arthritis in dogs

Author, 8 Weeks to a Healthy Dog, The Allergy Solution for Dogs, The Arthritis Solution for Dogs & Cats, and the award-winning The Natural Health Bible for Dogs & Cats www.petcarenaturally.com

One of the most common reason owners of older pets seek veterinary care is for lameness. While disorders such as bone cancer and nervous system damage can be a cause, in most instances older lame pets have arthritis. This article will review the causes of arthritis, as well as new treatment options that are available for your pet.

In order to better understand arthritis, it’s good to know what causes arthritis to develop. For this article, the term arthritis will refer to “osteoarthritis” (also called degenerative joint disease,) a condition in which bone and the cartilage covering bone is diseased. Rheumatoid arthritis, which is very rare in pets and is an immunological disorder, will not be covered. Arthritis is probably the most common condition musculoskeletal disorder in older dogs and cats. In my practice, almost all pets over the age of 10 have some degree of cartilage degeneration. Arthritis technically means "inflammation of the joint;" therapies for arthritis seek to decrease this inflammation, which causes swelling, stiffness, and pain. When possible, the therapy should also slow down the progression of the arthritis or if possible, actually help the joint to heal. Joints commonly affected with arthritis include the knee, shoulder, ankle, elbow, vertebrae, and hips.

The cause of arthritis is unknown. However, chronic instability of the joint, and normal wear and tear, lead to erosion of cartilage, inflammation, and the destruction of underlying bone. In dogs, joint instability can result from genetics (as in the case of hip dysplasia) or chronic overexertion.

The cartilage covering the bones (the articular cartilage) lacks nerves; a great amount of damage can occur to the cartilage before the surrounding joint tissues (joint capsule, bones, and ligaments) become inflamed and cause lameness. (Considerable damage is often present by the time the animal actually feels any pain and shows signs of lameness. Annual screening of the hips and spine, the most common joints affected with osteoarthritis, will allow for early diagnosis and treatment before irreversible cartilage damage occurs.)

Here’s how arthritis progresses in our pets. The joint cartilage is made of cartilage cells (chondrocytes) and the surrounding tissue matrix. The major components of the matrix are collagen (a type of protein), water, and proteoglycans. The proteoglycan molecule is made of a central core of protein with numerous side chains of glycosaminoglycans (GAGS.) There are several different proteoglycan molecules in the joint cartilage including chondroitin sulfate (the predominant GAG in cartilage) and keratan sulfate. Glucosamine, a popular treatment for osteoarthritis, is a precursor chemical necessary for GAG synthesis. As the animal walks and plays, a large amount of stress is placed on all the components of the joint. With years of wear and tear on the joints, the cartilage breaks down and arthritis develops. As wear and tear on the joint continues, the cartilage cells (chondrocytes) are not able to synthesize enough of the proteoglycans to help the cartilage heal. As the chondrocytes become further damaged, inflammatory chemicals are released causing inflammation and further damaging the cartilage. With continued damage of the cartilage, underlying bone can be damaged, and the animal may refuse to use the affected limb due to pain. At this point, owners often seek medical care. Some pets can still be helped with nutritional therapies to heal the joint, whereas others may have arthritis that is too advanced to actually allow for healing. The earlier the pet is diagnosed, the greater the chance for healing to occur using complementary therapies.

Conventional Therapies

Most conventional therapies do a great job of treating inflammation and pain but rarely help the joint to heal. In some cases, these anti-inflammatory therapies actually cause more cartilage damage as time progresses. The main class of drugs used to treat arthritis are the non-steroidal anti-inflammatory medications (NSAIDS.) These include Rimadyl, EtoGesic, and Metacam (in people, Vioxx and Celebrex are examples of NSAIDS.) While NSAIDS are extremely effective in treating arthritis, they should not be used on a regular basis for treating most pets. Side effects which can occur (and more commonly occur in older pets, pets also taking other medications, and chronic use of NSAIDS) include liver disease/failure, kidney disease/failure, ulcers or perforations of the stomach and intestines, and possibly further damaging the cartilage (heart attack and stroke, problems recently discussed in the media as side effects of NSAID use in people, have not been reported in pets o date.) The best use of NSAIDS, if they must be used at all, is to give them to the pet only on days in which the pet seems particularly uncomfortable (“bad days.”) Even then, the lowest effective dosage (which is usually much lower than the label dosage) should be used to minimize the chance of side effects.

Corticosteroids such as prednisone may be prescribed for arthritis. However, due to side effects (including cartilage damage, diabetes, and increased infections) they have no place in the long-term treatment of arthritis.

