Elbow dysplasia is a generic term used to describe several developmental problems that can occur in the elbows of dogs. It is most often seen in larger breeds of dogs, in particular Retrievers and German Shepherds. There are three common conditions that fall under this umbrella term:
- Fragmented medial coronoid process (FMCP)
- Ununited anconeal process (UAP)
- Osteochondritis dissecans (OCD)
Is Elbow Dysplasia Inherited?
There is a strong genetic component to this condition. Other factors that may be involved in the development of elbow dysplasia include nutrition, hormonal influences, and trauma.
Fragmented medial coronoid process
This is by far the most common of these conditions and refers to a developmental defect of the medial coronoid process, a small triangular piece of bone which is part of the ulna within the elbow joint. (Medial means the inside of the joint, as opposed to lateral). In this condition, the coronoid process does not attach properly to the rest of the ulna. This separation causes inflammation, pain and ultimately degenerative joint disease (arthritis).
What are the signs of a FMCP?
In dogs affected by this condition, lameness typically develops in the front legs of young dogs, often between 5 and 11 months of age. The lameness is often fairly mild and is exacerbated by exercise. It is relatively common for the condition to develop in both elbows which can make the lameness more difficult to pick up.
How is FMCP diagnosed?
The clinical signs and breed can be suggestive. X-Ray images will typically be taken under sedation. A definitive diagnosis is sometimes only possible with a CT examination (computed tomography).
What is the recommended treatment for FMCP?
Surgery is the treatment of choice for this condition and the aim is to remove any abnormal or loose cartilage or bone. This procedure is most commonly done arthroscopically because that is a minimally invasive surgery and also allows the surgeon to examine the whole joint. An osteotomy of the ulna may also be advised - this is where the ulna is cut below the elbow to allow the ulna to move into a position that minimises pressure on the medial side of the elbow joint.
Prognosis
If the joint is not treated, degenerative changes (arthritis) tend to develop rapidly. If left too long, these secondary changes become a cause of chronic pain in the joint and make successful surgical intervention less likely. Surgical treatment of FMCP should be performed soon after diagnosis to minimise the development of degenerative joint disease.
In all cases, some degree of arthritis will develop in the elbow joint, but with surgical treatment, the arthritis will usually be less severe. Medical treatment such as joint protective supplements and/or anti-inflammatory medications will usually be recommended with or without surgery. Weight management is probably the most important non -surgical treatment.
Rehabilitation is an important part of the post-operative care of the dog with FMCP. In the immediate post-operative period, strict rest is required and anti-inflammatory and pain medication will be prescribed. Thereafter a gradual increase in exercise levels is encouraged. Both home and professional physiotherapy can be a very useful part of post-operative recovery.
None of the treatments are curative - the aim of treatment and rehabilitation is to minimise the degree of arthritis that develops, and to maintain a good quality of life for your dog.