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Elbow Pain in Dogs

The elbow joint in dogs is on the front legs and is a very complex joint made up of the radius, ulna, and humerus. Injury to the elbow or joint disorders can be very painful and debilitating to dogs. Elbow pain in dogs can be due to primary disorders of the elbow or secondary from conditions in other parts of the body.

Common Symptoms:

  • Lameness
  • Limping
  • Difficulty walking, standing or jumping
  • Reluctance to be touched in that area
  • Unable to walk or run normally
  • Walking at a slower pace
  • Not placing paw on the floor
  • Joint swelling
  • Licking, chewing, or biting the affected area

Causes of Elbow Pain

Elbow dysplasia is a condition that includes multiple developmental abnormalities of the canine elbow joint. The elbow joint consists of three bones (radius, ulna, humerus) and when they don’t join properly, problems can occur. Due to uneven weight distribution, these problems can include pain, lameness, and arthritis. Other conditions typically fall under elbow dysplasia (as a category) and include fragmented coronoid process (FCP), osteochondrosis (OCD), joint incongruity, cartilage anomaly and ununited anconeal process (UAP). The exact cause of ED is a combination of factors that involve genetics, trauma, defects in cartilage growth, and diet. As an inherited condition, most large to giant breeds such as Bernese Mountain Dogs, German Shepherds, and Golden retrievers have a higher susceptibility to developing ED issues. Unfortunately, once the elbow joint has been damaged, progressive arthritis is more likely to occur. Dogs who are affected with ED show signs during early age but can also be diagnosed around 4-6 years old. Clinical signs include front limb lameness that worsens after exercise, an abnormal gait, trouble with movement, and pain in the affected areas. If suspected, ED can be diagnosed through a physical exam and X-rays. Dogs will typically have pain when bending their elbow so vets will watch the dog walk or trot to detect lameness. X-rays will show signs of arthritis and any bone fragments if present. Other tests include CT scans, arthroscopy, and MRIs. 

 

Treatment:

  • Arthroscopic surgery to alleviate the elbow joint.

A dislocated elbow (congenital luxation of the elbow) commonly occurs in smaller breeds and can be a complete dislocation or partial dislocation (radial head with the ulna intact or partially intact). There is speculation on whether congenital luxation of the elbow is inherited, with questions on proper ligament growth being a possible cause. Breeds susceptible to this include pugs, afghan hounds, Dobermans, Yorkies, Boston Terriers, chihuahuas and Pomeranians. Nonetheless, congenital luxation of the elbow happens when the bone is displaced from the joint, typically affecting both elbows. Symptoms begin to show at around 3-4 months of age with dogs experiencing a partially flexed elbow, pain at the elbow with swelling, mild lameness, an inability to bear weight on the limb, pronation of the forelimb, and deviation of the lower leg. Chronic cases typically indicate osteoarthritis as a secondary condition. Classified in three ways, congenital luxation is defined as humeroradial, humeroulnar, and a combination of both. 

Humeroradial

  • Significant limb deformity and dysfunction
  • Could be partial or full
  • Seen in Pekinese, Shetland Sheepdog, Dachshund, Yorkshire Terrier, and  English Bulldog breeds

Humeroulnar

  • Mainly impacting Dachshunds, the dislocation of the radial head will occur, while the ulna is in a fairly normal position

Humeroradial and humeroulnar

  • Secondary to general joint laxity or skeletal abnormalities and in many cases, occurs along with several congenital issues 
  • A ligament may be completely missing 
  • Congenital elbow luxation is typically seen in both dog’s elbows but can occur in only one   

Diagnosing includes a physical exam where the elbow will be observed along with radiographs to show possible fissures, bowing, and bone growth deformities. 

Treatment:

  • Elbow would be put back into the correct alignment and put into a splint for 2 weeks.
  • Possible surgery to align the elbow.
  • Possible use of external plats and fixators.

Polyarthritis is the inflammation and swelling of joints making them painful and swollen that may cause dogs difficulty walking. Immune-mediated Polyarthritis refers to arthritis that’s a direct result of abnormal immune response by the body directed at the joints. This can come from either an auto-immune disorder or infection. Signs include overall joint pain, fever, loss of appetite, swelling of multiple joints, lameness. To diagnose this, a thorough physical examination and a variety of laboratory examinations, including blood and urine tests and urine culture, are common tests used to identify a possible origin of an internal infection.

Treatment:

  • Generally treated with immunosuppressive medications until the lowest dose is found that still manages the disease.

Juxta-articular fractures are fractures that occur near a joint surface and they may be intra- or extra-articular. Salter III and IV fractures, as well as humeral and femoral supracondylar fractures, are examples of intra-articular fractures. The bulk of juxta-articular fractures occur in dogs with immature skeletons. This type of fracture can cause immediate changes in joint anatomy, impacting joint cohesion, causing discomfort, and disrupting joint motion. Because of the short length of one of the bone segments, the possible small size of the bone, the relative softness of bone, and the involvement of articular surfaces close to the fracture site or involved in the fracture, these fractures are difficult to treat. Signs that a dog is suffering from a juxta-articular fracture include limb lameness and swelling around the affected area. Treatment goals include restoring joint flexibility and congruity, minimizing degenerative articular modifications, and maintaining joint efficiency.

