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What Is Elbow Dysplasia?

By Gail D. Mason, DVM, MA, DACVIM, Dr. Megan Sullivan, DVM, DACVS | Mar 04, 2019

 

Canine elbow dysplasia is an inherited syndrome that is made up of four separate diseases. This is usually caused by growth disturbances in the elbow joint which consists of the humerus, ulna, and radius. Elbow dysplasia most often occurs in large to giant breed dogs such as German Shepherds, Rottweilers, Labradors, and Golden Retrievers. Dogs with elbow dysplasia will show some degree of forelimb lameness between 5 and 12 months of age.

The four components of elbow dysplasia include fragmented medial coronoid process (FMCP- medial coronoid disease), ununited anconeal process (UAP), incongruity, and osteochondrosis (OCD). Any of these abnormalities will result in joint inflammation, cartilage damage, and subsequent osteoarthritis. The initial signs of elbow dysplasia include front leg lameness that worsens over weeks to months. Dogs are most often the most lame after exercise, in one or both front limbs. Initial evaluation may include physical examination to detect lameness, pain on range of motion of the joint, effusion (fluid) within the joint, or thickening of the joint. Radiographs can detect secondary signs such as arthritis, bone fragments in the joint, or an ununited anconeal process. If they do not detect the underlying cause of the elbow pain/swelling, then more advanced “imaging” (such as a CAT scan) has a greater ability to definitively diagnose the specific form of elbow dysplasia. A CAT scan can also diagnose if the elbow dysplasia is affecting one or two elbows. The CAT scan is a very rapid test and can be done under sedation. It is similar in cost to that of radiographs of both elbows, and therefore it is the best test to definitively diagnose elbow dysplasia. Elbow arthroscopy (internal viewing the joint with a fiberoptic scope) is another diagnostic tool and can be utilized to treat the elbow dysplasia as well.

Treatment for elbow dysplasia depends on the exact underlying form. Surgery is recommended to improve the patient’s quality of life, reduce pain, and minimize lameness and subsequent arthritis. Arthroscopy is performed under a brief general anesthesia. A camera is placed into the joint to visualize the cartilage and assess joint health. It is used to visualize any fragments within the joint and a minimally invasive instrument is used to remove the bone fragments. Postoperative recovery includes moderate exercise restriction for about 6 weeks, with gradual return to normal activity. Elbow dysplasia inevitably does result in some degree of progressive arthritis. The goal of surgery is to minimize pain and lameness and reduce long term consequences of the deformity. Reported prognosis for improvement is between 50-100%. Arthroscopy is a minimally invasive surgery and has less pain and faster recovery compared with arthrotomy (surgically opening the joint). If arthritis progresses, other modalities may be helpful such as: joint injections (PRP- platelet rich plasma), HA (hyaluronic acid) or stem cells. Shockwave (Pulsevet) therapy can also help to combat arthritis by bringing healing cells to the area and decreasing inflammation. Other recommendations for long term arthritis include weight control, Glucosamine supplementation (such as Dasuquin or Cosequin), and adequate exercise.

If patients continue to have severe lameness or pain post arthroscopy surgery, an additional surgery can be performed called the PAUL surgery. PAUL stands for proximal abducting ulnar osteotomy which helps to shift weight away from the damaged part of the joint to a healthier part of the joint. This surgery has shown good success with improving patient comfort levels.

Overall, elbow dysplasia is a very treatable condition with arthroscopy being the mainstay of treatment. As arthritis progresses, there are many options to control arthritis and improve function. A consultation with an orthopedic specialist, DACVS (Diplomate of College of Veterinary Surgeon) would be the best way to diagnose your pet and discuss treatment options such as arthroscopy or treatment of arthritis long term.

 

 

Dr. Megan Sullivan, DVM, DACVS (Animal Emergency & Surgical Care)

Dr. Gail Mason, DACVIM (Portland Veterinary Specialists)

 

 

 

Gail Mason, DVM, MA, DACVIM

Portland Veterinary Specialists

739 Warren Avenue

Portland, Maine 04103

PH: 207.780.0271

FAX:207.780-0272

www.portlandvetspecialists.com