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.
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.
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.
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)
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.
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.
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
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.
You will be welcomed by one of our friendly receptionists or nurses.
One of our veterinarians will perform an orthopaedic examination of your pet
We will recommend X-RAYS of your pet’s elbows unless you have good quality radiographs already
We may recommend a CT of your pet’s elbows
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.
Social distancing is easy for pets and people in our spacious waiting areas.