Pug Dog Elbow Dysplasia

Overview

The elbow refers to the joints in the two front legs (the patella refers to the knee joint in the two hind legs). Elbow dysplasia is an umbrella term that refers to a growth abnormality of cells, tissue, and/or bone in the elbow joint but all involve improperly fitting elbow joint and socket.

Note that three bones are involved: the humerus, ulna, and radius. There are four basic types of abnormalities that can occur (most affected dogs will have only one of the four):

1. Ununited Anconeal Process (UAP): There is a growth plate located between the top of the ulna and a small projection of bone area called the anconeal process. With this condition, that growth plate does not fuse closed as it normally would (usually by the 5-month mark). In some cases, there are bone fragments floating freely.

2. Fragmented coronoid process (FCP): A small piece of the ulna bone breaks off and detaches. Left floating loose, it damages the joint and wears down the cartilage of the humerus.

3. Osteochondritis dissecans (OCD): A piece of cartilage breaks off and detaches.

4. Elbow incongruency: Either the radius or the ulna grows slower than the other, causing the bones to be mismatched.

Occurrence Rate

The Orthopedic Foundation for Animals (OFA) keeps statistics of this and several other issues. Note that this only includes dogs whose records are submitted to OFA. The Pug ranks #2 out of 126 breeds, with dysplastic elbows identified in 41.4% of 191 Pugs.

Age of Onset

It is typically diagnosed before the age of 12-months old.

Causes

There is a genetic component; this is seen most often in large and giant breeds; the Pug is one of the few smaller dogs that is predisposed to this. Other factors are thought to play a role including exercise and diet (thus excess weight) and trauma. Some studies suggest that males may be more prone to this than females.

Symptoms

Though the type of abnormality can vary, signs are usually the same:

Abnormal gait
Lameness in one or both front legs
Limping (only if just one elbow is affected)
Discomfort
An unusual stance of holding the elbows out or inward
Reluctance to stand or walk; preference to sit or lie
down
Tiring easily (can be mistaken for laziness or disinterest)
Unstable walk
Degeneration of the bone, which can be exceedingly painful

How this is Diagnosed

This is diagnosed via x-rays. Several may need to be taken and a dog may need to be sedated in order to position the leg as needed for a clear view. A CT scan may be done as well.

Treatment, Non-Surgical Vs. Surgical

Each case of elbow dysplasia with Pugs is unique. Depending on the specific abnormality and the level of severity, this may be able to be managed without surgery or it may be recommended to have surgery asap to try and help prevent crippling bone degeneration and subsequent arthritis.

Treatment, Non-Surgical

Note that the exact treatment plan will vary quite a bit, depending on the type of elbow dysplasia and the amount of pain that a dog is in. This may include:

• Bed Rest. If inflammation is severe, bed rest may be ordered and can range from 1 to 6 weeks.

• Exercise. Opposite to bed rest, it’s best for some dogs to continue with exercise to help prevent muscle atrophy, build up muscle surrounding the elbow, and/or help prevent stiff joints. This may include strengthening exercises such as walking up inclines (starts with slight inclines for short durations, working up to steeper inclines for longer durations).

• NSAIDs (non-steroidal anti-inflammatory drugs). These are often given for pain and inflammation. Dosing will need to be overseen by the veterinarian due to potential side effects including but not limited to organ damage.

• Excess weight gain prevention/weight loss. With pups, a plan will be put in place to prevent future issues of possible excess weight gain. With older dogs, the vet will speak to you about any excess weight that your dog may be carrying and devise a weight loss plan if needed. In many cases, offering the same amount of food but with a lower calorie count can help a Pug lose weight.

• Additional Pain Medication. Often, NSAIDs will be sufficient to bring discomfort to a tolerable level; however, if a dog is experiencing severe pain, analgesics such as tramadol (a synthetic opioid) may be prescribed.

• Anti-inflammatory steroids such as prednisone may be given. This is usually only given short-term since long-term use increases the chances of serious adverse side effects. Even so, there may be increased thirst, increased appetite, and lowered immune system response leading to risk of infections. Careful monitoring needs to be in place.

• Medications to help prevent arthritis. The knees are prone to arthritis and if a knee has slipped, it is even more so. For this reason, some veterinarians will suggest monthly Adequan injections (or a similar medication). Adequan is an FDA approved injectable disease-modifying osteoarthritis drug (DMOAD) for canines that has been shown to help repair cartilage and in these cases can help prevent the onset of trauma-induced arthritis.

• A joint supplement like Doggie Dailies Advanced Hip & Joint Supplement for Dogs with combined glucosemine, chondroitin, MSM, and CoQ10 can help with pain and inflammation, help a Pug with mobility and plays a big role in helping to prevent arthritis which commonly occurs in dogs with this condition.

• An omega-3 EPA and DHA should be given. This can also control inflammation, help with mobility, and are used to help prevent arthritis. One of the easiest methods of providing this is via a liquid fish oil, which most dogs love. Zesty Paw's Pure Wild Alaskan Salmon Oil is an excellent choice.

Treatment, Surgical

In severe cases, when a dog’s quality of life is affected and there is chronic pain and/or lameness, surgery will be recommended. Depending on the exact abnormality, this may involve removing affected cartilage and/or bone or fusing together certain areas of the bones or growth plates with surgical screws. Even with surgery, many of the treatments listed above will be prescribed as well, all in an effort to help a Pug recover, gain back mobility, and help prevent arthritis.

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