Treating arthritis

Arthritis can affect dogs and cats of any age, although we frequently think of it as a disease of the geriatric animal. There is still no cure, but veterinarians are able to offer a variety of treatment choices to allow our pets to live a fairly active and comfortable life. Early diagnosis is extremely important in finding effective medical treatment, and pet owners are the best equipped to notice day to day changes and first subtle signs of this crippling disease.

Taking longer to get to its feet, and inability to jump or climb are signs that arthritis could be affecting your pet. You should make an appointment with your veterinarian. (If, however, similar symptoms appear very suddenly, it is possible that your pet has suffered a ruptured disc in its back and should receive immediate medical attention.) Keep a record of the arthritic signs you’ve noticed, the conditions under which they occur (before or after exercise, for example), and the approximate time you first noticed the symptoms. Because most cases of arthritis are degenerative which arise from joint imperfections, make a note of any developmental joint defects (such as hip dysplasia) or accidents your pet has had. Sometimes, other types of arthritis (inflammatory) occur, arising from a systemic ailment such as Lyme Disease or rheumatoid arthritis so it’s also important to remember whether your pet has shown any signs of illness such as appetite loss.

At your pet’s appointment, your veterinarian will give it a general physical and an orthopedic exam. The vet will look for swelling, heat, or asymmetry between the animal’s limbs. He or she will flex and extend each joint to check for decreased range of motion, pain, or abnormal joint sounds. X-rays may be recommended. The animal will be examined for bone changes, such as mild dislocation or bony outgrowths known as osteophytes, which are early signs of degenerative joint disease. Sometimes the only way to check for early onset is by checking the fluid that lubricates the joint (synovial fluid). This is done by draining off and analyzing some of the fluid from a suspicious joint and is known as a joint tap. Your veterinarian may also recommend other diagnostic tests for arthritis.

Veterinarians usually advise a three-way approach to the medical management of arthritis; exercise moderation, weight control, and anti-inflammatory medication. Too little exercise can cause an arthritic animal to become stiff and sore, but too much can cause pain. Weight control is important because excess weight places undue stress upon the joints, accelerating joint degeneration. If you have an overweight animal, talk with your vet about a suitable weight loss program. Exercise moderation and weight control keep most arthritic pets comfortable for the most part, but when your pet has a bad day from time to time, your vet may prescribe an anti- inflammatory medication until the acute inflammation has subsided – usually in a couple of days.

Be careful about giving your pet an over-the- counter pain medication without first consulting with your veterinarian, since many of these medications can cause gastrointestinal upset.

New prescription medications have proven effective in the treatment of arthritis for dogs. One of them is called carprofen also known as Rimadyl, there have been a few (1-2%) reported liver related diseases with this medication especially in Labrador Retrievers. Before its use we recommend testing liver functions and periodic evaluation of liver enzymes while taking the medication. Another new medication similar to carprofen is Etogesic (etodolac). We do not have enough medical history to know what side effects this medication may have. These medications appear to have fewer gastrointestinal side effects then the traditional non-steroidal medications such as ibuprofen and are very effective at relieving pain and inflammation. Some veterinarians also offer injections of Adequan. These injections, not only seem to relieve pain and inflammation in some arthritic dogs and may actually slow the disease process.

Sometimes medical treatments fail to adequately relieve arthritis pain and surgery may be the next option. For example, if bone or cartilage fragments are in the joint, the surgeon can remove them to decrease inflammation. This may not stop the deterioration since damage has already been done, but it may slow it down. In some cases, an achy joint may need to be removed. Small dogs and well-muscled large dogs are the best candidates for this surgery since they are better able to support their weight without the joint. Hip replacement surgery is another alternative as is, in some cases, joint fusion.

Cats are also prone to arthritic conditions of the hips, elbows, spine and other joints. They are also prone to osteoporosis as they age. Treatments used for dogs may not help cats. Be careful of the use of Tylenol, non-steroidals such as ibuprofen , and high doses of aspirin. All of these products are very toxic to cats. Low dose of aspirin 80 mg (1\4 of an adult aspirin) weekly may be therapeutic. Use of nutraceuticals and cortisone may also be of some benefit as well as acupuncture and chiropractic care.

Food supplements, known as oral nutraceuticals, may have medical benefit. The products recommended in our practice include glucosamines, chrondroitin sulfates, MSM (methylsulfonylmethane) , and omega 3 fatty acids. These products we are prescribing we feel are produced by reputable manufactures. Glucosamines and chrondoitin sulfates act to increase the production of of joint fluid. MSM is a natural anti-inflammatory, and omega fatty acids are useful in aiding the immune system. We are continually researching newer products and treatment to help reduce the progression and pain associated with arthritis.

There are many other supplements available. But, my concern with these supplements is the lack of regulation of the product’s ingredients. Ask you veterinarian about these treatments and not your neighborhood health food store or pet food chain. They do not have veterinary degrees and are usually getting information without doing the proper research. There are now a plethora of touted treatments for arthritis. Some treatments claim to cure everything. Buyer beware. What works for one disease may not help another. Do you know what is in the ingested product? Has it been tested? Is the treatment anecdotal? Can it be combined with other medications your pet is taking? The problem today is that we are being bombarded with these cures and remedies. It is important to ask your veterinarian about anything you give your pet. The veterinary profession is not self serving. We are truly here to help both you and your pet. However, several proven alternative therapies are available. These include acupuncture and chiropractic care and, with proper training, are really of value.

Catching arthritis early is key to help your pet live comfortably if diagnosed with this disease. So pay close attention to your dog’s activities and movements.

Arthritis can affect any joint area, some of the more common sites are:

• Hips – Hip dysplasia ( a loose hipbone – thighbone connection) allows excessive movement between the femoral head and acetabulum. This leads to osteophyte formation and bone degeneration and is one of the most common causes of canine arthritis.
• Elbows – In fragmented coronoid process, a small piece of the coronoid process breaks off and floats in the elbow, causing inflammation and arthritis.
• Knees – If the cruciate ligament ruptures, it creates instability in the knee joint – allowing the tibia to move forward in relation to the femur – which can lead to arthritis.
• Backs and necks – If chronic disc disease develops, arthritis can occur between the vertebra causing a condition call spondylosis. This can be a very debilitating disease.