This would have to be THE most confusing condition for owners primarily because it has many different manifestations! There are three seperate processes that are put under the umbrella of Elbow dysplasia because they are all caused by abnormal Elbow conformation. They all occur as your dog is growing and developing and may cause pain and lameness of the front limb. They all cause significant changes to elbow biomechanics, Understanding which of these your dog has will greatly influence treatment options. They may be influenced by a missmatch between the ulnar and radius length, in turn causing abnormal pressure of the humerus on these two bones.
Osteochondrosis Dissican (OCD) -During the growth stage there is a localised loss of blood flow to a portion of cartilage on the humerus. This allows a flap to lift up and become detached.
Fragmented Coronoid process- The most innermost lip of the Ulnar (medial coronoid process) which cups the humerus may be damaged and chip off.
Ununited anconeal process- The anconeal process is found on the Ulnar as it wraps around to cup the humerus. In growing dogs this area is seperated by a growth plate that should calcify and disappear. In dogs with UAP this does not occur and the bone that should cups the humerus remains mobile and the joint is unstable.
In a normal dog 60% of their weight is carried through the front limbs, this puts a large amount of strain through the Elbow joint. There are three bones involved in this joint and it has a large range of motion. Malfunction in this joint will always require rehabilitation and preventative conditioning for the life of your pet.
- Pain management using a combination of appropriate medications, manual therapies and modalities is the cornerstone of caring for your dog.
- Strengthening active muscular support of the joint to maximise your dogs life enjoyment while also minimising pain and discomfort.
- Maintain range of motion to limit pressure being shifted onto other joints.
- Teach your dog appropriate compensatory
Early diagnosis is vital to appropriate management of Elbow dysplasia, slowing down arthritis progression and keeping your dog comfortable.
Typically investigation occurs when a lameness is noted in one or both front limbs in dogs aged 6-12mths of age. Physical exam can help localise pain to the elbow region. Your dog will often be uncomfortable when the elbow is extended and flexed.
Imaging is the first step, starting off with radiographs of your dogs elbow. The best way to obtain these is with your dog sedated so they do not move allowing the best positioning. This sedation will also contain pain relief- we need to ensure your dog does not feel that people handling their front legs cause pain because it can make management more difficult in the future- ensuring they do not feel uncomfortable during the process.
Occasionally it is possible to for X-rays to look normal even though the dog has elbow dysplasia. This is called a False negative result. In other cases it is possible to see that the Elbow is not normal but it is difficult to clearly identify what is occurring in the joint due to the overlapping bones.
Computed Topography (CT) is then used to show what is occurring in the joint and eliminate the overlapping image. It is the best method to identify the potentially involved structures and allow appropriate planning for treatments without needing to go into the joint itself.
Treatment depends on what abnormalities are occurring in the joint and how far the disease is progressed.
Early and accurate diagnosis allows surgical intervention to stabilise the joint and remove bone fragments that may cause pain. In many cases this can be done through arthroscopy which involves a keyhole procedure. Visualisation is maximised with magnification of the joint with minimal joint disruption.
Later stages may be appropriate for salvage surgery to relieve pressure within the joint. Particularly damaged joints may even require joint replacement to improve comfort. If they can be managed medically then surgery may not improve your dogs condition or prognosis long term.
Physical rehabilitation is important pre and post surgery as well as cases where surgery is not appropriate. Primal Paws has also started offering platelet rich plasma (PRP) to further manage pain in the elbow.
Why does this disease process occur, can we prevent it?
There are many different thoughts around why dogs develop elbow dysplasia which include
- Rate of growth
- Nutrition- deficiency and/or excessive nutrients or energy
- Trauma due to physical activity in young animals.
The reality is we can not identify what causes elbow dysplasia and what does not cause elbow dysplasia. The best we can do is reduce risks and act quickly if we are suspicious of abnormalities in the elbow.
Feeding your pup a good quality food, keeping them lean, buying from parents who have had their elbows radiographed and certified clear of elbow dysplasia and finally appropriate exercise. We can help you formulate healthy exercise plans and ensure your pup is developing appropriately to minimise risk.