A few nights ago, I saw a story on Instagram from someone who trains agility actively. She had X-rayed her young dog and the HD score came back as C/D. She was heartbroken. The replies were kind, but they carried a particular heaviness – a feeling that a line had been crossed, that certain lives or activities might no longer be responsible. I recognised that moment because I had been there myself.
For me, the heartbreak wasn’t really about agility. It was about something more basic and harder to answer: how do I live ethically with this dog? Not the dog on paper, but the one in front of me — fast, physical, unstoppable, and deeply alive in her body every single day. Restricting her life didn’t feel like care, and neither did ignoring risk so I had to find a way to live with that tension.
Yes, someone might say this is just an anecdote, or that I was simply lucky. In some ways, that’s true because 7 years ago I didn’t know what I know now – it took me years to understand in hindsight that what looked like luck was actually shaped by the life we lived and the things we learned along the way.
This is not an argument against screening, and it’s not a claim that hip dysplasia doesn’t matter. I’m not offering permission or advice. I’m sharing this because most stories end at the diagnosis, and very few follow what happens over years. Only now, with my dog at seven, can I look back and say something meaningful about the full arc of her life so far, so this is that other kind of story.
Grab a coffee and a comfortable seat – it’s a long story, because the topic of hip scores is not simple, straightforward or black and white.
You may also want to read these: 10 Myths about Hip Dysplasia,
Where I’m coming from
I’m Finnish, but I haven’t lived in Finland since my early twenties. All of my adult life with dogs has taken place elsewhere, mostly in the UK and the Netherlands, and I’ve also followed dog-related discussions in the US online for many years.
My understanding of Finnish dog culture has largely been filtered through these other contexts, and only in the past couple of years ( largely through social media) have I begun to see how explicit and strongly held some of the norms around early screening are. Seeing them from the outside has made certain assumptions feel less self-evident than they might if you’ve only ever lived within one system.
Ideas about dog health, responsibility, and risk are far more local than we often acknowledge. What feels obvious and morally sound in one country can feel unnecessary, or even strange, in another. Most of the time, this only becomes visible when those worlds collide.
In Finland, it is common to X-ray dogs at a young age even when they are healthy. Hip imaging is widely treated as a prerequisite for activities that are considered physically demanding, such as agility. The practice functions both as medical screening and as moral demonstration. There is also a fairly common perception that other countries are more relaxed or less strict about hip scoring, and that this strictness is what makes Finland safer or more responsible by comparison.
That is not how things look from the Netherlands. Here, pre-emptive imaging of healthy young dogs is not routine. Training, competing, or living actively with a dog who has never been X-rayed is not considered reckless. If you ask for extensive imaging without a clinical reason, you will of course get it, but you will probably be seen as someone with more money than common sense. The underlying assumption is not that problems should be identified as early as possible, but that they should be addressed if and when they present themselves clinically.
These differences reflect different baseline assumptions about responsibility. In one system, responsibility is closely tied to early identification and restriction. In the other, it is tied to function, observation, and intervention when something changes. Both are consistent within their own logic, and both are widely experienced as “just sensible” by the people who live within them.
Nell, and the first time an image didn’t tell the whole story
Long before Grace, there was Nell. She was a working cocker spaniel, active and physically busy in the way that spaniels tend to be. When she was seven, she became intermittently lame, so we had an X-ray taken of her wrist that showed arthritis.
The vet’s diagnosis was brief and definitive: there is nothing we can do, except maybe try a glucosamine supplement which may or may not work, and when she starts experiencing pain, we can manage it with medication. I asked whether there was anything proactive we could do and the answer was no. That was the first time I felt genuinely uneasy about following veterinary advice without question. What bothered me was what the approach implied: wait, and intervene only once decline had clearly set in.
I looked for alternatives on my own and eventually took her to a physiotherapist. The physio identified significant tension and compensation that hadn’t been visible on the X-ray. With regular physiotherapy and hydrotherapy, Nell moved differently. She was more comfortable and more relaxed in her body, and she remained active for several more years.
That experience changed how I understood medical authority in musculoskeletal issues. It was the first time I saw clearly that an image can be accurate and still say very little about how a dog is actually functioning, and that being told “there’s nothing we can do” is not a neutral position. From that point on, I stopped assuming that a diagnosis automatically defined the limits of responsibility.
