While it’s true that “age is not a disease,” it’s also true that advancing age is associated with the onset of more diseases. The skeletal support system and joints of dogs tend to bear the brunt of age-related problems. Let’s review one of the most common canine mobility diseases: arthritis.
The Facts about Canine Arthritis
Arthritis [osteoarthritis (OA) or degenerative joint disease (DJD)] is one of the most debilitating - and painful - medical conditions in dogs. Osteoarthritis affects approximately one in five dogs in the US. That’s approximately 18 million dogs! The signs of arthritis range from lameness to reluctance to rise to not eating (anorexia). It is imperative that pet parents are able to identify the early signs of this often under-diagnosed and incredibly painful condition. If you live with a middle-aged or older dog, carefully monitor its daily activity levels, ability to climb stairs or hop in your car, and responsiveness to commands. The signs of arthritis are often subtle for many years, and your dog will instinctively hide its pain. Arthritis is a progressive disease, resulting in joint damage worsening until it is irreversible. That’s what we want to avoid. Early recognition and intervention are key to successfully treating arthritis in your dog.
Quick Arthritis Facts
- Approximately 20% of US dogs will develop arthritis during their life
- Less than half of the dogs with arthritis are receiving any form of treatment
- The hips, knees, shoulders, and elbows are most commonly affected joints in dogs
- Rule-outs for osteoarthritis include ligamentous injury, neoplasia, joint infection, and infectious diseases such as Lyme disease
- The most common clinical signs include reluctance to climb stairs or jump into cars, stiffness when rising, ignoring commands and remaining in a resting position, intermittent lameness, decreased appetite, licking or excessively grooming a joint site, and decreased interest in walking, playing, or other physical activities
- Dogs with obesity are at increased risk of developing arthritis and rarely show overt clinical signs such as whimpering, crying, or pain when touched
Osteoarthritis affects the majority of dogs and cats over age seven. Hips, knees (stifles), shoulders, and elbows are the most common pain points. Excess fat and weight injure and exacerbate existing joint abnormalities, meaning overweight older pets are at tremendous risk for OA/DJD.
Any dog breed, including mixed breed dogs, are at risk for developing arthritis, with Labrador and golden retrievers, and German shepherds (and their mixes) presenting higher incidences. Diagnosis is based on symptoms, exam, and x-rays. If diagnosed early, weight loss, nutritional supplements, and anti-inflammatory medications can slow the disease progress and ease associated pain and discomfort. If you want to prevent arthritis in your dog, the most proven and reliable strategy is to keep your dog at a healthy weight. Studies prove leaner dogs (and cats) with low body fat have less joint disease and pain and live longer.
Arthritis is a complex condition involving inflammation of one or more joints. Arthritis is derived from the Greek word "arthro", meaning "joint", and "itis", meaning inflammation. There are many causes of arthritis in pets. In most cases, the arthritis is a progressive degenerative disease that worsens with age.
Arthritis is Painful
Pain is no fun. Chronic, daily, debilitating pain can be a nightmare. The problem with pain in dogs is first recognizing it. Most dogs rarely cry out or whimper due to arthritic pain, even when they're in what we humans would consider excruciating discomfort.
Symptoms of chronic soreness in pets are often subtle: decreased appetite, hiding more, not as eager to play or interact, accidents in the house, limping, or changes in sleep habits. If a dog is limping, it's seriously hurting. Osteoarthritis is one of the more common causes of chronic pain in middle-aged and older dogs. If your “sixth sense” or “pet parent radar” tells you something is wrong with your pup, chances are pain is involved.
The causes of arthritis
In general veterinary medical terms, arthritis can be classified as “primary arthritis” such as rheumatoid arthritis (RA) or “secondary arthritis” which occurs as a result of joint instability.
Secondary arthritis is the most common form diagnosed in dogs. The most common type of secondary arthritis diagnosed in dogs is osteoarthritis (OA), which is also known as degenerative joint disease (DJD). Some common causes of secondary arthritis in dogs include obesity, hip dysplasia, cranial cruciate ligament rupture, and so forth. Other causes include joint infection, often as the result of bites (septic arthritis), or trauma such as a car accident or athletic injury.
Infective or septic arthritis can be caused by a variety of microorganisms, such as bacteria, viruses, and fungi. Septic arthritis normally only affects a single joint and the condition results in intense swelling, fever, heat, and localized pain in the joint. With septic arthritis, your pet is likely to abruptly stop eating (anorexia) and often becomes lethargic, unresponsive, and depressed.
Rheumatoid arthritis (RA) is an immune-mediated, erosive, inflammatory condition of the joints. Cartilage and bone are eroded within affected joints and the condition can progress to complete joint fixation (ankylosis). If a dog’s RA progresses to ankylosis, that means the joint can no longer flex or bend, and this change is usually permanent. RA may affect a single joint or multiple joints may be involved (polyarthritis). In certain dog breeds Rheumatoid Arthritis (RA) factors can be detected with blood tests. Other types of immune-mediated arthritis can be non-erosive, such as arthritis that is associated with Systemic Lupus Erythematosis (SLE). SLE is often accompanied by other clinical signs in addition to arthritis.
Diagnosis of arthritis
Radiographs or x-rays are the most commonly used diagnostic test for canine arthritis. Radiography is often recommended in a dog displaying clinical signs consistent with arthritis, if it is an at-risk breed, or if the pet parent is suspicious degenerative joint disease may be developing.
Your veterinarian will conduct a comprehensive musculoskeletal exam, carefully evaluating the joint’s range of motion and observing any subtle signs of discomfort.
