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Elbow Dysplasia

Dog elbowAnimal physiotherapy can dramatically improve the quality of life and mobility in dogs with elbow dysplasia. Elbow Dysplasia is the most frequent cause of front leg lameness in the dog. Elbow dysplasia is the term used to describe a variety of conditions which may occur alone or in combination within the elbow. These are for the most part caused by incongruity or poor alignment of the joint surfaces within the elbow. Incongruity of the elbow may present as either an abnormal shape of the ulnar trochlear notch or a step between the radius and ulna, caused by either a short radius or a short ulna. This abnormality can cause increased local pressure within the joint, resulting in loose fragments at different locations: ununited anconeal process (UAP), fragmented medial coronoid process (FMCP), osteochondritis dissecans of the medial humeral condyle (OCD). If left untreated, these conditions result in degenerative joint disease in the elbow due to excessive wear and tear of the joint. Most primary lesions will occur in the young growing dog, particularly in large breeds, and are often present in both elbows.

Elbow dysplasia is a multi-factorial disease, which means that there are several factors which can influence the occurrence of the condition. The genetic make-up of the dog is the most important factor. Rate of growth, nutrition and exercise level all influence the chance of developing elbow dysplasia and the severity of the disease.

Elbow dysplasia is most common in Golden Retrievers, Labrador Retrievers, Rottweilers and Bernese Mountain dogs, but can affect most any large breed of dog including mixed breeds. Puppies may present for thoracic limb lameness, stiffness, exercise intolerance, or non-specific mobility problems as early as 4 months of age. Diagnosis of elbow dysplasia is often made after a prolonged period of fore limb lameness that is not responsive to anti-inflammatory drugs. Unfortunately, by this time, degenerative joint disease has already been established and surgical treatment will not prevent its progression entirely. Initial signs of joint pain in puppies are often not recognised because of the hyperactive nature of the young dog. Elbow dysplasia is often a bilateral disease making clinical signs of lameness less obvious than if the condition is unilateral. The first radiographic signs of elbow dysplasia may often be missed which delays the diagnosis. Radiographs and / or CT scan will be required to diagnose elbow dysplasia, determine which structures are affected and plan for surgical treatment When a definitive diagnosis of elbow dysplasia is finally made, the veterinary surgeon can improve elbow function with surgery but cannot entirely prevent the progression of degenerative joint disease.

Clinical examination may reveal pain on elbow extension and or flexion. As the disease progresses the joint range of motion will be limited. Muscle atrophy is typically present in the triceps and periscapular muscles.

The focus of management will depend on the age of the dog and severity of symptoms when the diagnosis of elbow dysplasia is made. Management may be medical, or surgical or both. All dogs with a diagnosis of elbow dysplasia benefit from physiotherapy to make their life more comfortable and improve mobility.

 

Physiotherapy and Rehabilitation Therapy for Elbow Dysplasia

All dogs with a diagnosis of elbow dysplasia, whether managed medically or surgically, benefit from physiotherapy to make their life more comfortable and improve mobility. At Dogs In Motion, we will work with the veterinary surgeon to provide your pet with a tailored rehabilitation program, specific to your pet’s needs and time since diagnosis or surgery.

Treatment ideally would start 5 -7 days after surgery, or on diagnosis if being managed conservatively. Treatment may include manual therapy techniques such as massage and joint mobilisation, modalities such as heat and ice, dry needling for pain relief, or a supportive brace to limit motion and pain. Advice on appropriate bedding will be provided to ensure your pet is well supported.

Hydrotherapy plays an important role in the rehabilitation program for dogs with elbow dysplasia. Underwater treadmill is ideal for patients with elbow dysplasia. The buoyancy of the water means strengthening can occur with less joint loading and pain. This is ideally performed 2-3 times per week for acceleration of muscle growth. Strengthening of the surrounding muscles will help support the elbows and reduce pain.

A customised home exercise program will be provided at your pet’s initial evaluation, so you can continue therapy at home on a daily basis. This will also include an outline of exercise restrictions specific to your pet’s stage of healing or disease and your home environment.

Regular reviews with your pet’s physiotherapist are important to ensure your pet is progressing correctly. At these appointments, your pet will be reassessed and their home exercise program will be progressed as they improve. Advice will also be provided for return to appropriate leash and off leash exercise.

Overall, the prognosis in most cases of elbow dysplasia is good, if diagnosed and treated early. As degenerative joint disease progresses, the prognosis for your pet to return to a pain and lameness free gait diminishes. Longterm exercise restriction and lifestyle modification will be required to keep pain and lameness to a minimum. You animal physiotherapist can devise a lifelong exercise program, specific to your pet’s needs.