Surgical intervention

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My 3 year old chocolate lab has been diagnosed with severe bilateral elbow arthritis. She is on supplements, having hydrotherapy, and has had a course of Cartrophen injections. Her recent x-rays reveal the extent of her arthritis, and my vet asked for advice from an orthopaedic vet in Leeds. They said there is nothing they can do, and to continue with conservative management. I just find it hard to swallow. It feel almost like we have to accept this is going to shorten her life, and we need to keep her comfortable, and give her pain relief when she needs it. As a nurse, I know the things we can do for humans, and I can’t believe veterinary medicine appears so far behind this. I’m trying to be proactive, and am certainly not seeking for her to have radical, painful surgery if it’s going to make things worse. But, she’s only 3, I’m just struggling to accept her fate.

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Hi Emma,
It is always a really tough time when you first get a diagnosis of arthritis, and even more so when you have such a young dog. First of all, I would say to take a deep breath and know that you can be pro-active in helping her from today onwards and hopefully be able to slow the progression of the disease by being aware of her limitations and what you need to think about in terms of her everyday life. Bodyweight, home and ifestyle are extremely important and I think to have this covered before you jump into surgical interventions etc is well worth doing. Keeping her lean is one of the best things you can do for her to reduce load on the joints and fat also releases inflammatory mediators that exacerbate inflammation within the joint. We have a home assessment tool on our website, that will help you to view your home objectively for any hazards that she might be encountering, slippery flooring, stairs, how she gets in and out of the car, her exercise and hobbies – does she chase a ball for example? Avoiding high impact exercise such as ball throwing is desirable. Ensuring you can maintain her muscle mass and strength is important for the future, to support the failing joints and also should she ever have surgery. Rehabilitation and pre-habilition will stand her in good stead, so things like hydrotherapy, physiotherapy will be useful to get in place if it is within your budget.
Once you are happy to have these basics in place, then there are a few more options open to you. Yo haven’t said if she has elbow dysplasia or not, but it may be a possibility because of her breed. You could ask for a referral to a specialist, who will be able to look at her as an individual and provide you with some potential treatment options. Arthroscopy or CT, or both may help to identify exactly what is happening within the elbow and can lead to different treatment paths. There are differing surgical interventions, or regenerative medicines that are relatively new to the canine market but are out there such as stem cell therapy, platelet rich plasma and other intra-articular treatments such as arthramid.
A pain clinic may be another route, they will help you with ensuring her pain relief is adequate and can point you to appropriate rehabilititation. Either one will require a referral from your vet.
Hopefully you have already found the website, but if not, grab a cuppa and browse www.caninearthritis.co.uk We also have a FB page and Holly’s Army is another FB page with over 1000 other owners of arthritic dogs who are all very supportive and willing to share their management of their dog, many of them have younger dogs and will be able to help and support you.

Hope this helps and please know that you are not alone!

Lynsey

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