Veterinary care should include diagnostic tests and subsequent treatment recommendations.Diagnosis In-depth
Diagnostic tests are needed to recognize OC and exclude other diseases causing lameness in young dogs. The age, breed and clinical signs are characteristic for the disease and may cause your veterinarian to strongly suspect these conditions. OC should be suspected in any large-breed dog less than two years of age that is lame. Tests that your veterinarian may wish to perform include: Orthopedic examination. In addition to lameness, affected dogs may exhibit pain on extreme flexion or extension of the joint. An effusion (increased amount of joint fluid) may be present in the affected joints.
Radiographs of the affected limb. After a careful lameness exam, radiographs (X-rays) of the joint are probably warranted to help identify the cartilage defect or the subsequent osteoarthritis.
Arthroscopy. As arthroscopy is becoming more advanced in small-animal orthopedics, the procedure may be recommended to help confirm the diagnosis.
Treatment for OC may include the following:
Most surgeons recommend early surgical treatment when OC or one of its clinical syndromes is diagnosed. If the offending piece of cartilage is removed at an early age, the secondary arthritis that develops will probably be less severe.
When FCP is suspected, a small surgical incision is made into the joint to expose the loose piece of cartilage and bone and allow the abnormal cartilage to be débrided or removed to hasten its healing. If the amount of arthritis is severe, some surgeons recommend cutting the ulna to allow a newer portion of the joint to bear additional weight. The addition of the osteotomy (bone cut) has yet to be proven to have a substantial clinical benefit. This procedure can be performed on both forelegs using conventional or arthroscopic surgery.
With OCD of the shoulder, elbow, stifle (knee) or hock (joint below the knee) joints, surgical exploration is also recommended. A characteristic large cartilage flap is present and should be removed to decrease the degree of secondary arthritis. Following either conventional or arthroscopic cartilage flap removal, the cartilage bed is débrided to stimulate healing.
With UAP, a large piece of the anconeal process is not fused properly. The standard treatment has been to remove the process surgically; however, because of continued joint instability, secondary degenerative arthritis occurs. There have been recent reports of attempting to re-attach the process with a screw or allowing the body to fuse the process back on the ulna by "taking pressure" off of the bone by an ulnar osteotomy. Although some patients have had successful results with these procedures, the overall results are not yet known.
Chondroprotective agents like glucosamine and chondroitin sulfate probably play a beneficial role in the healing of cartilage, and patients should be supplemented with these nutraceuticals. However, how long these should be given is not known.
Non-steroidal anti-inflammatory medications (NSAIDS) are helpful to ameliorate the clinical signs of secondary arthritis and may play a role in long-term management of these patients.
Your veterinarian will usually prescribe pain medication to ensure your pet's comfort, prior to definitive diagnosis and/or in the aftercare period from surgery. This can be done through the use of pills or narcotic pain patches (placed on the skin) that release a constant level of pain medication.
Prior to definitive therapy, you should limit your pet's activity to reduce pain and minimize the chance of a pathologic fracture occurring. Your pet should not run, jump or play during this time and should be watched carefully. Give assistence when he climbs stairs or gets in and out of the car.