Not all cases are going to be surgical cases.
Many lameness investigations 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 endeavour and treatments can become complicated.
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 must take place within 48 hours of the onset of symptoms. Access to MRI, has made the localisation of disc material much more accurate and the subsequent surgery more specific.
NOAH (North Dublin Orthopaedic Animal Hospital) offers a full emergency service to referring veterinary surgeons in cases of urgency, such as an acute disc extrusion.
We see many cases of osteoarthritis in a week. There are multiple treatment options. We advise a multi-factorial approach which includes surgery. A long term strategy is important to control the symptoms, and even then, there still needs to be an occasional 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 to use pain relieving anti-inflammatories to manage the pain. However there are problems with long term medicine use to control 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.
Read more about surgical treatment of 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 incongruency then the joint surfaces do not bear the weight evenly. 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, and German shepherds.
Incomplete ossification of the humeral condyles is another genetic problem of elbow joints 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 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 from the medicines. A joint like this is called a terminal joint and needs some more drastic procedure. Total elbow replacement is one 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 and there is change and awkwardness of the gait thereafter.
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 str not within the right range for good hips will significantly reduce its incidence. Such programs such as BVA /KC or OFA or the more sensitive Pennhip are well established systems.