Bullmastiff Hip and Elbow Dysplasia


We will first look at Hip dysplasia, which is a deformity of the hip joint (coxofemoral joint) that can occur during the Bullmastiff’s growth period. Hip and Elbow dysplasia are in fact two different conditions and are not isolated to large breeds such as the Bullmastiff. Many large breed dog owners have heard of it, but the fact is that anyone owning a dog should become familiar with this – these conditions affect various breed sizes despite being more prevalent in large breeds.

Please also refer to our article on Early Spaying and Neutering of Bullmastiff puppies and Juniors. We maintain that spaying or neutering a young Bullmastiff affects the dog’s full hormonal symphony and, as a secondary or tertiary domino effect, accelerates the onset of hip and elbow dysplasia.

In essence, the ball of the femur can not fit properly into the hip socket. Bullmastiffs are extremely tolerant of pain. An affected dog may show absolutely no signs of this condition, whilst others may show severe signs, which usually also indicate severe pain.

Despite taking our best breeding precautions, we maintain that no breeder can guarantee that they are able to deliver pups that will always be free from hip and elbow dysplasia throughout their lives.

What causes Hip dysplasia?

Several factors contribute to the development of this problem. Some breeds are more likely to genetically inherit hip dysplasia. Various breeds which evolved from the early Molossers such as German Shepherds, Labrador Retrievers, Golden Retrievers, Rottweilers, Bullmastiffs, St Bernards and Old English Sheepdogs are affected, just to mention a few.

Environmental factors play a major role in the development of dysplasia including diet, weight gain and exercise.

What to look out for

Hip dysplasia develops in young growing dogs, and signs maybe noticed as early as four to six weeks of age. However, there is no link between age and severity of this condition which means a very young puppy can be debilitated very early. In other cases young Bullmastiffs may not show any abnormalities until one or two years of age and in some cases may not become painful and lame until they are geriatric (6-10 years of age). Here are some signs you should look out for:-

  • Hind leg lameness
  • Lack of coordination in the hind quarters (swaying and staggering)
  • Reluctance to run and jump
  • Difficulty when attempting to lie down or stand up
  • Abnormal gait

Diagnosing hip dysplasia

Your veterinarian will undertake a physical examination checking the motion of your Bullmastiff’s hip joint. X-rays maybe taken to confirm the condition, and highlight the amount of associated arthritis.


Various medical and surgical options are available today to help restore your Bullmastiff’s mobility and to ease discomfort. The method of treatment depends on a number of factors including age and severity of the problem. Surgery is generally a last option and is usually recommended when other forms of treatment are not effective, when athletic performance is desired in young patients or to slow the progression of degenerative joint disease to enhance the probability of good long term limb function.

Non surgical options

Non surgical treatment is essentially the same as treatment for arthritis including a weight management program (including nutritional supplements), medications to help support and repair cartilage and medications to relieve pain and reduce inflammation.

Surgical options

Femoral head ostectomy (FHO) The hip joint is a ball and socket joint. FHO is the removal of the ball part of the joint. This gives excellent results in small dogs because a functional “false joint” forms. Some large dogs may not form this “false joint” as well however this is recommended for patients with severe arthritis, if the hip dislocates, or if the expense of the other procedures is prohibitive.

Triple osteotomy is a procedure in which the pelvis is cut in three places around the hip joint. The bone is rotated to create better alignment with the femoral head (the ball). It is reattached so that the joint functions in a more normal fashion without looseness and pain. This should only be performed in a dog with no arthritic changes in the joint and is only an option for younger patients.

Total Hip Replacement (THR) is possible, as is done in humans. The hip joint is replaced with an artificial ball and socket often made of plastic and stainless steel attached to the pelvis and femur in place of the abnormal joint. This procedure can give many years of pain-free use of the hips however is generally only an option for patients who have not responded to other forms of treatment, and is a very specialised procedure.

Breeders, can anything be done to prevent hip dysplasia in Bullmastiff puppies?

Research has shown that the cause of hip dysplasia is related to a combination of genetic and environmental factors. The disease is known to be an inherited condition and the genetics of hip dysplasia are extremely complicated. In addition, environmental factors such as overfeeding and excessive exercise can predispose a Bullmastiff (especially a growing puppy) to developing hip dysplasia. Because the inheritance of the disease is so complicated, many questions remain regarding eradication of the disease. However there are several practical things you can do to ensure that the incidence of the disease is reduced.

