The patient was a 7 month old intact male St. Bernard who presented to the orthopedic surgery service at the Cornell University Hospital for Animals for evaluation of a one month history of carpal valgus and hip dysplasia. The patient’s elbows were considerably more painful than any other anatomical site. Radiographs and a CT scan were indicative of bilateral fragmented coronoid processes, and the fragments were removed via arthroscopy. Eight months of rehabilitation was pursued to accelerate surgical recovery and manage the long-term complications of osteoarthritis. Rehabilitation demanded a multimodal approach that included regenerative medicine, physical therapy for strengthening supportive musculature and maintaining joint motion, therapeutic modalities such as Extracorporeal Shockwave Therapy, changes in diet targeted to weight control with chondroprotection, and the addition of pharmaceuticals.