Elbow Dysplasia is a common cause of lameness in dogs. It can affect one or both front limbs. Fizz, above, had Elbow Dysplasia and is seen wearing TTouch leg wraps as part of her care.
The canine elbow joint is a composite joint and consists of three bones which meet and function close together. These bones are the humerus, the radius and the ulna. Due to the tight fit of these three bones where they meet, there can be problems if there is any incongruity.
The term ‘Elbow Dysplasia’ covers several individual developmental abnormalities, which can be the cause of elbow dysplasia individually or as a combination.
- OCD – Osteochondrosis Dissecans
- FMCP – Fragmented Medial Coronoid Process (which is the most common)
- UAP – Ununited Anconeal Process
Incongruity between the radius and ulna growth rate can resolve but it may have caused a stress fracture of the coronoid process, which then becomes the persisting problem.
Ulnar notch incongruity can occur where the ulnar notch is completely the wrong shape relative to the humerus, which should sit in it. This leads to abnormal wearing of the joint surfaces causing cartilage erosion.
These abnormalities eventually lead to osteoarthritis, which then becomes the ongoing degenerative problem.
Possible symptoms
- Swelling
- Joint effusion
- Pain and reduced range of motion of the elbow
- Lameness – you will see the head ‘nod’ when the good limb is placed on the ground and the head will lift when the affected leg is placed on the ground. If both legs are affected there may be a ‘paddling’ gait. Lameness is often seen after prolonged rest.
Cause and diagnosis
The cause can be genetic (many genes code for elbow dysplasia) and/or environmental (diet, exercise, etc.)
Diagnosis is often via radiography or CT scan and arthroscopy.
Knowing which stage the disease progression is at determines the best treatment options for the individual. Arthroscopy can give that information and is considered the gold standard for diagnosis.
Blood tests can also be particularly useful to gain information.
Surgical treatment options
The main aim with any treatment is to limit or remove the damaging areas to lessen the impact of osteoarthritis throughout life.
If the joint is not incongruent and there is no radio/ulna conflict, arthroscopy can also be used as a treatment to remove loose fragments within the joint and/or to perform a coronoid ostectomy and removal of fragmented or inflammatory areas of the coronoid process. This is keyhole surgery and dogs are usually walking the next day and recover well.
Biceps ulna release can be carried out in cases where the radius and ulna conflict. This is where the biceps tendon is released on the ulna only, leaving the radius attachment in place.
Medication
Analgesia medication such as NSAIDs may be necessary to kick-start mobility if the pain levels are high. Movement is essential to joint health so reducing pain allows the dog to begin moving around more and mobilising the joints.
Blood tests should be done to assess potential damage to kidney and liver function.
Cox 2 inhibiting NSAIDs may be slightly better in terms of causing fewer potential side effects, but there is no strong evidence to support this.
Disease Modifying Osteoarthritis Drugs such as Cartrophen can be effective but only if the dog is not also taking steroids or NSAIDs, as this could exacerbate any potential stomach ulcer problems arising from NSAID use.
Diet and management options
A species appropriate highly nutritious diet is essential both in terms of obtaining essential nutrients for growth, repair, healing and function and to avoid additional inflammation.
Essential fatty acids to reduce inflammation – a ratio of 1.5:1 of EPA: DHA is ideal. Cold water fish or krill are the best sources. Algae can work well for some dogs who cannot tolerate fish.
Weight control is particularly important to avoid excess loading of the joints.
Exercise and activity management can make an enormous difference. Simple daily activities such as jumping in and out of the car, running up and down stairs or walking on slippery floors inside the house can cause constant re-injury and wear and tear.
Alternative and complementary treatment options
- Physiotherapy and hydrotherapy treatments can improve the range of movement of the affected joints, improve the gait and proprioception, reduce pain and address other areas of compensation
- Acupuncture – laser or needle
- Platelet enriched plasma
- Stem cell therapy
- Chondroprotectants such as glucosamine (begin at minimum 22mg/kg), chondroitin sulfate (begin at 15mg/kg) or ASU – avocado/soybean unsaponifiables (begin with 4.3mg/kg loading dose).
- Homeopathy
- Curcumin, MSM, Boswellia, Quercetin, CBD, PEA (Palmitoylethanolamide)
Julie Moss BSc. Hons., AdvCertVPhys, Dip.APhys.
Julie is a canine behaviourist, veterinary physiotherapist and TTouch Practitioner. She started Best Behaviour in 2005, which has since become part of her business, Canine Mind and Body Balance. She has a special interest in integrative veterinary care, where CAM therapies play an important role in truly holistic animal care. Her passion is working with older animals to give them back the best quality of life possible and she is committed to education and enabling people to recognise early signs of lameness in our dogs.
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The veterinary Surgeon’s Act 1966 restricts the treatment of animals (usually other than your own*) by anyone other than a qualified vet. Always consult a veterinary surgeon if you are concerned about your animal’s health. *For full details visit the RCVS website