Grace’s early years
Grace grew up active from the start. She lived in the Netherlands, with daily off-leash exercise, running in forests, uneven terrain, swimming regularly for much of the year, and generally moving a lot more in everyday life than she ever did in formal training. Nothing about her lifestyle was structured as conditioning at the time; it was simply how we lived. Because I was already taking Nell to a physiotherapist, I often had Grace checked at the same time while I was there. The consistent feedback was that there was nothing concerning – so much so, that on more than one occasion, I was told I didn’t need to bring her as often!
At that point, I was simply a normal dog owner. I didn’t have any special knowledge about joint development, conditioning, or long-term musculoskeletal health. Almost everything I understand about those topics now, I learned later, retrospectively, as I tried to make sense of what had already happened.
Her second year of life was 2020 – we had only just begun some basic agility training when everything shut down. For most of that year, there was no formal training plan, no regular sessions, and no progression. What she did instead was move freely: long walks, varied terrain, and unstructured activity made up the bulk of her physical life. I also wasn’t thinking in terms of puppy development or conditioning – I was just focused on what felt right for Nell, and Grace was often simply there alongside her. Whatever benefit this had for Grace came as a side effect, not as planning.
Adult Grace and the x-ray
By the time Grace was three, I was often genuinely in awe of how she moved with the kind of casual confidence you’d expect from a crossing between a monkey, a cat and a kangaroo. In the forest, she regularly jumped onto large fallen tree trunks, scaled up steep surfaces like a cat, and chose to jump high over small branches that she could have just stepped over – not to mention jumping backwards at speed.
Nothing suggested this movement came at a cost. She didn’t hesitate before jumping, didn’t avoid certain movements, and didn’t show stiffness or reluctance afterwards. Day after day, this was just how she was – and luckily I have a lot of videos from that time (playlist).
Against that background, I decided to have her hips X-rayed as due diligence because we were considering having a litter with her. The first assessment came back as “possibly D hips.” D-grade hips indicate severe dysplasia with visible joint erosion – the kind of result that typically ends breeding prospects before they begin, and raises serious questions about whether a dog should do physically demanding activities at all. The vet was not entirely certain, but the conclusion leaned clearly in that direction.
I was shocked – the result didn’t match anything I had observed in Grace’s movement or behaviour, and the contrast was immediate and difficult to reconcile.
Because of that uncertainty, and because the positioning in the initial images wasn’t ideal, I sought further opinions. Another vet reviewed the images and reached the same conclusion. When Grace was examined physically, including passive range of motion, there was no pain response and no obvious limitation. That was noted, but it didn’t change the interpretation of the X-rays. The advice I was given was to carry on as normal and deal with problems later if and when they appeared. I recognised the pattern: we might get a few good years, and then manage pain once deterioration became unavoidable.
Hearing that, I realised this was the same situation I had faced years earlier with Nell. Once again, the medical advice offered no way to act responsibly in the present – waiting for damage and then medicating it was presented as the default. That didn’t align with how I understood my responsibility to the dog I was living with.
If I wanted answers that fit my own ethics, I would have to look for them myself. The veterinary advice didn’t tell me what to do now, only what to expect later. That might be sufficient for some people, but it wasn’t for me. Grace wasn’t a hypothetical future problem – she was a dog who used the forest as her own agility course every single day voluntarily, joyfully, and spontaneously.
What do I owe this dog in her everyday life? That was the question that mattered – not breeding plans or competition prospects, but everyday responsibility.
Movement was fundamental to who she was and to her quality of life, and how she existed in the world. Against that background, the idea of significantly limiting her movement in order to preserve her future didn’t make ethical sense to me. So, I kept looking for answers, because I needed a way to live with her that respected what she needed to be well.
Note: Grace’s official score later came back as C.
DETAIL: Third opinion in Poland and decision to breed
A few months after the Dutch x-rays, we took Grace to Poland to see an orthopedic radiologist in Warsaw – someone who had seen multiple Polish Hunting Spaniels and could evaluate her hips with breed-specific context, and possibly in a different context of different veterinary standards/norms.
