Specialty veterinary medicine is a relatively new advancement in pet care. Similar to human medicine specialists, board-certified veterinary specialists focus their education and services in one specific area. Treatment of Dysplasia Have you been referred? Oakland Veterinary Diagnostic is considered the gold Things to bring at the time of your standard for treatment of CED. Arthroscopy permits consultation: Referral Services minimally invasive evaluation of the joint surfaces, facilitates removal of abnormal tissue and allows for t3FDFOUSBEJPHSBQITBOECMPPEXPSL evaluation of EI. The treatment for elbow incongruen- t"DVSSFOUMJTUPGZPVSQFUTNFEJDBUJPOT cy generally involves cutting the below the joint. In 2004, a total elbow replacement (TER) was introduced. TER had a reported success rate of ap- proximately 80% in selected cases, but is considered unproved by many. TER technology is still being re- fined. OAKLAND VETERINARY REFERRAL SERVICES 1400 Telegraph Prognosis

Prognosis for CED depends upon how severe the arthritic changes are at the time of treatment. Typi- cally, dogs have clinical improvement after de- spite the persistence of arthritis. All CED patients will demonstrate progression of arthritis and may display 463(&3: intermittent lameness or stiffness. These patients gener- ally respond to non-steroidal anti-inflammatory drugs (NSAIDs), chondroprotectants or agents designed 1400 Telegraph Road to slow cartilage degradation, weight management, Bloomfield Hills, MI 48302 judicious exercise and diets containing high concen- trations of omega-3 fatty acids. Future treatments for (248) 334-6877 arthritis (such as TR Matrix™ injections) may prove to Fax: 248-334-3693 be beneficial for patients that do not respond to con- ventional treatments. Email: [email protected] Elbow Dysplasia

www.OVRS.com 6OVOJUFE"ODPOFBM1SPDFTT 6"1 What is Elbow Dysplasia? UAP is found typically in large breed dogs, particu- The term “canine elbow dysplasia” (CED) is a general Arthrocopic view of a canine elbow larly in dogs. UAP is a failure of joint – identification and removal of the anconeal process to fuse to the ulna by 5 months term for several conditions that result in arthritis of an fragmented coronoid process of age. The loose fragment results in pain, swell- the elbow joint. Dogs diagnosed with elbow dysplasia ing, lameness and arthritis. UAP can also affect both suffer from one or more of the following conditions: The main disadvantage of the CT scan is the need . Early treatment is advised and involves surgi- ununited anconceal process (UAP), fragmented medial to have the dog under general anesthesia to prevent cal removal of the UAP. In some early cases, successful coronoid process (FCP), dissecans movement. When possible, surgery is performed im- fusion of the fragment has occurred by performing an (OCD) or elbow incongruency (EI). These are mediately after the CT to eliminate the need for a sec- ulnar osteotomy (cutting the ulna). developmental disorders that affect primarily large and ond anesthesia. giant breed dogs. It frequently can involve both elbows. &MCPX*ODPOHSVFODZ &* Many factors have been implicated as causes of elbow Types of Elbow Dysplasia dysplasia including genetics, nutrition and trauma. Trauma is the most common cause of growth de- Young dogs with front limb lameness should be 0TUFPDIPOESJUJT%JTTFDBOT 0$% formities. The lower ulnar growth plate is susceptible evaluated for CED. All forms of CED result in el- to injury and early closure resulting in a growth distur- is a disturbance of bone forma- bance between the two-bone system. Growth plate in- bow arthritis. Early diagnosis and treatment is recom- tion during growth that leads to the thickening of the jury can produce shortening of the forelimb, external mended to improve comfort, function and decrease joint cartilage which often progresses to separation of rotation, bowing and partial elbow dislocation. This the progression of arthritis. All dogs with FCP, OCD the cartilage (fissuring) and formation of a flap. It af- results in lameness, swelling, pain and arthritis. and UAP should be eliminated from breeding. fects one particular area on the inside aspect of the lower bone. When it becomes a flap it is Diagnosis known as OCD. This results in pain, swelling, inflam- mation and eventually arthritis. Most affected dogs Clinical signs are generally first noted after 5 to 7 are rapidly growing, large to giant breeds. Diagnosis is months of age although may not appear until the dog generally based on plain radiographs although CT can Elbow dysplasia typically occurs in the of the is older and develops signs of arthritis. The lameness is also be performed. Treatment involves removal of the humerus (OCD) and ulna (FCP and UAP). frequently most pronounced after exercise or upon ris- cartilage flap and curettage of the defect (scraping the ing. Affected dogs often hold the elbow close to their defect) to promote healing. bodies and rotate the affected foot outwardly. Physical examination reveals elbow joint swelling, pain and re- duced range of motion. 'SBHNFOUFE.FEJBM$PSPOPJE1SPDFTT Diagnosis is confirmed by radiographs or com- '$1 Humerus UAP puted tomography (CT). Radiographs can diagnose a FCP is the most frequently encountered manifesta- UAP, most OCD lesions and often EI although it does tion of elbow dysplasia. FCP commonly affects large OCD not diagnose a FCP. Radiographs are also useful to rule and giant breed dogs and may be associated with ab- out other conditions such as fractures or dislocations. normal loading of the coronoid if bone growth is not A CT scan is necessary to visualize the FCP lesion proportional. The coronoid forms as a separate piece FCP although plain radiographs will reveal the secondary of bone and produces pain, lameness, swelling and ar- arthritis. A CT scan allows three dimensional recon- thritis. The FCP is not visible on plain radiographs Ulna struction of the joint for more thorough evaluation of and a CT scan is advised for accurate diagnosis. Treat- Radius specific regions of the elbow. ment consists of removal of the fragment via arthros- copy or surgery.