Chronic Pain From Canine Hip Dysplasia: Can You Miss It?

“Do all dysplastic dogs have pain?”

This question cannot be answered with absolute certainty. However it can be said with confidence that hip dysplasia does cause pain for most, if not all, dogs that are affected by it.

In our last post on hip dysplasia (HD) we pointed out how the severity of symptoms and the age they become apparent vary widely from dog to dog. Typically owners first notice symptoms when the dog is in late middle to old age (often 8-12 years of age). However, the disease can and does cripple dogs early in life. And at the other end of the spectrum, some dysplastic dogs never show obvious symptoms. In this post we will focus on this last category of dogs. Those that, according to their owners, never have any pain.

“The chronic pain caused by HD can be difficult to detect and is often overlooked by breeders and owners alike.”

Lack of any visible signs of pain is one of the most common excuses breeders use to justify failure to screen for HD, in effect ignoring the most prevalent serious health problem that continues to face English setters today.

The misconception that we can judge our dogs’ hip status, or know their level of pain, based on whether we see overt symptoms is a major stumbling block in efforts to control the incidence of hip dysplasia.

“Why does this misconception hold back the control of hip dysplasia?”

Because it directly affects the actions of breeders. Think about it. If all dysplastic dogs were crippled early in life who would breed them? And even if breeders did breed dogs like this, before long they should have trouble selling puppies because customers wouldn’t tolerate seeing their dogs suffer from that kind of acute and severe pain.

But that’s not how things are. In reality the breeders who choose to ignore health issues like HD have figured out they still CAN sell puppies. Even though more puppies from their litters eventually suffer pain these breeders are unlikely to face any repercussions. Their customers don’t understand the chronic pain dysplasia usually causes, so they keep buying those puppies.

“Some breeders take advantage of the fact that customers won’t realize their dog is dysplastic.”

They count on the probability that most of the dogs they sell will never be x-rayed. Owners probably won’t realize that old age arthritis is caused by hip dysplasia (It is). Barring known serious trauma or clinically evident pain early in a dog’s life, the disease will likely be dismissed as “getting old” or go completely undetected for reasons we will discuss. But let’s consider a real life example first.

A Ryman-type owner recently related an experience that demonstrates how easy it is for breeders to avoid any consequences from taking this approach. It goes like this:

A breeder placed a young dog known to have hip dysplasia with this owner but didn’t tell him about the dysplasia. The owner inadvertently heard about the diagnosis later, after he was already attached to the dog. When confronted about his failure to disclose the dysplasia, the breeder arranged a conference with his own vet and the new owner during which an x-ray of the dog’s hips was discussed. Both the breeder and his vet assured the owner “while he would not gain an OFA [certification]” his condition was “no threat to him living a full, active, productive life”.

The rest of this story will be the subject for a later post. For now we should point out that it is well established it is not possible to predict onset or severity of clinically evident pain by simply looking at an x-ray.

Now the owner of this dog says the prediction that there would be no trouble from the dysplasia turned out to be correct. But did it? To him, the dog lived a long happy hunting life. You, or somebody you know, may have had a similar experience with a dysplastic dog. You honestly felt your dog didn’t suffer any issues due to the dysplasia. Or because you didn’t notice him having pain you assumed he had normal hips, and never felt you had a reason to have your dog x-rayed.

Lets talk about why this might not be true, and why you could have missed your dog’s pain.

“Do Animals Hide Pain?”

A quick search on this question will list many websites suggesting the idea that animals hide pain. Our pets certainly seem to be more stoic or tolerant of major surgeries and other injuries than we humans are. This is despite the fact that their system of nerves appears to be essentially the same as ours in structure and function. And there is no evidence they feel pain differently than we do.

“Is the difference between how dogs and humans express pain possibly behavioral?”

A video from a study on this subject made the rounds on television evening news. It showed the behavior of a dog soon after a spay surgery. She looked terrible and was obviously in pain- as long as nobody was in the room. When someone walked in she perked up, wagged her tail, and acted like little was wrong.

Now imagine the dog with an abscessed tooth. As the abscess develops he may not eat quite normally or may be a little dull. But usually the first noticeable sign of trouble is a swollen face after the bone becomes infected. Most humans with this condition would be focused on their pain and insisting they be seen by their dentist long before their jaw becomes visibly swollen.

