In elbow dysplasia, the elbow joint does not develop normally and this leads to pain and lameness in the front legs. The condition can result in arthritis or fractures within the elbow. The signs of elbow dysplasia are often noticed at a young age, and the prognosis will be better if your dog is diagnosed and treated early.
What happens in elbow dysplasia?
The dog's elbow is a complicated joint as there are three bones involved - the humerus above the joint and the radius and ulna below. These bones fit together and move in relation to each other.
In elbow dysplasia, the three bones do not fit together as snugly as they should, because the elbow develops abnormally. This means that the force does not go through the joint as it normally would, resulting in areas of stress within the elbow. Eventually, arthritis or fractures can develop.
There are several different developmental conditions that all come under the umbrella term 'elbow dysplasia':
- Fragmented medial coronoid process (FCP) - where a small part of the ulna in the elbow joint breaks off
- Osteochondritis dissecans (OCD) - where some of the cartilage on the bottom of the humerus lifts off and causes problems in the joint
- Elbow incongruity - where the bones are not the right shape to fit together well, so the cartilage gets eroded
- Ununited anconeal process (UAP) - where a part of the ulna does not connect to the rest of the bone.
What is a fragmented medial coronoid process?
The coronoid process is a part of the ulna that is involved in the elbow joint. If the elbow does not develop normally, this can result in excess force through the coronoid process and tiny fractures can develop. Eventually, a part of the bone can break off, causing pain and inflammation.
Animation on FCP:
What is an ununited anconeal process?
The anconeal process is towards the top of the ulna. This part of the bone develops separately but normally fuses to the rest of the ulna when the dog is about 4 months old. If the elbow does not develop properly, the anconeal process may not fuse properly.
Animation showing an ununited anconeal process:
An ununited anconeal process can often be diagnosed by an X-ray of the elbow.
Radiographs of an affected dog with UAP:
What are the signs of elbow dysplasia?
As elbow dysplasia is a developmental condition, dogs typically develop signs at a relatively young age, about 6-12 months old. However, if the disease is less severe, the signs may be only noticed in adulthood when dogs have developed arthritis secondary to the condition. Large and giant breeds are generally more likely to develop elbow dysplasia, and predisposed breeds include Bernese Mountain Dogs, Labrador Retrievers, Golden Retrievers and German Shepherd Dogs.
The most obvious sign of elbow dysplasia is forelimb lameness. Dogs may 'nod' as they walk, lifting their head when the sore leg touches the ground. If both legs are sore, the nod may be less obvious but the gait will not look normal. Often, the signs are most obvious when dogs get up after resting. They may also have difficulty going down stairs, as this places a lot of load on the front legs.
It is worth taking your dog to the vet as soon as you see symptoms, as the prognosis is better if the disease is diagnosed and treated early.
How will my vet diagnose elbow dysplasia?
Your vet will discuss your dog's signs and examine their joints. They may find that the elbow joint appears swollen and its range of motion is restricted. Your dog may also show signs of pain when the elbow is manipulated.
If your vet suspects problems with your dog's elbows, they may advise further investigation. Typically, the first step is X-rays. An ununited anconeal process is often easily diagnosed on X-rays, but the other elements of elbow dysplasia may require further tests to identify, such as CT scans or arthroscopy (using a tiny camera to see inside the joint).
It is worth noting that there are many other causes of lameness in dogs, and your vet may not advise performing advanced imaging straight away, depending on how suspicious they are of elbow dysplasia versus other problems.
How is elbow dysplasia treated?
The best treatment depends on which elements of elbow dysplasia your dog has and how severe they are. If the signs are mild, your vet may recommend managing the condition conservatively with rest/controlled exercise, weight control, medication or supplements and sometimes hydrotherapy.
In some cases, your vet will advise that surgery is the best option for your dog. There are several surgical treatments available and the right choice depends on which specific joint problems your dog has. Sometimes, small fragments of bone can be removed via arthroscopy, which is keyhole surgery so it is not too invasive. However, some dogs may need bigger surgical procedures. Following surgery, it is important to follow your vet's advice regarding aftercare.
What is the OFA elbow certification scheme?
Elbow dysplasia can be inherited, so it is advised not to breed from dogs who have the condition. To help inform breeding decisions, the Orthopedic Foundation for Animals (OFA) runs a certification scheme. Elbows can be certified through this scheme once dogs are 2 years old, but preliminary evaluations can be performed for younger dogs to inform the breeder.
In this scheme, your vet will take particular X-ray views of your dog's elbows. The positioning for these views must be very precise, so they will be taken under sedation or general anesthesia. The X-rays are then submitted to specialists for evaluation. If there are signs of elbow dysplasia, this is graded from 1 to 3, where 1 indicates mild bony changes and 3 indicates well-developed degenerative joint disease.
It is best to choose dogs without X-ray signs of elbow dysplasia for breeding, and it is advised not to breed from dogs with a score of 2 or 3. However, it is still possible for a puppy to have elbow dysplasia even if both parents have low elbow scores. Knowing whether the parents have previously produced puppies with good elbow scores, and knowing the scores of other dogs in the family, can help inform breeding decisions.
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