Case Study: Milo
Conservative Management of Hip Dysplasia — From Toe-Touching Lameness to Full Activity, Surgery Avoided
Patient Summary
Presentation and Background
Milo’s owners noticed he was becoming increasingly reluctant to use his right hind leg, and by the time he was assessed he was barely touching it to the ground. General anaesthetic radiographs confirmed bilateral hip dysplasia — interestingly, more severe on the left side, though it was the right hip causing him the most difficulty day to day. His vet started him on pain relief and a joint supplement, and referred him for physiotherapy alongside hydrotherapy, which had already been running for a few months by the time his rehabilitation programme began.
His vet’s plan was an eight-week trial of structured physiotherapy before revisiting the question of surgery. Milo’s owners were open to surgery if it became necessary, but keen to see how far conservative management could take him first.
Milo was a sociable, food-motivated one-year-old who loved his walks — managing his condition without limiting the active life his family wanted for him was the central challenge of his rehabilitation.
Rehabilitation Programme
When Milo arrived for his first session he was toe-touching only on the right hindlimb, leaning heavily to the left in standing, and showing a 3 out of 5 lameness grade. His right hip extension was restricted to around half of its normal range, and there was already significant muscle wasting through his right thigh and hindquarters. His rehabilitation was structured across four phases.
Early sessions focused on reducing pain and gently encouraging Milo to bear weight through his right hind leg again, using laser and cluster electrotherapy to the hips, gentle introductory massage, and simple weight-shifting and supported standing exercises. At home, his owners continued twice-daily massage and ice therapy after walks, kept him off the stairs and sofa, and worked through a structured programme of paws-up loading exercises.
As weight-bearing improved, the programme progressed to ground pole work, sit-to-stand repetitions, and early balance exercises on foam and a wobble cushion, alongside continued hydrotherapy. A boisterous play session with other dogs set Milo back briefly partway through this phase — a useful reminder of how easily overexertion can undo early progress in a hip rehabilitation programme, and a lesson that shaped how his activity was paced from then on.
With his hip signs largely resolved, Milo’s programme deepened to include more advanced balance and proprioceptive challenges, figure-of-eight work, and paw-give exercises, while his hydrotherapy sessions were gradually spaced out from weekly towards monthly as his fitness and skin allowed.
By his most recent review — fifteen sessions and eight months from his first assessment — Milo was moving freely with no lameness in either hindlimb, managing fifty-minute walks twice daily, and reported by his owners to be asking for his walks himself. His hydrotherapy had reduced to a monthly maintenance frequency, and a modest reduction in weight was helping to further ease the load through his joints.
The Result
Over eight months, Milo went from toe-touching, non-weight-bearing lameness in his right hindlimb — with a standardised mobility score indicating moderate disability — to even weight-bearing through both hind legs and a mobility score consistent with minimal ongoing impairment. The 3.8cm difference in thigh circumference measured at his first appointment narrowed to around 1cm by his most recent session — genuine evidence of restored muscle, not just a subjective impression of improvement.
Surgery, discussed as an option at referral, has not been required, and Milo’s vet continues to monitor his progress alongside the physiotherapy team.
What Made the Difference
Three things stood out in Milo’s recovery. Early, appropriately paced rehabilitation gave his right hindlimb the chance to start loading again before compensatory patterns could set in. Consistent home exercise and flexibility around his hydrotherapy schedule kept the programme sustainable over many months, rather than asking for an intensity that couldn’t be maintained. And close communication with his referring vet throughout — particularly around the early overexertion setback and the ongoing question of surgery — meant the plan could adapt quickly whenever it needed to.
Milo’s case shows that even significant hip dysplasia, picked up in a young dog, can sometimes be managed very successfully without surgery when conservative treatment is given the time, consistency, and multimodal support it needs to work.