Treatment:

  • Internal plating of the fracture via surgery.
  • External coaptation which is the use of bandages, casts and splints to stabilize the fracture.
  • Transarticular external stabilization is a procedure that involves positioning an external skeletal attachment mechanism above and below a joint and connecting it with rigid bars to minimize joint mobility.

Lyme disease is not directly a joint-related disease but causes pain. Lyme disease is the most common disease transmitted from ticks although it only shows symptoms in 5-10% of infected dogs. The most notable signs of Lyme disease are recurrent lameness from inflammation of the joints, general discomfortness, and a fever. Lameness from lyme disease usually only lasts about 3-4 days but often recurs in the same legs or other legs days or even weeks later. Only your veterinarian can diagnose lyme disease through blood tests, urinalysis, fecal examination, complete blood cell count, x-rays, and possibly fluid drawn from the joints.

Treatment:

Osteoarthritis, also known as Degenerative Joint Disease (DJD), affects both dogs and humans alike and is the most common form of arthritis affecting nearly a quarter of a million dogs worldwide at any given time. It is a progressive, chronic joint condition marked by the weakening of joint cartilage, thickening of the joint capsule, and the forming of new bone around the joint (osteophytosis), both of which contribute to pain and limb dysfunction. The majority of OA in dogs is caused by developmental orthopedic diseases including cranial cruciate ligament disease, hip dysplasia, elbow dysplasia, OCD, and patella (knee cap) dislocation. In a small percentage of dogs, OA develops for no apparent reason and is linked to genetics and age. Bodyweight, obesity, exercise, and diet are all factors that contribute to osteoarthritis. Symptoms of osteoarthritis itis in dogs are fairly noticeable and include stiffness, limping, difficulty standing, not wanting to run or jump, weakness, muscle atrophy irritability, weight gain, vocalizing when touched, and incontinence. Unfortunately, the damage caused by OA is irreversible but treatment plans help reduce pain and improve quality of life. 

Treatments: 

  • Weight loss for overweight dogs can help take pressure off affected joints.
  • Regular moderate exercise helps keep joints healthy.
  • Physical medicine including acupuncture, chiropractic, laser therapy, regenerative medicine, medicinal massage, and physical rehabilitation.

Osteochondritis Dissecans (OCD) is a painful abnormality that disrupts the healthy development of bone from cartilage. When OCD happens, a flap of cartilage develops within joints which then causes lameness and joint pain. The most commonly affected joint is the shoulder but also can commonly affect the knee, elbow and hips.. Dogs with OCD in the shoulder also tend to be male. Factors such as diet, genetics, hormonal imbalance, trauma, growth rate, and joint architecture, can increase the likelihood of developing OCD. Due to its nature, OCD tends to affect larger breeds like Golden Retrievers, Mastiffs, Old English Sheepdogs, Labrador Retrievers, Chow Chows, German Shepherds, Newfoundlands, Bernese Mountain Dogs, Rottweilers, and Standard Poodles. With genetics playing a big role, many vets recommend affected dogs be withheld from breeding. Dogs will start showing signs around 4-7 months of age with many displaying lameness after heavy exercise or long periods of rest. Clinical signs of OCD include limping and lameness in affected legs, vocalization of pain when the affected joint is touched. The affected joint will also be swollen and warm to the touch. Depending on the severity and pain level, dogs may avoid putting any pressure on the affected leg. OCD can affect both legs so determining if one leg is experiencing greater impact can be difficult. Diagnosing this condition primarily includes X-rays, CT scans, or MRIs. 

Treatment:

Osteochondrosis is a disorder that affects the development of cartilage and bones in both medium and large-sized dogs that grow quickly. The premature joint cartilage fractures and splits from the underlying bone in this state in which cysts will develop under the cartilage if fluid occupies the room. Cartilage fragments may come loose from the end of a bone and float about in the joint cavity which causes inflammation in the infected joint and may progress to arthritis and cartilage breakdown, restricting joint motion. Signs that a dog may be suffering osteochondrosis include lameness, fluid buildup within the joint, and joint stiffness. To determine the extent of the damage, a veterinarian might take an x-ray but endoscope surgery can also be done to further identify the damage. Another option is a CT scan.

Treatment:

  • Surgical removal of cartilage flaps or the free-floating fragments of cartilage.
  • Use nonsteroidal anti-inflammatory drugs and joint fluid modifiers.

