is an inherited condition in which one or both hip joints develop abnormally^[1]. The ball and socket do not fit together properly, so the joint becomes loose and unstable, which leads to pain, swelling and eventually arthritis^[4]. The damage cannot be reversed, so treatment focuses on controlling pain or replacing the joint^[6].

Genes are the main cause, and most affected dogs inherit it from a parent^[4]. Fast growth, being overweight and too much exercise while young can make it worse^[4]. Obesity and over-exercise during growth are also named as environmental factors in UK research on the screening schemes^[6].

Signs to look out for

Signs usually appear while a puppy is growing, often from around five to six months old^[4]. Mild cases may not show until arthritis develops later in life^[4]. Things to watch for include^[4]:

• “bunny hopping”, where both back legs move together when running
• limping, lameness or stiffness
• difficulty getting up, lying down, jumping or using stairs
• a swaying or wobbly walk
• less interest in walks
• thin muscles over the back legs and hips

Other problems can look similar, including cruciate ligament disease, spinal conditions and joint infection, so a vet needs to confirm the cause^[5].

How it’s diagnosed and treated

Diagnosis is based on a physical examination and X-rays of the hips^[5]. Some of the hands-on joint tests are likely to need sedation, and X-rays can miss looseness in very young dogs^[5].

Hip scoring under the BVA/Kennel Club scheme is a separate screening test, mainly for breeding dogs. The dog must be at least one year old and microchipped, each hip is scored from 0 to 53, and the total runs from 0 to 106, where lower is better^[1]. A single submission costs from £82.50 including VAT, on top of your own vet’s fee for the X-rays^[1].

Managing it without surgery. Most dogs are managed medically^[5]. That means weight control, short regular lead walks rather than running, jumping and chasing, anti-inflammatory pain relief, physiotherapy and hydrotherapy^[4]. It is a lifelong condition, and most affected dogs develop arthritis later on^[4].

Surgery. Surgery is considered for dogs that stay painful despite daily management, and most options need referral to a specialist hospital^[4]. The main operations are^[5]:

• Juvenile pubic symphysiodesis (JPS): a short preventive operation on puppies, which has to be done between 12 and 16 weeks of age (up to 22 weeks in giant breeds), before most puppies show signs.
• Double or triple pelvic osteotomy: an operation on the pelvis to improve the hip joint in young dogs, usually aged five to ten months. It is a major operation and not commonly done in UK specialist practice.
• Femoral head and neck excision: removing the head and neck of the thigh bone to relieve severe pain. It tends to work better in dogs under about 15–20kg, and recovery can take up to six months.
• Total hip replacement: replacing the joint with an implant, usually from around ten months old, with no upper age limit if the dog is otherwise healthy. Most studies report complications in 10% to 15% of cases, and dogs need strict rest for at least eight weeks afterwards.

At two UK referral hospitals with published price lists, a total hip replacement for a dog of Labrador size costs from £7,750 to £9,000 per hip, and one of them charges a separate £1,350 work-up on top^[7][8]. These are single-hospital prices, not national averages.

Breeds most affected

Any dog can develop hip dysplasia, but it is much more common in medium and large pedigree breeds, including Labradors, German Shepherds, Golden Retrievers, Rottweilers, Bernese Mountain Dogs and Newfoundlands^[4]. The BVA publishes a median hip score for each breed screened, and recommends breeding only from dogs scoring at or below their breed median^[1]. For dogs scored in the five years to the end of 2025, the median was 8 for Labrador Retrievers, 11 for Golden Retrievers and German Shepherd Dogs, and 9 for Bernese Mountain Dogs^[2]. Breeding from low-scoring dogs reduces the risk but does not remove it^[1].

Screening appears to be helping. A study of BVA/Kennel Club scheme data found that mean and median hip scores in Labradors fell significantly over time, and the biggest change was a shrinking number of very high, badly affected scores^[6].

Labradors are also among the breeds at risk of elbow dysplasia, a separate inherited condition where the elbow does not develop properly, which has its own BVA screening scheme^[3].

How insurers treat it

Hip dysplasia is a lifelong condition that often needs ongoing medication and may need surgery on both hips, so it tests a policy’s limits. The key points:

Timing matters most. Insurers will generally not cover illness that your dog had, or showed signs of, before the policy started, and future flare-ups of that condition are usually excluded too^[13]. Which? gives hip dysplasia as an example of a chronic pre-existing condition^[10]. Moving to a new policy later will likely exclude conditions your dog has already had^[13].

Both hips can count as one. In a 2025 decision, the Financial Ombudsman accepted that an insurer could decline a claim for both hips because signs in one hip pre-dated the policy, noting that treating two-sided conditions as one is standard in most pet policies^[11].

Watch for extra restrictions. Some policies go further on two-sided conditions. One insurer’s terms for newly added pets say that if one hip or elbow was treated before cover started, the other side will not be covered for 12 months^[12].

Check the limit type. A time-limited policy pays for each condition for 12 months, and a maximum benefit policy stops once its per-condition amount is used up^[9]. A lifetime policy pays up to a set amount each year for as long as you renew^[9].