Overview of Elbow Dysplasia
The word “dysplasia” means means abnormal development of a tissue or organ. Elbow dysplasia therefore means that there has been abnormal development of the elbow joint. The elbow is a complex joint because it involves the articulation of three bones. If the three bones do not fit together absolutely perfectly as a result of abnormal development, the consequence is abnormal concentration of forces on a specific region of the elbow joint. Forms of primary cartilage disease may also constitute abnormal development. The term “Developmental Elbow Diseases” may be a more descriptive nomenclature for this condition since most people will have heard of “dysplasia” only in reference to the hip joint, and elbow dysplasia has little in common with hip dysplasia. Furthermore, the term elbow dysplasia intimates a discrete entity, when in fact there are many forms of developmental elbow diseases, which have very different causes and treatments.
Certain dogs are predisposed to elbow problems, primarily large and giant breeds, including:
- Golden retriever
- Labrador retriever
- English setter
- St. Bernard
- English Springer spaniel
- German shepherd
- Burnese mountain dog
- Chow Chow
- Bassett Hound
- Chinese Shar-Pei
If you rescued your dog, you obviously don’t have a choice when it comes to his DNA.
However, if you plan to purchase a dog at high risk of elbow dysplasia from a breeder, I strongly suggest you insure your prospective pup’s parents have been cleared for elbow dysplasia by OFA.
Elbow dysplasia typically occurs in puppies between 4 and 10 months, but some dogs don’t show any signs of the problem until they develop degenerative joint disease as adults.
The problem usually affects both elbows, but sometimes it’s unilateral, meaning it only occurs in one elbow.
Symptoms of Elbow Dysplasia
The first sign of a problem is a mild to moderate front limb lameness in a young dog between the ages of 4 to 10 months. If the problem is not diagnosed at this stage, more marked lameness may be noted as severe arthritis sets in.
Dogs with elbow dysplasia are often lame or they have an abnormal gait (they ‘paddle’ or ‘flip’ their front feet when they walk).
Sometimes elbow dysplasia causes dogs to hold their elbows out or tightly into their bodies, and often a dog’s feet will rotate outwards. Sometimes dogs with this condition will choose to spend much of their time sitting or lying down, and when they play it’s usually not for long periods of time.
Dogs with elbow dysplasia tend to tire easily, and their owners may assume they’re just lazy or quiet when really their elbows hurt. You might also notice your dog is stiff when he attempts to stand, and exercise frequently makes the situation worse, not better.
If your dog has dysplasia in both elbows, his lameness may shift from one leg to the other. When both legs hurt equally, dogs with this condition don’t limp. They alter the way they stand and walk in order to shift their weight back and forth. If one elbow hurts more than the other, you’ll notice an obvious limp.
Symptoms of elbow dysplasia can range from an occasional lameness to severe and crippling arthritis and very painful elbows.
- Not all affected dogs will show signs when young
- Sudden episode of elbow lameness due to advanced degenerative joint disease in a mature patient are common
- Intermittent or persistent forelimb lameness that is aggravated by exercise; progresses from stiffness, and noticed only after the dog has been resting
- Pain when extending or flexing the elbow
- Tendency for dogs to hold the affected limb away from the body
- Fluid build-up in the joint
- Grating of bone and joint with movement may be detected with advanced degenerative joint disease
- Diminished range of motion
Diagnosis of Elbow Dysplasia
Diagnosis of elbow dysplasia is usually made by observing clinical signs, palpation of the joints, and taking X-rays of the elbow joint. A dog with elbow problems will often resist any attempt by the veterinarian to manipulate the elbow.
Joint capsule swelling can sometimes be felt, especially after exercise. The joint capsule can also appear thickened. There can be changes to the musculature in the shoulders, so muscle atrophy is not uncommon.
X-rays will permit the vet to visualize abnormalities in the appearance of the joint, as well as increased bone density at the ulnar notch. They will also sometimes (but not always) show lesions caused by OCD, as well as ununited anconeal process, a missing coronoid process, and arthritis.
A CAT scan can also be used to arrive at a definitive diagnosis, as well as to perform a minimally invasive diagnostic arthroscopy, which involves passing a tiny camera inside the joint.
Your veterinarian will want to rule out several possible causes for the symptoms before arriving at a diagnosis. For example, whether there has been trauma to the joint, or whether there is an infection that has brought on, an arthritic condition will need to be explored. A tumor may account for the symptoms, and this possibility will be taken into account as well.Your doctor may also want to order a computed tomography (CT) scan, or magnetic resonance image (MRI) to look for fragments. A sample of fluid will be taken from the joint with a fine needle aspirate for laboratory testing, and an arthroscopic examination (by use of a tubelike instrument for examining and treating the inside of the joint) may be utilized to help for making a definitive diagnosis.
Treatment of Elbow Dysplasia
The type of treatment given depends on several factors, including the amount of pain the dog is living with, and the extent of arthritic changes to the joint. The goal of treatment of elbow dysplasia is to relieve pain and maintain function in the affected limbs. We want to help these patients live active, normal lives.
Surgery may be the treatment of choice. An ununited anconeal process is typically removed through a small incision made in the elbow. Studies suggest that if a UAP is detected early enough, an ulnar osteotomy, which is the cutting of the ulna bone, can be used to reduce stress and potentially allow the UAP to unite normally in a growing puppy.
Cold-packing the elbow joint immediately following surgery to help decrease swelling and control pain is advised. You will want to continue to apply the cold pack five to ten minutes every eight hours for three to five days, or as directed by your veterinarian. Range-of-motion exercises will be beneficial for healing therapy until your dog can bear weight on the limb(s). Your veterinarian will demonstrate the types of range of motion movements you will be working on with your dog, based on the location and severity of the affected limb.
It’s very important for dogs with elbow dysplasia to stay at a very healthy, normal weight, and to get moderate exercise. Sometimes veterinarians suggest that the dog should has no exercise but that advice may results in significant muscle atrophy.
Dogs with elbow dysplasia usually respond well to rehabilitation therapies such as underwater treadmill/swim therapy, massage, joint mobilization and therapeutic exercises.
Anti-inflammatory medications are often prescribed for elbow dysplasia patients, but I’ve had really good success using natural anti-inflammatory agents like esterified fatty acid complexi .
If arthritis is present, injectable polysulfated glycosaminoglycans, which is a big fancy term for injectable substances such as Adequanii , can be of great benefit.
Also proteolytic enzymes is being used to help reduce inflammation, as well as CPAs, which are chondroprotective agents such as eggshell membrane. Cetyl myristoleate, or CMO, can be used to reduce cartilage deterioration.
Home Care and Prevention of Elbow Dysplasia
Excessive intake of nutrients that promote rapid growth can have an influence on the development of elbow dysplasia; therefore, restricted weight gain and growth in young dogs that are at increased risk (due to breed, etc.) may decrease its incidence. Avoid breeding affected animals, since this is a genetic trait. If your dog has been diagnosed with elbow dysplasia, you will need to have it neutered or spayed, and you will need to report the incident to the breeder your dog came from, if that is the case. If the affected dog came from a litter in your own home, do not repeat dam–sire breedings that result in these offspring.
Yearly examinations are recommended for assessing the progression and deterioration of joint cartilage. Progression of degenerative joint disease is to be expected; however, the prognosis is fair to good for all forms of this disease.