Osteoarthritis signs and treatment

Bassettdog_jpg_jpg“My dog seems to be getting up and moving slower since the weather change. What should I do?”

The most common reason for an increase in lameness or stiffness secondary to changes in the weather is osteoarthritis. Osteoarthritis is the deterioration of joint cartilage and the inflammation associated with this damage. It can be limited to one joint or can affect multiple joints of the body. It is most commonly seen in middle age to older patients, and it can be a result of previous injury, genetic predisposition, conformational stresses, obesity, or excessive wear and tear from overuse. According to Parrish Tanner, DVM, at Quail Hollow Animal Hospital in Wesley Chapel, FL, the typical symptoms of arthritis include difficulty standing up or sitting, stiffness after laying down that improves with activity, and worsening symptoms with weather changes especially rain and cold. Osteoarthritis is seen often in all breeds of cats and dogs.

The first step for any patient displaying symptoms consistent with osteoarthritis is to evaluate their body condition/weight. The vast majority of dogs with symptoms of arthritis are heavier than their ideal body weight. If your dog is overweight, weight reduction through reducing food intake and moderate consistent low impact exercise (fast paced walks, swimming, etc.) of 30-60 minutes a day can have a profound positive effect. Even if a patient is not overweight, moderate exercise is almost always beneficial because it helps maintain or even build muscle mass.  This helps to support the damaged joints, reduces pain in the joint, and improves a patient’s range of motion. It is important to note that osteoarthritis and its symptoms are usually slowly progressive and lifelong, therefore, treatment and lifestyle changes to combat arthritis are life long as well.

Medical treatment for osteoarthritis usually comprises a multimodal approach. Treatment can include but not be limited to dietary changes, nutritional supplements, anti-inflammatory and pain medication, physical therapy, acupuncture, cold laser therapy, and occasionally surgical intervention. By treating arthritis in multiple ways, improvement of clinical symptoms is more greatly achieved while at the same time reducing side effects associated with high does of pain medication.

Dietary changes and nutritional supplements are often the first logical step to combat osteoarthritis. There are two prescription diets that have been shown in studies to help control symptoms of arthritis, and they also help in achieving an ideal body weight through calorie restriction. Supplementing the diet with omega 3 fatty acids and glucosamine/chondroitin can also have a very positive effect on patients that are suffering with arthritis.

If lifestyle changes, dietary changes, and nutritional supplements are not controlling the symptoms of arthritis then medication and other therapies would be indicated. The most commonly used medications for arthritis are nonsteroidal anti-inflammatory drugs. NSAIDs can have a significant effect on the inflammation and pain of arthritis, but it is important to understand that there potential side effects associated with these medications and all other medications used for arthritis. Consistent monitoring, examinations, and bloodwork are needed when patients are on any medication for arthritis.

As our pets age, the signs of osteoarthritis can become evident to us either gradually over time or sometimes very acutely. Dr. Tanner stresses the importance of contacting your veterinarian for an examination, if your dog has started to have difficulty with mobility. An exam is the first step in determining whether a patient is developing osteoarthritis or has other medical cause for immobility. If arthritis is the cause, we can begin tailoring therapy for your dog to hopefully give him/her the most pain free, happy life possible.

Arthritis? Are you crazy? My dog is only 5 years old!

Most of us have had dogs in our home that reach that ripe old age where they start to slow down.  Sometimes it’s difficulty getting up, sometimes it’s simply having less interest in longer walks. Osteoarthritis (also known as degenerative joint disease, DJD) is a progressive condition that will affect most of our pets at some point in their life states Dr. Jonathan Smith, VMD, from Larkin Veterinary Center from West Lawn, PA.  Common signs of the joint pain associated with DJD include difficulty rising or climbing stairs, difficulty getting in and out of cars or onto furniture, limping, and  having an abnormal gait.  It is important to recognize the early signs of DJD and it’s causes so you can help to limit the impact of this disease as your dog ages. In normal joints in a dog, cat, or person, the articulating bones move smoothly and comfortably against each other, allowing easy movement. The key to this smooth joint operation is cartilage, which covers the surface of both bones where they come into contact.  Cartilage is a soft rubbery tissue that acts as lubrication and a shock absorber.  When damaged, or worn down through a lifetime of use, joints no longer work so smoothly.  In addition, the body’s natural inflammatory response also slowly contributes to the chronic changes in any joint with DJD. You might ask yourself, then, “why does my dog have arthritis while other dogs of the same age appear to be unaffected?” The simple answer is that size matters.  There are many potential risk factors for any dog that can make them more or less likely to acquire DJD at any age, most of which are related to how much weight the joints have to support:

