Elbow dysplasia, which is now more properly termed developmental elbow disease, is one of the most common causes of forelimb lameness in young, large and giant breed dogs. By definition 'elbow dysplasia' basically means abnormal development of the elbow joint.
There are 4 types of elbow dysplasia that affect dogs:
Fragmented medial coronoid process (FCP)
Osteochondritis dissecans (OCD)
Ununited anconeal process (UAP)
Medial compartment disease
The elbow joint itself consists of 3 main bones, humerus, radius and the ulna. If these bones do not fit together, there will be high contact pressure which in turn leads to complications listed above.
Elbow dysplasia is a multifactorial condition, which means that a wide variety of different factors impact the occurrence of the disease. The most influencing factor being the genetic make-up of the dog, hence why it is widely considered to be primarily a genetic developmental disease. Several large scientific studies have confirmed 78 different breeds of dogs are predisposed to elbow dysplasia. The most common breeds being that of medium and large sized dogs such as Labrador Retrievers, Golden Retrievers, Rottweilers, German Shepherds and Newfoundlands, to name a few. Scientific research also states that males are two times as likely to be effected compared to females. Nevertheless, elbow dysplasia has also been reported in smaller chondrodystrophic breeds such as the French bulldog and dachshunds. Other causes that influence the severity of elbow dysplasia include rapidity of growth caused by over nutrition with calcium, vitamin D and high calorie intake.
Clinical signs are typically seen from 4 -10 months of age, with a diagnosis being made within the first 18 months of the pups life.
Signs and Symptoms:
Regardless of which type of elbow dysplasia is present, the signs and symptoms of the condition are the same.
Limping in one or both forelimbs
Stiffness on rising
Reluctance to exercise
Feet on the forelimb often point outwards
Compensating on a ‘good’ limb
Behavioural changes
Muscle wastage in the shoulder
Lameness if often triggered by exercise. The dog will seem sound while running around and walking; however, afterwards they will limp freely.
Diagnosis:
In most cases, orthopaedic examination will show pain and swelling to the joint with a degree of restriction in the joints normal range of movement. This is due to joint thickening as a result of arthritis. Radiographs (X-rays) are usually taken to establish what changes have already occurred within the joint however, in some cases a CT Scan and/or arthroscopy (camera in the joint) are required in order to confirm a diagnosis.
Treatment:
The treatment options can vary depending on the radiograph diagnosis. In severe cases, your veterinary surgeon may recommend a surgical solution. However, for many dogs, the combination of a good, balanced diet, regular physiotherapy treatments, a low impact exercise program, anti-inflammatory drugs as well as joint supplements will aid the management of the condition.
It is important to note that usually, degenerative joint disease (arthritis) will occur as the animal ages regardless of the treatment option selected. It will be important to treat these arthritic changes in order to keep the dog as comfortable and pain free as possible.
The role of physiotherapy in elbow dysplasia:
Dogs that have been diagnosed with this condition will benefit from physiotherapy.
Whether they are managed surgically or medically, a bespoke treatment plan will be designed to ensure that the dog continues to lead a full and comfortable life.
Massage and passive range of movement (PROM) exercises can help to increase your dog’s mobility. These exercises will help to build and restore lost muscle tone as well as assist with pain management.
Hydrotherapy also plays an important role in the rehabilitation process and complements physiotherapy well. The buoyancy of the water allows them to exercise without overloading and stressing their joints. It will also help to increase and strengthen areas of muscle loss, which will help to support the joints.
It is essential to diagnose and treat elbow dysplasia as early as possible, this is key in maintaining the dogs wellbeing. Elbow dysplasia is a degenerative disease of the joints that will only deteriorate the longer it is left.
Home-based Programmes:
A specific home care exercise programme and walking advice will be given to you by your chartered physiotherapist and it will be uniquely designed to suit your dog’s needs. Your physiotherapist will also be able to offer advice on daily living activities such as how best to assist your dog in and out of a car, avoidance of slippery floors, and avoidance of high impact activity such as jumping up or down from furniture, running up and down stairs.
The following table outlines an example elbow dysplasia rehabilitation plan:*
*Please note that rehabilitation plans should only be followed under the guidance of a qualified rehabilitation professional, who will be able to provide a tailored plan based on the individual patient’s rehabilitation needs.
For further information regarding this condition, please contact your veterinary surgeon or The Vet Physio Centre for details.