Treating Elbow Dysplasia

Surgically, to remove joint fragments, the best treatment option would be arthroscopic surgery however, this is not easily available except at some veterinary teaching colleges and private practice surgical referral hospitals. Arthrotomy, where an actual incision is made into the joint, is the most common surgery performed however it is more invasive. Studies comparing surgical arthrotomy treatment with non-surgical treatment have repeatedly shown that the incidence of lameness is the same in both groups. Some studies have shown that the severity of lameness is reduced in surgically treated dogs, but radiographic progression of osteoarthritis occurs irrespective of the treatment given. Studies have shown a much more favorable outcome with the use of arthroscopic surgery with a more rapid return to normal joint function.

Medical management would be used for treatment of osteoathritis. The use of pain relievers/anti-inflammatory agents such as Aspirin, EtoGesic or Rimadyl can be used during bouts of lameness especially an hour or so before known periods of exercise. Various nutraceuticals now on the market would be another option such as Cosequin, SynoviCre, Glycoflex, Arthramine, and MaxFlex Pet. The use of these drugs should be tailored for the individual dog's improvement. If side-effects occur or there is persistence of obvious lameness, change the therapy to a different drug from the above choices. You may notice obvious improvements this way. With oral nutraceuticals, the dog may have to have taken the medication for an extended period of time before benefits are noted. It may take 4 weeks or more. It would be important to keep your dog as lean as possible to reduce concussive mechanical forces across the diseased joints. Also, to maintain the range of joint motion, strengthen surrounding muscles to improve joint stability and improve the health of the joint fluid, non-weight bearing forms of exercise such as swimming or low weight bearing exercise with leash walking should be done on a regular basis.

The outcome or prognosis of elbow dysplasia depends on the degree of severity of the underlying disease etiology and the degree of severity of secondary degenerative joint disease (osteoarthritis). Dogs with severe degenerative joint disease are more likely to have occasional bouts of lameness even after surgery. Overall, the outcome for full return to joint mechanical function for fragmented medial coronoid disease of the ulna is guarded unless arthroscopic surgery is performed. With regular surgery where the joint is opened with an incision: a number of reports show that only 35-50% of dogs return to full soundness. In another report, 84% of 158 surgically treated cases were sound 12 months after surgery. In this study, the more favorable report was partly due to early diagnosis and treatment.

If your dog's quality of life and comfort can not be maintained with medical management or from the previous surgeries stated above, the final treatment option would be elbow arthrodesis. This is where the joint is fused surgically to do away with the pain. Hopefully, in the near future, elbow replacements in dogs using an elbow prosthesis will be performed to treat arthritis just like what is currently being done in the hip.

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