His assessment surprised me: he said that earlier in his career, he would have been much more black and white about it – he wouldn’t have recommended using a dog with C hips for breeding, but his views had evolved. In Grace’s case, because of the muscular development and conditioning work evident in how she moved, he gave us the green light. He acknowledged this wasn’t a simple binary decision – smaller breed populations, individual variation, and functional capacity all mattered.
With that professional validation, and armed with probability data showing that breeding A hips to C hips doesn’t significantly increase offspring risk (from roughly 3% to 5-6%), I made the decision to match her to a male with A hips.
This added yet another layer to the cultural contrasts I’d been observing. Here was a specialist orthopedic radiologist in Poland, with breed-specific experience, taking a contextual rather than absolute approach – the kind of nuanced, individual assessment that didn’t seem available within the frameworks I’d encountered elsewhere.
Life after the x-rays
After the x-rays, life went on much as it had before. Grace stayed active in her everyday life, with the same amount of free movement, off-leash walks, swimming, and time spent in varied terrain. We did agility training and competitions intensively throughout the summer, though they were still only a small part of her overall physical life compared to what she did every day on her own.
With Nell, discomfort had always meant crankiness and tension between the dogs, so I had been well trained to watch for any signs of issues in movement and behaviour. Nothing about Grace changed. She moved the same way she always had. No hesitation, no stiffness, no avoidance of movement, and no shift in behaviour. I documented a lot of Grace’s movement in slow motion to study it closely and to keep it as a benchmark for the future.
Still, I was not a trained professional, so that year we also did a lot of dog shows. Whatever their limitations, movement is a central focus in the ring, and judges are trained to observe it. Across multiple shows, the written critiques consistently described smooth, effortless movement – even at a show we went to after a morning agility competition. After she became Dutch and Belgian champion, I felt it was probably safe to conclude that even if my untrained amateur eyes had missed something, she was fine.
I continued to look for ways to better understand how Grace’s body worked – not just her hips in isolation, but how movement, structure, and everyday life fit together. I read, talked to our physiotherapist, attended seminars, and watched many different dogs move. I became more attentive to how bodies carry load, how movement is organised, and how different parts of the body contribute to stability.
For example, hips are only one part of a much larger system – stability depends on how muscles, connective tissue, and skeletal structure work together. Proportions matter, as does angulation, spinal length, and how the pelvis relates to the rest of the body during movement. Grace’s structure is fairly moderate: compact outline, relatively short loin, balanced rear angulation. The more I learned, the clearer it became how this kind of structure can support efficient movement and distribute load evenly through the body. (Read more here and longer article about structure – and also some thoughts on leash laws and restricting dog movement)
DETAIL: Breed differences and the limits of universal metrics
As I learned more, I began to notice something that felt increasingly important: not all breeds are built to move the same way. Much of the advice around hips assumes a generic dog, but breeds vary hugely in pelvic shape, spinal mechanics, and rear assembly. What creates risk in one structure may not translate directly to another. (Read more, also here)
I learned that modern hip scoring systems – including the Norberg angle and early hip dysplasia benchmarks – were originally developed using German Shepherd data. German Shepherds have atypical anatomy. Their pelvis is positioned unusually relative to the front end and centre of gravity.
Around three years ago, before Grace had puppies, I attended a two-day seminar with Dr. Martin Fischer, co-author of Dogs in Motion and holder of unique X-ray-in-motion datasets. He stated that German Shepherds are structural outliers. I asked explicitly what that implies for hip dysplasia standards being generalised across breeds. He acknowledged the implication without oversimplifying it.
I am cautious about relying too heavily on what amounts to a seminar exchange, but the point stuck with me: if the reference model is an outlier, what happens when its metrics are universalised?
I also came to understand that hip scores were designed for population-level risk reduction, not individual life planning. Scores work statistically across many dogs, not predictively for one dog. There’s a mismatch between what screening is meant to do (guide breeding decisions at scale) and how results are often used (to make absolute judgments about individual dogs’ lives).
Measurements acquire meaning through interpretation. A score describes anatomy under specific conditions. It does not describe movement quality, muscular control, or adaptation over time. My concern grew when scores shifted from informational tools to moral verdicts.
