Some people gravitate toward big dogs. They love Mastiffs who think they’re lap dogs or Bernese Mountain Dogs that make everything around them seem small by comparison. The list of big breeds goes on and on—from slender Afghan hounds to clumsy Great Danes, slobbery St. Bernards to fluffy Cuvacs. These breeds are all unique and different in their own way, but all have size in common.

Unfortunately, with size comes the potential for certain illnesses and health conditions. Bigger dogs are more prone to specific ailments that their smaller cousins might not experience. It’s important for big dog lovers to understand this and to be aware of the conditions that may pose a threat for their oversized companions.

Here’s a look at eight ailments that commonly affect large-breed dogs—what they are and what they mean for the health and wellbeing of your pet.

1. Dysplasia

Dysplasia can occur in the hips, elbows or both. It’s a condition that arises when the hip or elbow joint doesn’t fit properly into the socket and deviates, causing everything from pain during walking to lameness. While German Shepherds are the breed most commonly associated with dysplasia, many larger breeds suffer a proneness to developing it. Mastiffs, Great Danes, and Great Pyrenees all have a higher-than-average risk of suffering from hip or elbow dysplasia. Many times, surgery can alleviate the pain associated with the condition.

2. Panosteitis

Because they grow quickly and to such great sizes, many large-breed dogs suffer from Panosteitis (Pano) during their maturation. This condition affects the legs and can cause everything from temporary lameness to pain. It’s a condition defined by bone inflammation and often goes away by itself in time. That doesn’t make it any less painful for your pup, though! Pano is similar to growing pains in humans, which means your pup can benefit from gentle massage and rest.

3. Dilated Cardiomyopathy

Dilated Cardiomyopathy is a condition affecting the hearts of larger dogs—specifically the different chambers of the heart. Dilated Cardiomyopathy causes the heart to literally swell, which stretches the aortic walls too thin. This, combined with inflammation of heart tissue, makes Dilated Cardiomyopathy a dangerous condition for bigger pups. Unfortunately, it’s also a lifelong condition, but it can be managed with medication.

4. Aortic Stenosis

As something of an opposite to Dilated Cardiomyopathy, Aortic Stenosis involves the narrowing of aortic valves, which decreases blood flow. Many times, dogs can seem perfectly normal until the aortic valve becomes too restricted, and they collapse due to lack of blood flow. It’s a condition primarily affecting bigger dogs and is hereditary, which makes it easier to identify if you have a consistent lineage. This condition can be managed if discovered early.

5. Spondylolisthesis

Bigger dogs have bigger physiology, which can cause spinal issues to form. Spondylolisthesis is one of them. Often called “wobblers” because of the way a dog sways back and forth, spondylolisthesis is an abnormal curvature of the spine. Unfortunately, the disease is progressive and will degenerate your dog’s quality of life without proper management. Medication can be effective in some cases; however, surgery is often recommended. Even then, there’s no stopping spondylolisthesis—only delaying its effects.

6. Cherry eye

Cherry eye is one of those conditions that doesn’t necessarily affect bigger dogs—rather, the specific breeds prone to cherry eye are larger breeds. While it’s most associated with Mastiffs, other “droopy” dogs are prone to developing cherry eye. This condition sees the dog’s third eyelid protrude from the eye, causing a painful mass that can make it difficult for them to see. Left unchecked, it’ll become more and more inflamed and red—thus the name, “cherry eye.” It’s correctable with surgery.

7. Arthritis

The bigger the body, the more gravity takes its toll. As a result, bigger dogs are more prone to developing arthritis in their joints, including the knees and elbows. Arthritis tends to set in during the latter half of a dog’s years, so it’s important to start watching out for signs after your big breed turns 5 or 6 years old. If they seem to have trouble getting up from a laying position or are reluctant to use stairs, it might be time to chat with your vet about potential arthritis management strategies.

8. ACL tears

Big dogs are known for their powerful muscles and strength. Unfortunately, they don’t always have the strongest ligaments to support them. As a result, larger breeds commonly face ligament tears and strains—especially ACL tears. All it takes is one sharp turn at a high-speed gallop to cause a tear or strain that might leave your poor pup limping. You can help them avoid ACL tears by exercising them regularly and keeping them within healthy weight parameters.

Big breeds need extra love!

Every breed has their own unique health concerns to worry about—big dogs especially. Understanding some of the potential afflictions your big pup might be up against can help you protect them and make sure they get the care they need. Consult with your vet about any of these conditions and how to manage them if your big breed is diagnosed with one.