My little guy has severe HD.
The most important thing for me is to keep the muscle as built up as possible. I give him supplements (I like Cosequin DS chewables, fish oil, and various vitamins). But I try, as much as our budget will allow, to keep him swimming and doing treadmill therapy.
The more his muscle supports the hips, the less wear and tear they'll take in the long run. While running and playing builds up certain muscles, it doesn't build up ALL of them.
I take him to a chiropractor now and then, when I think that his hips may be throwing off his gait enough to affect the rest of his structure. But that doesn't really work into my long term preventative plan. We can't really "adjust" those hips back into place. All we can do is support the spine and other joints.
But like Elsa, my guy is young and his spine is pretty flexible. My goal is to spend my funds (which, after all, are not unlimited) to keep the hips supported, so they're not bearing most of his weight. I want the muscle to bear the weight. The more the hips are supported, the less funky his gait is, so the less the spine, opposing hip, knees, front end, etc need chiropractic support.
I've had an older dog with dysplasia (and one with arthritis) and both of them benefited from chiropractic. But by then, the damage to the joints was done. (But they benefited A LOT from swim therapy too).
I can give you numerous examples of humans who have been able to avoid surgery AND pain by building up muscles to support skeletal anatomy. I was able to do this with with my older dogs to some degree, and am certain that had I known about swim therapy earlier in their lives, I could have done so to a greater degree for them too.
In your shoes, I would consult with a vet certified in rehab and talk to her about all of your options. I think you'll find that you have a lot more options than you realize. http://www.caninerehabinstitute.com/Find_A_Therapist.html
Here's some info on water therapy:http://lapawspa.com/the_association_of_canine_water_therapy_000202.htmlhttp://lapawspa.com/dog_pools_for_swimming_therapy_what_to_look_for_000186.html
I get my Cosequin DS from Entirely Pets through Amazon, which offers the best price that I've been able to find. The 2 pack is a bit cheaper than the single bottle on a per tablet basis: http://www.amazon.com/gp/product/B000O5H...HJHBGA3PJJ5VPGC
If you're worried about "making up" lost time, you can ask the rehab vet about Adequan injections for a short while, until the glucosamine has a chance to get flowing. Yes, it can be used on younger dogs. The general opinion I've gotten from numerous vets is that it won't help if the dog's been on a quality glucosamine product for a while. But it can help if she hasn't and you're trying to jump-start her. Ask your vet.
Personally, I don't think that 6 months is that big of a deal over a 13+ life span. Unless she has been doing a lot of crazy activities that are really hard on her hips (jumping off agility equipment mid-span, jogging on asphalt everyday, that sort of thing), I don't think it makes a difference at all.
Another thing I'll mention, even though I can't imagine that you've let Elsa get overweight at all, but my orthopedic surgeon repeats over and over that one of the best things we can do for our dysplastic kids is keep them lean. Not just a nice healthy weight, but slender. The less weight those hips carry, the less wear and tear, of course. My guy varies between lean and on the skinny side. And my surgeon (who sees my pup every 6 months) is pleased with his weight. He's healthy, eats a good diet, active, not showing any signs of pain or compromise. Apparently, with the dogs who do have a THR surgery, the ones that have the most difficulty and side effects are the ones that are on the heavy side.
I fully anticipate my guy will need a THR. As soon as he shows any signs of pain, he can go in. The nice thing is that he won't need to drop a few pounds first. My surgeon says he's not so sure he'll need surgery because we're doing rehab and doing all the other stuff. Either way, we're good....
So even if Elsa is normal weight, maybe she could resolve at the new year to lose a few pounds...
Ask your vet. Best yet, ask the rehab vet.
Feel free to drop me a note anytime.