Elbow dysplasia is a common and potentially debilitating orthopedic condition affecting dogs, characterized by the abnormal development of the elbow joint. While hip dysplasia often receives more attention, elbow dysplasia is the second most frequent cause of lameness in dogs’ elbows, often preceding or accompanying osteoarthritis. Although there is no cure, effective management strategies, including surgical interventions and medical treatments, can significantly improve a dog’s quality of life and long-term prognosis. This condition requires careful diagnosis and a tailored treatment plan to alleviate pain and maintain mobility.
Symptoms of Elbow Dysplasia
Dogs suffering from elbow dysplasia typically exhibit lameness that is exacerbated after periods of exercise and does not resolve with simple rest. A noticeable decrease in activity levels and an unwillingness to engage in play or exercise are common indicators. Owners may observe their dog adopting an altered gait, often turning the paws inward and holding the affected elbow away from the body to reduce pressure on the painful joint.
When only one elbow is affected, lameness may be more apparent. This can manifest as a distinct “head bob,” where the dog’s head rises higher when the affected limb lands, only to lower as the “good leg” touches the ground. If both elbows are equally affected, recognizing lameness can be more challenging, though a shortened stride and reduced range of motion in the elbow joints are often observed. Dogs might also repeatedly extend and flex the elbow, a behavior frequently associated with pain. In some cases, owners might notice swelling around the elbow joint, accompanied by abnormal warmth in the area.
According to Kei Hayashi, professor of small animal surgery at the Department of Clinical Sciences, “In my experience, almost all dogs with elbow dysplasia show both pain and lameness. Pain on palpation or on full extension/flexion is often noticed with careful examination.”
What is Elbow Dysplasia?
Dysplasia, in a general medical sense, refers to a developmental abnormality in the body’s tissues. In the context of a dog’s elbow, this means that the three crucial bones forming the joint—the humerus, ulna, and radius—do not develop correctly. For a dog to have pain-free movement, these bones must articulate precisely. When this alignment is disrupted due to developmental defects, it leads to pain, inflammation, and the progression of osteoarthritis.
Diagnosis of Elbow Dysplasia
A definitive diagnosis of elbow dysplasia cannot be made before a puppy reaches 4 to 6 months of age, as the growth plates within the joints are still developing and closing. Most diagnoses are confirmed when the dog is a few months older. A thorough lameness examination, often combined with radiographs (X-rays), is essential for diagnosing elbow dysplasia. Specialized flexed views of the elbows can reveal defective areas and identify early signs of arthritis. Advanced imaging techniques like CT scans and arthroscopic surgery are frequently employed to provide a more precise diagnosis and guide treatment decisions. In milder cases, symptoms might not become apparent until arthritis develops later in a dog’s life, around 7 to 8 years of age.
Treatment Options for Elbow Dysplasia
Early intervention is key for managing elbow dysplasia. Surgical procedures can often significantly reduce a dog’s pain. Hayashi strongly recommends a CT scan and arthroscopic surgery for all symptomatic dogs as soon as pain or lameness is detected.
For mild cases, surgery aims to remove damaged tissues, providing at least temporary pain relief. Dogs with moderate to severe deformities may require more extensive reconstructive surgery to realign the elbow joint. The American College of Veterinary Surgeons reports that approximately 85% of cases show some improvement in lameness and comfort after surgical treatment, despite potential radiographic progression of arthritis. The primary goal of treatment is to slow the development of arthritis and prolong the joint’s functionality.
Surgical elbow replacement is a complex and expensive option that has been performed, though the technology and extensive experience seen with hip replacements are not yet as established. Several elbow replacement systems exist, but they carry significant risks of complications. Ongoing research focuses on improving surgical techniques and implant designs to mitigate these risks. For dogs undergoing elbow replacement, maintaining an ideal weight and ensuring the health of other joints are critical, alongside rigorous post-operative rehabilitation.
