Hip dysplasia is a disease of the coxofemoral joint (hip) and refers to the abnormal development of the hip joint.  Canine hip dysplasia is found in nearly every breed, including the Chinese Shar Pei.  It is more common in the medium and large breeds and ranges from mild to severe with arthritic complications.  It stems from the abnormal development of the hip joint where the balls of the hipbone do not fit snugly into the hip socket.  Hereditary factors play a role in canine hip dysplasia, so when choosing a Shar Pei puppy, it is important to know the quality of the parents' hips.  However, environmental factors such as type of diet, weight gain, and rate of growth also contribute to abnormal hip development or hip dysplasia. 

Any reputable breeder will have the hips of their breeding dogs evaluated.  This evaluation is done by examining X-rays of the dog's hips.  The Orthopedic Foundation for Animals (OFA) is an evaluation organization that rates hip X-rays and gives hip certification scores of fair, good, and excellent when dogs are a minimum of 2 years old and are not found to have dysplastic hips.  Dogs who do have hip dysplasia are also rated with scores of borderline, mild, moderate, and severe.  Preliminary OFA scores are given on dogs under two years of age and the PennHIP program for evaluating canine hips can provide objective information about hip joints in dogs as young as four months old.

Chinese Shar Pei are not one of the breeds that are "known" to have major problems with hip dysplasia.  This is due in large part to the many reputable breeders who are diligent in having their dogs evaluated and refrain from breeding dogs whose hips are dysplastic.  This being said, it is important to note that having a dam and sire who have excellent hip scores does not guarantee that your puppy will be free from hip dysplasia, but it greatly decreases the possibility.  There are also many non-hereditary, environmental factors that affect hip development and can cause hip dysplasia in a Chinese Shar Pei dog.  Diet, weight gain, and rate of growth can significantly contribute to hip development.  Joint stress and injuries at a young age can damage hip joints and cause dysplasia in a dog that would not be dysplastic if the injury had not occurred.  Vitamin C plays a large role in proper joint and ligament development and dog's whose bodies do not naturally produce enough Vitamin C can end up with dysplastic hips and weak ligaments.  Dogs who experience accelerated growth at an early age can develop hip problems and ligament problems.  Chinese Shar Pei puppies tend to grow and develop quickly, with some lines reaching full height by 6 – 9 months of age.  Because of this rapid growth, Chinese Shar Pei puppies should NOT be fed high calorie, high protein "puppy formula" food and instead should always be fed a high quality lamb and rice "adult formula" food.  Do not let unknowledgeable veterinarians or pet store employees convince you differently.  Puppy formula food can increase the rate of growth in your Chinese Shar Pei puppy and cause joint and ligament problems. 

Vitamin C plays an important role in the development of joints and ligaments in all breeds of dogs including Chinese Shar Pei.  It was originally thought that dogs did not require Vitamin C supplements because their bodies naturally produce this vitamin. Recent studies have shown that hip dysplasia is connected to a vitamin C deficiency.  Although a dog's body does produce its own Vitamin C, the amount produced by each individual dog varies and some may not produce adequate amounts for proper collagen production.  Collagen is important in the formation of bone and muscle tissue. 

Vitamin C supplementation in Chinese Shar Pei puppies and all medium and large dog breeds is becoming more and more advisable as is limitations on exercise and types of exercise.  It is important to remember that your puppy's young body cannot withstand constant joint stress before it has matured.  Vigorous running and jumping or being "tackled" by another dog before these fragile joints and ligaments have had a chance to develop and mature can have life long implications.  Just as football and other sports activities can injure unstable joints and ligaments in human children, puppies must have their play and activity monitored to eliminate injuries.  Running full stride places enough stress on a Shar Pei puppy's knee ligaments, but combine that with being hit or clipped from the side by another dog and you can end up with ruptured or torn knee ligaments.  Being pounced on and squashed to the ground can injure hip and elbow joints, which could affect your dog for the remainder of its life.  Be careful and be sensible – most young Shar Pei will run and play without any consideration for the soreness or damage to their hips and joints.  Chinese Shar Pei have an extreme tolerance to pain, but this type of prolonged abuse to under and undeveloped joints and ligaments can mean a lifetime of problems.

The cruciate ligaments are located within the stifle (knee) joint and stabilize the femur on the tibia.  The cranial cruciate ligament and the anterior cruciate ligament can be torn or injured due to acute trauma or slow progressive breakdown.  Structure of the dog is also a contributing factor.  Heavily muscled dog breeds with a low center of gravity, like the Chinese Shar Pei, tend to have an increase incidence of cruciate rupture or tear.  Also, the tendency of any breed to luxating patella (loose kneecaps) is a contributing factor in some cases.  In addition, many preventable injuries occur in young Shar Pei dogs and puppies whose ligaments are not mature and fully developed.  Cruciate ligament injuries are also common in adult humans and young children involved in athletic sports such as football, hockey, basketball, and skiing.