  • Being a Large or Giant Breed: Larger breeds of dogs simply weigh more, and daily exercise causes more trauma to their joints than with a smaller dog. Many larger breeds are also predisposed to abnormal joint conditions such as hip dysplasia, elbow dysplasia, cruciate injuries, and other conditions discussed below.
  • Obesity: Even if your dog is not a larger breed, if they are overweight it will cause more trauma to their joints during their normal routine.
  • Joint Instability: Normal cartilage can be damaged when joint surfaces don’t line up properly or wear unevenly. The most common conditions of joint instability in dogsinclude:
    • Hip Dysplasia: Common to many larger breeds, this is a condition where the hip joint does not form appropriately. Similar to people, the hip joint in dogs is made up of a ball (at the top of the femur) and socket (of the pelvis). Dogs with hip dysplasia often have a shallow socket resulting in limited contact between ball and socket, and also excess laxity.  Both of these allow the ball of the femur to pop in and out of the joint easily.
    • Elbow Dysplasia: Also affecting many larger breeds, this condition can be caused by a number of abnormalities of the bones that make up the elbow, resulting in poor joint alignment .
    • Cruciate Tear: While cartilage ensures smooth operation of the joints, ligaments hold the joints together, ensuring correct alignment. Like football players, larger dogs are prone to tearing their crainal cruciate ligament (CCL) which leads to instability in their knee.
    • Luxating Patellas: While larger dogs are more likely to suffer from dysplasia and ligament tears, smaller dogs can have kneecap problems. Usually affecting smaller breeds, this condition causes the kneecap to pop in and out of place (usually inward), which can result in  abnormal function and wear and tear.

How can you minimize the impact of DJD in your dog?  For any  larger dog, or any dog who already has osteoarthritis, the most important thing you can do is to keep them as lean as possible, so as to limit the trauma to their joints. In addition, most of the above conditions can be successfully corrected surgically.  If done early enough, this can significantly reduce future joint damage. If your dog already has DJD, don’t feel helpless! There are many options out there to help slow the progression of their osteoarthritis and help control their pain, including:

  • Controlled Exercise: While it may seem counter-intuitive, exercise is actually very important to keeping the muscles that support the joints strong. Low impact activities such as leashed daily walks, swimming, or even slow jogging are acceptable.
  • Weight Reduction: As discussed above, by keeping our pets lean we help to limit the impact on their joints. Feel free to ask your local veterinarian for guidance.
  • Supplements: Glucosamine/chondroitan sulfate, and omega-3 fatty acids (fish oils) in the correct proportions can help support joint health and also have anti-inflammatory properties. Many products or prescription diets (Hills J/D) are available at your veterinarian’s office or can be purchased over the counter.
  • Physical Therapy: There are many options for physical therapy for dogs with DJD.  Ask your veterinarian for more information and a referral.
  • Prescription Medications:  Non-steroidal anti-inflammatory drugs (NSAIDS) such as Rimadyl or Dermaxx are safe and effective medications for dogs with DJD. When these medications are used long term, routine bloodwork should be performed to ensure adequate liver and kidney health. Other pain medications (tramadol, gabapentin) can also be effective, either on their own or in combination with NSAIDS.
  • Injectable Agents: Adequan acts to promote joint health and limits the breakdown of cartilage. Ask your veterinarian for details on this treament.

While osteoarthritis can sound like a horrible thing, it’s important to remember that there are many treatments that can help your dog feel more comfortable. The key to preventing this condition in your own dog is to recognize potential risk factors, and to look for early signs of DJD so that treatment can help to limit it’s progression. As always, your veterinarian can help you decide what treatment options are best for your own furry family member.

Submitted by:
Jonathan Smith, VMD
Larkin Veterinary Center
2333 Penn Avenue
West Lawn, PA 19609