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Health Testing Guide
Which tests are mandatory, how to spot responsible breeders — and what it costs when things go wrong.
For the German Shepherd we have compiled 6 mandatory and 13 recommended health tests, drawn from breed-club regulations, the University of PEI (CIDD), and OMIA — weighted by severity and heritability.
What this grade means
The German Shepherd faces significant health challenges, reflected in the extremely high number of 28 mandatory health tests. Hip dysplasia (HD) and elbow dysplasia (ED) are particularly deeply rooted musculoskeletal issues that continue to occur frequently despite strict breeding controls. Prospective buyers must be extremely diligent and demand complete, gapless health test results for both parents.
Every breed is susceptible to certain inherited conditions. Just like humans, dogs inherit predispositions from their parents. Responsible breeders screen their breeding dogs for these conditions and make informed mating decisions to reduce the risk passed on to puppies.
No — but it's the strongest tool we have. Diet, exercise, environment, and genetics all contribute to whether a dog develops a condition. When breeders use the right tests to identify risk in potential parents, the likelihood of many conditions appearing in the puppies drops significantly.
There's no one-size-fits-all here. For the German Shepherd we track 6 mandatory tests plus 13 additional recommended ones. The specific tests and passing thresholds are detailed further below.
Keep in mind
Reliable screening tests still don't exist for many hereditary conditions, and tests for complex polygenic conditions are not always predictive of severity in the puppies. Even so, they're a powerful tool used by every responsible breeder.
There are two main types of health tests:
Screen the dog's DNA for known disease-causing mutations. Can be performed from puppyhood and give a binary result (clear / carrier / affected).
Clinical and imaging exams like X-ray, ultrasound, or ophthalmoscopy. They show how a predisposition actually manifests — usually only conclusive after 12–18 months.
We group breeding programs into three levels based on testing depth. Ask your breeder directly which level they meet.
A breeder at the Great level performs all mandatory tests plus 13 additional clinically recommended screenings that reduce risk in this breed.
In addition to mandatory tests:
Cleft palate
Allgemeine Fitness und Anatomie
A cleft palate is a congenital birth defect where the roof of the mouth fails to fuse properly during development in the womb. This failure leaves an abnormal opening between the oral cavity and the nasal passages. Because these two systems are directly connected, food, liquids, and air cannot be properly separated during swallowing.
Physisch
Cervical vertebral compressive myelopathy(CVCM)
Bewegungsapparat
Cervical vertebral compressive myelopathy, commonly known as Wobbler syndrome, is a condition affecting the spine where the spinal cord in the neck becomes pinched. This compression is caused by malformed neck vertebrae or slipping discs between the bones. Over time, the constant pressure damages the nerve pathways that carry signals from the brain to the limbs.
Roentgen
Lumbosacral Transitional Vertebra(LTV)
Bewegungsapparat
Übergangswirbel, also known as lumbosacral transitional vertebrae (LSTV), is a congenital skeletal malformation where a vertebra at the junction of two spinal sections—usually the lower back and the pelvis—develops abnormally, sharing characteristics of both areas. This anatomical variation can cause instability or uneven pressure in the lower spine. It is frequently identified during standard hip dysplasia screening radiographs, which evaluate the same pelvic region.
Roentgen · Passing: Type 0 or Type 1
Lupus erythematosus (systemic, cutaneous/discoid)(SLE)
Haut und Fell
Lupus erythematosus is a severe autoimmune disease where the dog's immune system mistakenly attacks its own healthy tissues. In the cutaneous or discoid form, this damage is limited to the skin, while the systemic form can affect multiple internal organs, including the kidneys, joints, and blood vessels. This abnormal immune response causes chronic inflammation and tissue damage throughout the affected areas.
Koerperfluessigkeiten
Aortic valve stenosis(AS)
Herz
Aortic stenosis is a narrowing of the aortic valve in the heart, which controls blood flow from the main pumping chamber (the left ventricle) to the rest of the body. Because of this restriction, the heart muscle must work much harder to pump blood, which eventually causes the muscle wall to thicken abnormally. This is a severe cardiovascular condition that can strain the heart over time.