Prevention Strategies
Preventing elbow dysplasia involves several key strategies, particularly for puppies at higher risk. Maintaining a lean body condition during growth is crucial; while essential nutrients should not be compromised, avoiding an overweight puppy is important. Veterinarians may recommend joint supplements from a young age, even for healthy puppies, and encourage moderate, controlled exercise.
Activities that involve repetitive jumping down from elevated surfaces, such as furniture or vehicles, can lead to various front limb problems. Similarly, frequent use of long flights of stairs can cause trauma. Many breeders advise against puppies navigating more than two or three stairs until they are at least six months old, as their developing joints are more susceptible to damage than those of adult dogs.
The most effective long-term strategy for reducing the incidence of elbow dysplasia lies in rigorous screening of breeding animals, with transparent public reporting of results. While unaffected parents can still produce offspring with elbow issues, the probability is significantly lower compared to breeding dogs with known elbow problems. A registry system to track and reduce the number of dysplastic puppies born is considered the most critical measure. While various commercial treatments are proposed, their scientific efficacy remains unproven.
Hayashi advocates for early detection of pain and lameness, followed by arthroscopic coronoidectomy and intensive non-surgical supportive care. He notes the complexity of canine elbow disease, stating, “Canine elbow disease is a developmental problem with significant dynamic components contributing to pain and disability. I believe it is arrogant to think we can fix it once the problem develops.”
Fragmented Medial Coronoid Process (FCP)
Fragmented medial coronoid process (FCP) is one of three specific bony defects falling under the elbow dysplasia umbrella, alongside osteochondrosis of the humeral condyle and ununited anconeal process. These conditions invariably lead to secondary arthritis. While some dogs are affected unilaterally, many experience problems in both elbows. FCP is the most prevalent among these defects. Selena Tinga, assistant professor of small animal surgery, explains that for mild FCP cases, surgery is an option but not always pushed due to uncertainty about outcomes and the potential for worsening the condition. She advises that if owners opt for surgery, it is best performed soon after diagnosis rather than delaying. For moderate to severe FCP cases, surgery is recommended more strongly, though a cure cannot be guaranteed, and surgery is only one part of lifelong management.
Non-Surgical Management
While surgery is generally the most effective option for addressing elbow dysplasia, non-surgical management strategies can provide comfort and support, especially when surgery is not feasible. These therapies aim to manage severe arthritis and improve the dog’s well-being:
- Weight Management: Achieving and maintaining a healthy weight can significantly reduce pain by lessening the load on the affected joint.
- Exercise: Moderate, consistent exercise helps maintain joint mobility and supports the natural cushioning mechanisms. It is crucial to incorporate proper warm-up and cool-down periods, such as a short walk before a more vigorous activity like playing fetch.
- Physical Therapy: Modalities like massage and hydrotherapy (e.g., underwater treadmills, swimming) can be beneficial, often used post-surgery but also helpful in non-surgical cases. Other therapies such as laser treatment, transcutaneous electrical nerve stimulation (TENS), ice therapy, and acupuncture may also be considered.
- Pain Medications: Veterinarians may prescribe non-steroidal anti-inflammatory drugs (NSAIDs), such as carprofen, to manage pain and inflammation.
- Joint Supplements: Ingredients like glucosamine, hyaluronic acid, and chondroitin can support cartilage health and joint fluid production. Consulting with a veterinarian is essential to select effective supplements, as product quality varies.
- Injectables: Adequan, an injectable medication, can help alleviate osteoarthritis and associated pain, though it does not correct the underlying dysplasia. Platelet-rich plasma (PRP) injections have also shown some success. Synovetin OA is a newer injectable therapy that uses electron therapy to target inflammatory cells within the joint.
- Braces: While elbow braces are available, they are generally more effective for dislocations, hygromas, or ligament tears rather than loose cartilage or bone fragments. If considering a brace, proper fitting by a veterinarian or a veterinary rehabilitation specialist is critical for effectiveness.
This article was reprinted with permission from the Cornell University College of Veterinary Medicine’s DogWatch newsletter.
