Elbow dysplasia is a painful condition that causes one or both elbows to develop abnormally while a puppy is growing. There are three main areas inside the elbow joint that can be affected; some dogs have just one affected area, while others suffer with a combination. It predominantly affects larger breeds but can also sometimes be found in smaller breeds. In fact, elbow dysplasia in small dogs is thought to be often mis-diagnosed, leading to it being greatly under-reported.

Elbow dysplasia is predominantly a hereditary disease however, like hip dysplasia, it can also be triggered due to excessive exercise or your dog being overweight while young and their joints are still developing. It is the most common cause of forelimb lameness in young, large breeds. Most dogs have a limp on one or both front legs. This can be seen as a nodding of the head when the good leg is placed and lifting of the head when the bad leg is placed.

Some dogs that limp on both front legs will not have a limp, but will have an unusual “paddling” gait. Lameness is often triggered by prolonged rest and exercise. For this reason, many dogs will be lame when they wake up but after a warm-up, they will exercise freely then limp again afterwards. Although most dogs will be diagnosed before they are two years old, some dogs will not limp until they are older.

Impotant points:

• Even a small change in the shape of one part of the joint can severely impact overall joint function. An imperfect fit means that there’ll be areas of abnormally high contact pressure, or possibly the joint becoming overloaded.
• Injuries such as stress fractures within the joint.
• Joint abnormalities might affect the growth of the cartilage which surfaces the joint. This can result in primary lesions in the cartilage or bone, which can then cause secondary changes resulting in canine osteoarthritis (sometimes termed arthrosis or Degenerative Joint Disease).  The most common primary lesions are:
• Fragmented or ununited medial coronoid process (FCP) 
• Osteochondritis dissecans (OCD or OD) 
• Ununited anconeal process (UAP)
• Medial compartment disease (MCD)

Elbow dysplasia is the most common reason that young, large and giant breed dogs develop lameness in their front legs. When the elbow joint is affected, the front gait changes.

Although the condition predominantly affects larger breeds, it can also sometimes affect smaller breed dogs. In fact, elbow dysplasia in small dogs is thought to be often misdiagnosed, leading to it being greatly under-reported.

Elbow dysplasia is predominantly a hereditary disease.  However, like hip dysplasia, it can also be triggered due to excessive exercise or your dog being overweight while young and their joints are still developing. It is the most common cause of forelimb lameness in young, large breeds. Most dogs have a limp on one or both front legs. 

If your dog is displaying forelimb lameness, regardless of age, elbow dysplasia and elbow osteoarthritis should be considered as a possible culprit. Even if your dog is a small breed, unless there’s been a trauma or accident, elbow dysplasia needs to be ruled out if there’s forelimb lameness.

The severity of symptoms in dog with elbow dysplasia can vary, ranging from mild, intermittent lameness to more severe and constant discomfort.

It’s crucial to recognise the symptoms of elbow dysplasia in dogs for early intervention. 

When a dog has elbow dysplasia, they’ll often be limping. This can be seen as a nodding of the head when the good leg is placed and lifting of the head when the bad leg is placed. Some dogs that limp on both front legs will not have a limp, but will have an unusual “paddling” gait. 

Lameness is often triggered by prolonged rest and exercise. For this reason, many dogs will be lame when they wake up but after a warm-up, they will exercise freely then limp again afterwards. 

Symptoms may appear between 6 and 10 months of age, and most dogs will be diagnosed before they are two years old. However, some dogs won’t limp until they are older.

Common Elbow Dysplasia Symptoms:

• Intermittent lameness in one or both front legs
• Reluctance to exercise, go for their normal walks or play
• Swollen, puffy elbows (in severe cases)
• Limping &/or stiffness in front limbs. This is usually worse after exercise but can be difficult to spot if your dog is symmetrically lame in both elbows.
• Audible clicking or snapping sounds during movement
• The front paws may appear turned out &/or elbows held at a strange angle
• Difficulty rising, such as when getting out of their bed or climbing stairs
• Going down stairs may look difficult because of the sore elbows
• Restricted range of motion of the elbow joint (because it’s thickened)

If you observe any of these in your dog, it’s essential to seek vet attention promptly

What should I do if I think my dog has elbow dysplasia?

If you suspect your dog has elbow dysplasia, consult with your veterinarian for a thorough physical examination. Lameness is often diagnosed based on lameness, and pain found on flexion and extension of the elbow joining. The joint will also probably be enlarged.

Your vet may perform diagnostic tests such as X-rays to confirm and assess the extent of the condition. However, it can be hard to see changes in the joint on an X-ray, because they’re so subtle. In such cases, a CT Scan or Arthroscopy (keyhole surgery) will be needed for further, reliable information about the elbow dysplasia. Depending on the severity of the elbow dysplasia you might be referred to an orthopaedic specialist. 

Once a diagnosis has been reached, an appropriate treatment plan will be tailored to your dog's needs.