At this point, I was not rejecting screening, but I did question how much weight it is asked to carry. A single early measurement was being given more authority than years of lived evidence, and that felt increasingly difficult to accept.
I also learned more about joint laxity and hypermobility. In both dogs and humans, lax joints place greater demands on muscular control. When that support is present, movement can remain stable and coordinated. When it isn’t, problems are more likely to appear. Grace had spent years moving over varied terrain, self-directed and unstructured. That kind of movement builds exactly the muscular support that lax joints need.
When Grace was five, I decided to repeat the HD imaging and this time include elbows and the whole spine. By that point, she had had a litter of puppies and life had continued much as before – daily movement, varied terrain, training, competition, recovery. No one asked me to do it – it was a matter of my own conscience. In the time since breeding her, I had learned more about the IVDD/CDDY mutation she carries two copies of, and I wanted to know – for myself, and to be able to speak responsibly to the people who had her puppies – what several more years of active life had meant for her body.
The results showed no meaningful change from the earlier X-rays. No progression of joint changes, no new findings, no emerging issues in her hips, elbows, or spine. The images described essentially the same anatomy they had before. Grace had lived several more years of daily movement, varied terrain, training, competition, and motherhood. The follow-up imaging didn’t change how she lived, but it showed that the anatomy described aged 3 hadn’t translated into deterioration over time.
Hypermobility, movement, and understanding a body from the inside
One of the stranger turns in this whole process is that I learned that I also had joint hypermobility which is related to the laxity dimension in HD scores.
Joint hypermobility is not flexibility in the glamorous sense – it means joints that move further than they are well supported to move, and muscles that are forced to take on stabilising work that ligaments would normally help with. When those muscles are strong and well trained, things feel stable – think professionally trained gymnasts or ballerinas – but when they are not, the body compensates with tension, stiffness, fatigue, and eventually pain.
At 45, I know what poorly supported hypermobile joints feel like. I live with the consequences of not taking care of myself when I was young – of sitting too much, moving too little, never building the core strength my loose joints needed because I didn’t realise how important it was.
I understand what stiffness feels like, what compensation feels like, what happens when muscles aren’t strong enough to do the work ligaments can’t. Of course, my experience is not identical to hers but understanding what joint laxity feels like from the inside gives me a visceral sense check when I think about her body.
At seven years old, Grace is entering middle age far fitter than I am at the same life stage. She has been supported in ways I never was. The varied, unstructured movement of her early years built exactly the muscular control her hypermobile joints required. By sheer coincidence, she got what I didn’t. My lived experience therefore also shapes how I think about my responsibility to her when making decisions about her care.
To be honest, I treat her better than I treat myself – I am not athletic, I dislike exercise, and I haven’t supported my own body well even after I learned about how much it matters. However, I can’t ethically neglect her because life is shorter than mine and entirely dependent on my decisions. That creates a higher standard of care and a stronger moral obligation.
My own experience trying to get medical support for hypermobility has been an insightful and somewhat absurd contrast to how the same condition is discussed in dogs. Far from a rare condition, new research suggest that hEDS and hypermobility spectrum disorder affect 1 in 500 people, 70% of whom are women. Getting human doctors to take hypermobility seriously is notoriously difficult – many people are dismissed for years, sometimes decades, even when suffering from pain and joint instability. The prevailing attitude is essentially: deal with it, manage the pain, carry on. The standard advice is more movement – often generic exercise that doesn’t account for hypermobile joints which tends to cause more harm than good.
The parallel with dogs? Well, joint hypermobility in dogs is similarly heritable and strongly sex-biased (3.5 times more common in females) yet the response to hypermobility could not be more different across species. In dogs, the same condition is treated as potentially life-limiting. The default response is restriction, and active movement raises ethical questions about whether it’s responsible at all.
Both extremes are harmful: generic exercise without proper support doesn’t help hypermobile humans, and blanket restriction doesn’t help hypermobile dogs. What both need is the same thing: varied movement that builds the muscular control loose joints require but the contrast in how seriously the condition is taken, and what advice follows, is shocking to me.