Studies also show that animals heal more quickly and have fewer complications if given pain control medication before and after invasive procedures. In addition, whether or not the pain is apparent, it causes stress that interferes with healing. In other words, it has been been proven that pain that isn’t visible to us causes stress to the animal.

“Why would they hide pain?”

A leading theory is that animals hide pain because they instinctively don’t want to look weak to predators or competitors. And there is another possible explanation for this behavior in dogs. In areas where humans don’t hunt them, the most likely cause of death for wild wolves is other wolves. Wolf packs kill each other, and they also kill their own weak members. A weak or compromised wolf takes more resources from the pack than it provides. It inherently cannot contribute to the fitness of the others so it is not allowed to survive.

“Even if dogs don’t actually hide pain, it can be hidden from you.”

Now imagine what happens to people who end up with a hip replacement. They don’t suddenly wake up one day in pain, limping, and needing surgery. The pain gradually increases for sometimes many years before the decision is made to do something about it.

Maybe you have a bad hip yourself, or can think of someone you know who does. What if you can’t talk or write, or cannot communicate with words.

• How many years would you live with increasing pain before someone else could tell?
• How bad would it get before your gait or the way you got up off the couch changed enough to make the pain obvious to other people? Maybe your hunting companions thought you were just slowing down because of your age, when what was really wrong was you had to be careful not to walk in a way that hurt- remember you can’t tell them.
• How bad would the pain have to be to keep you from pushing through it to go hunting or get up off the couch?
• How severe would the pain need to be for you to involuntarily vocalize when you felt it? Especially if you happen to be more stoic and able to handle pain a little better than the next person.
• Now think about how much further it would go if you didn’t want anyone to know.

Now we can begin to see the different reasons that outward signs of chronic pain may be subtle and easily missed. Nobody would suggest a human can’t be in pain unless he or she is limping, has trouble getting up, no longer wants to participate in favorite activities, or is crying out in pain. Yet this is exactly what we do with our dogs. Even those diagnosed with a disease we all know causes painful joint degeneration.

“Chronic pain usually isn’t obvious until it’s severe.”

This is one of the challenges dog owners and veterinarians face all the time. Many conditions, from rotting teeth to growing tumors, cause insidious and increasing pain. Osteoarthritis, including that caused by hip dysplasia is no different.

Many of us have had an experience similar to this: Your dog has begun to limp a little so you start him on pain medications, and he responds by reverting back to more puppy-like behavior and activity. Only then do you realize he has been in pain and you can’t even know for how long.

We all want the best for our dogs and we don’t want to make owners feel guilty. What we do want is to dispel the ideas that a dysplastic dog that seems to have been perfectly fine is evidence hip dysplasia doesn’t matter, and that HD is not a source of serious pain. Also, the belief that when owners do not detect pain in their dog it is proof that the hips were normal. We can’t know our dog isn’t in pain, and a diagnosis of hip dysplasia is irrefutable evidence to the contrary.

“Understanding that dysplastic dogs do indeed have pain well before it becomes visible to you is important on multiple fronts.”

• It lays to rest the misconception that we can judge our dogs’ hip status, or know their level of pain, based on whether we see overt symptoms.
• Once you realize chronic pain caused by dysplasia is likely to be hidden until in it’s later more severe stages, it should become obvious you can’t know your dog’s hips are normal without an x-ray and OFA diagnosis.
• With a diagnosis of HD in hand owners will know to start early interventions with diet, supplements, and exercise that can lessen the inflammation and slow the progression of arthritic changes.

“What can you, the puppy buyer, do?”

In the end, understanding this issue and avoiding breeders who don’t screen for HD is the most important thing you can do to be as sure as you can be that your next hunting buddy will not suffer unnecessarily. If we all set standards for ourselves and our dogs we can decrease the incidence of HD in the setters we all love. We’ll discuss exactly how to go about this in a future post.

General Treatment Guidelines From the Orthopedic Foundation For Animals

---

RymanSetters.com series on Canine Hip Dysplasia. Our comprehensive guide to HD and the effective steps breeders and buyers can take to control it.

Upcoming Series on Hip Dysplasia
Old Age Arthritis is Not Normal, It Comes From Hip Dysplasia
Chronic Pain From Canine Hip Dysplasia: Can You Miss It?
There Is No Such Thing As “Environmental” Hip Dysplasia
Hips and Dysplasia and Heritability, Oh My!