# Bilateral Elbow Dysplasia - surgery or not?



## cookiemonster (Nov 20, 2017)

Hi all -- I've read a lot of the informative posts on here about goldens with elbow dysplasia, and I wanted to crowd source some advice about our own golden. 

She's a year old. She has had intermittent front limb lameness since she was six months old -- limping for a month, fine for two months, limping for a month, fine again. We finally got a CT scan, which revealed elbow dysplasia, moderate arthritis, and bone chips in both elbows. The orthopedist recommended surgery to remove her medial coronoid process and bone chips. He said that surgery would likely postpone severe arthritis by ~4 years but that she would develop severe arthritis no matter what. i.e. If you remove the MCP from healthy dogs, they'll develop arthritis, just more slowly than dogs with a fragmented or ununited MCP.

We plan to start our pup on Dasuquin and omega-3 fatty acids. What we don't know is whether we will get the surgery. Cost is a consideration but not an insurmountable obstacle. 

The way I see it, surgery is guaranteed to make our pup miserable for several weeks -- there's the post-surgery pain, but once that gets better, it'll take 3-6 months for her to get back to running and playing. Just like every other golden pup, she loves to play and starts going stir crazy after a day with no/little exercise. After that 3-6 month window, there's a chance she'll be 100% pain-free for a few years, but there's also a reasonable chance that she'll experience intermittent lameness.

Without the surgery, her arthritis is very likely to become severe within the next couple years. So she could potentially be looking at a decade of sore elbows. The orthopedist said that it won't be debilitating, i.e. she'll be able to walk and function, but she won't be able to play as much as she wants to. He said it's not so bad that we'll eventually have to put her down. We can manage the ongoing pain with Dasuquin, pain meds, and other measures like joint mobility exercises and regular trips to the lake.

We have no idea whether to get the surgery. It feels like darned if we do, darned if we don't. If surgery was guaranteed to make her 100% better, we would do it in a heartbeat. But I've read on this message board about the mixed outcomes, and our orthopedist confirmed as much. 

Does anyone have any experience NOT doing the surgery? How did your dog's arthritis progress? 

Does anyone come down strongly on one side or another: surgery vs. no surgery? Why?

We appreciate all thoughts and advice.


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## hotel4dogs (Sep 29, 2008)

I'm sorry I don't have any advice about surgery, but look into Adequan injections. Many of the sports and rehabilitation vets believe that it can help prevent or delay arthritis. You can do the injections at home, they are generally given once a month for maintenance.


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## Megora (Jun 7, 2010)

We went through that with my Danny...

Same thing going on with his elbows. Though in his case, one elbow was worse than the other. 

He also had pano which added to all the problems he had around the time he was 8 months old. 

The orthopedic specialist (top guy at MSU) strongly came down against any surgery on the basis that it would not have benefited our dog and he felt the majority of the problems our dog was having were due to pano. 

When we pointed out that our dog couldn't even walk across the room without stopping to rest his elbows - and we had our personal vets pushing us to do the surgery, he instructed us to wait and see until our dog was 2. And if our dog was still really struggling then, he promised to personally do the surgery then. And promised that would not be the case. He told us we'd see things get better by 15 months and gave us instructions for diet changes, etc.

He was right in that our dog's condition really did improve between the time he was 15 months and 24 months. The elbow problems did not go away, but this dog could actually go on walks and run, play, and be a normal dog without pain meds. 

We had him on cosequin (which was kinda new back then and I knew of it from horses) all his life. And we also had a permanent prescription for tramadol to treat pain as needed. 

I've heard of dogs living every day of their life getting rimadol and stuff, but we did not have to do that. He was just fine as is and mostly sound for the first 8-10 years of his life. He had limitations, but we knew what they were and let him self-manage for the most part. 

If we took him for walks and he started pulling back - we took him back home and let him rest a few days. Stuff like that. 

We were doing obedience comp around the time that agility was "new" and starting to take off. This dog was the same one who did have exposure to all that through his life and did agility classes for "fun" after he got his obedience title. He could have entered trials back then if he had "Wanted" to. But the first time he balked about going out into the agility ring, we retired him to just be a regular dog who was spoiled rotten. 