DETAIL: Movement, joints, and everyday function
As I learned more about movement and joints, one thing became increasingly clear: joints are not passive structures. For example, joint cartilage doesn’t have its own blood supply – it relies on the movement of synovial fluid to receive nutrients and remove waste. That fluid is produced and circulated through regular, varied motion so when movement is reduced, joint health tends to suffer rather than improve. (Full article: The power of movement: why varied exercise matters for dog joint health).
Muscles also play a central role in joint function. They guide movement, control range of motion, and provide dynamic stability. In dogs with joint laxity, muscular support becomes especially important, because control comes from active systems rather than passive structures alone. This is where restriction-based advice becomes counterproductive. When movement is limited to protect joints, several things happen:
- Synovial fluid circulation decreases, reducing cartilage nutrition
- Muscles weaken from disuse
- Joint stabilization decreases
- Each remaining movement places more stress on the joint, not less
- The dog becomes more reliant on passive structures (ligaments) that are already insufficient
Over time, this can increase arthritis risk rather than prevent it. For hypermobile dogs specifically, whose joints already lack passive stability, restricting movement removes the very thing – muscular control – that compensates for loose ligaments.
Everyday varied movement contributes to joint support in ways formal exercise often doesn’t. Walking on uneven ground, changing direction, adjusting balance, jumping, climbing, and swimming all place slightly different demands on the body and ensure that joints experience pressure evenly. Together, these demands build coordination, strength, and tolerance to load.
When movement remains varied and frequent, joints and muscles adapt together. Strength and coordination develop alongside flexibility, and the body maintains its ability to manage force efficiently. This process supports comfort and ease of movement over time – the opposite of what restriction aims for but often fails to achieve.
Three countries and the cultural interpretation of responsibility
Grace is seven now – two sets of imaging, no progression, and still a monkey dog despite years of high-level movement. She was never managed around a diagnosis because there was no diagnosis at the time. That accident of timing gave me something unusual: perspective across how different countries interpret the same uncertainty. My experiences have shown me that that veterinary cultures operate from different ethical starting points, and each believes it’s acting responsibly.
- In Finland, early screening is widely treated as moral requirement – comprehensive skeletal imaging at young age is common and expected, because it functions as medical information and as permission structure for activity. This default leans toward restriction: identify risk early, limit activity to prevent damage – sport and physical demands are granted after clearance, not assumed as baseline.
- The Netherlands works differently: pre-emptive imaging of healthy young dogs isn’t routine, and the default is functional until proven otherwise. This works for many dogs but offers little preventative guidance.
- I also encountered a third perspective in Poland, where the specialist assessing Grace’s imaging took a contextual approach – considering function, conditioning, and individual capacity alongside structure. I can’t claim deep knowledge of Polish veterinary culture, but that encounter suggested another way of holding the same information.
In all three places, veterinarians believe they are acting ethically and in all three places, millions of dogs live active lives.
That raises a quiet but unavoidable question: if one system is treated as the only ethical standard, what does that imply about all the others? Would it mean that the routine, accepted practice of entire veterinary professions elsewhere is irresponsible by default?
I don’t think any one country is “right” or “wrong,” because I don’t believe that our ethical responsibilities toward dogs fit into neat little black and white boxes that allow us to make categorical statements.
Why I took the time to write all this
This is also why I’m telling Grace’s story: most narratives around hip dysplasia stop at diagnosis, very few follow what actually happens over years. Even fewer leave room for uncertainty, adaptation, and learning after the fact.
Grace has lived a life of constant movement and she has done so without the progressive breakdown I was warned to expect. She was never managed around a diagnosis because there was no diagnosis at the time. I’m not telling her story as proof of anything, and it does not invalidate HD screening or suggest that risk does not exist.
What I have is a natural experiment: a dog who lived actively before anyone thought to restrict her, and who continues to move well. I needed was a way to support her body as it was, not to freeze her life in the hope of avoiding a future that might never come.
If you have just received a result that feels devastating, I’m not here to tell you what to do or how to feel. Once upon a time, I also felt like that. With the years that followed, I learned that labels are not destinies, that bodies respond to how they are lived in, and that care does not always look like restriction.
For me, care looks like learning how to support a life already in motion.
Cover image by Tytti Ojala (Photos by Tytti)
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