Front end lameness in Bernese Mountain Dogs - Elbow Dysplasia (ED)
What are the signs of ED?
► Limping on a front leg
► Tiring or resting more than other dogs
► Stiffness after rest
► Stilted, awkward gait
What should you do if your Berner puppy has any of these signs?
Call your pup's breeder to seek their advice. Find out why. A dog that is limping, stiff or 'walks awkwardly' for more than a day or two or one that is experiencing pain in the front end should be taken to a veterinarian for an orthopedic examination. Knowing the cause of these symptoms will help you to make the best decisions about how to improve the quality of your pup's life now and into the future. While other there are other causes for front end lameness (panosteitis, OCD of the shoulder, soft tissue injuries or Lyme disease), ED could be causing your Berner pain. Radiographs (x-rays) are used to determine the presence or absence of Elbow dysplasia and other conditions that may be interfering with your pup's ability to live a 'normal' life. Diagnosing ED defects in Bernese pups can be difficult. Ask your regular vet if he/she has experience taking radiographs of elbows and has experience diagnosing and treating ED. Some ED conditions may not easily identified on radiographs by your vet. Sometimes elbow radiographs of dogs' less than 6 months of age do not show clear evidence of ED and accompanying degenerative joint disease. Your vet may choose to refer you to an orthopedic specialist who will be better trained to examine your pup, take x-rays and determine if there is a defect(s) in your dog's elbow joint(s).
At what age can ED begin to affect a Berner's mobility?
Berners can show signs of ED defects as young as 4 months; but symptoms of ED may occur at any time in a Berner's life. ED defects are developmental in nature. Degeneration of cartilage and fluid around the joint surfaces causes inflammation in the elbow joint which in turn causes osteoarthritis, also called degenerative joint disease (DJD). Osteoarthritis is a slowly progressive disease which starts with mild discomfort and may progress to the point where the dog is in so much pain that it may be reluctant to walk, get up from a resting position, climb stairs, or jump into a car. *Some Berners that are affected with ED may show no outwardly visible signs.
Elbow Dysplasia defects that typically affect Berners
· Fragmentation of the medial coronoid process (FCP) 
· Ununited anconeal process (UAP)
· Osteochondrosis dessicans (OCD)
J.D. Wheat Veterinary Orthopedic Research Laboratory at the University of California (website) describes these defects as follows:
Fragmentation of the medial coronoid process (FCP)
Fragmentation of the medial coronoid process or FCP is probably the most common of these diseases. FCP affects many large breed dogs particularly Labrador Retrievers, Golden Retrievers, Newfoundlands, and Bernese Mountain Dogs. In this disease a small portion of the joint surface (coronoid process) of one of the three bones that make up the elbow joint (the ulna) breaks of within the joint. This loose fragment is thought to contribute to the pain and arthritis associated with this problem. In addition, however, there are other relatively large areas of the joint that loose cartilage and contribute to the pain of this disease. The underlying cause of this disease remains unknown. The most popular theory is that abnormalities in the growth of the bones that make up the elbow joint lead to poor fit of the joint and subsequent formation of bone chips. Surgical treatment of this disease has been limited to surgical or arthroscopic removal of the bone fragment and attempts to realign poor fitting joints. Generally, surgical management has not been shown to be better than medical treatment with aspirin or other analgesics although the value of arthroscopic treatment has not been well evaluated. Attempts to control FCP have been led by the UC Davis Wind-Morgan program that applies radiographic screening for early detection of the disease prior to breeding. Unfortunately the minimal understanding of the underlying causes of this disease has significantly limited the success of both treatment and prevention of FCP.
Ununited anconeal process (UAP)
Ununited anconeal process or UAP is a disease which can affect Bernese. In this disease a much larger portion of the ulna fails to fuse with the remainder of the bone. This large portion of the ulna is important to joint stability but in UAP it remains loose in the joint, contributing to arthritis and joint instability. Again the specific cause of this problem is unknown but is likely related to abnormalities in bone growth. Treatment in this case may involve removal of the loose bone, surgical reimplantation, or attempted joint realignment. Like FCP, the success of surgical treatment of UAP has been very limited as have attempts to eliminate the disease by controlled breeding programs.
Osteochondrosis dessicans (OCD)
Osteochondrosis dessicans or OCD is a disease that occurs in both humans and dogs and may occur in any of several joints. When OCD occurs in the shoulder joint it may be treated very successfully probably because of the large size and simple shape of the joint. When OCD occurs in smaller joints such as the elbow or hock the outcome is much worse, leading to arthritis and chronic lameness and pain. OCD is due to an abnormality of bone maturation resulting in a joint surface that cannot tolerate normal activity. This leads to tearing of cartilage and subsequent pain. Treatment of this disease involves surgical or arthroscopic removal of damaged cartilage and analgesic therapy. Again, the success of prevention and treatment of this disease in the elbow of dogs has been very limited.
* Reference
J.D. Wheat Veterinary Orthopedic Research Laboratory at the University of California. July 2008.
< http://www.vetmed.ucdavis.edu/VORL/canine.html>
INFORMATION FOR OWNERS
What causes ED?
Both environmental factors and genes contribute to Elbow dysplasia.
