Elbow bursitis in dogs: diagnosis, symptoms and treatment methods

Bursitis in dogs is an inflammation of the elbow and knee joints. Dogs often have to be on their feet. They must look for food, otherwise they simply will not survive in the harsh environmental conditions. In addition, dogs are animals that live in a pack, so they have to defend themselves from unfriendly relatives and enemies. Healthy legs for these animals are an important condition for their prosperous existence. This disease does not spare pets. The dog becomes helpless and inactive, which makes the life of the owner more difficult. Animals require more care and attention than usual

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With bursitis, the following become inflamed: the elbow, knee or hip joints, or rather the mucous membranes of the bursa in which they are located. The disease gets its name from the bursa, the bursa surrounding the joint. It contains synovial fluid. The role of the bursa is to protect the joint and soften the friction of the articular surfaces during movement.

Etiology of bursitis in dogs

Basically, bursitis develops due to open and closed mechanical damage. Less often it occurs due to the spread of the inflammatory process with a number of underlying tissues, and sometimes as a result of the spread of infection by hematogenous route (brucellosis, campylobacteriosis, tuberculosis, sepsis, etc.).

The main causes of bursitis in dogs:

• constant increased load on the joint;
• tendon injuries in the area of ​​the periarticular bursa. These are all kinds of wounds and bruises that may not initially bother the dog;
• associated diseases such as arthritis. These diseases can cause the development of bursitis;
• penetration of infection inside through tissue in the joint area;
• some autoimmune diseases;
• allergic reactions or abnormal metabolism;
• the temperature factor can also contribute to disruption of the blood supply to the skin and underlying tissues, including synovial bursae;
• Improperly selected and hard litter can cause disease.

Young dogs of giant breeds (Mastiffs, Shepherds, Rottweilers, Black Terriers, St. Bernards, Ridgebacks, Mastiffs, Giant Schnauzers, etc.) are more prone to bursitis.

Recovery

If the owner closely monitors the condition of the recovering dog, final recovery may take from a couple of weeks to a month and a half, depending on the severity of the disease. Pain and swelling go away in the first days, however, even after significant improvement, the owner must not lose vigilance: healing of the joint takes time and patience.

Dog with a bandage on the elbow joint

Most likely, the veterinarian will prescribe a special brace for the dog (especially if it has had fistulas), which will fix the position of the limb in the correct way. Under no circumstances should this corset be removed from the animal ahead of time, even if it interferes with the dog, or if the owner seems that his pet has already recovered. Aseptic bursitis goes away in two to four weeks, while purulent bursitis requires treatment for five to six weeks.

The best Yorkshire terrier shits everywhere, he's pretty tired of it!

Strengthening the immune system

Regardless of whether the pet has undergone surgery or not, most specialists, along with a corset and compresses, prescribe immunomodulators that will help strengthen a weakened immune system. The most popular immunomodulators these days are presented in the table below.

Table. Immunomodulators for dogs

You can also add vitamins to your dog's diet, but only after consulting a doctor.

Symptoms of bursitis in dogs

According to clinical signs and course, bursitis is distinguished between purulent and aseptic, acute and chronic.

Main signs of the disease:

• pain, swelling, hyperemia in the joint area;
• local increase in temperature;
• limited movement.

A painful, dense, reddish and mobile swelling appears in the joint area. This is how acute aseptic bursitis occurs. With chronic bursitis, the swelling can grow stronger, and when contaminated with secondary microflora, bacterial inflammation develops with purulent exudate, which can spread to the tissues surrounding the bursa and be accompanied by their necrosis and the development of phlegmon. If the bursa is opened, fistulas are formed that do not heal for a long time. When connective tissue grows around a joint, it can cause joint stiffness. Calcium deposits may occur in the bursa.

Bursitis in a dog. Elbow joint.

Treatment of inflammation of the joint capsule of the elbow joint

Is your elbow swollen, red and painful? Possibly elbow bursitis

- inflammation of the intra-articular bursae, resulting from microtraumas, local overload of the joint, or as a manifestation of systemic diseases. This inflammatory process is considered one of the most common types of bursitis and is accompanied by an increase in the size of the joint, redness, and the inability to bend and straighten the arm due to severe pain and swelling of the elbow.

