Could you please take me off the mailing list...thanks!
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Bernese Mountain Dog Mailing List [EMAIL PROTECTED] wrote:
BERNER-L Digest 4556
Topics covered in this issue include:
1) Everything you ever wnated to know about elbows
by Tim McNair
2) list
by Betsy Brainard
3) Re: Everything you ever wanted to know about elbows
by [EMAIL PROTECTED]
4) carting clinic
by Andrea Brin
5) Re: BERNER-L digest 4555
by Tim McNair
6) Re: no-pull devices
by S. Walquist and J. Patenaude
7) Re: BERNER-L digest 4555
by S. Walquist and J. Patenaude
8) Puppy Rescue
by Andie Reid
9) Lancaster Boycott
by Pat Long Paul Dangel
10) Re: Everything you ever wanted to know about elbows
by [EMAIL PROTECTED]
11) FYI: Articles on Health, Orthopedic evaluations, etc.
by Patricia Tackett
12) Simbo's 4th Birthday!
by Jean Cheesman
13) Berner is pet store
by Chris Marjorie Cottle
14) I spoke too soon
by [EMAIL PROTECTED]
15) Re: Gentle Leader
by [EMAIL PROTECTED]
16) Re: BERNER-L digest 4553
by [EMAIL PROTECTED]
17) Re: Gentle Leader
by Janice Parky
18) JUST ONE MORE DAY
by Dr. William B. Neff
19) RE: BERNER-L digest 4555 - Nipping Puppy
by Ivana Leonard
20) RE: JUST ONE MORE DAY BG Fundraiser
by Pat Long Paul Dangel
21) RE: JUST ONE MORE DAY BG Fundraiser
by Dr. William B. Neff
22) Re: toe sprain
by [EMAIL PROTECTED]
ATTACHMENT part 2.1 message/rfc822
From: Tim McNair
To: [EMAIL PROTECTED]
Subject: Everything you ever wnated to know about elbows
Date: Fri, 29 Aug 2003 23:56:54 -0700
We have a 16 month old boy with pretty bad elbow dysplasia who has just had surgery
and I thought that I'd share our experiences with you so if you're ever in this
situation it may make your decision making a bit easier. We did a bunch of research
and saw several docs to try to figure out what's best. Bottom line--no one knows for
sure. My task was perhaps a bit easier since I could talk doc-to doc and the anatomy
is similar.
Elbow dysplasia is thought by most to be caused by incongruency between the radius and
ulna (bones in the forearm). This is thoought to be very small in teh range of a few
millimeters. This causes changes in the way weight is born on the joint leading to
wear on the cartilage in places it was not meant to wear, eventually exposing bone.
There are several procedures that have been tried to fix this--none of which work
reliably. (FWIW anytime there are multiple surgical procedures to fix a problem it
means none of them works very well.)
The first procedure was an ulnar osteotomy--cutting the ulna to shorten it thus
changing the stress on the joint. My understanding is that almost nobody does this
anymore because it doesn't work.
The current vogue is radial osteotomy--cutting the radius to shorten it (it seems to
me that it woul be pretty much the same as lengthing the ulna) . Sometimes this seems
to help. BUT and it is a huge but. You can't accurately predict wihich animal it will
help and it almost as frequently hurts. Dr. Davis at UC Davis has done a lot of
research on this. It is felt by the guys that do this that it corrects the
inconguency. Dr. Davis has done research that shows that you can't tell when a joint
is incongruent. He created incongruent joints in cadaver dogs, x-rayed them and sent
the pictures to radiologists. They were no better than chance and figuring out whether
the joint was incongruent or not. In other words the test to see whehter or not
surgery might help is NOT RELIABLE. He thinks the dogs that do get better are largely
a matter of chance. Remember we are talking about millimeters here--so if you get it
just right it works if not it doesn't---orthopedic surgery just isn't that
precise.
Another new procedure is called an ulnar splitting osteotomy, where they split the
ulna to change the weight bearing. The folks that do this are apparantly clicquish and
have not published any data in any journals to show that the procedure actually works.
Dr Schulz is very sceptical about this since there is no published data.
The last procedure is one he has invented a humeral osteotomy, changing the weight
bearing at the elbow by changing the angle that the humerus impacts the elbow as I
understand it. He's been doing these for a couple of years and says he's got an 80%
success rate, but also has a 5% complete failure rate, making the joint worse. He's
still trying to figure out what makes the difference.
All 4 of these are major procedures with a long recovery time, think months. In
addition you can only do one limb at a time. A lot of rehab is needed.
Probably the best initial step, the one Dr Schulz recommends, and the way we went is
arthroscopy. First it allows you to see exactly what is going on. Second, it allows
you to remove loose bodies from the joint. If there are loose bodies they will cause
more damage if they are left behind. Third you can do both elbows at once. As he does
the procedure he makes micro-fractures
