The 'Other' Dysplasia in Large Breed Dogs - Elbow Dysplasia
Most owners of large breed dogs are aware of the perils of hip dysplasia. In contrast, when I mention elbow dysplasia as a possible cause of a pet’s lameness, I tend to be met with blank stares.
The term "dysplasia" simply refers to an abnormality of development. So in the case of both hip and elbow dysplasia, the underlying problem is abnormal development of the respective joints. These abnormalities occur early in a dog’s life (as the skeleton is maturing) although they may not result in obvious clinical signs until further joint damage in the form of osteoarthritis builds up.
Like hip dysplasia, elbow dysplasia most commonly affects large breed dogs, including Rottweilers, Labs, Golden Retrievers, German Shepherd Dogs, St. Bernards, Newfoundlands, and Bernese Mountain Dogs. Genetics and unnaturally rapid growth seem to play a role in determining which individuals develop the condition and which do not.
A diagnosis of elbow dysplasia can actually incorporate one or more distinct developmental abnormalities including:
- ununited anconeal process (UAP)
- fragmented coronoid process (FCP)
- ununited medial epicondyle (UME)
- osteochondritis dissicans (OCD)
- uneven growth of the three bones that meet at the elbow
Whatever the specific abnormality, the dysplastic elbow does not move as smoothly as it should. The wear and tear that results is the trigger for joint inflammation and eventually osteoarthritis.
Elbow dysplasia is the most common cause of chronic, front leg lameness in large breed dogs. Limping after exercise and/or stiffness after rest are the typical symptoms, but dogs that suffer from dysplasia in both of their elbows may more subtly shuffle their front legs rather than taking the long strides that increase their discomfort.
Most cases of elbow dysplasia can be diagnosed via a combination of history, orthopedic exam, and X-rays. Sedations and multiple views of the joint may be necessary to uncover the specific type of developmental abnormality that underlies the dysplasia. In some cases, advanced imaging (e.g., a CT scan) or surgical exploration of the joint may be necessary to reach a definitive diagnosis.
When elbow dysplasia is diagnosed in a young dog that is not yet suffering from much osteoarthritis, surgery to repair the joint is the treatment of choice. Unfortunately, many pets are not diagnosed until significant arthritis has developed, which reduces (but may not eliminate) the benefit of surgery. Medical treatment (e.g., nonsteroidal anti-inflammatories, nutritional supplements, physical therapy, weight loss, and acupuncture) keeps most pets with mild to moderate osteoarthritis comfortable, but in very severe cases, the new option of elbow replacement surgery can be considered.
Similar to the situation involving hip dysplasia, wise breeding decisions and appropriate nutrition reduces the incidence of elbow dysplasia in at-risk breeds. The Orthopedic Foundation of America (OFA) will evaluate and certify X-rays of a dog’s elbows once the animal has turned two years old. The better the parent’s elbows are the lower the risk of elbow dysplasia in their offspring. Maintaining a slower rate of growth and keeping young dogs slim is also helpful. Large breed puppies should eat an appropriate amount of a food with a reduced caloric density and carefully balanced calcium / phosphorus ratio.
Don’t worry. Even with these dietary modifications large breed puppies still get as big as they would otherwise. It just takes them a little longer to get there, and that’s not a bad trade-off for a lifetime of healthy elbows (and hips).
Dr. Jennifer Coates