Elbow Arthritis

Q.  My dog Louise is 5 years old and has severe degenerative arthritis in her left elbow. The arthritis stems from either a prior trauma that resulted in a bone chip or from a genetic problem such as osteochondrosis dissecans. She had surger y 2½ years ago to remove the chip, but by the time she was correctly diagnosed, the arthritis had developed. I have looked into elbow replacement only to find it is experimental and not very effective. If removing the leg is going to be my only option, however, I would like to try elbow replacement and then remove the leg if it doesn't work. Have you heard anything about elbow replacement, or do you have any advice?

A. Elbow arthritis, or degenerative joint disease, called DJD, is quite common, especially in larger breeds. The arthritic changes can develop rapidly and become severe and crippling. Most elbow DJD is caused by age-related changes or elbow dysplasia. Young dogs also may develop the disease. Early treatment and surgery help to slow ongoing degeneration. Undiagnosed or untreated dogs suffer lameness, pain and limited mobility later.

Anti-inflammatory medications and supplements can provide some relief. Intra-articular (in the joint) injections are especially helpful in some individuals and can delay the need for surgery. Chiropractic and acupuncture treatments help some dogs. Newer nutraceutical products - nutritional supplements developed for veterinary treatment - seem to help significantly in some cases and may help to rebuild the joint and reverse some of the degenerative changes.

When medical management no longer provides relief, surgery must be considered. In early cases, joint surgery can successfully clean up the joint and add stability. This surgery can be done by opening the joint or via arthroscopy, in which a special surgical instrument is inserted through miniscule holes in the skin. With advanced cases, more drastic surgery is needed. Amputation can be considered but is probably not the best option. Fusing the elbow joint is an excellent alternative. Performed by an able surgeon, this procedure results in a stiff, somewhat awkward but functional, pain-free limb.

Elbow replacement surgery is an option for dogs weighing more than 60 pounds. Success rates should be 75 to 80 percent in the near future as knowledge increases and implant quality improves.