Elbow dysplasia literally means an abnormality of the development of the elbow joint, resulting in a joint that is often misshapen, which does not function as it should and which eventually develops osteoarthritis. The causes are multifactorial, but as there is a strong genetic component, screening dogs elbows by radiography and grading any changes found will help breeders select the most suitable dogs for breeding. If either, or both, of the parents of a pup have been screened it will also help us decide how likely it will be that the pup will develop elbow dysplasia. Remember that as the causes of elbow dysplasia are multifactorial, the grading should only be regarded as an indicator of what might happen, it is not an absolute measurement of what is going to happen.
Many breeds are susceptible to elbow dysplasia but there is a higher incidence in certain breeds, two of which are the Labrador Retriever and the Golden Retriever.
The idea behind the scheme is that radiographs of both elbows of a dog are examined for signs of any primary lesions, or any secondary osteoarthritis, caused by the conditions that lead to elbow dysplasia. This examination involves detailed evaluation of the anatomical features of the joint and any pathological changes. The information is then used to grade each elbow joint. In the United Kingdom screening is controlled by the British Veterinary Association and the Kennel Club using the BVA/Kennel Club Elbow Dysplasia Scheme. For the scheme to be as successful and meaningful as it can it is important that radiographs of each elbow from dogs intended for breeding are examined. It is also important to monitor the elbows of their offspring.
The British Veterinary Association and the Kennel Club have issued Elbow Dysplasia Scheme Procedure Notes in order to ensure that all the information required is sent to them and that the dog's elbows are radiographed using standard positions. A certificate to be used for the submission of details and reporting the grade of the elbows is provided by the BVA. This certificate is printed on a heavy gauge gold coloured paper. The minimum age of a dog for taking and submitting a radiograph is one year. There is no upper age limit. Initially the dog owner would contact their veterinary surgeon to arrange to have the dogs elbows radiographed. This is done under general anaesthesia and the veterinary surgeon in question will provide further details about admitting the dog for the procedure. At the time of the radiography the following documents must be made available to the veterinary surgeon:
At some stage prior to the radiography, often on the morning of admission for the procedure, the owner must complete and sign the first section of the certificate "Section A" the Owners Declaration. This is to verify that the details given in this section relate to the dog being submitted, that the details are all correct and that the owner agrees to the results being used by the Kennel Club. The details required are:
The following information is requested but is not mandatory:
The Elbow Dysplasia Scheme Procedure Notes detail how the veterinary surgeon should position the dogs elbows for radiography, what information should be marked on the films, and what sort of image quality is required. Two specified views of each elbow are required with the joint in a different position for each. Thus a total of four radiographs are taken for each dog, two for each elbow. The submitting veterinary surgeon then fills in "Section B", the Submitting Veterinary Surgeon's Certificate, after he has checked all the details required by the scheme. The radiographs and the Elbow Dysplasia Certificate are then sent to the BVA. The current fee for the BVA must be included at the same time. This fee covers the BVA costs, the KC costs and the scrutineers' fee. The veterinary surgeons fee to cover the cost of obtaining the radiograph and processing the required paper work is not included in the BVA fee. Radiographs that do not meet the strict requirements of the scheme are not scored; they are returned to the submitting veterinary surgeon and a radiograph of appropriate quality requested. This is to make sure that there is consistence and a level playing field for all the radiographs submitted for grading. When subsequent radiographs are submitted a new certificate and a further fee must accompany them.
The results of grading are normally sent to the submitting veterinary surgeon after about three weeks. Two scrutineers, appointed by the BVA, examine each radiograph and agree a grade. The grades are based on the International Elbow Working Group grading criteria for the views specified. Four grades are possible for each elbow joint. The minimum is 0 and the maximum is 3.The grades are made by examining each elbow for evidence of either primary lesions or secondary osteoarthritis in the joint. The overall grade for both elbows is the grade that was give to the elbow with the highest grade. The lower the grade the less the degree of elbow dysplasia. The grade is recorded in "Section C", the Certificate of Grading section, of the certificate which is also signed by the two scrutineers. The radiographs are sent back to the submitting veterinary surgeon with the completed certificate to be given to the owner of the dog. The results for all Kennel Club registered dogs are sent to the Kennel Club for publication. Details may also be sent to a geneticist for statistical analysis.
Once a certificate of Elbow Dysplasia Grading has been issued for a dog, further radiographs of the dog may not be resubmitted for grading under the scheme. If an owner feels that the score is incorrect they have the right to appeal. The procedure is that the owner must lodge any application for appeal against the result of an elbow dysplasia grade with the BVA, in writing, within 45 days from the date of dispatch of the radiographs from the BVA. The same radiographs used for the initial grading must be resubmitted by the veterinary surgeon, with an Appeal Certificate and a regrading fee to the BVA. The Chief Scrutineer, whose decision is final, will regrade the radiographs, and the reviewed grade results will be reported in the normal way.