This disease is commonly observed in young large breeds such as Great Dane, Rottweiler, Labrador Retriever, German Shepherd and Burnese Mountain Dog and is associated with a number of underlying etiologies:
- Elbow conformational incongruity
- Osteochondritis dissecans
- Ununited anconeal process
- Fragmented coronoid process
- Primary flexor enthesopathy
This condition can occur unilaterally or bilaterally and usually becomes apparent at a young age (often by 6 months). The condition is aggravated by obesity and heavy exercise.
Affected dogs usually present with an intermittent but progresssivly worsening lameness of the foreleg, variable top-stepping and shifting lameness if both elbows are affected. There is reluctance to walk, reduced exercise activity and reluctance to have the elbow extended through full motion.
Diagnosis is based on clinical signs of elbow lameness and arthroscopic, radiographic or CT scoring of medial coronoid disease, medial humeral condyle changes, osteoarthritis and radioulnar incongruence.
A fragmented coronoid process (usually genetic in large-breed dogs), blurring of the medial coronoid process cranial edge, ulnar trochlear notch sclerosis, a radioulnar step and the widening of the humeroulnar and humeroradial joint space are indicative of elbow dysplasia.
Surgical repair is usually indicated for ununited anconeal process or fractured coronoid process.
Non-surgical intervention usually requires long term palliative treatment with NSAID-based medication such as carprofen, fentanyl, tramadol, meloxicam, gabapentin or in severe cases, prednisolone.
Use of exercise has significant benefits in long-term therapy associated with osteoarthritis, and leash-held walking is recommended in dogs that are not unduly ataxic or in pain.
Adjunct medication such as pentosan polysulfate, glucosamine, veterinary therapeutic diets rich in omega-3 fatty acids, curcumin and root extracts of Brachystemma calycinum (an indigenous plant of southwestern China) have predictable improvements in clinical amelioration of symptoms.
Managing chronic pain is the critical aspect of this relatively incurable disease, affording as good quality of life as possible based on economic feasibility and response to medical and physical therapy.
Screening has resulted in a gradual reduction in clinical severe cases by routine screening of potential sires.
- Vet Surgery Central
- Phillipe Duponant
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