Prevalence of elbow dysplasia in 13 dog breeds in France: a retrospective radiographic study (2002–2022)

Joséphine Roels Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l’Etoile, France
Research Unit ICE, UPSP 2016-A104, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l’Etoile, France

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Jean-Pierre Genevois Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l’Etoile, France
Research Unit ICE, UPSP 2016-A104, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l’Etoile, France

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Mathilde Fostier-Humbert Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l’Etoile, France
Research Unit ICE, UPSP 2016-A104, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l’Etoile, France

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Charles Porsmoguer Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l’Etoile, France
Research Unit ICE, UPSP 2016-A104, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l’Etoile, France

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Margaux Blondel Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l’Etoile, France
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Guillaume Chanoit Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l’Etoile, France
Research Unit ICE, UPSP 2016-A104, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l’Etoile, France

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Didier Fau Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l’Etoile, France
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Thibaut Cachon Surgery Unit, Lyon Veterinary Teaching Hospital, University of Lyon, Veterinary Campus of VetAgro Sup, Marcy l’Etoile, France
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Abstract

OBJECTIVE

To describe the prevalence of elbow dysplasia (ED) in 13 dog breeds in France.

ANIMALS

A total of 18,870 elbow radiographs taken from 2002 to 2022 were evaluated by 2 independent examiners.

METHODS

For each breed, the incidence of each of the 4 International Elbow Working Group scoring classes was extracted from the database. Breeds were excluded if fewer than 150 radiographs had been read for that breed.

RESULTS

This study included 17,861 records for 13 dog breeds: American Akita, Alaskan Malamute, Old German Shepherd (Altdeutscher Schäferhund), American Staffordshire Terrier, Australian Shepherd, Belgian Shepherd, White Swiss Shepherd, Bernese Mountain Dog, Cane Corso, Czechoslovakian Wolfdog, Rhodesian Ridgeback, Rottweiler, and Dogue de Bordeaux. The overall prevalence of ED was 11.4%, ranging from 1.1% in the Czechoslovakian Wolfdog to 32.2% in the Dogue de Bordeaux. The Dogue de Bordeaux, Rottweiler, Bernese Mountain Dog, and Cane Corso breeds were most commonly affected by ED. The prevalence of ED was significantly higher in male dogs than in female dogs (17.5% vs 10.5%, P < .05). Joint incongruity and fragmented coronoid process were the 2 most common primary ED lesions identified. The prevalence of ED among the dogs evaluated decreased over the timeframe of the study.

CLINICAL RELEVANCE

The results of this study help to clarify the prevalence of ED in different breeds in France. These data should be interpreted with caution as this study included a small percentage of the total number of dogs born for each breed in France over the study period.

Abstract

OBJECTIVE

To describe the prevalence of elbow dysplasia (ED) in 13 dog breeds in France.

ANIMALS

A total of 18,870 elbow radiographs taken from 2002 to 2022 were evaluated by 2 independent examiners.

METHODS

For each breed, the incidence of each of the 4 International Elbow Working Group scoring classes was extracted from the database. Breeds were excluded if fewer than 150 radiographs had been read for that breed.

RESULTS

This study included 17,861 records for 13 dog breeds: American Akita, Alaskan Malamute, Old German Shepherd (Altdeutscher Schäferhund), American Staffordshire Terrier, Australian Shepherd, Belgian Shepherd, White Swiss Shepherd, Bernese Mountain Dog, Cane Corso, Czechoslovakian Wolfdog, Rhodesian Ridgeback, Rottweiler, and Dogue de Bordeaux. The overall prevalence of ED was 11.4%, ranging from 1.1% in the Czechoslovakian Wolfdog to 32.2% in the Dogue de Bordeaux. The Dogue de Bordeaux, Rottweiler, Bernese Mountain Dog, and Cane Corso breeds were most commonly affected by ED. The prevalence of ED was significantly higher in male dogs than in female dogs (17.5% vs 10.5%, P < .05). Joint incongruity and fragmented coronoid process were the 2 most common primary ED lesions identified. The prevalence of ED among the dogs evaluated decreased over the timeframe of the study.

