Planning and waiting on a future hopeful, such care was made in searching pedigrees  and top producers for this puppy, as well as checking for all the clearances on sire and dam; grandparents too.  Working with the new puppy changes when things begin not to look right .... “But this new puppy that has been perfectly cared for,  taken to classes and retrieving nicely, is now showing signs of stiffness the first few minutes after resting. People have noticed at puppy class...  She seems to stand funny with more weight on the inside of the front paw as if needing to take weight off the elbow.  There's really not much of a limp and this just started at about five months old... I was just getting ready to show her and now, I'll have to stop training too.”

The Labrador Retriever has been respected for decades for it's many uses, hunting with enthusiasm, giving assistance to disabled, working hard for border protection, excelling in performance events and being active with his family.  Hiking with the family and keeping up with the kids is often as demanding as competition. Those involved with Labradors have for many years been very aware of the hip dysplasia problem but I personally remember beginning to do OFA elbows as well as hips on my dogs about 1990.  OFA began their data base on elbows in the late 1980's and The Wind Morgan Program for Diagnosis of Heritable Joint Disease in the Labrador Retriever was initiated in August of 1990.

The term 'elbows dysplasia' was actually introduced in 1961 describing  a generalized arthritis of the (elbow) bone AND ASSOCIATED WITH UNUNITED ANCONEAL PROCESS (UAP).   Over time, FRAGMENTATION of a specific part of the ulna (smaller leg bone) at the elbow joint (FCP) was  typically seen with the arthritis.  Elbow dysplasia includes OSTEOCHRONDROSIS Dissecans, a disease that affects cartilage formation.  

OCD develops  because of abnormal thickening it doesn't receive proper nutrients from the joint fluid causing it to become weaker and susceptible to damage.  When the gliding layer between bone, the cartridge becomes injured and bone defect that causes flattening or a cartilage flap forms.  The lesions/cysts  may occur on one or both sides of the body. Movement of these fragments causes pain and further damage.  THESE THREE COMPONENTS (OA Osteoarthritis, FCP Fragmentation of the (humerus) Coronoid Process.piece, and OCD- OSTEOCHRONDROSIS, ARE THE CURRENTLY ACCEPTED ENTITITES COMPRISING ELBOW DYSPLASIA ( ref*OFA Examining Elbow Dysplasia).

There are TWO DIFFERENT THEORIES for the resulting lesions of elbow dysplasia.  The first is this as a disturbance of cartilage forming into bone. The fragmented coronoid process ( lines or cracks in the cartilage ) occurs between 4 and 10 months of age and won't likely be visible on x-ray until degenerative changes eventually become severe enough. As a part of my Receipt and Guarantee, the new owners agree to not allow puppy to play or rough with dogs of greater size and weight and always with direct supervision until twelve months. Exercise should be sensible as joints aren't formed and growth plates at the end of long bones closed until after twelve months. I remember my youngest son playing baseball all the way through school and how there were specific years that the kids weren't allowed to pitch because of stress or injury to the elbow at a vulnerable stage.

The 'second theory' is “lack of fitness of the parts forming the joint as the primary cause of the fragmentation OR lack of fusion.”  The elbow joint requires three different bones to fit together smoothly  to allow for a gliding movement in flexion and extension as well as internal and external rotation.  This would be abnormal bone growth forming pieces of the joint that don't fit properly together.  

Because certain breeds tend to be affected with one 'particular' component of ED more than the others, this gives data to support  the HERITABILITY of the disorder.  One reason this disorder has become so common in our Labradors is affected individuals have been used in breeding programs; dogs without any signs of lameness. Most breeders are including elbow certifications as well for hips in their breeding stock guidelines.

Lameness may be very subtle or when present in both limbs, it is much harder to notice in the gait. Most often, the symptoms are stiff gait after rest, holding the elbows close to  the chest, lameness in the front end eventually, and  pain when the elbow is flexed for exam. Many factors both genetic and environmental will affect whether a puppy may show signs of lameness.  The rate of weight gain and an over-weight puppy, the amount and kind of exercise and perhaps stairs, influence environmentally. 

Dogs showing signs of lameness should be evaluated at any age. The best current method to diagnose elbow dysplasia is x-rays. Because the developing  anconeal process (part of the forming bone), may not fuse until after five months of age, to be able to accurately diagnose that area as UAP, the puppy must be older than 5 months.  UAP is bilateral in about 1/3 of dogs and males are more frequently affected because of more rapid growth and larger overall size.  It IS VERY important that the veterinarian obtain a lateral x-ray view of the elbow in extreme flexion. If not properly positioned,  there could be confusion with a 'separation line' that would show up because of positioning and could be confused with a problem.

Some dogs do recover on their own without surgical intervention, this happens only if the flap breaks loose and is absorbed by the body. This may take twelve months and yet almost 70% won't recover to a point of soundness. Surgery is the best option for elbow dysplasia that is associated with UAP and OCD.  Treated surgically and early in the disease gives the best chance for outcome with minimum arthritis. Most dogs will though develop degenerative arthritis over time and treatment will be with long-term non-steroid anti-inflammatories and drugs with chondrotin  to attempt to develop more cartilage. Treatment includes rest when limping, weight loss to reduce stress on the joint, and low impact exercise.  Elbow dysplasia can be a crippling disease. The degree of arthritic change may be severe enough by even age two, that pain medication is needed. 

   Nutrition does have a direct effect and frequency and severity in those dogs who are genetically predisposed ( being prone to these elbow disorders because of relatives).  The degree of arthritic change that results from elbow dysplasia affects the joint instability that is created by the disability. Dogs  competing or working in performance areas may be significantly limited in their ability and I ask performance competitors to examine gait for soundness.  Elbows dysplasia for some breeds has become more a problem than hip dysplasia.  I x-ray my dogs between 12 and 13 months and send to OFA for a preliminary evaluation (report by ONE veterinary radiologist vs three at 2 year certification).  I get a near 80% look at the joints developing and make adjustments in any breeding program involving those dogs if necessary or, get excited about going forward with that young hopeful.  Wind Morgan's program will issue a number for certifying four joints including the elbow, at or beyond 12 months of age.  Screenings such as OFA and elbow certifications before selective and controlled breedings, are critical to reduce elbow dysplasia.

References:

OFA, Orthopedic Foundation for Animals, “Examining Elbow Dysplasia”, www.ofa.org

The Wind Morgan Program for Diagnosis of Heritable Joint Disease in the Labrador Retriever