1. The South African Veterinary Association / SAVA runs a Canine Hip & Elbow Dysplasia scheme in association with KUSA through which your Bullmastiff’s x-rays will receive a score from a veterinary radiologist. Since in some HD prone breeds it is virtually impossible to find an animal that is hip dysplasia free, the object is to ensure that you breed from a dam and sire whose scores are both better (lower) than the breed average score. In this way the chance of reducing the incidence of the disease is greatly increased.

The procedure is as follows:
(a) Your Bullmastiff must be over one year old and can be radiographed by your own veterinary surgeon.
(b) General anaesthesia is necessary in order that correctly positioned plates are obtained.
(c) The x-rays are then submitted to the Onderstepoort Veterinary Academic Hospital with the appropriate fee and the hips are assessed by a veterinary radiologist and a score awarded and reported to the veterinary surgeon.
(d) The higher the score, the worse the hips or elbows.

2. When purchasing a puppy it is always worthwhile ascertaining whether the parents have been radiographed by SAVA and if so, what their respective scores were. Even if you did not do this at the time and are contemplating breeding from your Bullmastiff, it is still worthwhile contacting the breeder to see if you can obtain this information. However it should be borne in mind that because heredity is not the only factor involved, there is still a chance of parents with normal hips throwing a puppy with hip dysplasia. Once you have obtained the necessary information, including the hip score, do discuss any breeding programme with your veterinary surgeon.

3. Keep your Bullmastiff in shape! That means check the weight of your Bullmastiff regularly and correct this through dietary control if required. Everyone likes a ‘big’ Bullie, but nobody wants an overweight, unfit Bullie to end up with dysplasia and in pain.

Diet and exercise in growing Bullmastiffs

There is a growing body of evidence indicating that any dog that grows very rapidly is more likely to develop hip dysplasia. Many authorities recommend feeding a specifically formulated puppy food to puppies of high risk breeds so their growth is slower. They will still reach their full genetic body size, but just not as rapidly.

Avoid excessive exercise in a growing puppy. Any abnormality in the structure of the hip joint is magnified if excessive running and jumping occur. It is not necessary to treat your puppy as if it were disabled, but long sessions of running or repetitively chasing thrown objects, running on the beach or alongside a bike can be detrimental to joints.

Caring for a Bullmastiff with hip dysplasia

There are a few things you can do to assist your Bullmastiff:-

  • If you suspect your Bullmastiff has hip dysplasia, seek advice from a vet immediately to minimise the arthritic changes that will develop as the problem worsens.
  • Monitor your Bullmastiff’s body weight and avoid obesity, ask your vet or healthcare team for a nutritional plan
  • Avoid strenuous exercise but provide moderate exercise as indicated by your veterinarian

Elbow dysplasia in Bullmastiffs – What is elbow dysplasia?

Elbow dysplasia means abnormal development of the elbow joint. This causes damage to the cartilage surface of the joint – a process called osteochondrosis or OCD. Elbow dysplasia and osteochondrosis collectively lead to the development of arthritis (osteoarthritis). Any one of these three conditions may cause elbow pain.

Elbow dysplasia is a genetic disorder caused by the combination of genes from the parents (dam and sire). The exact detail of how the elbow develops abnormally is currently still poorly understood in comparison to hip dysplasia. An uneven fit (or incongruency) is suspected and this results in abnormal distribution of weight within the joint. Points of increased pressure cause damage to the cartilage covering the bones, and fragmentation of cartilage and the underlying bone may develop (osteochondrosis).

What are the signs of elbow dysplasia?

Elbow dysplasia is a common condition, especially in large breeds. The key signs are fore limb lameness and stiffness. The latter is generally most evident after rest following exercise. Reduced weight-bearing on the limb and outward rotation of the paw may be evident.

Signs tend to develop : when the pup or junior is immature and growing (five to eight months of age); or once adulthood has set in (perhaps a few years of age) due to osteoarthritis.

How is elbow dysplasia diagnosed?

Examination may reveal muscle wastage (atrophy). Manipulation of the elbow joints may cause increased pain. Swelling and restriction in range of movement may be evident.

X-rays (radiographs) are the most common method of diagnosing elbow dysplasia. They enable the presence and severity of secondary osteoarthritis to be assessed. The underlying elbow dysplasia and osteochondrosis are not always apparent. In some dogs no abnormalities are even evident.

A CT scan is a form of X-ray that produces thin slices through the joint in any plane. These images can be reformatted to give a 3-D model of the joint. CT gives excellent detail of the shape (congruency) of the joint and enables detection of small bony fragments. Damage to the surface of the joint can be assessed by placing a small camera in the joint – this is called arthroscopic examination. It provides more detail of the joint surfaces than radiographs or a CT scan.

