Our two-year old Labrador was recently diagnosed with elbow dysplasia. What is this and what can be done for it? Do you have any information on the treatments that can be done to ease the pain? Do you think it's worth looking in to some holistic treatments? Can you suggest a holistic veterinarian we could contact?

Degenerative arthritis secondary to faulty development of the elbow. It is treated surgically and with medications.

Elbow dysplasia is the abnormal development of the elbow that results in degenerative arthritis of the elbow joint. It is a common disease in many large breed dogs including Labrador retrievers, Golden retrievers, Saint Bernards, German shepherds, Rottweillers, most other giant breeds and many large mixed breeds. There are three primary manifestations of elbow dysplasia, and affected dogs may have one, two, or all three types, although most have only one. The types are fragmented coronoid process, ununited anconeal process, and osteochondritis, or OCD.

Fragmented coronoid process is the most common type seen in Labradors. This involves the formation of a chip fracture or loose piece of cartilage on part of the weight-bearing surface of the cartilage. Surgery involves removal of the fragment, which often results in improvement in condition-associated lameness. This does not cure the problem, and arthritis can and often does progress, but in many cases the surgery can improve function.

Another procedure, which many veterinary surgeons have used, is an ulnar osteotomy. This involves cutting the ulna below the elbow joint, in an attempt to create a more congruent joint. Personal experience shows that this is often successful in young patients with minimal arthritis. Unfortunately, there are not any objective publications of results for this procedure in the veterinary literature to date.

Ununited anconeal process is a second form of elbow dysplasia in which part of the growing ulna, the smaller bone of the forearm involved in the elbow joint, that is supposed to fuse by six months of age fails to do so. This piece of bone is typically removed, which helps the lameness; however, some arthritis will progress. An ulnar osteotomy can be performed in cases without significant arthritis and minimal displacement of the anconeal process from the rest of the ulna. In some cases the result is normal elbow function.

A less common form of elbow dysplasia involves osteochondritis, or OCD. This is a flap of abnormally formed cartilage, usually on the humerus, which leads to arthritis. Surgery is usually recommended. However, the prognosis usually depends on the size of the flap and the amount of arthritis present. The smaller the cartilage flap, the better the prognosis.

As for pain medications, non-steroidal anti-inflammatory drugs, or NSAIDs, such as aspirin, Rimadyl, and Etogesic tend to be the mainstay of therapy. Supplements such as Glycoflex, Cosequin, and others may also have some benefit. Also, Adequan, an injectable medication, may offer some benefits for the cartilage, in addition to pain relief.

We don't have any recommendations for holistic veterinarians. However, we have seen acupuncture show benefits in pain control, but not in stopping the progression of arthritis.

05/12/03