Surgery is often overlooked as an effective therapy for pets with arthritis. Interestingly, surgery is really the only therapy that can cure some pets. While surgery cannot cure arthritis per se, it can replace defective anatomy. For example, for the dog with bad hip dysplasia, surgery such as a total hip replacement will cure the problem. Unfortunately, many of our arthritic pets are older and may not be suitable candidates for such an involved surgery. Still, it is worth discussing the possibility of surgery with your veterinarian if you are interested in curing your pet’s problem.

Complementary Therapies

Many complementary therapies not only relieve pain and inflammation but actually supply nutrients to help the cartilage heal and slow down the destructive forces of nature which act to destroy the injured joint.

By far, the most common complementary therapies are various joint supplements. These supplements typically contain ingredients such as glucosamine, chondroitin, MSM, DMG, or hyaluronic acid (hyaluronin.) While each ingredient works differently, in general all of these joint supplements work in 2 ways. First, they supply nutrients (building blocks) to the damaged cartilage, actually helping the damaged cartilage to heal (something no conventional therapy can do.) Second, like conventional therapies, these supplements inhibit the inflammatory enzymes that destroy the cartilage, bone, and other parts of the joint. By doing so, they reduce pain and encourage normal joint function.

As a rule, I always use some type of joint supplement as part of my therapy for dogs and cats with arthritis. Unlike NSAIDS, they usually don’t work overnight and may require 4-8 weeks to achieve maximal effectiveness. However, unlike NSAIDS they have a “lag” period where they continue to help the pet even when they are stopped (typically the lag period lasts 2-6 weeks.)

While any joint supplement can be effective, you may need to work with your doctor to find the most effective supplement. I discourage pet owners from buying supplements on their own. There are too many inferior products available for sale. Instead, seek advice from your veterinarian about which supplement may be best. I try to recommend those whose manufacturers have the seal of approval from the NASC (National Animal Supplement Council.) This ensures a high quality product. While these superior products may cost more than those obtained at the local store, you really do get what you pay for with supplements. I can certainly sell cheap supplements, or I can sell quality supplements that I know work. I choose to sell the better products.

Finally, when considering which supplement to use, it’s tempting to compare the costs of the products. While I have no problem with this, the only way to compare costs is on a per dose or per day basis. For example, let’s assume that your dog requires 1500 mg of glucosamine per day. Supplement A contains 1500 mg of glucosamine per pill, and a bottle of 90 pills costs $75; Supplement A has enough pills to last 90 days. Supplement B contains 250 mg of glucosamine per pill, and a bottle of 90 pills costs $35; Supplement B has enough pills to last 15 days at the prescribed dosage for your dog. While Supplement A costs more when purchased, it is actually much less expensive than Supplement B when the correct dose is used. If you choose to compare costs, you must compare them in this way in order to find the most cost-effective product.

Additional therapies that may help pets with arthritis include herbs, homeopathics, and homotoxicologic agents. Examples of herbs that may be used include white willow bark,Devil's claw, horsetail, ginger, alfalfa, licorice, boswellia, feverfew, and capsaicin(cayenne.)

Homeopathic remedies that may be prescribed for pets with arthritis include Caulophyllum, Lithium Carb, Rhus Tox, Bryonia, Hecla Lava, and Actaea Rac. Homotoxicologic agents that may be helpful include Traumeel and Zeel (Zeel has be shown in studies in people to be as effective as NSAIDS without the side effects that are commonly encountered when using NSAIDS.)

Additional complementary therapies that may be useful include acupuncture and magnetic therapy. These therapies will not usually heal damaged cartilage but will reduce pain and inflammation. They can be used in conjunction with joint supplements as needed.

Prevention

While I can never guarantee an owner that arthritis can be prevented, there are definitely a few things that can be done to minimize the occurrence of arthritis. First, do not breed dogs that are known to carry genes that predispose to arthritis (for example, dogs with hip dysplasia should not be bred.) Second, while exercise is important, don’t overdue it. Your veterinarian can prescribe a sensible exercise program. When possible, for pets with arthritis, exercises such as supervised swimming that limit weight-bearing are preferred. Third, weight control is critical. Many pets I treat with arthritis are overweight, forcing damaged joints to bear even more stress. Keeping pets lean can minimize arthritis and is a critical part of treating arthritis.

I believe the best approach to treating arthritis involves the use of joint supplements to help heal the cartilage and reduce pain and inflammation. Conventional medications such as NSAIDS can be used safely on a short-term, as-needed basis in most pets, but really have no place as the sole therapy for treating arthritis. Additional therapies such as acupuncture or magnetic therapy can also be used as needed. Finally, the proper use of exercise and a weight control program are essential in minimizing the need for medications and maximizing the effectiveness of any therapeutic program.

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1/10th of oz = 2,800 mg

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