Elbow Dysplasia in Dogs: Is Surgery a Must?

Elbow dysplasia is caused by faulty coding in the genes controlling the bone growth of the elbow. Surgery is not always necessary.

To find out which leg hurts, watch the dog's head as it bobs up and down while walking. By:
To find out which leg hurts, watch the dog’s head as it bobs up and down while walking. By: Anthony van Dyck

On my journey to work, I pass a young chocolate Labrador who limps on her left front leg. Because she is a Lab, statistically the odds are that she has elbow dysplasia. This condition is the most common cause of lameness in young, large or giant breeds of dog.

The word “dysplasia” means an abnormality of growth. With respect to the elbow, this means the bones don’t fit together correctly.

The elbow joint is made up of 3 bones:

  • Humerus (upper arm)
  • Radius
  • Ulna (the forearm)

They all slot together in a 3-D puzzle. However, if one of the bones is a bit short, or the shape is wrong, the result is abnormal strain on the elbow, which causes pain and therefore lameness.

Symptoms

As with my chocolate Labrador, the typical sign is a young dog with foreleg lameness.

To discover which leg or legs hurt, watch the dog’s head as it bobs up and down. The head goes “down on the sound” leg, or rather, it jerks up when the sore leg takes her weight.

However, not all dogs with elbow dysplasia are lame all the time, in which case they tend to be most stiff after rest and can run the lameness off.

Causes

Elbow dysplasia is caused by faulty coding in the genes controlling the bone growth of the elbow. Because there are more than 100 gene codes for this, there is plenty of scope for error — some breeds have more than their fair share.

This means elbow dysplasia is a complex condition.

The most common development problems include:

  • Osteochondritis dissecans (OCD): The joint’s cartilage lining flakes away and causes pain.
  • Fragmented coronoid process (FCP): A tiny spur of bone breaks loose and moves when tendons pull on it.
  • Un-united anconeal process (UAP): A piece of bone designed to stabilize the elbow doesn’t fuse properly and moves as the joint flexes and extends.

Gene coding errors can mean bones grow at different rates; this places greater stress on certain pressure points, which can lead to micro-fractures. The latest thinking is that some of the cartilage problems associated with elbow dysplasia are actually the result of micro-fractures in the underlying bone.

Diagnosis

How the dog reacts when his elbow is moved in certain directions can be suggestive of elbow dysplasia.

Radiographs help confirm the diagnosis, but they can miss subtler changes. Modern techniques, such as CT scans, pick up much more detail including tiny stress fractures and minor displacements.

Another useful tool is arthroscopy, where a tiny camera is inserted into a keyhole incision to get a panoramic view of the joint surfaces.

Treatment

Is surgery a must for elbow dysplasia? No, not always. Mild cases can be managed with physiotherapy, weight control and use of painkillers (commonly non-steroidal analgesics).

However, if the underlying anatomical defect is not fixed, the dog is more likely to develop arthritis later.

If the dog is severely lame, then referral to an orthopedic specialist is advisable. In the hands of a skilled surgeon, corrective surgery carries every chance of success.

In the video below, a pet parent chronicled the progress both before and after surgery for elbow dysplasia in her Rottweiler, Gary:

Prevention

Elbow dysplasia is a genetic condition. The best prevention is to breed from dogs free from elbow dysplasia to reduce the risk of affected offspring.

Unfortunately, this idea is not as simple as it sounds — some dogs have great elbows on an X-ray, but can carry faulty genes that show up in their puppies. Responsible breeding will go a long way to reduce the incidence of elbow dysplasia.

If you have a large or giant breed puppy, keep your pet lean in his first year of life. This helps reduce the load on his bones at a time when he is still growing and developing. Once the bones have matured, they are hardier and less vulnerable to damage from ordinary wear and tear.

Reference

  • A Guide to Canine and Feline Orthopedics. Denny & Butterworth. Publisher: Wiley-Blackwell. 4th edition.

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This pet health content was written by a veterinarian.

Dr. Pippa Elliott, BVMS, MRCVS

View posts by Dr. Pippa Elliott, BVMS, MRCVS
Dr. Pippa Elliott, BVMS, MRCVS, is a veterinarian with nearly 30 years of experience in companion animal practice. Dr. Elliott earned her Bachelor of Veterinary Medicine and Surgery from the University of Glasgow. She was also designated a Member of the Royal College of Veterinary Surgeons. Married with 2 grown-up kids, Dr. Elliott has a naughty puggle called Poggle, 3 cats and a bearded dragon.

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