Patent ductus arteriosus (PDA)(PDA)
Herz
Patent ductus arteriosus is a congenital heart defect where a normal fetal blood vessel connecting the aorta and the pulmonary artery fails to close shortly after birth. This failure allows blood to continuously recirculate through the lungs instead of flowing to the rest of the body, putting severe, permanent strain on the heart muscle. Over time, this volume overload causes the left side of the heart to enlarge and weaken.
Ultraschall
Hemophilia
Herz und Kreislauf
Hemophilia is an inherited blood clotting disorder affecting the circulatory system, where the body lacks specific proteins needed for coagulation, which is the process of blood clotting. Because the blood cannot clot properly, even minor injuries can lead to prolonged internal or external bleeding. This condition is inherited through an X-linked genetic trait, meaning it primarily affects male dogs.
Koerperfluessigkeiten
Degenerative Myelopathy(DM)
Nervensystem
Degenerative Myelopathy is a progressive disease of the spinal cord where the protective sheath around the nerves slowly breaks down. This deterioration disrupts the vital communication signals between the brain and the muscles of the hind limbs. Over time, this lack of signal transmission leads to a complete loss of muscle control in the back legs.
DNA
Epilepsy(IE)
Nervensystem
Epilepsy is a chronic disorder of the brain and nervous system where abnormal electrical activity causes sudden, temporary disruptions in normal brain function. These disruptions lead to repeated seizures, which are involuntary changes in body movement, sensation, or behavior. Because the underlying cause is often complex, the brain's electrical signaling remains permanently prone to these sudden misfires.
Physisch
Nodular dermatofibrosis and renal cystadenocarcinoma(RCND)
Nieren
This is an inherited condition that affects both the skin and the kidneys. It causes non-cancerous, firm lumps of connective tissue (nodules) to form under the skin, while simultaneously causing fluid-filled sacs (cysts) and cancerous tumors to grow in the kidneys. Over time, these kidney abnormalities damage the organ's ability to filter waste from the blood.
Pituitary hormone deficiency, LHX3-related(CPHD)
Stoffwechsel
This condition is an inherited underdevelopment of the pituitary gland, which is a small hormone-producing organ at the base of the brain. Due to a genetic mutation, the gland cannot produce enough growth hormone and other vital regulatory hormones. This deficiency severely impacts the dog's overall development and the function of other organs like the thyroid.
Passing: Clear/Carrier
Exocrine pancreatic insufficiency(EPI)
Verdauung und Darm
Exocrine pancreatic insufficiency (EPI) is a digestive disorder where the pancreas fails to produce enough essential enzymes to break down food. Without these enzymes, the dog's digestive system cannot absorb nutrients properly, leading to malnutrition. Diagnosis is typically confirmed using a specific blood test called the canine trypsin-like immunoreactivity (cTLI) serum test.
Koerperfluessigkeiten
Megaesophagus(ME)
Verdauung und Darm
Megaesophagus is a disorder of the digestive system where the esophagus, the muscular tube connecting the throat to the stomach, becomes abnormally stretched and loses its muscle tone. Because these muscles can no longer contract to push food and liquid downward, meals become trapped in the tube. This trapped material is typically regurgitated, meaning it is passively cast back up before ever reaching the stomach.
Roentgen
These levels are a comparison framework, not an official certification. They help compare breeding programs at a glance.
A complete checklist with every mandatory and recommended test plus identity and rearing questions — take it with you.
Open the full checklistFor breeders
Machine-readable mating rules, minimum ages, scoring schemes, and what's required for HonestDog verification — as a printable guide.
Example rule — Elbow Dysplasia
Both parents must be 1 or better or better.
We compile mandatory tests from official breed regulations and veterinary databases — and check every uploaded certificate for authenticity.
L1 = mandatory under breed-club regulations. L2 = recommended or clinically indicated. L3 = lower prevalence. Every assignment carries a source and confidence rating.
VDH breeding regulations, CIDD (University of PEI), OMIA (University of Sydney), curated veterinary input.
Uploaded certificates are AI-extracted and reviewed by our team for authenticity, date, and result.
6 tests are currently mandatory under the relevant breed-club regulations. The most common are DNA-Identitätsnachweis, Zahn- und Bissbewertung, Elbow Dysplasia (ED). Every test must be completed before mating, and the result must fall within the threshold defined by the regulation.
See breeders who have already uploaded their mandatory tests for verification.
View verified breeders