FCP in Staffy

RE: FCP in Staffy

Martin Atkinson — Thu, 15 Dec 2016 10:51:53 GMT

[quote user="Bob Russell"]Sorry it is going off topic[/quote]When did anything stay on topic? As it was my OP I more than happy for this to digress.

RE: FCP in Staffy

Bob Russell — Thu, 15 Dec 2016 09:48:33 GMT

Thought our GSD had broken his leg bouncing on the trampoline! Turned out some tail hairs had become caught in one of the springs.

(Sorry it is going off topic but Malcolm has really answered the question!)

RE: FCP in Staffy

Martin Atkinson — Thu, 15 Dec 2016 09:02:59 GMT

[quote user="Bob Russell"]Who thinks straight when it is their own pet? [/quote]When you've had to deal with a phone call from someone who says he's kidnapped your daughter and if you don't pay him a ransom straight away you'll never see her again, a lame pet is pretty insignificant and rather easy to think straight about I can assure you!

RE: FCP in Staffy

ruths — Thu, 15 Dec 2016 05:35:55 GMT

[quote user="Bob Russell"]

Who thinks straight when it is their own pet? I did not realise there were thin elastic bits to go round the back legs and one of these had become hooked up with the strap! Marie only found out when she took the coat off!!

[/quote]

i thought one of my cats had broken his pelvis

he had a piece of sellotape stuck to his bum

RE: FCP in Staffy

Martin Atkinson — Wed, 14 Dec 2016 16:48:43 GMT

Thanks Malcolm, I think this is the news she wants to hear. I will try and get more information but it will be difficult because I'm not officially the second opinion.

RE: FCP in Staffy

Malcolm Ness — Wed, 14 Dec 2016 14:53:12 GMT

Hi Martin. Ideally, we need to know more about the clinical picture with this case.

These days, I will occasionally, but only very occasionally, consider removal of fragmented coronoid and then only after a history of ongoing lameness and disability that is inadequately responsive to lengthy NSAID courses. I remain uncertain that I am doing any good at all.

Most of these dogs cope extremely well with their lesions in that although some degree of lameness might persist, the dog remains fully active and apparently comfortable over many years and usually lifelong as suggested in an earlier post. I counsel the owners that occasional extended courses of NSAID (6 weeks +) will be needed to deal with occasional acute flares of the chronic elbow OA but otherwise the dog can be kept fully active. I have managed a good number of working spaniels and labradors this way.

These cases are a magnet for enthusiastic surgeons but I am still unaware of any convincing evidence that surgery of any kind (open or arthroscopic removal of coronoid; debridement/re--sculpting of the coronoid 'bed'; sliding humeral osteotomy etc etc) has any measurable benefit either therapeutically or prophylactically. Most proponents of surgery tell tales of how they see dogs do well following their preferred intervention and how they are helping to prevent later disasters but, as I say, none of that is supported with any good quality evidence.

The problem is that the fragmentation of the coronoid is but one manifestation of a dysplastic elbow joint, the aetiology and pathogenesis of which is not adequately understood.

I think an important factor to consider is the question of exactly why the dog might be lame. The FCP is but naming an abnormality. Elbow dysplasia is developmental so there was almost certainly something going wrong from the time the dog was about 7 moths old. The elbow will have grown and remodelled since then and a secondary OA developed. Any current lameness might be due to the FCP, it might be due to other aspects of the elbow dysplasia, it might be due to the chronic, secondary OA and it might be due to an acute flare of the secondary OA. Given the age of this dog and assuming that the lameness that led to the diagnosis is recent, then I would suggest that an acute flare of the OA is currently the most significant cause hence my keenest to manage these medically in the first (and second) instance.

A few of these cases go bad no matter what you do - though it is a small number of them - these are the dogs that remain very lame despite anything you do and end up as candidates for arthrodesis or elbow joint replacement.

RE: FCP in Staffy

Rob Loxley — Wed, 14 Dec 2016 13:42:13 GMT

Generally I find that they do well (better) with removal of the fragments, but hit a point 4-6yrs down the line where the lameness returns with development of arthritis, which eventually becomes quality-of-life-limiting.

If costs allow arthroscopic treatment I generally recommend this, with the proviso the elbow will never be perfect, and the fMCP is only part of overall elbow dysplasia. £5-6k total sounds steep for arthroscopy, unless they are suggesting some fancy sliding humeral osteotomy / ulnar abducting osteotomy?

We equally have comfirmed fMCP cases managed medically, but I've yet to see one get better back to normal and not need ongoing treatment.

RE: FCP in Staffy

Bob Russell — Wed, 14 Dec 2016 12:17:03 GMT

RE: FCP in Staffy

Martin Atkinson — Wed, 14 Dec 2016 12:11:39 GMT

[quote user="Bob Russell"]I brought her in for PTS this morning because she could not use one of her back legs. Fortunately the nurse identified that she had caught the leg in her posh new coat! [/quote]You cannot be serious man!

RE: FCP in Staffy

Bob Russell — Wed, 14 Dec 2016 12:05:02 GMT

Our 16yr old Staffie had the same but as it was before most of the very clever referral centres and she was not particularly lame she was treated conservatively. This involved her running away across the Forest for miles, creating havoc so really nothing conservative about it!

She has knackered elbows now but not sure any surgery would have prevented that in the long term so quite glad we did nothing.

I brought her in for PTS this morning because she could not use one of her back legs. Fortunately the nurse identified that she had caught the leg in her posh new coat! She lives another day!