Posted in Veterinarian Information

Elbow dysplasia is a common orthopedic condition that affects the elbow joint in dogs, particularly in larger breeds. This document aims to provide a clear understanding of what elbow dysplasia is, its symptoms, diagnostic procedures, treatment options, and preventive measures.

What is Elbow Dysplasia?

Elbow dysplasia is a term that encompasses several developmental abnormalities of the elbow joint, which can lead to joint instability, arthritis, and pain. The main components of elbow dysplasia include:

1. Osteochondritis Dissecans (OCD): A condition where the cartilage does not properly form and may become damaged, leading to joint issues.
2. Elbow Incongruence: A mismatch in the size and shape of the bones that make up the elbow joint, causing abnormal movement.
3. Ununited Anconeal Process (UAP): A developmental defect where a small bone (the anconeal process) fails to fuse with the ulna.
4. Fragmented Coronoid Process (FCP): A condition where a part of the ulna (the coronoid process) becomes broken off, resulting in pain and instability.

Symptoms

The symptoms of elbow dysplasia can vary depending on the severity of the condition, but common signs include:

• Lameness in the front legs, which may be intermittent or persistent
• Pain when moving the elbow or during specific activities
• Swelling around the elbow joint
• Decreased range of motion
• A reluctance to engage in physical activities like running or jumping

Diagnosis

To diagnose elbow dysplasia, veterinarians typically perform a combination of the following:

1. Physical Examination: A thorough examination to assess the dog's gait, range of motion, and areas of pain.
2. X-rays: Radiographs are commonly used to visualize bone abnormalities in the elbow joint.
3. Advanced Imaging: In some cases, CT scans or MRIs may be necessary to identify cartilage damage or other subtle changes not visible on X-rays.

Treatment

Treatment options for elbow dysplasia vary and may include:

1. Conservative Management:
   • Weight management and dietary adjustments
   • Controlled exercise to maintain joint function without exacerbating symptoms
   • Anti-inflammatory medications to reduce pain and swelling
2. Surgical Interventions:
   • In more severe cases, surgical options such as arthroscopy may be necessary to remove fragments or repair abnormalities.
   • Joint stabilization procedures may be employed to restore function to the elbow joint.
3. Rehabilitation: Post-surgical rehabilitation and physical therapy can help improve joint function and mobility.

Prevention

While not all cases of elbow dysplasia can be prevented, certain measures can help reduce the risk:

• Genetic Testing: If acquiring a puppy, choose reputable breeders who screen for elbow dysplasia in breeding stock.
• Proper Nutrition: Ensure that your dog receives a well-balanced diet appropriate for their age and activity level to promote healthy growth.
• Management of Exercise: Provide suitable exercise without excessive strain during the growth phase, especially for large breed puppies.

Conclusion

Elbow dysplasia is a manageable condition when identified early and treated appropriately. If you notice any symptoms in your dog, it is crucial to consult your veterinarian for a thorough examination and a tailored treatment plan. By understanding elbow dysplasia, you can take proactive steps to ensure your dog's well-being and maintain their quality of life.

If you have any questions or concerns regarding elbow dysplasia, please feel free to reach out to us for more information or further assistance.

Tibial plateau Levelling osteotomy  or TPLO is a procedure for managing stifle instability due to failure of the anterior cruciate ligament, also know as the cranial cruciate ligament.

The cranial cruciate ligament (CCL) fails most commonly in the dog due to cruciate disease which is a degenerative condition which sees the CCL weaken over time and fail. The process of weakening and failure is painful and we see lameness, pain and reduced activity.  This process has also been referred to as non traumatic cruciate rupture as it is not associated with trauma - the ligament fails during normal daily activity.

Cruciate disease is a very common issue in the dog and is the commonest orthopaedic procedure performed. Their are likely lifestyle factors and genetic factors contributing to the frequency of this condition.

Cruciate management surgery has often been referred to as cruciate repair surgery - however this is not correct. None of the procedures performed to manage cruciate disease actually “repairs” the cruciate.  Instead, cruciate surgery manages the consequences of cruciate disease, mainly; stifle instability, pain, lameness and degenerative joint disease (DJD).

There are many ways cruciate management surgery may be performed. The two basic groups are:

1. Those that replace the function of the cruciate and
2. Those that change the way the joint works so we don’t need a cruciate .

TPLO surgery falls into the second category and is the originator of this concept. The joint is altered and no longer requires the cruciate to be stable during loading.

The TPLO procedure is only part of the surgical procedure. The overall procedure consists of;

• Anaesthesia and Analgesia - This is keeping the patient calm, still and pain free during the procedure. At ACE we subscribe to the Zero pain philosophy and use many different components together to keep patients comfortable and pain free. These include pain control via constant intravenous infusion, ultrasound guided blocks to the sciatic and femoral nerves and anti-anxiety medications to reduce response to the changed environment.
• Arthroscopy - To examine the inside of the joint. This is the use of very small cameras - usually under 3mm, to examine the inside of the joint through small incisions. This causes less pain and is more sensitive to finer issues as the picture is magnified.  If problems such as a meniscal tear are found we can remove this via arthroscopy also.
• The TPLO procedure - The proximal tibia is approached through a small incision and the tibia is cut with a curved saw and the bones altered in position. Finally a plate is applied to hold the bones in position while they heal.
• Physical therapy - Before and after surgery the leg is placed into a compression ice pack. Additionally patients are given massage and physical movement to aid in rapid return to weight bearing during their hospital stay.

Benefits of TPLO

Patients that have undergone cruciate management surgery show:

• Rapid return to weight bearing 
• Vastly improved function
• Reduced pain
• Reduced progression of degenerative joint disease
• Patients who have had TPLO surgery get lifelong management of the cruciate disease.