Most often it occurs in professional athletes, manual workers, as well as people who, due to their profession, are forced to perform monotonous actions every day with support on their elbows. These are predominantly young and middle-aged people who work as miners, plumbers, roofers, drivers and clerks.

To make a diagnosis and effectively combat this disease, our sports rehabilitation center uses a set of diagnostic measures, conservative and surgical treatment methods. We are attentive to each patient and are ready to select individual treatment that will allow you to get rid of unpleasant sensations and change the quality of life after the first contact with us. Symptoms of the disease

With bursitis of the elbow joint, the patient's condition worsens slightly. There is a general malaise and an increase in body temperature, which can persist for several days. A painful formation may appear on the elbow - a lump that looks aesthetically unattractive and is elastic to the touch.

The following symptoms are also observed:

• slight elbow swelling and swelling;
• redness, local increase in temperature;
• moderate pain, limitation of movements.

In most cases, inflammation goes away without complications, excess fluid is absorbed, the skin acquires a natural color, and overall health improves. However, after another injury or overstrain of a joint, the disease may recur and become chronic. With this type of bursitis, pain may intensify with prolonged physical activity and contact with the work table. The lump on the elbow can feel different to the touch - elastic, soft, hard, etc. If the bursa is suppurated against the background of chronic or acute bursitis, the nature of the pain in the elbow changes to a tugging, bursting sensation. The elbow joint becomes hot and painful on palpation, swollen and hyperemic. Hand movements are limited and difficult. Symptoms of general intoxication are also noted: headaches, high fever, weakness, body aches. When inflammation spreads, fistulas may appear, purulent arthritis, abscess or osteomyelitis may develop.

Make an appointment and get a comprehensive consultation from a traumatologist-orthopedist, sports medicine doctor Ondar Temir Evgenievich:

Causes of the disease

If you look inside the joint, you can see that above the olecranon there is an anatomical formation with fluid, which in its shape resembles a bag. It is a bursa that serves as a shock absorber, reducing friction between bones, ligaments, tendons and skin, allowing ease of movement and preventing damage to surrounding tissue. In a healthy person, there is a small amount of fluid inside this formation. With excessive physical exertion or microtrauma, the situation is different: fluid in the bursa is actively produced, does not have time to be absorbed and causes characteristic swelling. The tightly filled pouch begins to bulge, reaching a considerable size. Outwardly, it looks like a “bump”, which can hurt and cause some inconvenience to the patient. If an infection occurs in the bag with liquid, purulent inflammation begins, which can cover adjacent tissues and organs.

Among the main reasons for the onset of the inflammatory process in the bursa are the following:

• repeated injuries to the elbow or pressure on this area, for example, while performing a specific type of work;
• performing monotonous mechanical movements due to professional activities;
• sports loads that involve systematic bending of the arm at the elbow joint (weightlifting, gymnastics, baseball) or a fall on this area (football, hockey, rugby);
• regularly resting your elbows on a solid base, due to the presence of chronic lung diseases and the need to increase inhalation effort;
• forced preservation of body position (most often in patients on hemodialysis);
• local hypothermia of the limb (for example, when performing cargo-loading work in an open warehouse area).

The localization of inflammation can be different, depending on the characteristics of the load. In office workers, miners and wrestlers, the subcutaneous ulnar bursa is mainly affected, and in athletes, the radioulnar bursa is affected. In gout, rheumatoid arthritis and other diseases, inflammation is more likely a reaction to the formation of salt deposits in the bursa. The cause of purulent bursitis is the penetration of microbes through existing skin lesions: abrasions, small wounds, pustules or boils. In the case of erysipelas, osteomyelitis, the presence of purulent wounds and bedsores, the infection can be introduced into the bursa along with the flow of lymph or blood.

Undoubted risk factors influencing the likelihood of infection are:

• diabetes mellitus or the presence of other systemic diseases;
• long-term use of steroid drugs;
• metabolic disorders and weakened immunity;

In addition, it matters whether the patient abuses alcohol and tobacco products.

Classification

The most common types of bursitis, as a rule, are aseptic, i.e., germ-free, resulting from overload of the joint, and septic, accompanied by the development of infection due to the contamination of the sac with various microorganisms (mainly bacteria). Aseptic bursitis most often occurs as a result of:

injuries, minor (leaning on the elbow) or excessive, which lead to hemorrhage into the bursa and the development of inflammation; the presence of systemic diseases, including diabetes mellitus, gout, rheumatoid arthritis, and ankylosing spondylitis.

