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Probably the most commonly known health fault that can occur in German Shepherd Dogs and other large and giant breeds is canine hip dysplasia (CHD). While not the most devastating and life threatening, it is the one of the most common and most widely publicized health problem affecting GSDs and is thus of high concern to puppy buyers. While less widely known amongst the public, canine elbow dysplasia (CED) is just as common and in most cases much more debilitating.


What dysplasia is.


The term “dysplasia” is a catch-all phrase used to describe an improperly formed joint. There are many ways a joint can be malformed; socket is shallow and not sufficiently deep to hold the femoral head, femoral head is flattened or pointed instead of rounded and thus does not move freely in the joint causing excessive wear and tear, there is sublaxation (looseness) and the ball and socket, even if properly formed, are not tight again causing excessive wear and tear due to too much free movement of the bones forming the joint. Likewise with elbows, there are many different forms of joint malformations combined together under the term elbow dysplasia.

 

Figure 1: OFA Good (free of dysplasia).

Note the properly formed and sufficiently deep sockets, round femoral heads, and overall consistency and tightness of the joint.

 


Dysplasia is genetic.

Many breeders and other "experts" will claim that dysplasia is environmental, not genetic. This is entirely false. Dysplasia is a polygenic genetic disorder. Environmental factors such as excessive strenuous exercise, obesity and improper nutrition can influence the age of onset and severity of symptoms. But they cannot cause dysplasia. The only way a dog can develop dysplasia is if he has the genes for it.


Environmental Factors

Dysplasia is genetic, and anyone who says differently is ignorant or lying. But environment can have enormous effects on the age of onset, and severity, of any symptoms experienced by a dog who has the genetic predisposition toward dysplasia. Therefore, it is important for the owner of any large breed dog prone to dysplasia to understand these factors and work to minimize the impact the disorder can have on their dog's quality of life if he does have the genes for it.

The most common, and most potentially damaging, environmental factor is obesity. Puppies grow at rapid, but inconsistent rates. It is important to monitor food intake carefully and adjust it accordingly so that the puppy remains thin. Carrying extra weight on developing joints can lead to developmental problems within the joints. When puppies and dogs are overweight, it causes unnecessary stress on the joints. And as obese dogs are generally lacking muscle tone, this puts additional stress on the joints because the muscles are not strong and able to bear some of the load. Obesity and lack of physical fitness equates to excessive wear and tear on the skeletal system, which will over time lead to the development of arthritis. This will in turn magnify the severity of arthritis developing due to an improperly formed joint. Dogs should be kept fit, and thin enough that when the dog is standing the owner should be able to feel all of the ribs easily. If the ribs can’t be felt easily, the dog is overweight.

It is also important to feed a good premium, holistic dog food or well researched and planned homemade/raw diet, and be careful to avoid overuse or inappropriate use of supplements. Though there are many excellent supplements out there, many are fads and are unnecessary when the dog is fed a quality food. Many a good intentioned owner has supplemented his pup's diet with calcium in an attempt to try to prevent dysplasia, only to find this can cause more problems and actually contribute to dysplasia by interfering with the natural calcium/phosphorus balance in the growing pup's bones and joints.

We also recommend switching German Shepherd Dog puppies to adult food by the time they are 4-5 months of age in order to slow down the growth process. At our kennel, our puppies are weaned directly onto the same food that our adults eat and are never fed puppy food. Puppy food is a recent advent of the dog food manufacturers and little more than a marketing ploy directed at the uninformed, but well meaning public. Wild canid puppies eat the same food as the adults, as did domestic puppies until a couple decades ago when a marketing guru came up with the idea of puppy food. And they all did just fine. Feeding your pup adult food won’t stunt his growth. He’ll still reach the same adult size, but will take longer to get there allowing his bones and joints to better keep up with his development and causing less stress on his skeletal system.

In addition to obesity, over-exercise at too young an age is a contributing factor to the onset and severity of dysplasia. Complete calcification of a German Shepherd Dog’s bones does not occur until 12-18 months of age. It is important to avoid exercise that can strain the joints and any excessive, repetitive activity on hard surfaces until this process is complete. We recommend that new owner’s avoid as much running, jumping and stair-climbing as possible with their puppies until they are at least a year old. This certainly isn’t to say the pup should be kept cooped up and not allowed to run around and play. Puppies will be puppies and are by nature energetic, and need exercise. A lack of exercise is every bit as detrimental to physical and mental development as too much. But owners should use common sense. Allow the pup to self limit his exercise, and when he’s tired don’t make him keep going. Pups are silly in that regard, and will keep chasing the ball as long as you keep throwing it, regardless of how exhausted they are. This means you as the owner need to pay attention to your dog, and stop the game when he’s getting tired and let him rest. If your goal for the dog is sport competition, save the hurdle jumping training until he’s older. And if you want your GSD to be your next jogging partner, it is best for the health of his joints to wait until he is over a year old before you start having him accompany you on your morning runs. All of these things will help lessen the development of skeletal problems, particularly if your dog has a genetic predisposition toward them.
 

