Osteochondritis dissecans is a condition of immature dogs in which an area of cartilage becomes thickened and detaches from the surface of the joint. The result is inflammation and potentially a loose fragment in the joint.

This condition may cause stiffness and lameness similar to other conditions that cause elbow dysplasia.

Treatment is surgical removal of the fragment.

Prognosis is favorable in young dogs.

What is it?

• OCD is an abnormality in the transformation of cartilage to bone formation that occurs in growing animals.  This can lead to the formation of a loose flap of cartilage in the joint (sometimes called a “joint mouse”) which can lead to degenerative joint disease (DJD) and pain. 
• It is not known what causes this to occur, but some factors that are thought to contribute are genetics, rapid growth and over nutrition, and trauma.

Clinical signs

• OCD most often affects large breed dogs like Golden Retrievers and Rottweilers, and lameness usually first appears around 5 to 8 months of age, but can show up later.  Owners often note that their dog is stiff in the morning and after rest. The lameness becomes worse following exercise.  Sometimes there is a history of trauma or injury, but not always. 
• During a physical examination, a veterinarian may recognize a decreased range of motion (inability to fully flex or extend the joint) in one or both elbows, and extension or rotation of the affected elbow may be painful.  Crepitation (crackling) of the joint may also be present.  Sometimes joint swelling is evident on palpation and the joint is often painful during these manipulations.

Diagnosis

• One of the first things your veterinarian may recommend is radiographs (x-rays) of both elbows—even if only one elbow seems to be affected—because this disease is often in both elbows.  This may involve several different views of each elbow joint.  On radiographs, OCD may be appreciated as radiolucent (dark) area of bone on the end of the humerus (upper arm bone).  There may also be secondary signs of arthritis and DJD found on the radiographs.  
• Although results of blood work and urinalyses are often normal, your veterinarian may recommend them to rule out other underlying diseases and to ensure your pet is a good surgical candidate.

Treatment

• The most common form of treatment for dogs with lameness associated with OCD is removal of the cartilage flap, usually by arthroscopy.  Arthroscopy allows the veterinary surgeon to visualize the joint, remove the flap of cartilage and help smooth out any lesions in the joint. 
  
• Following this procedure, it will be important for you to limit your dog’s activity for the first 6-8 weeks.  Most dogs are able to walk within the first day or so, but they should be limited to very short leash walks to urinate or defecate.  Rehabilitation therapy may include cold packing the elbow(s) for the first few days and warm packing for the next several days to weeks.  Flexing and extending the joint after warm packing will help minimize stiffness of the elbows.  After that, a gradual increase in activity will generally be allowed.  
  
• Whether or not your pet has surgery, he or she may need long term medical therapy to help with elbow arthritis.  This often involves short term pain medication after surgery, such as Tramadol.  Tramadol can cause signs associated with stomach upset, and should be discontinued if constipation, vomiting or loss of appetite occur.  Dogs are often also put on a non-steroidal anti-inflammatory drug (or NSAID), which will help with both pain and inflammation. This class of drugs can cause stomach upset and if your dog experiences vomiting, diarrhea, black stools or loss of appetite, it should be discontinued and your veterinarian should be contacted. A medication such as gabapentin may also be beneficial to reduce pain that is magnified in the spinal cord.
  
• Some dogs also benefit from a special diet that helps to promote joint health.  One such diet is Hills’ j/d diet, which contains omega fatty acids, glucosamine and chondroitin sulfate, all of which may help with joint pain. 

Prognosis

• Generally around 75% of dogs improve following surgery (arthroscopy), although younger dogs (less that 9 months old) have a better prognosis that mature dogs.  Dogs that have already developed signs of significant arthritis at the time of diagnosis tend not to do as well, and may require medical treatment for pain, but lameness is usually intermittent following exercise.

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