Septic bursitis usually develops when bacteria enter the intraarticular bursa. In some cases, these are Staphylococcus aureus and Streptococcus. Infections caused by fungi and mycobacteria are more common in people with weakened immune systems or autoimmune disorders.

Bursitis can also be classified depending on:

localization (inflammation of the radioulnar, ulnar or interosseous ulnar bursa); course (acute, subacute and chronic); the nature of the fluid (serous, hemorrhagic, fibrinous and purulent).

Depending on the type of microorganisms that have entered the pouch, specific (caused by pathogens of specific infections, for example, gonococci, mycobacterium tuberculosis) and nonspecific (caused by streptococcus or staphylococcus) inflammatory processes are distinguished.

Diagnostic methods

The most important diagnostic criteria for establishing a diagnosis are:

• swelling of the elbow, which usually appears a few hours or days after injury to the joint. Most often painless, soft and warm to the touch;
• plasticity and mobility of the joint;
• no pain in the elbow joint except in cases of flexion, when the bursa is compressed.

When examining a patient, a thorough history and clinical examination are performed. In addition, the complex of diagnostic measures includes:

• Laboratory diagnostics. A blood test (clinical, biochemical) and a general urine test are recommended. Based on these tests, the degree of inflammatory activity is determined (leukocyte count, C-reactive protein level);
• Instrumental diagnostics: the patient is prescribed an ultrasound or radiography - the most important components of the study, the conduct of which makes it possible to determine in which particular bursa the inflammation has occurred, and whether this disease can be attributed to bursitis, since similar symptoms can be observed in other diseases (for example, arthritis, ligament ruptures, tumor diseases of the bone and muscle system);
• Other diagnostics. If the measures taken turn out to be uninformative, the patient is prescribed a puncture of the intra-articular bursa - a procedure during which the bursa is punctured to collect and examine fluid (most often for infected bursitis). Allows you to determine the type of microorganisms that caused inflammation in the joint capsule, as well as their resistance to antibiotics.

In some cases that require clarification, an MRI of the joint is performed, in particular, in cases of damage to the interosseous and radioulnar synovial bursae, which are difficult to diagnose due to their deep location. Consultation with other specialists can also be used, including a venereologist, phthisiatrician, rheumatologist (if rheumatoid arthritis, gout, specific bursitis is suspected).

Features of treatment

Treatment of the disease is complex and always begins with ensuring the rest of the limb using a fixing bandage, orthosis or splint. This helps eliminate pain, reduce swelling and prevent joint injury. If the cause of inflammation is microtrauma, immobilization of the hand must be preceded by the application of a cold compress.

Among the modern methods of treating acute bursitis, the following are distinguished:

• Intra-articular injections with GCS (hydrocortisone, betamethasone) to minimize relapses of the disease, instantly relieve pain and eliminate swelling. The procedure is recommended for use only in a medical institution, since infection may occur due to non-compliance with the rules of antiseptic treatment;
• Prescription of medications, including NSAIDs (aspirin, voltaren, diclofenac, ibuprofen, etc.) to relieve inflammation and pain relief, drugs with chondroprotectors for tissue regeneration and antibiotics for infectious inflammation;
• The use of local remedies that will help not only relieve pain faster, but also speed up tissue restoration, reduce swelling and inflammation. These can be absorbable compresses with dimexide, as well as ointments with anti-inflammatory components, collagen, glucosamine and chondroitin sulfate;
• Physiotherapy and physical therapy, through which it becomes possible to relieve local symptoms of bursitis. They are recommended for patients with a chronic course of the process, as well as in the subacute period. The following physiotechniques are usually used: ultrasound, shock wave therapy, UHF, microcurrents, phonophoresis, electrophoresis, dry heat, paraffin therapy and balneotherapy, massage.

For atrophy or necrosis of tissues accompanying the chronic process, as well as for purulent inflammation of the bursa, surgical treatment methods are used (excision of the bursa under local anesthesia). They are usually carried out if there is no effect as a result of the use of conservative therapy for one to two months, including with the fistulous form of bursitis. In case of frequent exacerbations of the disease, all tissues of the joint capsule or its separate part are removed without opening it, after which a splint is applied and comprehensive rehabilitation is carried out in a sports medicine center.