CLINICAL RELEVANCE

The results of this study help to clarify the prevalence of ED in different breeds in France. These data should be interpreted with caution as this study included a small percentage of the total number of dogs born for each breed in France over the study period.

Elbow dysplasia (ED) is a complex developmental disease of the elbow joint and is one of the most common orthopedic problems affecting large- and giant-breed dogs.13 Elbow dysplasia encompasses a group of primary lesions involving the humeroradioulnar joint, including medial coronoid process disease, ununited anconeal process (UAP), osteochondrosis dissecans of the medial humeral condyle (OCD), fragmented coronoid process (FCP), and joint incongruity.13 These orthopedic conditions can occur individually or in association with each other. Elbow dysplasia is caused by an abnormal development of the elbow joint resulting in cartilage damage and leading to inflammation and secondary osteoarthritis associated with pain and lameness that ranges from mild to severe.1,2 The diagnosis of ED is based on clinical signs, epidemiology, and diagnostic imaging. Elbow radiographs have a sensitivity and specificity ranging from 16% to 98%, depending on the screening method (radiographic projection), the observer’s experience, and the patient’s age.1,47 While CT is currently the gold standard method for detecting ED, large-scale screening of dogs is still based on radiographs.79

Elbow screening programs have been established to identify elbow lesions and discourage breeding of affected dogs. Screening programs often require only 1 or 2 views in most countries. Diagnosis can be established based on evaluation of radiographs according to the International Elbow Working Group (IEWG) protocol, which identifies signs of osteoarthritis and aims to assess major primary lesions (FCP, UAP, OCD, and incongruity).10 First, the degree of osteoarthritis is evaluated, followed by identification of primary lesions when possible. The cumulative evaluation is expressed from grade 0 (normal) to grade 3 (severe).2,8,11,12 With this method, the presence of osteoarthritis in the elbow joint suggests ED, without giving a definitive diagnosis.

In France, the first ED screening program began in 1997 for the German Shepherd breed. It was based on 3 radiographic views, including a true mediolateral view with the joint flexed approximately 45° (ML flexed), a true mediolateral extended view (ML extended), and a craniolateral-caudomedial 15° oblique view (Cr15L-CdMO).4,11,13 Based on the Fédération Cynologique Internationale recommendations, the minimum age for official screening must be 12 months. For each breed, an official reader is appointed by the breed club to analyze the radiographs.

The first objective of this observational study was to describe the ED prevalence in affected breeds over a 20-year time period in France using radiographs from the official screening program and to compare the prevalence of ED between males and females. We hypothesized that ED is more common in male than in female dogs. The second objective was to assess the effectiveness of the ED screening program in France by analyzing the prevalence of ED over time.

Methods

Data

ED assessment was performed by 2 independent examiners (JPG and DF) on 18,870 elbow radiographs from 54 different breeds assigned to these 2 examiners, taken between 2002 and 2022 and submitted by breeders or owners. Radiographic views included ML flexed, ML extended, and Cr15L-CdMO views. All data were digitized and recorded in a single electronic database to allow further analysis. Breeds were excluded if fewer than 150 radiographs were read for that breed. A total of 13 breeds were included in this study. For each breed, the incidence of each of the 4 IEWG scoring classes was extracted from the database for each year of the study period (2002 to 2022).

Scoring protocol

All dogs were scored according to the IEWG grading system (Table 1).10 Each joint was assigned 1 of 4 grades (0 to 3), defined as follows: grade 0 (normal) refers to a normal joint with no evidence of incongruity, sclerosis, or arthrosis; grade 1 (mild, ED1) refers to the presence of osteophytes < 2 mm in size and subtrochlear sclerosis but with a trabecular pattern still visible; grade 2 (moderate, ED2) refers to the presence of osteophytes of 2 to 5 mm in size, obvious subtrochlear sclerosis, and no trabecular pattern, a radioulnar step of 3 to 5 mm in size, and indirect signs of a primary lesion (UAP, FCP, OCD, and joint incongruity); grade 3 (severe, ED3) refers to the presence of osteophytes > 5 mm in size, a radioulnar step of > 5 mm in size, and obvious presence of a primary lesion (UAP, FCP, OCD, and incongruity).

