Medial Fragmented Coronoid Process

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Medial fragmented coronoid process is one of the three main causes of elbow dysplasia and elbow pain in young, large breed dogs. In this condition, one of the coronoid processes (the bony outcroppings at the end of the ulna) is broken.

Breeds, Gender, and Age of Dogs Most Affected by Medial Fragmented Coronoid Process

• Large breed dogs such as German Shepherds, Labrador Retrievers, Bernese Mountain Dogs and Rottweilers are especially prone to developing a fragmented coronoid process.
• Most often, this disorder occurs in younger dogs (under 1 year).

Presentation and Signs of Medial Fragmented Coronoid Process

• Elbow pain: Pain can sometimes be difficult to gauge in animals, as they don't always cry out or show otherwise overt signs.
• Crepitus: Popping sounds that are associated with movement of the elbow, caused by arthritis that occurs if the medical fragmented coronoid process is not surgically corrected. This is most often diagnosed in older dogs.
• Decreased range of motion: The leg is not able to flex or extend to its normal degree.
• Swelling: The tissue surrounding the elbow joint may be enlarged.
• Both front legs are often involved.

Causes of Medial Fragmented Coronoid Process

• Conformation abnormality: The defect occurs while the bones, cartilage, and joints are forming or growing.
• Abnormal stress on the elbow: This can be the result of a dog's increased body weight or poor nutrition.

Diagnosis of Medial Fragmented Coronoid Process

This disease is diagnosed through a veterinarian's examination and x-rays, but it is sometimes difficult to see the fragmented coronoid well on an x-ray. Instead, a veterinarian can often see associated elbow arthritis, bony fragments forming near the coronoid process, or bone loss where the coronoid attaches to the ulna.

A veterinarian will also suspect this condition when none of the other causes of elbow dysplasia can be seen and there is evidence of arthritis in the elbow joint. A CT scan may be needed to confirm the diagnosis.

Treatment of Medial Fragmented Coronoid Process

Medications can provide some pain relief for the arthritis that is likely to go along with this condition:

Do not give your dog any medications unless your veterinarian has advised you to do so.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) like Rimadyl and Deramaxx are very helpful in fighting the pain and inflammation associated with elbow dysplasia due to medial fragmented coronoid process.

Adequan is a polysulfated glycosaminoglycan that can repair cartilage and lubricate joints. It is a good option to help reduce pain if it is in your budget. This drug is safer for long term use than other medications, but it does cost more and needs to be given as an injection by a veterinarian. The specific way that this drug works has not been fully explained, but studies have shown success in its treatment of the pain from a medial fragmented coronoid process.

Surgery, in many cases, works well for medial fragmented coronoid process if it is caught early, but owners should be aware that any component of arthritis that is already present in the elbow joint will continue to cause the dog pain, even after surgery. The most frequently used and effective surgery for this condition is the removal of the extra fragment of bone.

If you decide with your veterinarian that surgery is the best step for your pet, it is recommended to seek out a board certified veterinary orthopedic surgeon who is able to do arthroscopic surgery.

Prevention of Medial Fragmented Coronoid Process

• There is a large genetic component to this disease. The best way to decrease the number of animals afflicted with medial fragmented coronoid process in the dog population is to require breeders to use good practices. There is a certification process that breeders can have done to guarantee their dogs' orthopedic health. If you are acquiring a dog from a breeder, be sure to ask for proof that this certification has been done.
• If you adopt a dog rather than using a breeder, feed a high quality diet and keep your pet at a healthy weight to help decrease the risk of joint problems.

Prognosis of Medial Fragmented Coronoid Process

• The outlook for this condition is good if surgical intervention is done early, before arthritis sets in.
• With only medical treatment, dogs with medial fragmented coronoid process will develop progressive arthritis in the elbow joint and may no longer be good candidates for surgery.

Alternative Therapies for Medial Fragmented Coronoid Process

• There is good evidence that giving glucosamine and chondroitin sulfate supplementation as directed by your veterinarian is helpful for slowing the progression of the arthritis associated with elbow dysplasia caused by medial fragmented coronoid process. Omega 3 fatty acids have also been used as a nutritional supplement that may benefit these dogs. These medications may help prevent ongoing damage to the joint and also decrease pain and swelling.

  • Glucosamine supplements should be in the form of glucosamine hydrochloride (HCl) not glucosamine sulfate as glucosamine HCl has better bioavailability.
  • Omega 3 fatty acids should be in the form of fish or krill oils, not flaxseed. Fish and krill oils provide the correct forms of anti-inflammatory omega 3s, whereas flaxseed requires conversion to the anti-inflammatory compounds and dogs have limited amounts of the enzyme required to make this conversion.

• If you feed your large breed growing puppy a homemade diet, it is extremely important that the mineral amounts are balanced properly. If you decide to use a homemade diet, it is critical to use one developed by a veterinarian or veterinary nutritionist.

References

• Cahn, C. L. (2010). The Merck Veterinary Manual. John Wiley and Sons.
• Tilley LP, S. F. (2011). The Five-Minute Veterinary Consult: Canine and Feline. Wiley and Sons.

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