Elbow pain is crippling and invalidating. If it isn’t diagnosed in the first year of life then significant damage has already been done. There is still hope! Proximal Abducting Ulna Osteotomy – PAUL

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If your pet is faced with a lifetime of chronic pain from elbow disease, PAUL or Proximal Abducting Ulna Osteotomy can provide a solution where there isn’t an alternative.

It can be difficult to know if your best friend is in pain. Unfortunately, elbow disease if often bilateral (meaning both legs). When pain is in both legs, the animal often doesn’t limp. Your pet will stand with their feet abducted (turning out) to take pressure of the inside of the elbow where the pain is. Since elbow disease is often hard to diagnose in the early stages, your pet may not get a diagnosis until there is significant joint disease and pain. Unfortunately, there isn’t a lot of options at this stage….until now.


The laser treatments worked brilliantly on our 9 year old girl Jess, who has severe arthritis in both elbows.
On our very first visit they suggested laser therapy.
I had to carry her into the practice as she was limping so badly and in obvious pain.
After a few minutes of laser therapy she miraculously lost her limp and was running around on her own.
We’ve since been back to continue with more laser treatments. It definitely works for her!!
Thank you so much Treendale Pet Medical!! – Chris Brown

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Bringing advanced orthopaedic services to the South West

We can help you if your pet has been diagnosed with elbow disease. Proximal abducting ulna osteotomy can bring tremendous relief to your pet with elbow disease. The earlier it is done the less damage will be inflicted upon the joint slowing down and reducing osteoarthritis and enabling pain free weight bearing again.

Why Do Dogs Get Elbow Disease?

Elbow development involves the growth and articulation of three bones into a hinge joint. One bone rubs on two bones. If there isn’t a smooth surface there will be rubbing and cracking of the cartilage in the joint. This can lead to elbow dysplasia and OCD lesions of the elbow. The forearm has two bones (the radius and the ulna). They grow independently. Often the ulna grows longer than the radius. This creates a “step” or ridge inside the elbow joint instead of a smooth surface. This is called elbow incongruity and this is what causes elbow disease because of uneven weight bearing. The uneven surfaces wear causing cracks and fissures of the joint surface.

What Is Elbow Dysplasia And Elbow Disease?

Elbow dysplasia means simply that the joint doesn’t fit together properly. This happens if the radius and ulna do not grow at the same pace. If one bone is longer than the other, there will be a “step” form inside the elbow joint. This uneven surface created inside the joint causes the cartilage to wear unevenly. Abnormal pressure causes the cartilage to crack and fissure. UAP and medial coronoid disease can result. Fractures and fissures can form within the joint especially the medial coronoid process. (mFCP)

What Is Medial Compartment Disease?

The abnormal formation within the joint results in severe overloading of the medial extremity of the joint. Friction creates a lot of heat causing cartilage cell death. As cartilage dies and is eroded the joint starts to collapse on the medial side. As the cartilage erodes there is even more friction and heat production as bone rubs on bone. The joint collapses further. Friction in the medial compartment and exposure of bone leads to osteoarthritis formation.

Elbow Treatments

AGE 3-5 MONTHS – Distal Ulna Osteotomy can be performed to release the radius and ulna link to allow self-adjustment and normal joint formation.
AGE 5-12 MONTHS – Oblique Proximal Ulna Osteotomy. There is a very strong interosseous ligament that forms between the radius and ulna so a distal osteotomy is no longer effective. There may be significant pain and pathology by this age that may require an ARTHROSCOPE to clean up.
1-8 YEARS – PAUL (Proximal Abducting Ulna Osteotomy)
OA MANGEMENT : K- Laser, NSAIDS, Antinol, 4CYTE, Cartrophen, weight loss, PRP, Stem Cells.

Why Is Paul A Good Treatment For Elbow Disease?

This is a surgical treatment that can still have an effect even if there is joint destruction and osteoarthritis in the medial compartment.

It shifts weight bearing within the joint from the medial compartment to the lateral surface of the joint which is healthy and pain free.

It prevents further friction on the painful surface of the joint thus preventing further joint collapse on the medial side.

It is more simple than a Sliding Humeral Osteotomy that carries greater risks of complications such as non-union and radial Nerve paralysis

I Cannot speak highly enough about the care and expertise of Treendale Pet Medical. Very thankful to have this level of professionalism in our area. – Florinda Spragg

PAUL is the solution your pet needs for less painful elbows.

Your pet may not get a diagnosis until there is significant joint disease and pain. Unfortunately, there isn’t (wasn’t) a lot of options at this stage….until now.

  • Stops weight bearing on the painful medial compartment giving immediate relief
  • Shifts weight bearing from the medial compartment of the elbow to the lateral compartment
  • Immediately reduces friction of the wearing surfaces of the medial compartment
  • Prevents further collapse of the medial compartment of the elbow joint before the lateral surface becomes involved
  • Immediately reduces friction and heat production in the joint preventing cell death and further degradation of the articular cartilage
  • Reduces the need for anti-inflammatories with time as the condition settles (if performed early in progression of the disease)

# 1

You will be welcomed by one of our friendly receptionists or nurses.

# 2

One of our veterinarians will perform an orthopaedic examination of your pet

# 3

We will recommend X-RAYS of your pet’s elbows unless you have good quality radiographs already

# 4

We may recommend a CT of your pet’s elbows

# 5

If your pet is a candidate for PAUL we will discuss this with you and make a date for the surgery should you wish to proceed.

A corrective limb alignment to unload the medial compartment of the elbow alleviating lameness, stiffness and elbow pain

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