In certain cases, advanced imaging such as computed tomography (CT) or magnetic resonance imaging (MRI) may be indicated. There are also specialized tests that involve injecting dyes into a joint space to search for tiny lesions or injuries.
Treatment options for dogs with arthritis
Treatment will depend on the specific cause of arthritis. Immune-mediated and rheumatoid arthritis are usually treated with high doses of drugs such as corticosteroids, often with dramatic improvement. The control of these conditions often involves the long-term use of corticosteroids and other drugs including immunosuppressive or cytotoxic agents.
The treatment of septic arthritis involves determining the type of microorganism involved and its antibiotic sensitivity. Antibiotics are usually administered for a minimum of a month and analgesics (pain relief medications) are necessary to combat pain and inflammation.
Analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) are the most common form of treatment for canine arthritis. It is important to select these medications carefully since some dogs are more sensitive than others to the potential side effects of analgesics. The most common side effects of analgesics include decreased appetite, vomiting, and diarrhea, although some pets may experience kidney or liver problems when taking NSAIDs. Pre-medication blood tests must be performed to make sure that the pet can safely metabolize and eliminate the medication and then periodic blood tests are necessary to ensure continued safe usage. Other analgesics such as gabapentin and amantadine have been shown to help. Tramadol is no longer recommended to treat arthritic pain in dogs.
Weight loss and exercise programs are an essential element of the longterm management of arthritis in dogs. Your veterinarian will recommend specific activities such as underwater or terrestrial treadmills, walking on soft or grassy surfaces, physical therapy exercises, and more. A weight-loss and restricted caloric diet regimen will also be recommended if your dog needs to lose excess weight.
Some dogs will benefit from intra-articular injections of stem cells, platelet-enriched plasma, hyaluronic acid, or steroids. I also routinely use injectable polysulfated glycosaminoglycan (PSGAG) in my patients.
I typically recommend and use Class-4 laser therapy (“cold laser”) and acupuncture for my dog patients suffering from arthritis. I continue to be amazed at the results we've witnessed with these non-invasive and relatively inexpensive technologies. A series of initial Class-4 laser treatments followed by regular follow-ups improves many painful conditions in both dogs and cats. What's even more inspiring is watching the expressions on a patient's face during the treatment. They visibly relax and seem to say, "Ahhh, that feels good." I’ve also seen success with therapeutic massage.
I also often advise the use of hot and cold packs to soothe achy joints, especially during painful flare-ups or acute joint injuries.
Surgery may be indicated in certain dogs. Total hip replacement for hip dysplasia or severe hip arthritis, femoral head ostectomy (FHO), and arthroscopy are some of the common surgical procedures used to treat canine arthritis.
Nutritional supplements for arthritis
Omega-3 fatty acid supplements, DHA and EPA, have been proven in humans to help with the discomfort of osteoarthritis. Nutraceuticals such as glucosamine and/or chondroitin are also helpful in many cases. Injectable medications such as polysulfated glycosaminoglycan (Adequan) may help reduce pain and improve the quality of life in some dogs. We often teach pet parents to administer these tiny injections to their dogs at home.
Omega-3 Fatty Acids
The omega-3 fatty acids are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). These are essential fatty acids needed to sustain life. They are commonly derived from cold-water fishes, algal oils, or flaxseed. I prefer algal sources because flaxseed oil requires digestion to convert a portion to DHA and EPA. Fish or algal oils do not require any additional conversion or digestion.
The benefits of omega-3 fatty acids in your pet’s diet include a healthier, more lustrous coat and skin, eye, proper nerve and brain health and development, reduction of pain and inflammation.
In many of my dog patients, I use higher doses of omega-3’s to combat pain from osteoarthritis, reduce inflammation associated with allergies and immune diseases, and after injury. Think “anti-inflammatory” when thinking about omega-3’s. In my opinion, adding additional omega-3 fatty acids should be part of your dog’s daily nutrition.
In my opinion, it’s hard to beat omega-3 fatty acids when it comes to reducing pain and inflammation in dogs, cats, and humans. Every pet should be on a daily fatty acid supplement and pets in pain should receive higher dosages. I often combine a fatty acids supplement with glucosamine/chondroitin in my arthritic patients. In addition, injections of Adequan, a natural building block of healthy joints, can literally erase the hurting many pets experience. We also employ core-strengthening exercises and a special rehab treadmill to buildup support structures and muscles around affected hips, knees, and elbows. Exercise and weight loss are critical in reducing arthritic discomfort.
Glucosamine has been used for hundreds of years as an arthritis treatment. Glucosamine is naturally found in the shells of shellfish, when corn or wheat is fermented, and in one of our fungi, Aspergillus. Glucosamine can be thought of as a building block of healthy cartilage.
Glucosamine is often combined with chondroitin sulfate to aid in the treatment of osteoarthritis.
I typically recommend using glucosamine in all of my patients with osteoarthritis, those with joint injuries, and in very active performance or working dogs.
Talk with your Vet
No dog should suffer the constant pain and debilitation of arthritis. Talk with your veterinarian about these safe and simple to administer nutritional supplements and whether your pet could benefit from their use. Combining weight loss, omega-3 fatty acids, glucosamine, and NSAID therapy will help the majority of dog patients suffering from arthritis.
Ernie Ward, DVMis an internationally recognized award-winning veterinarian and the author of five books, including 'The Clean Pet Food Revolution: How Better Pet Food Will Change the World’ and numerous textbook chapters and peer-reviewed articles. He also writes “The Vet Is In”, a monthly column for Dogster Magazine.
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