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Elbow dysplasia is a term used to describe a general incongruency of the elbow joint. The elbow itself is a complex joint composed three major bones, the humerus, radius, and ulna, joining together. Elbow dysplasia is seen most often in young, fast growing, large and giant dog breeds. It will normally affect both elbows with one being slightly worse than the other, though unilateral cases are also seen. Elbow dysplasia consists of 4 conditions: joint incongruity, ununited anconeal process, fragmented coronoid process, and osteochondrosis. One or more of these conditions may be present in cases of elbow dysplasia.
In joint incongruity the elbow joint does not fit together properly. This is normally due to the bones not growing at the same rate causing the conformation of the elbow to be incorrect. This increases the wear and tear of the joint and will most likely lead to general arthritis.
Ununited Anconeal Process (UAP)
The anconeal process is a hook like projection which connects the humerus and the ulna. In normal development the process is fused with the ulna between 20-24 weeks. In UAP the anconeal process does not fuse with the ulna. It is held mostly in place by ligaments but does not provide the amount of stabilization as it should. This makes the joint very unstable and can cause pain.
Fragmented Coronoid Process (FCP)
In a fragmented coronoid process, this area of the ulna degrades or breaks off. The coronoid process of the ulna helps hold the humerus in place as well as helping distribute the dog?s weight through the joint. The fragmented process causes pain and can lead to other problems in the joint.
In osteochondrosis the bones and cartilage in the elbow joint do not form correctly. Instead of being a thin layer of cushion, the cartilage is abnormally thick. This creates problems because the synovial fluid, which provides the cartilage with its nutrients, cannot reach the entire cartilage. It results in cartilage being broken down. In many cases parts of the cartilage will separate from the underlying bone. This can either happen as a flap of cartilage or it can come completely loose and be floating in the joint. This causes pain and swelling of the joint.
Elbow dysplasia is normally seen in young, fast growing, large and giant breeds; there are some breeds however, which seem to have a higher risk of elbow dysplasia than others. These breeds include the German Shepherd, Labrador Retriever, and Golden Retriever. If any young, large dog shows signs of front leg pain, elbow dysplasia should be considered when determining the cause.
The exact cause of elbow dysplasia is not known. Evidence points to genetic means as many cases have been seen in family lines. In some instances trauma and nutrition have been factors contributing to the dysplasia as well.
The main sign of elbow dysplasia is lameness in one or both front legs. In some cases the lameness may be very mild with the dog only having a slight limp while other cases the lameness may be very severe where the dog will not put any weight on the leg at all. The lameness may be intermittent and come and go over a period of time. Lameness has been noted as early as 4 months in some cases. Eventually arthritis will form in the joint.
Radiographs are the most common tool used to diagnose elbow dysplasia. It is very conclusive for diagnosing ununited anconeal process. In addition to x-rays, diagnostic arthroscopy is commonly used when fragmented coronoid process or osteochondrosis is suspected as the cause of lameness. Diagnostic arthroscopy is helpful because it provides a clear picture of the joint, is minimally invasive, and, if needed, treatment can be administered at this time also.
Elbow dysplasia can be treated either surgically or medically. Medical treatment consists of low impact exercise (swimming), special diets to keep weight controlled, and non-steroidal anti-inflammatory drugs to manage pain. Medical management is usually used in mild cases of OCD and FCP. If symptoms are severe surgery may be considered. In cases of OCD and FCP arthroscopic surgery is performed to clean out the damaged cartilage or bone fragments which are causing the dog pain. Surgery is also performed when an UAP is present. The anconeal process may be removed or pins and screws used to join the bones and stabilize the joint. Care for Dogs with Elbow Dysplasia Caring for dogs with elbow dysplasia consists of keeping them comfortable and following the instructions given to you by your veterinarian. Weight management is very important as keeping your dog at a healthy weight reduces the amount of stress put on the elbow joint. Care should be taken when exercising your dog with elbow dysplasia to make sure that the exercise is low impact to again reduce stress on the elbow joint. Following surgery your dog?s activity should be restricted. For the best success in dealing with elbow dysplasia it is important to follow your veterinarian's instructions.
The AKC Canine Health Foundation has been involved in funding research which aims at developing better diagnostic tools for identifying elbow dysplasia. With early diagnosis it may be possible to reduce the risk of arthritis developing in the elbow joint. With your continued support CHF will be able to fund more studies focused on elbow dysplasia.
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