Place oatmeal, onion, garlic, milk, salt, pepper, cayenne, mustard, ketchup, worchestershire sauce, and ground elk in a large mixing bowl. Mix gently with hands or a spoon.
Form into a loaf and place in a greased pan. (I use a 9x13)
For the sauce: Mix 1 cup ketchup, 3 T brown sugar, 2 T vinegar, 2 T worchestershire, and 1/4 cup onion together. Spread over th e meatloaf and bake uncovered for 1 hour.