Medical Treatment

Not all cases are going to be surgical cases. Many lameness investigations would end with medical treatment. Successful management of chronic ligament or tendon problems can at times be managed with medical treatment better than by surgery, and often we would recommend attempting medical treatment first. Dealing with various types of arthritis is primarily a medical endeavor and treatments can become complicated.

Disc Disease

Degenerative disc disease is a very common problem. In small animals it can be a very serious illness indeed, leading to total paralysis. Severe sudden collapse caused by disc disease is a surgical emergency. Treatment must be prompt and surgery after 48 hours from the onset of symptoms adversely affects the prognosis. With the access to the MRI the localisation of disc material has become much more accurate and the surgery subsequently more specific. We offer a full emergency service to our referring veterinary surgeons in cases of urgency, such as an acute disc extrusion.

Osteoarthritis

We would see very many cases of osteoarthritis in a week. Treatment options or really management options are multiple. In fact we advise a multi-factorial approach which includes surgery were needed. A long term strategy is important to control the symptoms, and even then there still needs to be an occasional fire brigade treatment of flare ups. It is often forgotten how easy osteoarthritis develops after even quite minor injuries to joints or the structures that are intimately associated with them.

The first route of treatment is pain relieving anti-inflammatories which can be highly successful in managing the pain. However there are problems with long term medicine use to control the pain and gastrointestinal ulceration can be seen in these cases. Also some dogs just simply cannot tolerate the medicine.

In these cases the dog can have either a triple pelvis osteotomy if less than 12 months for hip dysplasia, femoral head and neck excision for small dogs, or total hip replacement for any size of dog. To read more about surgical treatment of Osteoarthritis please read the information on our Joint Surgery page

Elbow Osteoarthritis

The elbow is a complex joint as three long bones meet to form the joint surfaces. Osteoarthritis of the elbow in the dog is a common problem. The most frequent cause is due to abnormal development of the elbow joint during growth which leads to elbow incongruenty. Once there is incongruenty then the joint surfaces do not bear the weight evenly and this leads to significant cartilage damage at even 6 months of age.

OCD is another disease of young dogs that leads to osteoarthritis. There is very significant genetic influence on these problems and for this reason elbow scoring is recommended now prior to breeding. Common breeds affected are Labrador Retrievers, Rottweilers, Golden retrievers, German shepherds etc.

Incomplete ossification of the humeral condyles is another genetic problem of elbow joins that can lead onto osteoarthritis or fracture. This disease is seen in springer spaniels and Cavalier King Charles spaniels.

Fractures or dislocations of the elbow invariably lead onto osteoarthritis despite successful repair. Septic arthritis can lead onto to osteoarthritis long after the infection is gone. Of course there are other types of arthritis such as immune mediated arthritis which are as debilitating.

Treatment options include as the first options always anti-inflammatory medicines such as non-steroidal anti-inflammatory, which are basically new generation aspirins. They have very little and low level of side effects and are very effective anti-inflammatories. Some dogs with terminal arthritis of the elbow may not get pain relief eventually from the medicines. A joint like this is called a terminal joint and needs some more drastic procedure. Total elbow replacement is one such procedure and can be very successful at bringing dogs back to their normal activity expectations. Total elbow arthrodesis (fusing of the joint) is a second option and because the joint is removed bone fusion occurs there some change and awkwardness of the gait thereafter.

Hip Osteoarthritis

Many humans will be very familiar with hip osteoarthritis due to either development issues or trauma. The hip is a versatile joint that provides much of the power of the hind limb whilst having the biggest range of motion of any joint in the body. Painful osteoarthritis can be particularly difficult to adjust to.

In dogs the picture is the same with the developmental condition hip dysplasia being the biggest cause of premature and late osteoarthritis of the hip. Other conditions such as Legg Perthes disease, fractures, immune mediated arthritis, dislocation and ischaemic necrosis lead to debilitating hip pain.

Inheritance of the hip dysplasia and legg perthes disease is a problem. Although hip dysplasia is a polygenic condition and therefore cannot be completely controlled or eliminated, it has be proven that controlled breeding programs that do not breed from dogs that have either hip dysplasia or hips that re not within the right range for good hips will signifcantly reduce its incidence. Such programs such as BVA /KC or OFA or the more sensitive Pennhip are well established systems.