Figure 2: Mild Hip Dysplasia.

The overall shape of the socket and femoral heads is this particular case is decent, but there is excessive laxity in the joint, particularly the hip shown on the right. This is a situation where environment would play a significant role in the future development of arthritis and the dog experiencing symptoms. Keeping the dog at an appropriate weight and in overall good physical condition, combined with the use of joint supplements, will help this dog remain symptom free for a long time. Likewise, obesity, lack of proper diet, and poor muscle tone will hasten the development of arthritis bringing about pain and stiffness at a younger age.


The impact of dysplasia on a dog's quality of life.

One of the common myths about hip dysplasia is that it equates to a death sentence, or a life of crippling pain for a dog. The truth is that this is rarely the case. The Orthopedic Foundation for Animals, the premier hip certifying organization in the United States, grades CHD in 3 categories based on severity; Mild, Moderate and Severe. In all but the most severe cases, it isn’t the malformed joint that causes pain, but rather the arthritis that develops in the joint because of the malformation. While all dogs, like humans, are likely to develop arthritis with age, dysplastic joints hasten this process because of excessive wear and tear that occurs due to things not fitting together properly.

Most dogs with Mild dysplasia, and a good number of those diagnosed with Moderate dysplasia, lead perfectly normal, active, health lives with few, if any, symptoms. Many of these dogs even go on to have illustrious careers in physically demanding dog sports such as schutzhund and agility, and as working law enforcement and search dogs. They will likely develop some arthritis in the dysplastic joint as they age, but then most dogs even without dysplasia will suffer from some form of arthritis in their later years. Proper exercise and nutrition, along with joint supplements such as glucosamine, chondritin, MSM and vitamin C can help slow the development of arthritis in dysplastic joints.

 

Figure 3: Moderate Hip Dysplasia.

Not only is there excessive laxity in the joint, but the socket is shallow and the femoral heads are poorly formed; rather than a thinner shaft with a larger, round head the shaft is thickened and the heads are flattened and pointed. This will cause significant wear and tear in the joint, leading to arthritis.

As an interesting note, this x-ray was taken when the dog was only a year old and we were told by two different vets to expect her to be crippled within a few years. That never came to be as thanks to proper nutrition, physical conditioning and joint supplements she lived a long, pain free life to the age of 13 and was never bothered a single day by her hips.


In some few cases, though, more intervention is needed. Severely dysplastic dogs are more prone to symptoms, and at a much earlier age. Arthritis will develop early, and often the joint itself is so malformed or so loose that it causes pain and stiffness itself. Dogs with Severe dysplasia are also more prone to injury, particularly in the case of severe sublaxation, where the excessive looseness of the joint can lead to dislocation. For these dogs, there are many surgical interventions that can help significantly. The most common are TPO, FHO and total hip replacement. While expensive, these surgeries will in almost all cases allow the dog to lead a normal, pain free life.

Fortunately, the vast majority of dogs diagnosed with dysplasia fall into the Mild or Moderate category. No surgery is required, and the use of joint supplements combined with common sense regarding the dog's weight, physical fitness and exercise regime can manage the condition quite well and allow these dogs to lead long, full lives.

Many pet owners never even think to x-ray their dogs unless the dog does show symptoms, and if the dog shows symptoms its dysplasia is most likely Severe. Likewise, if the joint is bad enough, or the arthritis sufficiently advanced, to cause symptoms, in many times it is too late to manage the condition through diet, exercise and supplementation. It may even be too late for many of the surgical options. This tendency to not check the joints until symptoms are apparent leads to the common misconception that a dysplasia diagnosis means the owner faced the choice of expensive surgery or putting the dog down, when in many cases a more proactive approach and earlier intervention would have allowed for more options in treatment and a better overall outcome.

