Elbow dysplasia

Elbow dysplasia is an inherited disorder that commonly occurs in large-breed dogs less than 1 year of age.

Overview

Elbow dysplasia (ED) is a term that describes the poor development of the elbow joint. Elbow dysplasia is an inherited disorder that commonly occurs in large and giant breed dogs. Problems are usually seen in dogs less than 1 year of age, predominantly between 4-10 months of age.

ED can be separated into different diseases:

1. Ununited anconeal process (UAP)
2. Fragmented coronoid process (FCP)
3. Osteochondritis dissecans (OCD) of the medial humeral condyle
4. Incongruities of the elbow joint (INC)

Dog breeds commonly affected by elbow dysplasia:

• Golden Retriever
• German Shepherd
• Bernese Mountain Dog
• Rottweiler
• Labrador Retriever

Breakdown of breeds at risk of ED disease:

Ununited anconeal process (UAP)	German Shepard dogs, Bloodhounds, Bassets, St Bernards and Great Danes
Fragmented coronoid process (FCP)	Labradors, Bernese Mountain Dogs, Rottweilers, German Shepard
Osteochondritis dissecans (OCD) of the medial humeral condyle	Retrievers and New Foundlanders
Incongruities of the elbow joint (INC)	Bernese Mountain Dogs and chondrodystrophic breeds

The problem usually occurs in both elbows in 30-70% of cases and causes pain and lameness.

Signs

Common signs of elbow dysplasia:

• Lameness
• Abnormal gait between ages 6-9 months
• Elbows out or tucked in
• Feet pointed out
• Stiffness
• Exercise intolerance

Causes

Predispositions to elbow dysplasia:

• Genetics
• Trauma
• Rapid growth
• Defects in cartilage growth
• Hormone imbalance
• Excessive nutrition

Diagnosis

Diagnosis is based on physical examination and x-rays with a potential referral for CT scans, MRI, or arthroscopy.

Management

Depending on the findings which are based on a series of specific x-rays, treatment usually results in surgery with the goal to relieve pain, maintain limb function, and reduce arthritis.

Ununited anconeal process (UAP)	Surgery to remove or re-attach the UAP
Fragmented coronoid process (FCP) Osteochondritis dissecans (OCD) of the medial humeral condyle	Surgical removal of any cartilage flaps and fractured bone and debris.
Incongruities of the elbow joint (INC)	Surgical removal of the fragmented coronoid process and the insertion of an external fixator.

Following surgery, home care may consist of:

• Strict rest following surgery
• Pain management
• Weight control to reduce added stress on the joints
• Long-term management to help reduce arthritis

Always follow strict instructions from your veterinarian. Exercise restrictions and confinement varies from 2-6 weeks post-surgery.

Prognosis

The success rate in surgical cases at a young age is as high as 78% and only 33% in dogs conservatively treated for FCP e.g. low body weight, controlled activity.

Prevention

Tips to help prevent elbow dysplasia:

• Always ask for a full medical history from the breed line before purchase
• Never breed a dog with elbow dysplasia

References

Busato A, Lang J, (1997, IEWG Birmingham (UK), p 11.

Matis U (1992), Proceedings 6th annual congress ESVOT, Roma (Italy), pp 16.

Read RA et al (1997), IEWG pp 7-8.

Roy RG , (1979),A retrospective long-term evaluation of ununited anconeal process excision on the canine elbow. Vet.Comp.Orthop.Traumat. 7:94-97

Sjöström L et al (1995) Vet.Comp. Orthop. Traumat. 8:170-176.

Swenson L, et al(1997 JAVMA 210, 215-221

Voorhout G, Hazewinkel HAW, (1987), Vet. Radiol. 5, 158-165.

Piermattei D, Greely RG, (1979), An atlas of surgical approaches to the bones of the dog and cat. Philadelphia, USA, WB Saunders Comp.