Table 1

Classification of elbow dysplasia according to the International Elbow Working Group.

Elbow dysplasia scoring Radiographic findings
Grade 0 Normal elbow joint Normal elbow joint, no evidence of incongruity, sclerosis, or arthrosis
Grade 1 Mild arthrosis Presence of osteophytes < 2 mm in size, sclerosis of the base of the coronoid process: trabecular pattern is still visible
Grade 2 Moderate arthrosis or suspected primary lesion

Presence of osteophytes of 2 to 5 mm in size

Obvious sclerosis (no trabecular pattern) of the base of the coronoid process

Radioulnar step of 3 to 5 mm in size (incongruity)

Indirect signs of a primary lesion (UAP, FCP, OCD)

Grade 3 Severe arthrosis or evident primary lesion

Presence of osteophytes > 5 mm in size

Radioulnar step > 5 mm in size (incongruity)

Presence of primary lesion (UAP, FCP, OCD)

Primary lesions included medial coronoid process disease, ununited anconeal process (UAP), osteochondrosis dissecans of the medial humeral condyle (OCD), fragmented coronoid process (FCP), and joint incongruity.

Statistical analysis

For each breed, the prevalence of ED, indicated as a percentage was calculated by dividing the number of dogs with scores 1, 2, and 3 by the total number of dogs evaluated for that breed. Subsequently, for each breed, an estimate of the birth count was made by assuming that dogs underwent screening in their second year of life as suggested in previous studies.11,14 The provisional registration data from the Livre des Origines Françaises by progeny were therefore used for the period spanning 2001 to 2021. For breeds with more than 200 cases of ED, a descriptive analysis was conducted, including the prevalence of UAP, OCD, FCP, and incongruity, expressed as percentages. For these breeds, the prevalence of ED in male and female dogs was compared using the Fisher exact test.

To evaluate changes in the prevalence of ED over time, a Spearman correlation test was performed, and the correlation test coefficient was calculated for the total population of dogs with more than 150 radiographs. All statistical analyses were conducted by a single author using a commercial software program (The R Foundation), and the results were considered statistically significant when P < .05.

Results

This study included a total of 17,861 radiographic records from 13 dog breeds, including the American Akita, Alaskan Malamute, Old German Shepherd Dog (Altdeutscher Schäferhund), American Staffordshire Terrier, Australian Shepherd Dog, Belgian Shepherd Dog (including Malinois, Groenendael, Laekenois, and Tervuren), White Swiss Shepherd Dog, Bernese Mountain Dog, Cane Corso, Czechoslovakian Wolfdog, Rhodesian Ridgeback, Rottweiler, and Dogue de Bordeaux. The overall prevalence of ED in our study population was 11.4%, ranging among breeds from 1.1% in the Czechoslovakian Wolfdog to 32.2% in the Dogue de Bordeaux. The breeds with the highest prevalence of ED were the Dogue de Bordeaux (32.2%), Rottweiler (21.3%), Bernese Mountain Dog (19.7%), and Cane Corso (15.7%). The ED prevalence for all 13 evaluated breeds is shown (Table 2). In our study population, mild disease (ED1) was most commonly diagnosed in all but 1 breed, the Dogue de Bordeaux, for which severe disease (ED3) was most prevalent. The proportion of dogs screened in this study relative to the number of births was comparatively low, varying from 0.2% for the American Staffordshire Terrier breed to 7.8% for the Dogue de Bordeaux breed. Data were not available for the Old German Shepherd Dog as there is no club for this breed.

Table 2

Prevalence of elbow dysplasia (ED) based on disease severity, breed, and sex.