These severe cases and situations of "too little, too late" are the ones we hear the horror stories about, but truth is they are relatively uncommon. Indeed, there are many dogs running around with Mild or Moderate dyspalsia and their owners don't even know it because they never bothered to have an x-ray evaluation done, and the dog shows no symptoms so the owners assume everything is fine. Fortunately, many good breeders are now requiring all of their customers to x-ray their dogs for dysplasia, even if it is a spayed/neutered pet. This allows breeders to better keep track of the incidence of dysplasia in their bloodlines by ensuring that every dog is evaluated, which in turn helps breeders make more informed breeding decisions. It also helps ensure the welfare of the dogs by using early x-ray evaluation to check for signs of dysplasia when it's still early enough to affect the long term outcome. Over time, this practice of encouraging or requiring x-ray evaluation on all dogs will also help better educate dog owners on the truth about dysplasia, and dispel the myths that dysplasia is a life threatening condition. It's not good.. but it's not the end of the world either.
 

Figure 4: Moderate Hip Dysplasia.

While the formation of the joint and femoral heads isn't horrible, it isn't good either. The really bad news is that these hips have severe laxity. Severe enough that dislocation of the joint (particularly the hip on the left) is a distinct possibility. While proper diet, muscle tone and supplementation would help this dog, the excess laxity in the one hip would indicate that surgery should be considered.


How can we prevent dysplasia?

Breeders have long pondered this question and as of yet there is no clear answer. The unfortunate fact is that any German Shepherd Dog, or other large breed puppy, can develop dysplasia despite the best efforts of breeders and owners alike. The reason for this is rooted in the very nature of the disorder.

Responsible breeders will try to eliminate as much of the genetic potential for dysplasia as possible by breeding only dogs with good hips that descend from bloodlines with good hips. As a puppy customer, it is important to look for hip certifications on breeding stock, particularly the perspective parents of a litter. Fact is, the only way to clearly and definitively determine if a dog has dysplasia is by taking x-rays of the joints and sending the x-ray films in for evaluation by an objective, qualified party. As dogs with Mild or Moderate dysplasia are most often symptom free, it is a mistake to assume that because the dog acts fine that the hips are good. Likewise, the many wives tales about watching a dog’s gait, or evaluating his structure, are false. Dysplasia can only be diagnosed by x-ray. Don’t take a breeder’s word for it. Don’t take a veterinarian’s word for it either, as few general practice vets are skilled at the proper interpretation of radiographs for dysplasia. Always ask for proof that the dogs are certified as free of dysplasia by a legitimate organization. There are many organizations that will certify hips. In the USA we have the Orthopedic Foundation for Animals (OFA), and the new PennHip system. In Canada there is OVC, and in Germany the A-Stamp program. Most other countries also have their own hip certifying program available.

Unfortunately, while it is a huge step in the right direction, the use of only hip certified breeding stock is not a guarantee. X-ray evaluation allows us to look at the phenotype (the genes the dog expresses) but does not allow us to look at his genotype (the full genetic make-up, including hidden genes that exist in the DNA but are not expressed).

Dysplasia is a polygenic trait, meaning that there are several genes, not just one, involved and they must come together in a certain number and combination in order to cause the development of dysplasia. Thus, a dog can carry a few of the genes but not be dysplastic himself and, for this reason, dysplasia can remain hidden for generations, only to rear its head when a specific genetic combination comes along. This is why it is possible for dogs that are themselves certified as free of dysplasia, to produce offspring that do have the disorder. This also explains why it is possible for one or few puppies from a litter to have the disease while their littermates do not.

As of now, the only tools available to breeders to attempt to eliminate dysplasia are x-ray evaluation and research into the incidence of dysplasia within a bloodline (the more dysplastic dogs, the higher the likelihood of that bloodline carrying a high number of bad genes). We’re hopeful that scientific advances into gene mapping may provide a solution, or at least more insight, in the future. But as of now, with the tools available, it is impossible for any breeder to eliminate dysplasia entirely.

Every breeder must live with the fact that a dog from his kennel may develop hip dysplasia. And every puppy buyer must accept that there is a risk of their dog developing dysplasia, regardless of the quality of the breeding or bloodlines. The breeding of only hip certified dogs, along with the careful research of pedigrees and bloodlines, will help significantly reduce the chances of pups developing hip or elbow dysplasia, but it cannot eliminate all risk. Thus, anyone considering purchasing a dog from one of the large or giant breeds, or any breed where dysplasia is a concern, should educate themselves about dysplasia. Not only as it pertains to selecting a breed, dog, breeder or bloodlines but also with regards to fundamentals of dysplasia and options for managing the disorder should his or her dog develop hip or elbow dysplasia.

For additional information about dysplasia, please visit the
Orthopedic Foundation for Animals Website.