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Avascular necrosis of the femoral head (Legg-Calvé-Perthes Disease)

Avascular necrosis of the femoral head (Legg-Calvé-Perthes Disease)

Avascular necrosis of the femoral head, also known as Legg-Calvé-Perthes Disease is a degenerative hip disease in young dogs. It causes reduced blood supply to the head of the femur, which is the “ball” part of the “ball and socket” hip joint. With inadequate blood supply, the cells in the head of the femur start to die off (known as necrosis). Blood supply returns, and new bone cells grow. With new bone growing and the dying bone breaking away, the head of the femur becomes misshapen and can no longer fit nicely into the socket of the hip. This results in pain and limping for the pup patient. Avascular necrosis of the femoral head thought to have a genetic component as if often affects small breed dogs. However, it can also occur secondary to traumatic injuries.


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Who is affected? 

Avascular necrosis of the femoral head typically effects small and toy breeds of dogs and less commonly cats between 3 to 18 months of age. 

According to PetSure data over the 2020 calendar year, avascular necrosis of the femoral head is most prevalent in the following breeds: 



Miniature Dachshund


West Highland Terrier


Bernese Mountain Dog


Miniature Poodle


Bichon Frise


Italian Greyhound


Miniature Fox Terrier






Japanese Spitz


*Prevalence = Total number of unique claiming pets / total number of insured pets across 12-month period. Excludes breeds with less than 500 active pet insurance policies.

Signs of Avascular necrosis of the femoral head

The symptoms and signs of avascular necrosis of the femoral head vary depending on the severity. In milder cases, pets may develop intermittent lameness in one rear leg that may progress or worsen over time. In severe cases, pets can have persistent lameness and may show signs of pain around the hip area when stroked or touched in this region. Some pets may become aggressive or withdrawn as a response to the pain.  

Diagnosing Avascular necrosis of the femoral head

To diagnose avascular necrosis of the femoral head, the Vet will take a thorough history and perform an examination of the patient. The vet will likely recommend X-rays of legs and pelvis, to observe any changes to the bones and joints. Follow up X-rays may be needed to see how the problem is progressing. 

Managing Avascular necrosis of the femoral head

Mild cases of Avascular necrosis of the femoral head may be medically managed through anti-inflammatories, pain relief and rest. For more severe cases, surgical intervention may be recommended. There are two common surgeries performed for Avascular necrosis of the femoral head. One is called the femoral head osteotomy. In this procedure the head and neck of the femur are removed. This stops the diseased head of the femur from touching the hip socket (acetabulum) and causing pain. Scar tissue forms and holds the joint into place. This surgery is generally better suited to small dogs and cats who will not put too much weight and pressure onto the scar tissue. Another procedure is the total hip replacement. In this procedure, surgical implants are used to replace the hip joint. Both surgeries require an extended recovery period with medication and physical therapy. 

How much does it cost to treat?

According to PetSure claims data from the 2020 calendar year, the average, single treatment cost relating to CLPD was $662, with the highest, single treatment cost being $4,373. It is important to highlight that hip disorders can require ongoing and, in some cases, lifelong management. The overall treatment cost of managing avascular necrosis of the femoral head will vary depending on the treatments that have been recommended and your pet’s response to those treatments.

Disclaimer: Reimbursement for these claims would be subject to limits, such as annual benefit limits or sub-limits, benefit percentage, applicable waiting periods and any applicable excess. Cover is subject to the policy terms and conditions. You should consider the relevant Product Disclosure Statement or policy wording available from the relevant provider.


  1. VCA Hospitals, “Legg-Calve-Perthes Disease in Dogs”, Accessed on 8 April 2021
  2. Orthopedic Foundation for Animals (OFA), “Legg-Calve-Perthes”, Accessed on 8 April 2021
  3. Holsworth, G, 2019, The Hip – A Ball and Socket and its Challenges from Birth to Death,  Accessed on 11 May 2021

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Kylie Mitchell is a veterinarian with over 17 years experience in animal health and welfare, including in the veterinary and pet insurance industries

She has three rescue cats (Noah, Bei Bei and Meeka), four very old cockatiels and a pond-full of fish.

Kylie's pets

Bei Bei
Bei Bei