Thus, only complex therapy in combination with the wide capabilities of a physiotherapy room can give a positive result in the treatment of the disease in question.

The modern equipment of our center allows specialists to use highly effective treatment methods. Immediately after diagnostic measures, an optimal treatment regimen is selected for each specific case, aimed at restoring performance and returning the patient to an active life.

Our specialists have extensive experience in treating elbow bursitis. After just a few weeks, patients forget about pain, and repeated images show positive dynamics in 80–90% of cases.

Complications

The main complications of acute bursitis are: purulent arthritis, sepsis, phlegmon, fistula formation, osteomyelitis, lymphadenitis. With the development of a purulent process, mechanotherapy, as well as any physical procedures, are contraindicated and are not carried out during the first three weeks.

Hospitalization is recommended for patients who have:

• severe infection with high fever, abscess, which requires immediate opening and drainage to eliminate;
• there is no positive dynamics after long-term conservative treatment (usually a referral is issued after two months, but can be issued earlier if significant discomfort persists).

Therapy in the acute phase of the disease is more successful compared to that of the chronic form. That is why the patient should not delay visiting the clinic and should not self-medicate.

Prevention

For patients with damage to the elbow joint, specific preventive measures have not yet been developed. But dynamic observation by a specialist is recommended after complex treatment, which should be provided at least once every quarter of the year.

The following recommendations may also be helpful:

If there are abrasions, scratches and small cuts, it is always necessary to disinfect these areas using antiseptic agents; If you experience the slightest pain in your elbow, you should avoid intense physical activity; It is advisable to switch to dietary nutrition and ensure complete rest of the limb.

The modern rhythm of life obliges many of us to move a lot and actively, undergoing unusual physical activity. As a result, even the strongest joints may fail. That is why it is necessary to take care of yourself in advance and protect your joints, especially if the profession involves heavy physical labor. For these purposes, special bandages and emollients can be used when resting on the elbows. When performing long-term work, it is imperative to take short breaks and allow yourself to rest.

Before training, athletes are recommended to do “warm-up” exercises to help stretch their muscles. Swimming, walking or running are recommended as additional exercises for all patients with joint problems.

The result of treatment can be negatively affected by:

• patient refusal to visit a physiotherapy room;
• his dishonest attitude and non-compliance with doctor’s recommendations, in particular, refusal of antibiotics in the event of the development of infectious complications;
• the use of physical activity during treatment.

Diagnosis and treatment of bursitis in dogs

The diagnosis is made comprehensively based on clinical signs. To confirm the diagnosis, laboratory and x-ray studies are needed to help differentiate bursitis from, for example, non-infectious arthritis or joint damage due to brucellosis, which is dangerous for animals and humans.

Conservative treatment of bursitis in dogs includes a regimen developed by a doctor that is optimal for a particular animal. In addition to drugs and ointments for topical use, it may include the application of pressure bandages in combination with cold compresses, complete rest, and physical therapy.

If bursitis is complicated by a secondary infection, it is necessary to resort to surgical intervention. This can be a puncture, opening the abscess cavity, removing the inflammatory exudate and subsequent washing.

Features of prevention

To prevent bursitis, it is necessary to combat predisposing factors, this is especially true for owners of large dogs. First of all, good living conditions are created:

• spacious enclosure;
• soft bedding, which is changed regularly;
• walking the animal, providing physical activity.

An important point is feeding control. In obese dogs, hygroma develops significantly more often. Excess body weight puts excessive pressure on the joint capsule. It is better to learn about proper nutrition for your pet from a veterinarian so that he can select an individual diet that takes into account the breed, age and weight of the animal.

In most cases, bursitis in dogs can be cured without surgical measures. Timely contacting a veterinary clinic and proper treatment allows the animal to recover quickly. The owner must play a large role in therapy - it is necessary to create high-quality conditions for keeping the pet in order to avoid repeated injuries.

Prevention of bursitis in dogs

Prevention of bursitis includes:

• Keeping dogs in warm rooms with moderate humidity and temperature, without drafts;
• Balanced feeding;
• Prevention of injury;
• Comfortable place to sleep;
• Exercise selected based on the physiological needs of the dog’s body.

It is important to remember that this disease is easier to cure by contacting a clinic when the first symptoms appear, and it is not difficult to avoid by following simple preventive measures.

