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. Slowness to rise is typically most marked after extended rest. A 'warming up' pattern, in which the difficulty eases once the animal is up and moving, is commonly described. Multiple joints may be affected, with hips, elbows, shoulders and stifles (knees) among the commonly affected 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, lumbosacral stenosis, and other spinal conditions can impair the dog's ability to coordinate and power the rising movement. Spondylosis is typically an incidental finding on X-rays, and its presence does not correlate with clinical signs. 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.
Sudden-onset causes
Difficulty rising that appears within minutes to hours, in an animal that was moving normally beforehand, is a separate picture from the gradual causes above. In dogs, signs of disc disease can be acute and severe. The American College of Veterinary Surgeons describes a sequence running from back or neck pain, to a wobbly hind end with crossing hind feet, to complete loss of hindlimb movement (usually with loss of the ability to pass urine), and finally to loss of pain perception in the limbs. Its published figures are that surgery can allow 90% of dogs that still perceive pain to regain use of their limbs, against 50 to 60% once pain perception is completely lost, and fewer than 10% of that group with strict medical management alone. Whether pain perception remains cannot be judged at home, because a leg pulling away from a pinch can be a spinal reflex and not felt pain. A bleeding mass on the spleen may show only as weakness, or as collapse with pale gums and a raised heart or breathing rate, and sudden death is reported when a mass ruptures. In cats, a blood clot that forms in a heart enlarged by cardiomyopathy and lodges in the artery supplying the hind legs causes sudden loss of hindlimb function with extreme pain at first, cold hind limbs, pale or purple paw pads and no pulse in the hind legs.
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, such as 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, and the gradual courses described here do not apply to difficulty that appears within minutes to hours, which is covered under sudden-onset causes. Osteoarthritis typically produces a gradually progressive pattern that worsens over months to years, and cold, damp conditions may worsen stiffness and discomfort. 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
Difficulty rising in osteoarthritis reflects the pain and stiffness caused by cartilage breakdown and joint inflammation, making the transition from lying to standing physically harder as affected joints struggle to bear weight.
Hip Dysplasia in Dogs
Difficulty rising in hip dysplasia reflects the instability and cartilage wear caused by an abnormally formed hip joint, reducing the power the hind end can generate to push into a standing position.
Degenerative Myelopathy in Dogs
Difficulty rising in degenerative myelopathy reflects progressive damage to the nerve pathways that coordinate hind limb movement, so dogs lose the strength and coordination needed to organise the sequence of standing up.
Spondylosis in Dogs
Spondylosis is typically an incidental finding on X-rays, with no correlation between its presence and clinical signs, although a bony spur growing near a nerve root may press on the nerve and cause pain or lameness, which can affect rising.
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.
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Legg-Calvé-Perthes Disease
Dogs may struggle or hesitate when standing due to pain in the affected hip joint.
Coxofemoral Subluxation
An unstable hip joint makes pushing up from lying down uncomfortable, so affected pets are slower or more hesitant to rise.
Lumbosacral Stenosis
Nerve root compression in the lower spine can make it harder to push up smoothly from lying down, especially after rest.
Meniscal Injury of the Stifle
Pain from a torn meniscus in the knee can make the first movements after lying down noticeably harder.
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Sacroiliac Disease in Dogs
Sacroiliac joint pain can make the transition from lying to standing slow and effortful.
Wobbler Syndrome (Cervical Spondylomyelopathy)
Weakness from spinal cord compression in the neck can make it harder to push up from lying down in a coordinated way.
Geriatric Frailty in Dogs
Declining muscle mass and joint reserve in frailty make the effort of standing up noticeably harder.
Sarcopenia in Senior Dogs
Reduced muscle strength in the hindquarters from sarcopenia can make it harder to push up from lying down.
Hyperaldosteronism in Cats
Getting up from a lying position becomes harder as low blood potassium saps strength from the muscles used to rise.
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Aortic Thromboembolism in Cats
A clot blocking the blood supply to the hind legs causes sudden loss of hindlimb function with extreme pain at first, cold hind limbs and pale or purple paw pads, so a cat that abruptly cannot get up on its back legs fits this picture and not a joint problem.
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Splenic Mass
A bleeding splenic mass can show as weakness or as collapse with pale gums, so a dog that suddenly struggles or fails to get up may be showing blood loss and not a limb or spinal problem.
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, which adds weight to establishing 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.
Difficulty rising that appears suddenly, within minutes to hours, in an animal that was moving normally beforehand does not fit the gradual patterns on this page. Hind legs that drag or cannot bear weight, loss of bladder control, pale gums, collapse, or in a cat cold hind paws with pale or purple pads and marked pain, point to spinal cord injury, internal bleeding or a blocked artery: conditions whose course is measured in hours, not days, and whose severity cannot be graded at home.
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, as can noting whether it came on gradually over weeks or appeared within a single day. 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: 9 October 2026 · Dr Alastair Greenway MRCVS