SYMPTOM
Difficulty rising
Noticeable effort or struggle when transitioning from lying or sitting to a standing position.
Osteoarthritis
Degenerative joint disease is one of the most common causes of difficulty rising, particularly in middle-aged and older dogs. Joint stiffness and discomfort are typically worst after periods of inactivity, when synovial fluid viscosity increases and inflamed joint surfaces stiffen. The classic 'warming up' pattern — marked difficulty rising that improves within the first few minutes of movement — is characteristic of osteoarthritis. Multiple joints may be affected, with hips, stifles, elbows, and the lumbosacral junction being common sites.
Hip dysplasia
Developmental abnormality of the hip joints can make the rising transition particularly challenging, as the movement requires significant hip extension and flexion against gravity. Dogs with hip dysplasia may shift their weight forward onto their front legs, use a rocking motion, or rise with both hind legs simultaneously rather than alternating. The difficulty may be present from a young age in dogs with significant joint incongruence, or may develop later as secondary osteoarthritis compounds the original structural problem.
Spinal conditions
Disc disease, spondylosis, lumbosacral stenosis, and other spinal conditions can impair the dog's ability to coordinate and power the rising movement. The spine must flex and extend during the transition from lying to standing, and conditions that cause pain or restrict spinal movement can make this process difficult or uncomfortable. Spinal causes may produce difficulty rising that is accompanied by a hunched posture, reluctance to flex the back, or neurological signs such as hindlimb weakness.
Neuromuscular
Conditions affecting the nerves or muscles involved in the rising movement can produce difficulty that differs in character from joint-related causes. Generalised muscle weakness, degenerative myelopathy, myasthenia gravis, or peripheral neuropathies may make the animal physically unable to generate sufficient force to stand, rather than being in pain during the attempt. The difficulty may worsen with repeated efforts (fatigability) or be accompanied by muscle wasting, trembling, or coordination difficulties.
Systemic weakness
General debilitation from chronic illness, metabolic conditions, severe obesity, or cardiovascular disease can reduce the animal's strength and energy to the point where the physical effort of rising becomes challenging. This type of difficulty is usually accompanied by other signs of compromised wellbeing such as reduced appetite, weight changes, exercise intolerance, or altered energy levels throughout the day. The difficulty rising is a manifestation of broader systemic compromise rather than a localised joint or spinal problem.
Why timing matters
Early observation
When difficulty rising is first observed, it may appear as a momentary hesitation before standing, a slight rocking motion to build momentum, or taking an extra second or two compared to the animal's previous transition time. Early difficulty rising is often most apparent after extended periods of rest — first thing in the morning or after a long nap — and may improve quickly once the animal is up and moving. These early changes can be subtle enough to be attributed to tiredness, a comfortable sleeping position, or simply 'getting older,' but they may represent the first observable signs of joint, muscular, or neurological changes.
Later presentation
Difficulty rising that becomes more pronounced may involve multiple attempts to stand, audible groaning or reluctance during the transition, or the need to use furniture or walls for support. The animal may develop a specific strategy for rising — such as rolling onto its side first, using the front legs to pull itself forward, or rocking repeatedly to generate enough momentum. This level of difficulty often affects the animal's willingness to lie down in the first place, as it may associate resting with the discomfort of getting back up. The time from lying to fully weight-bearing and moving may increase noticeably.
The trajectory of difficulty rising depends on the underlying cause. Osteoarthritis typically produces a gradually progressive pattern that worsens over months to years, with particular sensitivity to cold weather, damp conditions, and periods of heavy activity. Neurological causes may follow a more variable course, potentially progressing more rapidly or showing stepped declines rather than gradual worsening. Muscular causes may fluctuate with exercise levels and overall fitness. Some animals reach a relatively stable level of difficulty that persists without dramatic change, while others experience a progressive decline in their ability to transition from rest to standing.
Conditions commonly associated
Osteoarthritis in Dogs
Hip Dysplasia in Dogs
Degenerative Myelopathy in Dogs
Spondylosis in Dogs
Luxating Patella in Dogs
Difficulty rising can occur with patellar luxation, particularly in bilateral cases where both knees are affected, as the quadriceps mechanism is compromised and the dog struggles to extend both hind limbs simultaneously to stand.
Immune-Mediated Polyarthritis
Joint pain and stiffness from IMPA can make standing up from a lying position notably difficult and slow.
Steroid-Responsive Meningitis-Arteritis (SRMA)
The severe spinal pain in SRMA often makes rising from rest extremely difficult and painful.
Intervertebral Disc Disease (IVDD)
Weakness and pain can make it difficult for affected dogs to stand from a lying position.
Degenerative Myelopathy
Weakness in the hindquarters makes getting up from lying positions increasingly challenging.
Legg-Calvé-Perthes Disease
Dogs may struggle or hesitate when standing due to pain in the affected hip joint.
When to explore further
Difficulty rising that has progressed noticeably over weeks to months, requiring increasing effort or multiple attempts to stand, may warrant further assessment to identify contributing factors and explore management options.
When difficulty rising is accompanied by other mobility changes — such as limping, bunny hopping, reluctance to jump or use stairs, or visible muscle loss in the hindquarters — the combination suggests a more significant musculoskeletal or neurological process.
An animal that vocalises (yelps, groans, whimpers) during the rising process may be experiencing pain rather than simple stiffness, adding urgency to understanding the underlying cause.
Difficulty rising that is asymmetric — clearly affecting one side more than the other — may provide localising information about which joint, limb, or spinal region is most involved.
When difficulty rising is accompanied by hindlimb weakness, dragging of the paws, crossing of the legs, or loss of coordination, neurological involvement may be contributing and the assessment approach may differ from purely orthopaedic evaluation.
Noting when difficulty rising is most pronounced — after extended rest, in cold weather, following heavy exercise, or consistently throughout the day — can help characterise the pattern. Observing which limbs appear most affected, whether the difficulty is symmetrical or one-sided, and whether the animal improves significantly once moving (a 'warming up' pattern) or remains stiff throughout activity may provide useful context.
Last reviewed: 24 April 2026 · Dr Alastair Greenway MRCVS