Heidi is 5 years old and a German Shepherd x Collie. She was diagnosed with Fragmented Coronoid Process at 2.5 years old and she had arthroscopies in both elbows to remove fragments of bone. Recovery went well and she was sound for approximately 2years. 6 months ago she started to limp again and it became progressively worse. We finally got referred to the specialist vet at the beginning of June and he talked us through all our options from pain management, injections of Platelet Rich Plasma (PRP) and briefly touched on surgery. We opted for another CT scan to see the level of progression and the PRP injections. The CT scan showed significant advancement in the osteoarthritis in both her elbows. The first round of PRP injections didn’t do anything for her unfortunately so we went back to the vets last week. He said we can have another round of PRP injections as sometimes dogs do not respond to the first. He also talked us through two surgical procedures that Heidi would be suitable for as long as the lateral compartment of her elbow is still healthy. We would do the right elbow first as this seems significantly worse at the moment. Both surgeries sound pretty scary. I wasn’t ready to make surgery decisions at that time so opted for some more PRP injections and these seem to of given Heidi some slight relief. I’m currently trying to research the two procedures which are bioblique proximal ulna osteotomy (BOPUO) and unicompartmental elbow replacement (CUE) so would love to know if anyone has had any experience with these please? It’s such a difficult call to make but my feeling is that if she needs surgery then having it done sooner rather than later must make sense… I’m just not sure how to approach knowing what the best options are for Heidi.
It is hard to comment fully without knowing her. You may have gone though this already with your hydrotherapist, physio and vet, and as both elbows are affected I would pay a lot of consideration to how the left fore will cope post surgery…do you have a good plan around how to support the left fore (and her back and hindquarters) during the post-op period and rehabilitation of the right fore?
It sounds like you have a good team around you.
Kathryn’s suggestions are good, and I’d also go to the referral vet/your vet with an idea of the end point you’d like to reach with her in terms of exercise and mobility as well as pain control. This will help them to have a discussion with you based on this.
In terms of conservative management (and post-op recovery) acupuncture and myotherapy can also help a lot.
Good luck. Poor Heidi (and you!)…the elbow is such a complicated joint.
Let us know how you both get on.