Osteogenesis Imperfecta is also known as brittle bone disease. Osteogenesis Imperfecta is essentially the inability of the body to produce the collagen protein which provides elasticity to the bones. Because of this, affected dogs’ bones lack the ability to withstand impact and pressure causing them to easily break and fracture. Signs of Osteogenesis Imperfecta have reduced bone density, severe joint pain as well as bone and teeth fractures as affected dogs don’t have the Type 1 collagen needed. Other symptoms include difficulty walking, loose joints, stunted growth, weak tendons and muscles, and malformation of bones. They also present joint pain. There’s, unfortunately, no treatment for this condition but vets may prescribe pain medication to help. The occurrence of multiple bone breaks as well as x-rays can give a definitive diagnosis of osteogenesis imperfecta. Blood tests may also be run to see if the levels of vitamin D, phosphorus, calcium, and parathormone are abnormal. 

Treatment:

  • There is no true treatment that heals this disease.
  • Corrective orthopedic surgery may be done for mild cases.

Osteosarcoma is a bone tumor that is malignant and resembles human pediatric osteosarcoma. Limbs are the most often affected but it can still affect other bones like the jaw, hips, pelvis, ribcage, and skull. It's even possible for it to arise in non-bony tissue like mammary glands and muscle. It’s more often found in large and giant breed dogs such as Great Danes, Rottweilers and Irish wolfhounds. This disease can be quite painful in the joints and lameness is often presented in affected dogs. Pain medication may be given to help with joints and lameness but may only work for about one to two weeks. Swelling of the bone at the tumor site can be observed at this point and is sometimes sore, swollen, and hot to the touch. Amputation is often the recommended treatment to prevent the cancer from spreading but seeing an oncologist is recommended since it can still spread.

Treatments:

  • Amputation of the affected limb to maintain control of the spread of the cancer.
  • Chemotherapy.
  • Radiation therapy.
  • Pain Medication for temporary relief.

Rheumatoid arthritis in dogs is very similar to that in humans and the diagnosis criteria is very similar, just adapted for dogs. It’s an immune-related arthritis targeting the cartilage in the joints. Multiple joints are often affected at once and dog pain presents lameness from the pain. Symptoms may include recurrent UTIs, lameness, joint swelling, fever limb atrophy, joint pain, tonsillitis, and inability to walk. The causes of Rheumatoid arthritis aren’t exact but since it’s immune-related, some possible causes could be a genetic predisposition, digestive disease, or cancer. Because Rheumatoid arthritis is not common for dogs and the symptoms can vary greatly, it can be difficult to diagnose. The most common symptoms, such as lameness, is a common symptom in many other disorders and they can come and go. Radiographs are usually the most effective way to determine a diagnosis to see the swelling and trouble in the joints. The vet may also opt to do a biopsy of the tissue to test for inflammation.

Treatment:

  • Generally treated with immunosuppressive medications until the lowest dose is found that still manages the disease.

Septic arthritis is a painful disorder caused by the introduction of bacteria or another infectious agent into one or more joints, resulting in debilitating inflammation. Male, large, and giant breed dogs are the most frequently affected, and although septic arthritis may affect dogs of any age, it is most commonly seen in dogs aged 3 to 11 years. Pressure, swelling, and discomfort in one or more joints are all symptoms of septic arthritis. Reduced range of motion in the affected joint(s), as well as fever, lethargy, and a loss of appetite often accompany those prior symptoms. To diagnose, a vet will look at the dog’s complete medical history as well as any injuries that could have caused wounds leading to septic arthritis. They will do a blood test, a physical examination, urinalysis, and a biochemistry profile. Imaging is also used to diagnose septic arthritis in dogs and the vet will test for bacterial infection by taking fluid from a joint which is the most important test during this process

Treatment:

  • IV and oral antibiotics.
  • Lavage (flush) the joint to minimize joint damage.
  • Surgical opening of the joint, removal of abnormal tissue, and copious lavage.
  • Flushing catheter for post-operative flushing.

Systemic lupus erythematosus (SLE) is an immune-mediated disease in which a dog’s immune system begins to attack its own tissue. Essentially, the dog’s body produces antibodies to antigens that are found in its body systems and tissues. Some breeds have a greater predisposition to SLE such as medium to large dogs that are over five years of age. This includes the Shetland sheepdog, Old English sheepdog, Beagle, German shepherd, Irish setter, Nova Scotia duck tolling retriever, Poodle, Collie, and Afghan hound. Signs of SLE can peak and slow over a period of time, with signs increasing as the disease progresses. These include lameness that moves from limb to limb, lethargy, fever, enlarged spleen, enlarged lymph nodes, ulcers at mucocutaneous joints (lips), muscle pain (or atrophy), skin abnormalities (such as thinning or loss of hair, ulcers, redness). Factors such as genetic, physiologic, and environmental elements can increase SLE development. 

Treatment: 

  • Dependent on which body system is affected:
    • Kidneys: modified prescription diet.
    • Joints: limited and restricted activity.