ED0 ED1 ED2 ED3 Total ED
Total number of cases Estimation of the prevalence of screened dogs and number of births Number of cases and prevalence Number of cases and prevalence Number of cases and prevalence Number of cases and prevalence Number of cases and prevalence
Overall number of dogs evaluated 17,861 15,869 88.62% 1,358 7.60% 236 1.32% 438 2.45% 2,032 11.37%
F 1,147
M 6,414
American Akita 411 7.52% 403 5 0 3 8
F 208 n = 5,468 98.05% 1.22% 0.00% 0.73% 1.95%
M 203
Alaskan Malamute 554 6.73% 536 10 1 7 18
F 325 n = 8,228 96.75% 1.81% 0.18% 1.26% 3.25%
M 229
Old German Shepherd (Altdeutscher Schaferhund) 859 780 53 12 14 79
F 526 90.80% 6.17% 1.40% 1.63% 9.20%
M 333
American Staffordshire Terrier 357 0.25% 319 31 4 3 38
F 208 n = 142,942 89.36% 8.68% 1.12% 0.84% 10.64%
M 149
Australian Shepherd 5,424 3.68% 5,217 149 28 30 207
F 3,580 n = 147,198 96.18% 2.75% 0.52% 0.55% 3.82%
M 1,844
Belgian Shepherd 921 0.54% 888 29 3 1 33
F 499 n = 172,002 96.42% 3.15% 0.33% 0.11% 3.58%
M 422
White Swiss Shepherd 3,144 7.86% 2,792 280 39 33 352
F 2,065 n = 39,984 88.80% 8.91% 1.24% 1.05% 11.20%
M 1,079
Bernese Mountain Dog 1,299 7.13% 1,043 138 33 85 256
F 873 n = 18,219 80.29% 10.62% 2.54% 6.54% 19.71%
M 426
Cane Corso 383 0.56% 323 42 9 9 60
F 234 n = 68,869 84.33% 10.97% 2.35% 2.35% 15.67%
M 149
Czechoslovakian Wolfdog 186 2.88% 184 98.92% 1 0.54% 0 0% 1 0.54% 2 1.08%
F 107 n = 6,455
M 79
Dogue de Bordeaux 1,191 7.57% 807 133 43 208 384
F 810 n = 15,725 67.76% 11.17% 3.61% 17.46% 32.24%
M 381
Rhodesian Ridgeback 454 6.76% 429 17 2 6 25
F 306 n = 6,718 94.49% 3.74% 0.44% 1.32% 5.51%
M 148
Rottweiler 2,678 3.75% 2,108 470 62 38 570
F 1,706 n = 71,415 78.72% 17.55% 2.32% 1.42% 21.28%
M 972

Disease grades ED0 (no disease), ED1 (mild), ED2 (moderate), ED3 (severe), according to International Elbow Working Group.

F = Number of females in the population. M = Number of males in the population.

Five breeds had more than 200 cases of ED. Interestingly, a primary lesion was identified in 661 dogs among these 5 breeds, which represented a prevalence of 37.4% in the total dysplastic population. The percentage of dogs with ED that had a radiographically visible primary lesion varied across different breeds: 11.9% for the Rottweiler, 25.1% for the Australian Shepherd Dog, and 25.9% for the White Swiss Shepherd Dog. In the Dogue de Bordeaux and Bernese Mountain Dog breeds, the prevalence of primary lesions in cases of ED was much higher (68.8% and 72.7%, respectively) (Table 3).

Table 3

Prevalence of primary dysplastic lesions in dogs with and without elbow dysplasia (ED) in 5 commonly affected breeds.

Breed Number of cases FCP UAP OCD Incongruity Total ED
Australian Shepherd
   Number 5,424 21 0 13 18 207
   Prevalence in the total population 0.39% 0% 0.24% 0.33% 3.82%
   Prevalence in dogs with ED 10.14% 0% 6.28% 8.70% 25.12%
White Swiss Shepherd
   Number 3,144 18 14 0 59 352
   Prevalence in the total population 0.57% 0.45% 0% 1.88% 11.20%
   Prevalence in dogs with ED 5.11% 3.98% 0% 16.76% 25.85%
Bernese Mountain Dog
   Number 1,299 49 5 3 129 256
   Prevalence in the total population 3.77% 0.38% 0.23% 9.93% 19.71%
   Prevalence in dogs with ED 19.14% 1.95% 1.17% 50.39% 72.66%
Rottweiler
   Number 2,678 32 2 3 31 570
   Prevalence in the total population 1.19% 0.07% 0.11% 1.16% 21.28%
   Prevalence in dogs with ED 5.61% 0.35% 0.53% 5.44% 11.93%
Dogue de Bordeaux
   Number 1,191 173 21 11 59 384
   Prevalence in the total population 14.53% 1.76% 0.92% 4.95% 32.24%
   Prevalence in dogs with ED 45.05% 5.47% 2.86% 15.36% 68.75%

Primary lesions included medial coronoid process disease, ununited anconeal process (UAP), osteochondrosis dissecans of the medial humeral condyle (OCD), fragmented coronoid process (FCP), and joint incongruity.