Causes

• Moderate but repetitive trauma is the most common cause. For example, people who lean on their elbows cause friction and mild trauma to the tissue over the olecranon. For example, there are terms such as “student’s elbow,” plumber’s elbow or miner’s elbow, and these terms are based on prolonged support on the elbows.
• Single injuries, such as a blow to the back of the elbow, can cause inflammation.
• Arthritis. One or more bursae may become inflamed as a result of polyarthritis (but most cases of olecranon bursitis are not associated with arthritis).
• Bursa infection. This can happen if there is a cut in the skin over the bursa that allows bacteria to enter.
• Idiopathic. In many cases, bursitis occurs for no apparent reason. However, it is possible that in some cases, bursitis is associated with a minor injury that has been forgotten.

Symptoms

In dogs, symptoms usually begin with lameness that comes on suddenly. The affected elbow or thigh swells at the joint; when palpated, you can clearly feel fluid in the lump. If the disease has reached the stage of suppuration, the tumor will be hot, touching it will cause the dog to whine. In this case, the animal stops feeding and prefers to stay in one place. The usually calm four-legged friend becomes irritable and lethargic. From the cone that appears, ichor mixed with pus may protrude. The pet actively licks the disturbing area.

It is important to be able to distinguish real bursitis from a disease such as hygroma. The false form, unlike the ordinary one, can occur not only in an adult, but also in a puppy. Hygroma is expressed in a small tumor that occurs on the process of the elbow; it consists of a thick fibrous capsule, inside of which there is a clear liquid. Veterinarians divide them by degree of difficulty. Simple ones do not cause anxiety in the pet, they do not hurt, and their capsule is not pronounced. Complex hygroma is characterized by fever, is painful and leads to lameness. Let's move on to the question of how to treat real bursitis.

Methods of therapy

During the treatment of bursitis, physical activity is contraindicated for the dog. If the disease is purulent, puncture and drainage are performed to remove exudate, and antibiotics are prescribed after identifying the pathogen.

For aseptic bursitis, it is necessary to apply tight bandages, ice compresses, and then physical therapy.

The dog is provided with a soft bed. Pet elbow pads can be used to prevent further recurrence.

Pumping out fluid from the bursa in non-infectious disease usually turns out to be ineffective. If conservative therapy does not help, they resort to surgery.

NSAIDs and painkillers

Travmatin for dogs or Chondartron injections are prescribed as painkillers and anti-inflammatory drugs for bursitis. The drugs relieve swelling, reduce pain, and promote faster tissue regeneration. Injections also reduce the risk of relapses.

Ointments

For purulent bursitis, after pumping out the fluid or breaking through the phlegmon on its own, local ointments are prescribed:

• Ranosan;
• Saphroderm;
• Bioseptin;
• Sangel.

Medicines in this category have a pronounced antimicrobial and anti-inflammatory effect, help draw out remaining pus and promote faster regeneration of damaged tissues.

For non-infectious (aseptic) bursitis, you can use Hondartron-gel or Trauma-gel.

Surgery

In case of chronic bursitis, surgical treatment is indicated, which involves excision of the synovial bursa. In veterinary medicine, this operation is called bursectomy. It is performed under general anesthesia and local anesthesia. On average, the cost of an operation to remove a bursa is 5,000 rubles.

During the postoperative period, the dog must be provided with a soft bed to relieve pressure in the elbow area and prevent relapses.

Treatment

Treatment should begin with puncture of exudate from the bursa. Such a diagnosis will help the veterinarian distinguish bursitis from arthritis, which has similar external signs. Depending on the form, the disease can be treated either conservatively or with surgery.

At home, the animal needs to create comfortable conditions, protect it from intense stress on its limbs, and lay out a soft bed. In acute cases, you can secure the limb with a tight bandage and apply a cool compress there.

In case of a purulent form, an antiseptic ointment should be applied to the tumor, which will slow down the development of infection. When there is discharge on the bursa, the use of hot lotions is unacceptable; they provoke the proliferation of microbes. You can give the dog a light massage of the limb, especially those places adjacent to the tumor.

Surgery is necessary if calcium deposits have caused the joint to become ossified. In this case, the specialist will remove the infected and dead areas, after which they can be compensated with an implant made of wood or metal.