Frequently people with large-breed dogs are justifiably concerned about hip dysplasia, but an equally common orthopedic condition affecting the front leg is elbow dysplasia. The term broadly covers multiple conditions that affect one or both elbows of younger, growing dogs.
Limping on a front leg sometimes will appear when the dog is a puppy and over time significant arthritis develops. Many times it is difficult to determine which leg is affected. Dogs limping on front legs may bob their heads up and down when walking. Since dogs carry about 60 percent of their weight on the front legs, pain in the front legs disproportionately affects a dog’s quality of life.
The elbow is a joint that requires the perfect fit of three bones — the radius, ulna, and humerus. The bones need to grow in a synchronous fashion as the dog matures in order to avoid trouble. If the bones are uneven, a defect will develop that puts excessive pressure on parts of the joint. Over time a small ledge inside the elbow takes a beating, leading to fragmentation of the bone.
The condition, called fragmented medial coronoid processes, leads to pain and deterioration of the cartilage inside the joint. To make matters worse, occasionally a bone inside the joint called the anconeal process will fail to fuse, resulting in one too many moving parts inside the elbow.
A diagnosis is made when your veterinarian examines the front legs. Sometimes the legs are painful when the elbows are flexed, but typically X-rays are needed. Early in the process the signs can be very subtle and frequently X-rays need to be repeated to detect progression of changes in the elbows. Advanced imaging like a CT scan can be a sensitive method of diagnosing difficult cases.
A variety of treatment options exist for elbow dysplasia. The best option is early detection and diagnosis of the primary problem. It may seem counterintuitive, but the best option is surgery for dogs that are younger and mildly to moderately affected by the disease. Arthroscopic surgery, where a small fiberoptic scope is inserted into the joint to clean up small bone fragments and damaged cartilage, has the best long-term outcome and is the least invasive.
Early diagnosis can also uncover abnormal bone growth that may be treatable and help avoid significant pain and arthritis down the road.
For older dogs, weight control, regular exercise, and treating the arthritis will manage the symptoms but not slow the progression of the disease. Elbow replacements have been developed but have had limited success and are not widely recommended at this time. If your dog is affected by elbow dysplasia, your veterinarian can help with a number of treatment options to keep him active and comfortable.
Questions for Dr. Gary Thompson can be emailed to firstname.lastname@example.org or mailed to The Blade, Attn. Ask the Vet, 541 N. Superior St., Toledo, OH 43660. Dr. Thompson regrets that he cannot answer individual letters.