Medial Coronoid Process Disease (MCPD) is a developmental orthopedic condition affecting the elbow joint in dogs. It involves the fragmentation or abnormal development of the medial coronoid process, a bony protrusion on the ulna within the elbow joint. This condition leads to pain, lameness, and joint instability. MCPD is one of the most common causes of elbow lameness in young, rapidly growing dogs of large and giant breeds. The exact cause of MCPD is not fully understood, but several factors are believed to contribute to its development including genetic predisposition, as certain breeds are more prone to MCPD due to inherited genetic factors. Joint incongruency, abnormal joint alignment or incongruency between the radius and ulna bones can lead to excessive stress on the medial coronoid process, causing it to fragment. Rapid growth, especially in large and giant breed puppies, can also contribute to the development of MCPD and trauma, injury or excessive physical activity during periods of growth can exacerbate the condition.

©Toby Gemmill

Dogs with MCPD typically show signs of lameness in one or both front legs, which may be more pronounced after exercise or rest. Common signs include:

• Progressive lameness in the forelimbs, often starting between 4-5 months of age.
• Pain on full extension or flexion of the elbow.
• Swelling and warmth around  the affected joint.
• Decreased range of motion in the elbow.
• Abnormal gait, such as outward rotation of the feet ("duck-footed").

Diagnosis of MCPD involves a combination of clinical signs, physical examination, and imaging techniques. Your veterinarian may recommend X-rays (radiographs) to assess the elbow joint and identify any abnormalities. If more information is needed for a diagnosis or treatment plan, your veterinarian may recommend a CT scan (or MRI) for a more detailed view of the joint and to confirm the presence of a fragmented coronoid process. In some cases, arthroscopy, a minimally invasive procedure that allows direct visualisation of the joint and any fragments, may provide the best information to make a definitive diagnosis.

Treatment options for MCPD vary depending on the severity of the condition and may include:

• Conservative management: rest, weight management, and anti-inflammatory medications to reduce pain and inflammation.
• Surgical intervention: removal of the fragmented coronoid process via arthroscopy or traditional surgery to alleviate pain and improve joint function. Procedures may also be performed to improve joint congruency or correct abnormal limb alignment.
• Physical therapy: rehabilitation exercises to strengthen the muscles around the joint and improve mobility.
• Joint supplements: nutritional supplements to support joint health and reduce inflammation.

Preventing MCPD involves responsible breeding practices to reduce the incidence of genetic predisposition. MCPD commonly affects medium to large-breed dogs including:

• Bernese Mountain Dogs.
• English and Bull Mastiffs.
• German Shepherds.
• Irish Wolfhounds.
• Rottweilers.
• Saint Bernards.
• Labrador Retrievers.

If your dog is diagnosed with MCPD, work closely with your veterinarian to develop a comprehensive treatment plan tailored to your dog's needs. Regular check-ups, appropriate management, and supportive care can help your dog lead a comfortable and active life.

Providing supportive care at home is essential for managing MCPD and ensuring your dog leads a comfortable and fulfilling life. Here are some key aspects of home care:

• Weight management: maintaining a healthy weight is crucial for dogs with MCPD, as excess weight can put additional strain on the elbow joints. Feed your dog a balanced diet and monitor their weight regularly. Consult your veterinarian for dietary recommendations and portion control.
• Controlled exercise: engage your dog in controlled, low-impact exercises to maintain muscle strength and joint mobility without exacerbating the condition. Short, frequent walks on soft surfaces are ideal. Avoid high-impact activities such as jumping or running on hard surfaces
• Physical therapy: physical therapy can help improve joint function and reduce pain. Gentle range-of-motion exercises, hydrotherapy, and massage can be beneficial. Consult with your veterinarian or a veterinary physiotherapist for a tailored exercise plan.
• Comfortable resting areas: provide soft, supportive bedding to reduce pressure on the joints while your dog rests. Ensure that your dog has a comfortable and quiet place to relax.
• Pain management: administer any prescribed pain medications or anti-inflammatory drugs as directed by your veterinarian. These medications can help manage pain and inflammation associated with MCPD.
• Joint supplements: consult your veterinarian for recommendations on appropriate supplements to support joint health and reduce inflammation.
• Environmental modifications: make modifications to your home to accommodate your dog's needs. Use ramps or steps to help your dog access furniture or vehicles without jumping. Ensure that your home is free of slippery surfaces that could cause your dog to slip and injure themselves.
• Regular veterinary check-ups: schedule regular veterinary check-ups to monitor your dog's condition and adjust the treatment plan as needed. Your veterinarian may recommend periodic X-rays or other imaging to assess the progression of MCPD.