We then assessed the prevalence of ED in male and female dogs, with and without ED, in the total study population and in the 5 most commonly affected breeds (Table 4). In the total study population, ED prevalence was statistically higher in males, compared with females (17.5% vs 10.5%, P < .01). Similarly, in the Australian Shepherd, White Swiss Shepherd, Rottweiler, and Dogue de Bordeaux breeds, male dogs showed a higher prevalence of ED, compared with female dogs. This difference was statistically significant for the Australian Shepherd Dog (P = .043), Rottweiler (P < .01), and Dogue de Bordeaux breeds (P < .01). In the Bernese Mountain Dogs, the prevalence of ED was similar in males and females (P = .882).

Table 4

Prevalence of elbow dysplasia in male and female dogs from 5 commonly affected breeds.

Breed Number of cases Number of cases and percentage of dogs with ED Number of cases and percentage of dogs without ED
Total population evaluated 13,736 1,769 11,967
   Number of females (prevalence) 9,034 947 10.48% 8,087 89.52%
   Number of males (prevalence) 4,702 822 17.48% 3,880 82.52%
   P value < .001
Australian Shepherd 5,424 207 5,217
   Number of females (prevalence) 3,580 123 3.44% 3,457 96.56%
   Number of males (prevalence) 1,844 84 4.56% 1,760 95.44%
   P value .043
White Swiss Shepherd 3,144 352 2,792
   Number of females (prevalence) 2,065 216 10.46% 1,849 89.54%
   Number of males (prevalence) 1,079 136 12.60% 943 87.40%
   P value .073
Bernese Mountain Dog 1,299 256 1,043
   Number of females (prevalence) 873 171 19.59% 702 80.41%
   Number of males (prevalence) 426 85 19.95% 341 80.05%
   P value .882
Rottweiler 2,678 570 2,108
   Number of females (prevalence) 1,706 287 16.82% 1,419 83.18%
   Number of males (prevalence) 972 283 29.12% 689 70.88%
   P value < .001
Dogue de Bordeaux 1,191 384 807
   Number of females (prevalence) 810 150 18.52% 660 81.48%
   Number of males (prevalence) 381 234 61.42% 147 38.58%
   P value < .001

During the study period, the overall ED prevalence decreased as the number of dogs screened increased (Figure 1). During the period 2002 to 2010, a significant decrease in ED prevalence was calculated in the overall number of evaluated dogs with a negative correlation coefficient of 0.7 (P = .043). Over the period 2011 to 2022, no correlation was found.

Figure 1
Figure 1

Evolution of the prevalence of elbow dysplasia (ED) and the number of screened dogs between 2002 and 2022.

Citation: American Journal of Veterinary Research 85, 6; 10.2460/ajvr.23.12.0290

Discussion

In this study, we report a descriptive retrospective analysis of radiographic ED screening data in dogs in France over a 20-year time period (2002 to 2022). We found an overall prevalence of 11.4% in the total study population, with the lowest prevalence in the Czechoslovakian Wolfdog (1.1%) and the highest prevalence in the Dogue de Bordeaux (32.2%). A primary lesion was identified in 37.4% of dogs with ED. Elbow dysplasia prevalence was statistically higher in male dogs (17.5%), compared with female dogs (10.5%). Moreover, we showed that joint incongruity and FCP were the most common primary lesions in dogs with ED and that most dogs had mild (ED1) disease. A significant decrease in ED prevalence was reported in the overall number of evaluated dogs over the study period.

