The usual patient for this condition is a short-haired large breed dog, usually of an adolescent age, brought to the veterinarian for assessment of a fluid-filled swelling at the point of one or both elbows. This is the classical presentation of the “elbow hygroma,” the body’s response to chronic trauma to the point of the elbow. In more common terms, the dog is lying down on a hard surface and point of the elbow bone is traumatizing the soft tissue. Normally callus will develop to protect a bony prominence such as the elbow but if the trauma to the area is excessive, the inflammation caused by the trauma overcomes the new callus and a fluid pocket forms.
The Uncomplicated Hygroma
The simple hygroma is not painful and is mostly of cosmetic concern. Changing the dog’s bedding generally solves the problem though sometimes special pads or bandages for the elbows must be constructed. If the dog begins to lie on softer more pliant materials, the hygroma is likely to simply resolve over 2-3 weeks. It is best not to tap off the fluid as any time the hygroma is pierced, infection can be introduced, creating a “complicated” hygroma.
Treatment for uncomplicated hygroma is basically changing the bedding or surface upon which the dog lies.
The Complicated Hygroma
If the hygroma becomes infected, it will be come tender and surgical drainage becomes necessary. If the surface of the hygroma is not ulcerated, it can be drained and flushed and rubber drains inserted to allow for further drainage into bandages. The bandages should be changed daily but there is an excellent chance of resolution of the hygroma after a couple of weeks. Ideally the natural callus on the elbow is preserved for protection of the area.
Treatment for the infected but not ulcerated hygroma is surgical drain placement in addition to changing bedding as above.
If the hygroma is severely proliferative or chronically draining, or basically has a big sore on it, a more extensive surgery is needed. The callus is too far gone and must be removed. Special skin flaps or even grafts may be needed to reconstruct the skin of the elbow area after the infected callus is removed. A splint is likely going to be needed to sufficiently pad and immobilize the leg during healing, which takes a month or so.
It is important to recognize the hygroma early in its course so that it need not progress to a complicated status. If you are unsure about any swelling on a pet, it is prudent to see your vet promptly.
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