CT scans showing a fragment of bone in the elbow joint (arrows)

How can elbow dysplasia be treated?

Some Bullmastiffs with elbow dysplasia can be managed satisfactorily without the need for surgery. Exercise often needs to be controlled to some degree. Each dog will have its own threshold of duration and type of activity beyond which elbow pain may increase. Hydrotherapy is often beneficial. A Bullmastiff that is overweight will benefit in this regard from being placed on a diet. Tit-bits may need to be withdrawn and food portions reduced in size. Regular monitoring of weight may be necessary. Painkillers (anti-inflammatory drugs) may be indicated to make the dog more comfortable. Long-term drug therapy should be avoided if at all possible in view of potential side effects.

A dog with elbow dysplasia that fail to respond satisfactorily to conservative treatment may need surgery. There are three key types of surgery: (1) fragment removal (2) incongruencysurgery and (3) salvage surgery..

Fragments of cartilage 1 Fragments of cartilage 2

Fragments of cartilageand bone before removal

Fragments of cartilageand bone have been removed

    1. Fragment removal surgeryThis is the most common type of surgery for elbow dysplasia. It involves removing any loose fragments of cartilage and bone from the inside of the elbow joint. This can be done under guidance from a camera through a very small hole (arthroscopically) or via a direct surgical approach.Recovery, especially from arthroscopic surgery, tends to be reasonably rapid. Unfortunately, lameness fails to improve in a number of cases. This may be due to the underlying abnormal development of the joint (poor fit or incongruency) or the secondary osteoarthritis.
    2. Incongruency surgeryAttempts may be made to improve the shape of the elbow joint and make it a better fit (or more congruent). This can be done by either removing the key pressure point within the joint or cutting the bone at the back of the joint (the ulna) to change the shape of the joint. Recovery from the latter procedure is slow and thus this surgery is reserved for a few selected cases.
    3. Salvage surgerySalvage surgery for elbow dysplasia is rarely necessary. However, occasionally the combination of elbow dysplasia, osteochondrosis and osteoarthritis cause persistent elbow pain that cannot be controlled by other more conservative means. In these few cases there are three surgical options; sliding humeral osteotomy (SHO), total elbow replacement (TER) and elbow joint fusion (termed arthrodesis).

    Sliding humeral osteotomy is reserved for dogs where the outer part of the elbow joint (the lateral compartment) is relatively healthy compared to the inner part of the joint (the medial compartment) where the majority of damage tends to be. The bone of the forearm (the humerus) is cut and realigned in such a way that more weight is transferred through the outer, healthy part of the joint and less through the inner, diseased part of the joint. A special plate with a ‘step’ is applied to the inside of the bone. Although recovery from surgery can be slow, the majority of dogs improve and have less elbow pain. There are possible complications, for example, breakage of the plate or screws.X-rays showing a sliding humeral osteotomy (SHO). The bone above the elbow has been cut, re-aligned (arrow) and stabilised with a special plate X-rays showing a sliding humeral osteotomy(SHO). The bone above the elbow has beencut, re-aligned (arrow) and stabilised with aspecial plateFunction with elbow joint replacement is generally better than with fusion of the joint, however, there are potential complications with the surgery that need to be carefully considered prior to making a decision. Total elbow replacement surgery involves replacing the painful joint with metal and plastic components (humeral and radioulnar prostheses). Care following surgery is critical to reduce the possibility of complications, such as dislocation of the prostheses. Fusion or arthrodesis of the elbow joint results in a pain-free limb, but limb, function is compromised – since the elbow no longer moves, dogs tend to have to swing their limb around, rather than straight forward, in order to walk.

    What is the outlook with elbow dysplasia?

    The outlook or prognosis with elbow dysplasia and the associated osteochondrosis/osteoarthritis is quite variable. Some dogs can be managed successfully with conservative treatment involving modification of exercise and weight, with or without the need for anti-inflammatory painkiller drugs. Others benefit from removal of cartilage and bone fragments or surgery to improve joint congruency. The majority of dogs lead satisfactory lives, although their exercise and weight may need to be closely monitored. A degree of stiffness and lameness, especially after exercise, is not uncommon. In a small minority of cases that fail to respond satisfactorily to conservative procedures, salvage surgery, such as sliding humeral osteotomy or total elbow replacement, may need to be considered.

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