Our data are consistent with previous reports showing that ED prevalence ranges from 0% to 55% depending on the breed and screening program.1,1316 Several factors may influence data from official screening programs. First, many countries have mandatory ED screening, which provides more reliable data due to the higher number of screened dogs relative to the total number of dogs in each breed. Furthermore, breeding methods may influence data, since a more rigorous selection of breeding animals is expected to reduce the prevalence of dysplasia in that breed. Finally, various screening methods are used in different countries. In the US, Finland, Sweden, and Italy, only a single ML radiographic view with a flexed elbow (the minimum required by the IEWG) is required for ED screening, which may lead to underdiagnosis of primary lesions.2,8,10,17,18

In this study, the Dogue de Bordeaux, Rottweiler, Bernese Mountain Dog, and Cane Corso breeds were most commonly affected by ED, with prevalences of 32.2%, 21.3%, 19.7%, and 15.7%, respectively. These results reflect the recognized predisposition of large, rapidly growing dogs to develop ED.1,16,18 In the Rottweiler and Bernese Mountain Dog breeds, our prevalences (21.3% and 19.7%) were similar to those of the official mandatory ED surveillance program in Sweden, which found prevalences of 26.2% and 17.4%, respectively, in those 2 breeds (official data between 2001 and 2021 published by the Svenska Kennelklubben).19,20 In the Dogue de Bordeaux breed, the previously reported prevalences ranged from 25.5% (US) to 47% (Finland) and were consistent with our results (32.2%).21,22 These data highlight the high prevalence of ED in this breed and the importance of selective breeding. Moreover, the Dogue de Bordeaux was the only breed in which severe disease (ED3) was diagnosed in the majority of ED cases included in this study. The analysis of primary lesions must be correlated with the age of the animals during screening, as the radiographic lesions of a dysplastic dog tend to be more severe with age.18,2325The majority of dogs screened in this study were between 12 and 13 months old for 12 breeds, except for the Dogue de Bordeaux, which had an age of around 15 months. Screening was performed at the discretion of the breeder or owner and was conducted in young animals, generally in their second year of life.

In the Cane Corso breed, our prevalence (15.7%) was lower than those reported in the literature.15,16,2022 However, official screening is currently optional for this breed in France, whereas it is mandatory for registering a Cane Corso litter in Sweden. Moreover, there were only 383 radiographs of this breed in our study, compared with 1,350 in Sweden and 2,180 in the US over a similar time period.20,22 Our prevalences for the American Staffordshire Terrier, Rhodesian Ridgeback, and Belgian Shepherd Dog were also lower than published data.20,21 As these breeds are subject to official screening in Sweden (all 3 breeds) and Finland (Rhodesian Ridgeback), the larger number of screened dogs may have enabled a more accurate evaluation of prevalence in those countries.20,21 Indeed, mandatory screenings allow for obtaining a true prevalence of ED in the breed, avoiding any possible preselection during nonmandatory screening, based on clinical signs or radiographic images of the dog.11,13 For the White Swiss Shepherd Dog breed, the ED prevalence in our study was lower than that observed in other countries. In most of these countries, the number of screened dogs was lower than in our study (3,144 readings). However, over our study time period (2002 to 2022), only 7.5% of White Swiss Shepherd Dogs were screened for ED in France; therefore, our results may underestimate the real prevalence of ED. Four other breeds in our study (American Akita, Alaskan Malamute, Australian Shepherd Dog, and Czechoslovakian Wolfdog) showed a low prevalence of ED (< 4%), which is consistent with previous reports.2022

In accordance with previous findings, we found that the ED prevalence was higher in male dogs than in female dogs in the total study population and in Australian Shepherds, Rottweilers, and Dogues de Bordeaux.6,24,26 A sex-related predisposition to ED has been well established in these 3 breeds.16,27 Hormone levels, rapid growth, and weight gain may play a role in this predisposition and some risk alleles may be on the X chromosome.17,23,25 In contrast, we found no difference in ED prevalence between male and female White Swiss Shepherd dogs, which may be due to the relatively small number of dogs screened for this breed. The ED prevalence was also similar in male and female Bernese Mountain Dogs.

