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      Epidemiology and clinical management of elbow joint disease in dogs under primary veterinary care in the UK

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          Abstract

          Background

          Conditions affecting the elbow joint are a common cause of lameness in dogs. Primary-care veterinary clinical data are now recognised as a valuable research resource. Using data from the VetCompass Programme, this study aimed to report the frequency and risk factors for elbow joint disease in dogs under primary veterinary care in the UK and describe clinical management.

          Results

          From 455,069 dogs under veterinary care, the one-year period prevalence for elbow joint disease diagnosis was 0.56% (95% CI: 0.53–0.60). Of 616 incident cases, the most common specific variants of elbow joint disease were osteoarthritis ( n = 468, 75.97%), elbow dysplasia (190, 30.84%) and traumatic (41, 6.66%). The most common signs described by the owners were lameness ( n = 466, 75.65%), difficulty exercising (123, 19.97%) and pain (86, 13.96%). The most common findings recorded on veterinary examination were pain ( n = 283, 45.94%), lameness (278, 45.13%) and reduced range of movement (243, 39.45%). Common medications used included non-steroidal anti-inflammatory drugs ( n = 544, 88.31%), tramadol (121, 19.64%) and disease modifying agents (118, 19.16%). Of 109 deaths involving euthanasia with information available from the 616 incident cases, elbow joint disease contributed to the decision to euthanase in 45 (41.28%) dogs.

          Five breeds showed increased odds of elbow joint disease compared with crossbred dogs: Rottweiler (OR: 6.16, 95% CI 3.89–9.75), Labrador Retriever (OR: 5.94, 95% CI 4.65–7.60), German Shepherd Dog (OR: 4.13, 95% CI 2.88–5.93), Golden Retriever (OR: 3.11, 95% CI 1.93–5.00) and English Springer Spaniel (OR: 2.00, 95% CI 1.26–3.18). Additional risk factors included having an adult bodyweight that was equal or higher than their breed/sex mean, advancing age, being male, being neutered, being insured and larger bodyweight.

          Conclusions

          Elbow joint disease is a relatively common diagnosis in dogs and has a high welfare impact as evidenced by the high proportion of cases recorded with pain, lameness and analgesic therapy. There are strong breed predispositions, in particular for large breed dogs. These findings present a clear case for improved breeding programmes to reduce the burden of elbow joint disease.

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          Most cited references58

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          Inherited defects in pedigree dogs. Part 1: disorders related to breed standards.

          The United Kingdom pedigree-dog industry has faced criticism because certain aspects of dog conformation stipulated in the UK Kennel Club breed standards have a detrimental impact on dog welfare. A review of conformation-related disorders was carried out in the top 50 UK Kennel Club registered breeds using systematic searches of existing information. A novel index to score severity of disorders along a single scale was also developed and used to conduct statistical analyses to determine the factors affecting reported breed predisposition to defects. According to the literature searched, each of the top 50 breeds was found to have at least one aspect of its conformation predisposing it to a disorder; and 84 disorders were either directly or indirectly associated with conformation. The Miniature poodle, Bulldog, Pug and Basset hound had most associations with conformation-related disorders. Further research on prevalence and severity is required to assess the impact of different disorders on the welfare of affected breeds.
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            Disease surveillance and referral bias in the veterinary medical database.

            The Veterinary Medical Database (VMDB) is a summary of veterinary medical records from North American veterinary schools, and is a potential source of disease surveillance information for companion animals. A retrospective record search from four U.S. university veterinary teaching hospitals was used to calculate crude disease rates. Our objectives were to evaluate the utility of the database for disease surveillance purposes by comparing the utility of two methodologies for creating disease categories, and to evaluate the database for evidence of referral bias. Summaries of the medical records from November 2006 to October 2007 for 9577 dogs and 4445 cats were retrieved from VMDB for all canines and felines treated at Kansas State University, Colorado State University, Purdue University and Ohio State University. Disease frequency, computed as apparent period-prevalence and as the percentage of veterinary visits, was compiled for 30 disease categories that were formulated by one of two methods. To assess the possible impact of referral bias, disease rates were compared between animals residing in zip codes within 5 miles of the hospitals (zone 1) and those animals living at more distant locations (zone 2). When compared to zone 1 animals, disease conditions commonly associated with primary veterinary care were reduced by 29-76% within zone 2, and selected diseases generally associated with more specialized care were increased from 46 to 80% among zone 2 animals. The major differences in disease prevalence seen between zones suggests that substantial referral bias may exist, and that adjustment on the basis of geographical proximity to the university teaching hospitals may be useful in reducing this type of selection bias in the VMDB, thereby improve the accuracy of prevalence estimates and enhancing the utility of this database for purposes of disease surveillance. Copyright 2010. Published by Elsevier B.V.
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              Comparison of force plate gait analysis and owner assessment of pain using the Canine Brief Pain Inventory in dogs with osteoarthritis.

              Lameness assessment using force plate gait analysis (FPGA) and owner assessment of chronic pain using the Canine Brief Pain Inventory (CBPI) are valid and reliable methods of evaluating canine osteoarthritis. There are no studies comparing these 2 outcome measures.
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                Author and article information

                Contributors
                doneill@rvc.ac.uk
                dbrodbelt@rvc.ac.uk
                rhodge3@rvc.ac.uk
                dchurch@rvc.ac.uk
                rmeeson@rvc.ac.uk
                Journal
                Canine Med Genet
                Canine Med Genet
                Canine Medicine and Genetics
                BioMed Central (London )
                2662-9380
                14 February 2020
                14 February 2020
                2020
                : 7
                : 1
                Affiliations
                [1 ]GRID grid.20931.39, ISNI 0000 0004 0425 573X, Production and Population Health, , The Royal Veterinary College, ; Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA UK
                [2 ]GRID grid.20931.39, ISNI 0000 0004 0425 573X, Clinical Sciences and Services, , The Royal Veterinary College, ; Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA UK
                Author information
                http://orcid.org/0000-0003-1115-2723
                Article
                80
                10.1186/s40575-020-0080-5
                7371807
                32835227
                a3dab43a-eab9-4936-be6d-be78f5ffb527
                © The Author(s). 2020

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 3 December 2019
                : 5 February 2020
                Funding
                Funded by: Kenel Club Charitable Trust
                Award ID: 2017
                Categories
                Research
                Custom metadata
                © The Author(s) 2020

                general practice,first opinion,vetcompass,arthritis,degenerative joint disease,osteoarthritis,elbow dysplasia

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