Hyperextension of the cruciate ligament is the most common injury.  This can occur when a dog is running full stride and steps into a hole or slips on ice, or when the dog plants its foot and suddenly turns.  Running full stride and being struck or clipped from the side by another dog or loosing footing due to uneven terrain could suddenly cause the dog to become lame from a tear or rupture to the cruciate ligaments of the knee.  Damage can also occur to the menisci, which are cartilage cushions within the knee joint.  However, damage to the menisci more often occurs due to the joint becoming unstable after the injury to the cruciate ligaments than by the initial trauma itself.  Meniscus injury occurs in approximately 50 percent of completely torn cruciate ligament injuries.  Often there is a firm swelling on the inside of the knee joint in more chronic cases called a medial buttress.  This may be a consequence of chronic meniscus injury.

Sometimes injuries can occur in the house after jumping up or down off furniture or slipping on tile or wood floor surfaces.  An overweight Shar Pei dog jumping and landing awkwardly can cause a partial or full ligament tear.  Therefore, it is important to not allow your Chinese Shar Pei to become obese.

If the tear is sudden and complete, the dog may refuse to bear any weight on the leg.  If the tear is partial, the dog may experience intermittent lameness after exercising and appear to be more lame on some days than others.  Dogs with cruciate injuries to both knees can find it extremely difficult to walk and they can appear to be weak and clumsy on their back legs, similar to dogs with back and disk problems.  A dog with a low grade, partially torn cruciate ligament can suddenly progress to a full-blown tear, and refuse to bear weight on the leg. 

It is very important to differentiate cruciate ligament damage from Familial Shar Pei Fever symptoms.  Damage to the knee ligaments can produce swelling in the knee area and be confused with FSF and Swollen Hock Syndrome in the Chinese Shar Pei.  The swelling of the knee area and associated pain involved with a torn cruciate ligament can cause an increase temperature or fever.  And the dog may be lame and refuse to bear weight on the leg.  So the symptoms are very similar and mimic each other –  swollen joints, lameness, and fever.  However, FSF will only last for 24 – 48 hours and the Shar Pei will return to normal.  If your Shar Pei continues to exhibit signs of lameness, joint swelling and fever, it would be highly advisable to have a veterinarian examine the knees for a torn or ruptured cruciate.  In most cases, this examination is not possible unless the Shar Pei dog is under a general anesthesia.  You must remember how strong the Chinese Shar Pei dog is, and their extreme tolerance to pain.  Proper palpation and diagnosis of the knee joint is usually not possible while the dog is awake.

It is also very important to note that a dog with a fully torn cruciate, who is not bearing weight on one leg, is placing additional stress to the uninjured leg and knee joint.  So until proper treatment is obtained, restricted activity or cage rest is very important.  Do not let your Chinese Shar Pei run laps in the back yard or chase over an open field on three legs.  Your dog is at great risk of injuring the cruciate in his/her healthy uninjured leg.               

Depending on the degree of injury, either restricted movement for several weeks or surgery will be advised.  Partial ligament tears that cause intermittent lameness do not always require surgical intervention and can be treated with strict cage rest for 6 – 8 weeks, weight loss if necessary, and anti-inflammatory medications.  Completely torn cruciate ligaments require surgery to replace the cruciate ligament with a synthetic replacement to stabilize the knee joint.  If there is meniscus damage, the meniscus is often times removed.

Following surgery, strict cage rest is essential for 6 – 8 weeks, which means no stairs, no jumping, and going outside on leash for bathroom purposes only.  This follow up treatment is essential for full recovery.  Most Chinese Shar Pei will appear to have recovered from their surgery within a couple of days or a week, but they have not had enough time to heal.  Pain medication will make the dog feel as if nothing has happened, which is why I do not recommend using it for more than a day or two.  Do not give in to this false sense of security from dogs who appear to be doing very well very quickly following surgery.  They can very easily reinjure the surgical area and tear the newly implanted synthetic ligament.  Continue the cage rest for the full 6 – 8 week period.  Afterwards, a slow and gradual increase in exercise should begin with exercise gradually increasing weekly over another 6 – 8 week period.  By sixteen weeks after surgery, there should be no restrictions on exercise.

Lateral and medial patella luxation is a condition where the patella (kneecap) is dislocated or no longer rides in the natural groove in the femur.  The kneecap becomes displaced to the outside or inside of the knee joint.  This condition can be partial and intermittent or it can also be complete and permanent.  It can result from a trauma or injury or can develop early in the dog's life.  Medial patella luxation (dislocated to the inside of the joint) is more common in all breeds of dogs than lateral luxation (dislocation to the outside of the joint).  Shar Pei dogs may show symptoms during the first year of life, if the luxation is severe, or any time later in life if the condition is lower grade and progressive.  Lameness can vary from an occasional hitch in the leg to a weight bearing lameness.  The lower grade congenital or developmental luxating patella usually causes intermittent lameness, which varies and is often worse when getting up after lying down for a period of time.  Often no treatment is necessary other than being aware of the condition and monitoring it for progression, and restricting the dog?s exercise.  Jumping on and off furniture and especially climbing stairs can greatly exasperate the condition.  Non-steroid anti-inflammatory medication can also be used.  Severe luxating patella cases will require surgical correction and has a very good prognosis for normal functioning to return.