Elbow Dysplasia in Dogs
The conditions which fall under the term “elbow dysplasia” include the following:
Coronoid Disease
The coronoid process is a bony protuberance on the ulna which is situated in the centre of the elbow joint. Although it is a small area of bone, its location means a lot of weight is transferred through it during standing. In dogs with coronoid disease, part of this process doesn’t fully join to the body of the ulna during growth. It is held in place by cartilage, which coats the surface of the bone, however, over time it cracks, fragments, and can detach completely. This unstable piece of bone can cause great discomfort during walking and running, often described as similar to having a small pebble in your shoe. Coronoid disease is more common in Labradors and Rottweilers.
Osteochondrosis Dissecans (OCD)
Ununited anconeal process (UAP)
Joint incongruity
As elbow dysplasia is developmental, most dogs will first become lame at 6-12 months of age. All components of elbow dysplasia present similarly, and often cannot be distinguished on exam alone.
Over time, elbow dysplasia leads to development of arthritis, causing pain and lameness. Typically, dogs with arthritis demonstrate stiffness rather than overt limping, and this is often worse after rest. Dogs with arthritis due to elbow dysplasia often start showing symptoms from around 6 years of age.
Often, we have a high index of suspicion of elbow dysplasia due to the dog’s breed, age and history. The first step in diagnosis is radiography (x-rays) of both elbows. Sometimes this shows us the abnormality very clearly, however changes affecting the internal aspects of the elbow joint may not be visible on x-ray due to superimposition of the bones. UAP is the only component of elbow dysplasia that can be reliably diagnosed on x-ray, though OCD can often be seen.
If radiography is not diagnostic, the next step is a CT scan. CT creates a 3D image of the joint, so enables the inside of the joint to be visualised as clearly as the outside. CT is ideal to identify coronoid disease, confirm OCD, and diagnose incongruity. Occasionally, your vet may have a high enough index of suspicion for elbow dysplasia that they recommend a CT scan without radiographs first.
Examination of the joint, either arthroscopically (using a camera) or at surgery, may be required to assess the cartilage. This is most likely to be advised in cases of coronoid disease or OCD.
Due to the complex nature of elbow dysplasia, and the multiple conditions it can include, it is difficult to summarise treatment. For some components of elbow dysplasia there is debate between specialists about the most effective treatment, and there are many newer treatments being developed.
Some parts of elbow dysplasia are treated surgically, such as a UAP which can be screwed back in place, or an OCD lesion in which the cartilage flap can be removed. Treatment of coronoid disease is the area most under debate, and your vet will recommend what they feel is most appropriate for your dog as an individual. Since elbow dysplasia is so complex, and a developing field, referral to an orthopaedic specialist may be advised.
In general terms, dogs with elbow dysplasia should not be allowed to become overweight. Supplements can be used to help with joint health, and physiotherapy or hydrotherapy used to build muscle mass. Medication such as anti-inflammatories may be used for short periods or sometimes as a long-term management solution to alleviate joint pain.
