Elbow dysplasia in a 2 1/2 yr MN Golden Retreiver

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1 month ago, I saw a 2 1/2 yr MN Golden Retriever with intermittent front leg

lameness (owner not sure which one). Front leg lameness appeared after more

intense exercises for 3-4 episodes in the last 1 ½ yr, now more episodes lasting

longer and more intense. Lameness responds to ½ dose of Deramaxx (owner scared

to give more). He is on omega-3 and glucosamine/chondroitin supplements. Had one

episode where he would not go down the stairs in the morning. No problem going

up the stairs.

Dog is overweight with mild elbow DJD and incongruity on radiographs, bilateral

mild pain at compression of the elbow at 40 degree extension, mild bilateral

elbow effusion. On examination, the dog L elbow flexion 40 degree and the R one

flexes to 34 degrees. Crepitus L elbow at extension. Moves way too much to

measure or appreciate how good his extension is (and I do not want to force

anything). There are major muscle spasms in the rhomboideus, triceps and

thoracic paraspinals bilaterally. R carpus shows some valgus, worse on LF leg.

The dog did not present obvious front leg lameness when walking, but did present

a shorter stride in the hind legs. Sits and puts weight on ischial tuberosity.

No discomfort at hip extension. Orthopedic evaluation by surgeon did recommend

some pelvic radiographs too. His hamstrings are tight.

The owner was told at orthopedic evaluation they could do elbow arthroscopy in

case they find a FCP on both elbows. They of course do not offer any guarantee

this will make the dog more comfortable. No stem cell therapy was recommended.

The dog has already lost some weight in the last month.

I left the owner with whole front leg stretching exercises, front leg ROM of all

joints with not going to full extension/flexion with the elbows, hamstring

stretches. Recommended to do the arthroscopy, acupuncture, massage laser therapy

on muscle spasms and getting the pelvis radiographed before we start working on

the hind legs, rehab after arthroscopic exploration.

The owner had some concerns I could not answer and hope some of you surgeons out

there could comment:

- The dog in the few weeks is doing really well and the owner questioned if

arthroscopy is still a good option or not.

- Apart from possible complications from any type of surgery, could doing the

arthroscopy make matter worse?

- If there is improvements, is it worth doing the arthroscopy knowing that the

dog will develop severe DJD in later age? I hear some dogs do good for a year or

2, but then become really lame afterward anyway.

- The owner was wandering if the arthroscopy should be sooner then later. I

would assume sooner then later, but you might have some other opinions?

One question I have. If I have severe DJD of the elbow and I want to increase

the ROM of the joint by mobilization, do I risk moving some fragments into the

joint and worsen the situation?

I uploaded the radiogrpahs in the photos section. If somebody can tell me how to

upload them on a post, that would be great!

Thanks!

Caroline Goulard DVM CCRT CVA

Paws Back In Motion

At Home Veterinary Rehabilitation and Wellness Care