► Skeletal development is governed by the action of genes.
► ED can also be caused by trauma: rough playing with larger, stronger dogs, falls or accidents.
► ED is more common in some families of dogs within the Bernese Mountain Dog breed. ED is inherited and should be given serious consideration by breeders. No Bernese Mountain dog family or breeding pair is exempt from the potential to produce dogs with elbow dysplasia defects.
► Does the breeder of the puppy you plan to purchase seem to possess knowledge of the incidence of elbow dysplasia in the extended family of dogs they use for breeding?
Buyers need to know:
► Selective breeding has been proven to reduce the incidence of Elbow dysplasia. Parents with 'clear', 'normal' elbows have a better chance of producing pups that are not affected with elbow dysplasia.
► MYTH - The absence of elbow dysplasia in parents guarantees dysplasia-free pups.
► To ask the breeder of your puppy if any dogs from their breeding program have experienced front end lameness.
► To ask breeders if they radiograph (x-ray) their breeding stock to find out whether their dogs are affected with elbow dysplasia.
► To ask breeders if they follow the progress of every puppy they sell and if 'pets' they have sold to other people have experienced front end lameness.
► To ask breeders if 'pets' from their litters are radiographed.
► To check the BernerGarde database for evidence that the breeder of your puppy collects orthopedic data on the dogs they use for breeding and on puppies from litters they produce.
What can an owner do to help a Berner with ED?
Husbandry practices may help ease discomfort caused by degenerative joint disease. Good management of a Berner with ED can impact the progress and severity of the condition.
► Diet management - feed a good quality kibble, fresh foods and do not allow your dog to carry extra weight for his or her frame, activity level and age.
► consistent, regular, gentle exercise
► regular medication (Non-steroidal anti-inflammatory drugs such as RIMADYL® (carprofen), Etodolac (Etogesic Rx), or aspirin)
► supplements (glucosamine and chondroitin sulfates, Vitamin C, Omega-3 fatty acids, Methylsulfonylmethane (MSM), shark cartilage)
*Medications and supplements can be used to alleviate symptoms. Always consult a veterinarian and/or a holistic veterinary practioner when administering medications/supplements for dosages and discuss pharmaceutical drug/supplement interactions.
ARTICLES
Hydrotherapy
Hydrotherapy is now viewed by the veterinary profession as being an ideal form of non-weight bearing exercise to increase muscle and is an excellent way to encourage joint mobility and stabilize the joints.
Wiki Hydrotherapy http://en.wikipedia.org/wiki/Canine_hydrotherapy
COMPLIMENTARY THERAPIES BOOKS
Complementary and Alternative Veterinary Medicine: Principles and Practice
(Hardcover) by Allen M. Schoen (Author), Susan G. Wynn (Author)
Veterinary Acupuncture: Ancient Art to Modern Medicine (Hardcover)
by Allen M. Schoen (Author)
These books are available at http://www.amazon.com
SURGICAL OPTIONS
If your dog is experiencing debilitating pain that can not be managed with medicine, nutritional supplements, and/or other non invasive therapies, SURGERY may be necessary.
ELBOW SURGERY COSTS VARY DEPENDING ON REGION AND TREATING VETERINARIAN. EVEN SO - ELBOW SURGERY IS NOT INEXPENSIVE.
BOOKS FOR BREEDERS
GENETICS - CONTROL OF CANINE GENETIC DISEASES
by George Padgett
Helps the dog breeder take a positive role in enhancing the genetic health of his or her own dogs and the health of entire breed populations. Many practical issues are included such as ethical dealings with buyers of puppies showing late onset conditions,
GENETICS, AN INTRODUCTION FOR DOG BREEDERS
by Jackie Isabell
Provides breeders with a comprehensive yet easy to understand guide to the nature of heredity, the application of genetics to specific breeds, how to control genetic disorders, and the art of breed selection. This book is incredibly thorough, but understandable by the average dog breeder. A must-have for any breeder's library!
GENETIC CONNECTION: GUIDE TO HEALTH PROBLEMS IN PUREBRED DOGS
by Lowell Ackerman
A guide to health problems in purebred dogs! Contents include: the basics of inheritance, disorders of the cardiovascular system, dental disorders, dermatologic conditions, endocrine disorders, gastrointestinal disorders, hemolymphatic disorders, immunologic disorders, metabolic disorders, musculoskeletal disorders, nervous system disorders, ophthalmologic disorders, reproductive problems, respiratory disorders, urinary system disorders.
HEREDITARY BONE AND JOINT DISEASES IN THE DOG
by Joe Morgan, Alida Wind, Autumn Davidson
*Designed for the veterinarian, but suitable for the knowledgeable breeder/owner. Offers clear, well-illustrated explanations of dysplasias and various forms of osteochondrosis. Stresses the crucial aspects of selection when choosing animals for breeding. Focuses separately on pet, athletic, working or breeding dogs, and explores expectations and costs associated with each category. Describes the disease progression to osteoarthrosis and the lifetime of pain this can mean for an animal as well as the years of treatment expense for its owner. You will find the answers to questions that clients routinely ask, plus the information you need to support your answers. Text also covers the successes and failures of specific techniques.
These books are available at http://www.dogwise.com