OSTEOARTHRITIS IN DOGS
Arthritis (also called osteoarthritis or degenerative joint disease (DJD)) is very common in older dogs, but can easily be missed and put down to ‘normal’ stiffness and slowing down as they grow older. In arthritis, the protective layer of cartilage lining the joint, that usually helps to allow smooth movement of the joints, is damaged and worn away, and the joint fluid becomes less effective in providing joint lubrication. The bone becomes exposed, causing pain and inflammation. The body attempts to stabilise the joint by producing new bone but this can further add to the pain and discomfort. The most commonly affected joints tend to be the elbow, hip, and stifle (knee). Arthritis is a progressive disease – it cannot be ‘cured’ and will worsen over time but there are ways to manage it. The aim of treatment is to reduce your dog’s symptoms and improve their comfort and mobility. Arthritis is the most common cause of chronic and progressive pain in older dogs, and the earlier treatment is instituted the better!
A large number of causes of arthritis exist, including:
- Age-related wear and tear of the joint (‘primary’ arthritis)
- An underlying joint disease e.g. cruciate ligament rupture, elbow dysplasia
- Traumatic injury to the joint such as a dislocation
- As a consequence of joint infection
These can include lameness, difficulty getting up, reluctance to jump, play or climb the stairs, less enthusiasm on walks, and a general ‘slowing down’. Your pet may show variable degrees of pain, and may also have joint swelling. Pain can also alter their behaviour and demeanour, sometimes making them aggressive or go off their food. Often, it is not until we start treatment that we appreciate the degree of pain and discomfort they may have been in.
If you notice any of these changes in your dog you should have them examined by your veterinary surgeon.
This consists of many different aspects that work together to slow progression of disease:
- Weight control: Ensuring your pet is not overweight is the most effective way of slowing down arthritis. It reduces strain on arthritic joints, the severity of clinical signs, and can make it easier for them to get around. Animals with joint disease have less ability to exercise, which should be considered when feeding them. Weight control can be achieved with a calorie controlled diet and owners must be strict with treats.
- Controlled exercise: The key to this is to provide regular gentle exercise. Avoid long walks or long periods of rest. Over-exercise can increase strain and damage to diseased joints, while prolonged rest increases joint stiffness. Regular, gentle exercise can maintain muscle mass tone and joint flexibility. It also helps with weight control.
- Hydrotherapy and physiotherapy: Swimming can help build muscle and stimulate blood flow and avoids weight-bearing through painful joints. Massaging the limb and using a hot water bottle are helpful things you can do at home. You can also try gentle motion exercises e.g. bending each joint, or moving the foot in circular motions with your dog lying on their side.
- Diet: Specific prescription diets designed for dogs with arthritis include Hills j/d and Royal Canin Mobility Support. These diets contain beneficial essential fatty acids and antioxidants to help the joints and are also lower in calories to help weight control.
- Nutritional supplements: Supplements including glucosamine and chondroitin sulphate can really improve arthritis. They should be used longer-term, and several weeks of administration may be needed before improvements are noticed at home. Glucosamine is one of a group of molecules called glycosaminoglycans and these are the building blocks of cartilage. Chondroitin inhibits destructive enzymes in the joint and supplementation can help protect the cartilage and slow progression of arthritis. These compounds are available in products such as Synoquin, Seraquin, Flexadin and Cosequin and have become a mainstay of arthritis management. When these are used alongside anti-inflammatory drugs (discussed below), lower doses of the drugs can be used, minimising side effects.
- Prescription medications:
- Anti-inflammatory medications: The most common class of drugs used in OA are the Non-Steroidal Anti Inflammatory Drugs (NSAIDs).There are several available, including meloxicam (Metacam, Meloxidyl), carprofen (Rimadyl, Carprieve), firocoxib (Previcox) and mavacoxib (Trocoxil). They help to reduce inflammation, swelling and pain in the affected joints, improving mobility and comfort levels. Some, such as Metacam are available in a liquid form; others such as Rimadyl and Previcox are tablets. All should be administered with food and the dose required will be determined by your vet. There are potential side effects on the gut, kidneys and liver and your vet may wish to do occasional blood tests to monitor these.
- Additional pain relief medications: If you are unable to give NSAIDs to your pet (for example due to other medications they are also on or unacceptable adverse side-effects), or NSAIDs alone are not adequately controlling your pet’s comfort levels, your vet may advise some other pain relief medications such as Tramadol or Pardale. These are not actually licensed for use in animals, although they are used on a regular basis, so other options are usually explored first.
- Acupuncture: this can be a useful adjunct to other treatments in some dogs, but should be discussed with your vet first. Always ensure it is done by a certified veterinary acupuncturist.
- Cartrophen injections: These contain pentosan polysulfate sodium, a sulphated sugar which acts to stop the destructive enzymes that break down cartilage, increase cartilage and joint fluid production and increase anti-oxidant production. Weekly injections for four weeks are usually initially given, and the course may then continue dependent on your dog’s response to treatment.
- Surgery: Underlying conditions such as hip dysplasia or very severe osteoarthritis may necessitate surgery if medical management is not adequately controlling it. Surgeries such as total hip replacement are available. These would only be considered after other options have been explored, and would require an extensive consultation with your vet.