What Causes Elbow Dysplasia in dogs?

Elbow dysplasia is a complex condition influenced by genetic and environmental factors. It’s considered a multifactorial condition, meaning it has various contributing factors. 

First and foremost, it’s a genetic predisposition. Genetics play a significant role, and certain breeds may be more predisposed to this orthopaedic issue. So it’s worth checking both parents for elbow dysplasia when choosing a puppy. Responsible breeders will avoid breeding a dog with this genetic trait, to prevent passing it on to its offspring.

Other environmental factors, such as rapid growth and excessive weight gain during a dog's early development, can also contribute to the development of elbow dysplasia and influence whether your dog will develop it.

If you know that your puppy may be at risk of developing elbow dysplasia, it’s worth taking measures while they’re young to try and reduce, or even prevent, it developing.

Factors that Increase Elbow Dysplasia:

• Being overweight while young and developing
• Growing too rapidly
• Being excessively exercised
• Being given the ‘wrong’, or concussive exercise, which impacts the joints

Can I Prevent My Dog from Developing Elbow Dysplasia?

While elbow dysplasia isn’t preventable in certain dogs because of genetics, some lifestyle measures can reduce how severely the condition will develop.

However, a dog’s genetic makeup is the most important factor determining the occurrence, or not, of elbow dysplasia. A high proportion of the disease is genetic. This can’t be changed, even if lifestyle interventions can limit the severity of the disease. So in some cases, elbow dysplasia simply can’t be prevented or stopped from being passed onto offspring.  

Genetically ED is determined by the combination of many gene variants (polygenic characteristic), which means it’s not that straightforward to eliminate. It’s currently estimated that there are more than 100 gene codes for elbow dysplasia.

Medium and large breed dogs are considered most prone to developing elbow dysplasia. Select your dog carefully if you’re considering a pure-breed dog. A dog should be bred from parents who have normal (Grade 0) elbows.

Measures to minimise the risks of elbow dysplasia, and contribute to overall joint health, are:

• Providing a well balanced diet
• Avoiding excessive weight gain
• Controlling the rate of growth in puppies
• Regular, controlled exercise

Common breeds at risk of ED are the Basset Hound, Bernese Mountain Dog, Dogue de Bordeaux, German Shepherd Dog, Great Dane, Irish Water Spaniel, Irish Wolfhound, Large Munsterlander, Mastiff, Newfoundland, Otterhound, Golden Retriever, Labrador Retriever, Rottweiler and St Bernard.

What ages suffer from elbow dysplasia?

Symptoms may appear as early as 4-6 months of age, though they can also develop in older dogs too. Dogs with mild elbow dysplasia may not show signs until later in life, once they’ve developed arthritis in their elbows.

The treatment for elbow dysplasia depends on the severity of the condition and the individual dog's circumstances. Treatment can range from conservative (non-surgical) management to surgical intervention.
Non-surgical options can involve giving your dog anti-inflammatory pain killers, weight management, controlled exercise and/or applying a supportive brace which can help to support their elbow joints.

If your dog suffers with elbow dysplasia, it is really important to keep your dog at an ideal weight. Any extra weight that they carry, directly increases the strain on their elbow joint(s), thereby making symptoms worse and increasing the amount of pain which your dog will experience. Furthermore, research has shown that if your dog is overweight, or receives excess calories while young and growing, their chance of developing elbow dysplasia is greatly increased or if they are already genetically predisposed to it, they it will develop it to a greater degree.

If your dog has already developed elbow dysplasia, it can be a difficult balance of making sure they receive enough exercise (especially when trying to controlled their weight) and making the problem worse by over-exercising. You will need to make sure your dog stays fit by doing the ‘right’ type of exercise. Regular, short lead walks are ideal. Prevent your dog from jumping, skidding, chasing, racing around and walking or running for longer periods.

If you are looking for supportive Dog Elbow Braces, we recommend looking at two in particular. The Balto Soft is for a single elbow, and Balto Soft Plus is a double elbow brace. The Balto Soft offers excellent moderate support designed to protect the dog in cases of hygromas, sores, calluses on the elbow and bursitis. The Balto Soft Plus Elbow Brace is a double brace designed to protect both your dogs’ elbow. The second brace which we recommend and which receives excellent customer feedback, is the Kruuse Rehab Pro Dog Elbow Protector. This brace cushions and compresses the elbow joint, providing warmth and support to the affected area.

Both are well made quality dog elbow braces which can be worn all day, indoors or outdoors.

Surgical options can include arthroscopy, osteotomy (surgical correction of bone deformities) or joint replacement in severe cases. Post-surgical care involves many of the steps which conservative management does; weight management, controlled exercise and anti-inflammatories. Applying a supportive elbow brace post-operatively can also help your dog’s recovery and support their joint more fully.
Elbow dysplasia will always lead to the development of arthritis in your dog and so it is recommended also to give your dog a joint supplement to slow the progression of this and keep your dog more comfortable and active for longer.