Different things I wish I did with him was put more effort into keeping weight off him in old age. Some of his weight gain was related to really huge fatty tumors. But he was hefty (around 88-92) by the time he was 11-12 years old. This after he was normally between 72 and 77 pounds all his life. This made him struggle more with regular exercise because he had more weight on those elbows and was more sore after 1/2 mile walks because of the extra weight. 

Also, can't say enough about getting the cushiest beds for your dog. Give him lots of comfortable spots to sleep on. But also if you keep them in strategic spots, it's helpful for him if he's jumping off beds or couches. 

About whether or not to do the surgery - I still don't know what to think other than the surgery is very difficult on the dogs. Not so much the surgery, but the rehabilitation afterwards. With our dog especially just from the pano and ED, we struggled with resting him early on. We were told to keep him rested for 1-3 months while the worst of the pano got sorted out. And this dog was going CRAZY from not being walked. He was the type of dog who if he got loose outside during this time, he literally flew like the wind despite only have 2 good legs and you could not catch him unless he was ready for you to catch him. 

And after you get through all of that, you are literally still coming up on age 4 or age 5 being the point when any benefits of the surgery are undone because of arthritis. 

Other thing I strongly recommend - don't let socialization slide. With our dog - he was not permitted in obedience classes because he was limping off and on. He was allowed in by the time he was about 2 when we were able to show the instructor he was completely sound, but there was a gap between 8 months and 2 years when he missed out on positive socialization around other people. Which meant that his only exposure to people came from the vets pinning him down for xrays and pinching his legs. It made him reserved around people outside the family. He was this simply beautiful dog who attracted everyone's attention, but he could not handle random people coming up and reaching for him. <= He would pull away and hide. We got him through that, but it took years.


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## cookiemonster (Nov 20, 2017)

hotel4dogs and Megora -- thanks so much for your replies! It helps to hear some additional perspective. We will definitely be starting our pup on supplements, and we'll decide on surgery in a couple months after seeing how her elbows do with the supplements. I had never heard of Adequan, but I'll definitely ask the vet!


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## hotel4dogs (Sep 29, 2008)

Adequan® Canine

This is taken from Arthritis Management and Prevention (CSU vet school)

"...Polysulfated Glycosaminoglycans (PSGAGs, Adequan) and Polyglycan SA
This drug group was originally designed to treat acute joint cartilage injuries. It has recently been approved for use in dogs for arthritis. Not only may PSGAGs help repair damaged cartilage, but they can interfere with destructive painful pathways in the joint. PSGAGs can also be effective in cats. The PSGAGs are naturally occurring in joints. A series of injections, twice weekly for 4 weeks to start, is implemented to determine if a patient is responds well. If a patient has a significant beneficial response, a plan is implemented to continue the injections. The PSGAG product we utilize here at CSU is called Adequan. We also utilize a product called Polyglycan SA in a similar fashion. This product has been investigated at CSU. This product contains hyaluronic acid, glucosamine and chondroitin – the building blocks for one of the major molecules in cartilage...."


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## gdgli (Aug 24, 2011)

I swear by Adequan. Used it on my Springer.


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## hotel4dogs (Sep 29, 2008)

It has been used with great success on dogs who already have arthritis. Sports vets are now recommending it as a preventative.



gdgli said:


> I swear by Adequan. Used it on my Springer.


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## zoegirl0213 (Sep 7, 2018)

My 1.5 year old female golden, Zoe, had Elbow endoscopy surgery on June 1. After surgery she still limped a little, so I decided that physical therapy could be beneficial (and my pet insurance covers most of it - yay!). Her surgeon had wanted to do PRP injections, but I wanted to try a less invasive option first. Her PT is swimming, ESWT (shockwave treatment), and laser treatment. The therapist gave her Ligaplex, taking 2 twice a day. She is already on Cosequin Max twice a day, and omega 3 supplements as well.
Her therapist recommended the supplement - LubriSyn HA. Has anyone used that? I've read a few reviews on Amazon and Chewy, but wanted to see if any fellow golden owners have used it in a similar situation.


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## nolefan (Nov 6, 2009)

I admire your commitment to your dog's health. You might try starting your own thread with "LubriSyn HA" in the title. Also, check facebook for groups that might help - Golden Retriever Discussion Group, Golden Retriever Discussions on Everything, GRCA Field Education Committee, Performance Golden Retrievers, these are all groups who might have similar, useful experience.


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