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Animal Emergency

Our animal emergency hospital is open 24h per day, 365 days per year, and is staffed by experienced emergency vets and nurses caring for your pet.

Internal Medicine

Our Internal medicine service deals with heart problems, cancer, gastrointestinal disease, neurology and a range of other illnesses.

Animal Surgery

We offer the latest techniques in chest & abdominal surgery, cancer surgery, wound reconstruction, spinal imaging & surgery and advanced orthopaedics.

Elbow dysplasia

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Elbow dysplasia is a common developmental problem that affects purebred dogs such as Labradors, Golden Retrievers, Rottweilers, Newfoundlands and other popular large breeds. The term dysplasia means that the joint does not fit together perfectly and this causes a problem inside the joint leading to bone chips (fragmented coronoid process or FCP). These small loose bodies rub the cartilage off the bone surfaces which eventually leads to arthritis. Typically pups develop a minor limp which gets worse after rest and heavy exercise. We look for a ‘head bob’ where the head drops when the normal front leg is in contact with the ground and a head rise when the affected front leg is in contact with the ground. Unfortunately, many dogs have involvement of both legs. Click here for a PDF on what to do if your pup has elbow dysplasia or a clinical brochure on elbow arthroscopy

Patient Examination

Examination of the leg by an experienced vet should reveal some degree of swelling and discomfort when the affected elbow is manipulated. There is a high correlation between a positive response during the examination process and pathology inside. X-rays of the elbow can then be performed to assess bone structure and see if here is evidence of arthritis developing. We have a modern CT scanner to look at the small fragments that cannot be seen with conventional x-rays.  We also have digital radiography to allow further magnification of the elbow structures.

Examination
X-ray
CT scan

There have been many advances in the treatment of elbow dysplasia over the last ten years including: arthroscopy (keyhole), sliding humeral osteotomy (load-shifting reconstruction)and  total elbow replacement (joint replacement). Dr Chris Preston, specialist in sall animal surgery at Pet Emergency & Specialist Centre, is regarded as a pioneer in this field and has introduced all three of these treatment advances to Australia. He developed an in vitro research model to study the effects of elbow dysplasia in a laboratory setting. This model is now widely used in elbow research for improving the success of elbow surgery.

Arthroscopy

Arthroscopy allows immediate and unparalleled visualization of the internal condition of a joint using a small diameter rigid telescope (2.7mm). The operator learns how to move the telescope around to improve the field of view and see structures more clearly. Bone chips can be removed delicate hand instruments. Surgeons an grade the degree of pathology inside a joint and determine the best course of action from there on. Many younger dogs (6-18 months old) improve after arthroscopic ‘cleanups’ where abrasive fragments are removed prior to the development of advanced arthritis.  Typically we record the arthroscopic procedure of your pet on a CD and mail this to your vet so that they have an opportunity to see the problem first hand. This is of benefit to you as your vet is more likely to stay actively involved in the treatment of the arthritis process.

FCP with mild arthritis
FCP with moderate arthritis

Sliding Humeral Osteotomy

A new and exciting surgical option for elbows that have either not responded to arthroscopy alone or have medial compartment disease (full-thickness loss of cartilage), is a procedure called a sliding humeral osteotomy (SHO). This treatment was developed from the University of California and has been tested in Europe in many clinically affected cases.  We make a transverse cut in the shaft of the humerus (upper arm bone), slide the top section of bone towards the healthy side of the underlying joint, and then stabilize the bone using a custom, stair-step plate and screws on the inside of the leg. The bone will heal back to normal strength in 8 weeks. This style of surgery transfers the major compressive forces across the joint away from the diseased side onto the more healthy side.  It is a solution that saves the joint offers a low risk option in dogs with moderate arthritis.

Total Elbow Replacement

Elbow replacement surgery involves replacement of worn out parts with a metal-on-plastic false hinge. The implants are stable and only offer bending and motion in one plane. Dogs with severe arthritis and daily disability are candidates for this surgery. Cemented and cementless systems are available so that we can match the implant characteristics to the patient’s bone quality. Owners need to be aware that the recovery is prolonged and requires consistent attention and dedication over a period of several weeks. Excellent results can be achieved with marked improvements in limb use and overall mobility.