Elbow Dysplasia

Elbow Dysplasia

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What is elbow dysplasia?

The term elbow dysplasia refers to several conditions that affect the elbow joint: osteochondrosis of the medial humeral condyle, fragmented medial coronoid process, ununited anconeal process, and incongruent elbow. More than one of these conditions may be present, and this disease often affects both front legs. An affected dog shows forelimb lameness and elbow pain. These conditions may actually be different manifestations of a single disease process, osteochondritis dissecans (OCD). OCD is abnormal maturation of cartilage (the specialized connective tissue from which bone develops). While this in an inherited defect, environmental factors such as diet, activity, and trauma also have a role in the development and progression of the disease.

Osteochondritis dissecans (OCD): A fragment of cartilage peels away from the bone, within the joint.
Osteochondrosis of medial humeral condyle:  OCD develops on the elbow end of the humerus (the long bone in the front leg above the elbow).
Fragmented medial coronoid process and ununited anconeal process: The coronoid and anconeal processes are small bones which fuse with the main part of the ulna as the animal matures. (The ulna and the radius are the two bones which make up the front leg between wrist and elbow). These terms describe the condition where those processes either break off from the ulna, or fail to fuse normally.
Incongruent elbow: The bones which form the elbow joint grow at different rates and do not fit together properly.

What breeds are affected by elbow dysplasia?
Many large breed dogs are affected, and elbow dysplasia is more common in males than females. Affected breeds include the Basset hound, Bernese mountain dog, Bloodhound, Bouvier des Flandres, Chow-chow, German shepherd, Golden Retriever, Great Pyrenees, Irish Wolfhound, Labrador Retriever,  Mastiff, Newfoundland, Rottweiler, St. Bernard, and Weimaraner. Other large breed dogs may be affected as well.

What does elbow dysplasia mean to your dog & you?
Lameness usually starts insidiously at 7 to 10 months of age. It is present every day, and may be most obvious when you dog first gets up, or starts to walk or run. The likely outcome depends on how far the disease has progressed when treatment begins. Good clinical results (ie. your dog will not be painful) are usually seen if treatment starts early, before osteoarthritis (degenerative changes in the joint) has developed. If left untreated, your dog’s pain and lameness will gradually get worse.

How is elbow dysplasia diagnosed?

The initial lameness may be very subtle with this condition, and it may be some time before it can be documented or diagnosed. Your veterinarian will suspect elbow dysplasia if you have a young, fast-growing, large breed dog , with forelimb lameness and elbow pain. They will perform a physical exam and watch your dog walk or run to confirm which limb, and which joint, is painful. X-rays are necessary to diagnose elbow dysplasia. Your veterinarian will probably x-ray both elbows, because this disease is often present in both sides even if your dog is only lame on one side. If possible, they may do a CT scan; this technique will show certain bone fragments better than plain x-ray films.

How is elbow dysplasia treated?
Surgery is usually recommended to remove a bone or cartilage fragment. If unequal bone growth is the problem, surgery may help to relieve the pressure at the joint.

An appropriate diet in the growing phase of a dog’s life will go a long way towards preventing a problem or at least minimising it. That means keeping the energy and mineral balance correct and not over feeding. Overweight dogs suffer from osteoarthritic pain far more than slimmer dogs so if your dog is overweight it would help to put him on a calorie controlled diet. There are specifically formulated joint diets containing natural anti-inflammatory supplements that can alleviate pain.

Nutraceuticals such as glucosamine and chondroitin may also be helpful. These substances help to lubricate the joint and may replace lost nutrients in the damaged cartilage layer. Omega 3/6 oils help to alter the composition of the fatty layer surrounding the cells making it more likely to breakdown into non inflammatory rather than inflammatory products. A combination of the two is ideal. Various other supplements have been used to mixed effect.

Controlling exercise is important in managing the pain. Obviously it is best to rest the dog if the pain is acute but if you need to exercise then short frequent walks are better than long.
Physiotherapy, massage, acupuncture and hydrotherapy are also highly recommended as adjunctive therapies to strengthen and relax the muscles.

If surgical or conservative therapy doesn’t work your vet may resort to anti-inflammatory drugs.