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Elbow Dysplasia in Dogs

By: Dr. Nicholas Trout

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Diagnosis

Diagnostic tests needed to recognize elbow dysplasia, and identify or exclude other diseases, include:

  • A complete medical history and physical examination. Your veterinarian will walk and trot your dog, looking for front leg lameness. The lameness may be present in both front legs, producing a stiff gait and shortened stride. Pain may be produced on elbow flexion, with or without inward rotation of the paw or elbow extension.

  • Radiographs of the elbow should be taken, with several different views in order to identify even subtle abnormalities. Occasionally CT scans are needed for diagnosis. Both elbows should be examined as the problem often affects both right and left elbow joints.

    Treatment

  • Medical management is usually recommended for dogs with occasional lameness or dogs with significant arthritis. Such management would include the use of anti-inflammatory drugs such as deracoxib or aspirin; nutraceuticals, such as Cosequin or Adequan; regular, moderate exercise programs and appropriate weight control.

  • Surgical management would include procedures to remove damaged or fragmented pieces of cartilage, either directly by making an incision to open the joint or by arthroscopy. Cutting the ulna, one of the three bones that form the elbow joint, thereby avoiding direct intervention with the joint itself, can treat one form of elbow dysplasia. Surgery is most effective in younger dogs, before arthritis develops. It usually improves function but will not prevent some arthritis from developing in the dysplastic elbow joint.

    Home Care and Prevention

    After surgery, the leg is usually placed in a soft padded bandage for two weeks after which time stitches are removed. For the first 4 to 6 weeks after surgery, exercise is restricted. This can be difficult to enforce in young active puppies.

    After this time your pet can undergo a gradual increase in exercise. In some cases, intermittent lameness may persist despite surgery. It is usually mild and may improve with medical management.

    The exact cause of elbow dysplasia remains unknown, but it is almost certainly multifactorial, meaning that the abnormal development of your dog's elbow joint occurs because of a combination of genetic, growth rate, nutritional, hormonal and traumatic factors.

    Of these contributing factors, genetics and nutrition are probably the easiest to consider in terms of prevention of elbow dysplasia. When selecting a pedigree breed known to have a predisposition for elbow dysplasia, it would be helpful to know whether the parents had evidence of elbow dysplasia, or not. For this reason, a scoring scheme for elbow dysplasia has been set up by the Orthopedic Foundation For Animals (OFA). Dogs can be registered when they are over 24 months of age by submitting elbow X-rays to the OFA. They will be evaluated and scored as being normal or abnormal. Abnormal elbows will be graded from I through III, depending on increasing severity of change. This registry is described as "closed" in that it gives out information only on normal dogs to parties other than the breeder (owner). Clearly, it is preferable to purchase a puppy where the sire and the dam have been found to have certified, normal elbows.

    An "open" registry for elbow dysplasia to consider is the Institute for Genetic Disease Control at Davis, California.

    Certain puppy diets have a high protein content that has been cited as a possible reason for bony developmental abnormalities such as elbow dysplasia. Obviously not all puppies on such diets get elbow problems. Monitor your pet's rate of growth by measuring weight and height. If your dog seems to be growing too fast, it may be advisable to change the diet to a lower-protein, adult diet, after consultation with your veterinarian.

    Despite medical and surgical intervention, dogs with dysplastic elbows will go on to develop some degree of elbow arthritis. However, early diagnosis and treatment may help to minimize this problem. Prompt evaluation of a forelimb lameness that gets worse with exercise is recommended.

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