Treatment Options: How can I help my dog?

Treatment for dog elbow dysplasia depends on the severity of the condition and the individual dog’s circumstances. It can range from conservative (non-surgical) management to surgical intervention.

Non-surgical options can involve:

• Anti-Inflammatory Painkillers - To help control swelling and inflammation.
• Joint Injections - Injecting platelet rich plasma (PRP) into the joint has been shown to have some success in canine elbow dysplasia.
• Controlled Exercise - If your dog has already developed elbow dysplasia, it can be a difficult balance of making sure they receive enough exercise (especially when trying to controlled their weight) and making the problem worse by over-exercising. You will need to make sure your dog stays fit by doing the ‘right’ type of exercise. Regular, short lead walks are ideal. Prevent your dog from jumping, skidding, chasing, racing around and walking or running for longer periods.
• Using an Elbow Brace  - Sometimes applying a supportive brace which can help to support their elbow joints. The Balto Soft offers excellent moderate support in cases of hygromas, sores, calluses on the elbow and bursitis. The Balto Soft Plus Elbow Brace is a double brace designed to protect both your dogs’ elbows.The Kruuse Rehab Pro Dog Elbow Protector receives excellent customer feedback. It cushions and compresses the elbow joint, providing warmth and support to the affected area.
• Weight Maintenance - Any extra weight your dog carries directly increases the strain on their elbow joint(s), thereby making symptoms worse and increasing the amount of pain which your dog will experience. Furthermore, research has shown that if your dog is overweight, or receives excess calories while young and growing, their chance of developing elbow dysplasia is greatly increased or if they are already genetically predisposed to it, they will develop it to a greater degree.
• Physiotherapy/Hydrotherapy - Exercises and hydrotherapy can strengthen muscles and improve joint stability.
• Pain Relief Methods - Pain relief and infra-red pain relief wraps.
• Supplements - Joint health supplements, particularly ones that contain glucosamine or Omega 3s, support the joints and can make a difference.
• Alternative Therapies - Canine massage therapy, laser therapy, acupuncture, and stem cell therapy are all modalities that might help manage the symptoms and pain of elbow dysplasia.

Surgical options can include:

• Arthroscopy - Keyhole surgical diagnostic technique. Surgery - removing small fragments of bone - can often be done simultaneously. It usually has a short recovery time.
• Osteotomy (surgical correction of bone deformities) - There are various types of osteotomies, according to the specific manifestation of elbow dysplasia.
• Biceps Ulnar Release (BURP) - Sometimes where the elbow joint bones don’t fit well together, and because of the way the joint is loaded,  it can contribute to micro-fragmentations of the bones. The biceps tendon contributes to this. Releasing part of the biceps tendon where it’s attached to the bone, can help neutralise some of the excessive force on the ill-fitting joint. 
• Canine Unicompartmental Elbow Arthroplasty (CUE) - Known as a partial elbow replacement, this surgery has less possible compilations than a full elbow replacement.  The surface of the joint is partially resurfaced using special implants. This protects the cartilage and resolves lameness. The bones of the joint are no longer scraping against each other. 
• Joint replacement (TER - Total Elbow Replacement) - This is usually a last resort in severe cases when there’s no cartilage left. The elbow joint is replaced with a prosthesis.

Post-surgical care involves many of the steps which conservative management does: weight management; controlled exercise; and anti-inflammatories. Applying a supportive elbow brace post-operatively can also help your dog’s recovery and support their joint more fully.

Elbow dysplasia will always lead to the development of arthritis in your dog, and so it’s recommended also to give your dog a joint supplement to slow the progression of this, and keep your dog more comfortable and active for longer.

How to help around the house

Make sure that your dog’s got comfortable bedding. An orthopaedic bed is comfortable and supportive.

Assistive devices, such as a ramp onto the sofa, can aid mobility.

A full body or front lift harness might also be helpful if your dog needs to go up and down stairs or get in and out of the car. The harness means that you’re supporting your dog and taking some of the weight off the forelimbs, decreasing the impact on the joints.

Keep your dog warm, as cold weather may exacerbate symptoms. The cushioning and padding in elbow braces work to keep the joint warm and comfortable.

If your puppy or young dog has elbow dysplasia, keeping them stimulated and entertained can be a challenge. Snuffle mats and dog puzzles can help keep them mentally engaged.

Conclusion

Canine elbow dysplasia is a challenging orthopaedic condition that needs vigilant attention and proactive care. Recognising the subtle signs early on, such a foreleg limping, stiffness, or decreased activity, is paramount for timely intervention. Seeking professional veterinary guidance and conducting diagnostic tests, including X-rays, are crucial steps in confirming the diagnosis.

Your commitment is key when facing the challenges of elbow dysplasia. Stay informed, adopt preventative measures, and collaborate closely with your vet to manage this condition effectively. With proper care, affected dogs can lead fulfilling, fairly active lives.