In our study, primary ED lesions were not commonly identified in the total study population. The rate of identification of primary lesions was lower than a previous study, which reported that only 4% of the total population and 1.8% of Bernese Mountain Dogs diagnosed with dysplasia had osteoarthritis without primary lesions.25 However, that study included suspected primary lesions, whereas our results were based on identified primary lesions. We also found that the rate of identification of primary lesions varied according to previous studies, due to the difference in pathogenesis of ED between breeds, resulting in different primary lesions and presumably depending on the size of the bone and age of the dog.25

Our data showed that FCP and joint incongruity were the 2 most common primary lesions in the 5 breeds with the most cases of ED. In the Bernese Mountain Dogs, more than 50% of dogs with ED had joint incongruity and almost half of Dogues de Bordeaux (44.4%) with ED had an FCP. FCP is the most frequent primary lesion in dysplastic dogs while previous reports1,5,7,9,25,28 showed a radiographic sensitivity ranging from 10% to 62% based on osteophytosis or the visibility of fragments. Differences between screening methods and the number of radiographs required may affect the identification of FCP and other primary lesions.2,12 Several studies1,14 have suggested a causal relation between joint incongruity and the development of other lesions, notably OCD and FCP. Moreover, the predisposition of Bernese Mountain Dogs and Rottweilers for FCP, with or without joint incongruity, has been well established. Osteochondritis dissecans and UAP were infrequently identified in this study, similar to previous reports. This may be because obvious OCD and UAP lesions can be easily identified on radiographs, and therefore, an unknown proportion of cases may have been identified by veterinarians and thus not submitted to the screening program.

Previous studies29 reported that phenotypic selection over time reduced ED prevalence in Rottweilers and Bernese Mountain Dogs. In Germany, the proportion of unaffected Rottweilers rose from 34.8% to 53.8% over 4 years (1996 to 1999).29 In Sweden, the ED prevalence fell from 52% in 1985 to 24% in 1997 in Bernese Mountain Dogs and from 57% in 1984 to 37% in 1997 in Rottweilers.26,27 In our study, we found that ED prevalence significantly decreased during the period 2002 to 2010 in the overall number of dogs evaluated suggesting a positive impact of radiographic screening on reducing ED prevalence. Care should be taken when selecting on the basis of physical characteristics alone, as phenotypic signs of dysplasia may not be present. The cause of ED is not completely understood, but the disease is considered to be multifactorial. Environmental factors, such as diet and the type and amount of exercise, contribute to disease development in genetically predisposed individuals.1,3,1719,23,29,30 ED is a polygenic disease with incomplete penetrance. As a result, not all genetically predisposed individuals exhibit dysplasia.

Complementary diagnostic methods can improve the effectiveness of phenotypic selection to reduce ED.15,18,23 Various factors, including age at screening and the use of sedation during screening, can affect the results of radiographic screening.10,18,24 Therefore, the radiographic screening result for an individual dog may not be sufficiently accurate for selection purposes. While genetic testing is the technique of choice to identify breed-related disorders, it is not currently available for ED, a polygenic disease for which all causative genetic mutations are not known. Complementary information can be provided using the best linear unbiased prediction (BLUP) method, which combines all available phenotypic information from relatives in a pedigree while simultaneously adjusting for environmental effects.18,19,23 By using BLUP, the genetic gain per generation improves more than by simple phenotypic selection, but BLUP tends to increase the inbreeding rate per generation.18,19,23

The main limitation of our study is the relatively small number of individuals tested for ED, compared with the number of registered births for each breed over the study period. Analysis of the ED prevalence over time is subject to a number of biases, including variations in the number of readings per year and the motivations prompting for screening as it is not mandatory. Furthermore, this study did not include ED screening of other predisposed breeds, such as German Shepherds or Labrador Retrievers as the 2 examiners (JPG and DF) were not official readers for these breeds. Consequently, our results cannot be extrapolated to the entire population of dogs in France. Moreover, the screened population may be skewed toward breeding dogs, as breeders are generally more aware of screening for hereditary diseases than owners. Therefore, our data should be interpreted with caution, and further studies are needed to evaluate the effectiveness of screening programs in France.

Acknowledgments

The authors thank Dr. Leah Cannon for the English language editing of this manuscript and Dr. Thibaut Lurier for his assistance in the statistical analysis.

Disclosures

The authors have nothing to disclose. No AI-assisted technologies were used in the generation of this manuscript.

Funding

The research was funded by the authors’ departments.

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