Degenerative joint disease is the number one cause of pain in our pets. 20% of all pets of any age have arthritis. This figure climbs to 90% for the over-tens, afflicting both dogs and cats, particularly large breed dogs. The condition is the result of long-term stresses, from an old injury or from a poorly conformed joint during the growth stages of a puppy or kitten.  A pet doesn’t have to be a senior citizen to benefit greatly from joint care supplements or anti-inflammatories.

Surgery may be able to help in some situations e.g. with bone or cartilage chips floating around in the joint (ouch - what we call joint mice!). However most of the time the degeneration of the joint cannot be reversed and treatment focuses on preventing the progression of damage.

Arthritis is best addressed by what is called a multi-modal approach, meaning that safely combined treatments yield better results than any single therapy. 

As prevention of the progression of arthritis is all about maintaining the normal structures of the joint it is critically important to first understand joint structure.

The articular surfaces of the joint have cartilage caps on the ends of each long bone. These are the smooth surfaces that must glide across each other. Cartilage decreases joint stress by reducing impact on the ends of the bones in joints, like a gelatinous shock absorber. 

When there is an injury or simply poor conformation, the cartilage becomes roughened and can chip, flake off, or even wear down. When cartilage is damaged, a cascade of inflammatory changes occurs, eventually leading to destruction of the cartilage and subsequent damage to the underlying bone.  Cartilage contains no nerves – if your pet is showing any signs of pain, the damage and changes in underlying bone have already begun.

There is also a joint capsule that encloses the joint, creating the structure of the hinge. The capsule has an outer tough, fibrous layer and an inner layer that secretes joint fluid, a fluid that provides both nutrition and lubrication to the enclosed joint. The joint capsule must keep unwanted materials out of the joint and only let the desired nutrients inside.

The joint capsule becomes inflamed and thickened and no longer functions normally. Impurities enter the joint, the lubricating fluid loses its natural properties and ultimately a progressively abnormal and painful joint is created.

This degenerative disease may affect any joint but is commonly found in a pet’s  hip, elbow, shoulder, stifle (knee) , carpus (wrist), hock (ankle) or intervertebral joints (in the spine). 

Signs of arthritis to watch out for include:

• Reluctance to take walks of usual length

• Stiffness (that may disappear once the pet has ‘warmed up’)

• Difficulty climbing stairs, climbing in the car, on the bed or a sofa

• Difficulty rising from rest

• Limping

• An abnormal gait

• Licking of a single joint or part of a limb

• Acting withdrawn, spending less time playing with family

• Soreness, yelping or flinching when touched or moved

• Out of character grumpiness when touched or approached

As vets and pet owners our goal is to alleviate the pain and inflammation and provide the biochemical building blocks that allow the joint to heal itself.

There are many therapeutic options to help dogs deal effectively with this common condition.

Lightening the load on joints will help decrease the pain associated with arthritis, so if your dog is overweight, proper diet, exercise and weight control are essential. As veterinarians we can recommend a therapeutic diet and exercise program to safely and steadily reduce your dog’s weight.

Providing a padded bed, a warm, dry environment for your dog can also help control discomfort.

Warming up before exercise and providing passive physiotherapy should become part of your pet’s routine. Warming the muscles decreases stiffness, and increases blood flow.  It also directly reduces pain. A warm wash cloth in a plastic baggie makes an excellent warm compress (test it on yourself to be sure it is not too hot) for application to stiff joints. The joints can be flexed and extended passively and the muscles gently massaged. A good five minutes of this is helpful prior to exercise.

Arthritic joints rely on strong muscles for support, yet arthritis pain leads to disuse and poor muscle conditioning. For this reason, regular exercise is an important foundation. Short walks or swims that do not leave the pet unduly sore the next day should be part of the daily exercise routine.

If the pet is more sore or stiff after exercise, or on rising the following day, do not exercise until the pain seems to be resolved and re-start at 50% of the duration. Pets will guide you as to what level of activity their bodies can handle. Ideally a final 5 minute slower pace of exercise is followed by 5 minutes of massage.

Medications for arthritis pain can be divided into two groups: Slow-acting drugs and fast-acting (non-steroidal anti-inflammatory drugs and cortisone-type drugs).

Slow-acting drugs for arthritis ultimately improve joint function and help with pain relief, but they require a time frame of weeks to months to exert their effect. These products are typically what are called Neutraceuticals, meaning that they are nutritional supplements that have medicinal properties. All arthritis patients can benefit from their use and they are considered a basic starting level for joint care. These products often complement treatment with anti-inflammatory medications and in most studies allow a 50% reduction in prescription drugs required to adequately manage inflamed joints.

Glucosamine:

These products are cartilage components harvested chiefly from sea slugs. By taking these components orally (pills in the mouth), the patient is able to have plenty of the necessary building blocks needed to repair damaged cartilage. It is also felt that these products may have some anti-inflammatory properties separate from their structural uses. They can be given as a powder or already incorporated into special veterinary cat and dog diets.

Omega Three Fatty Acids:

Certain dietary fats, typically cold water fish oils, have been found to have anti-inflammatory properties. While this finding has primarily been used in the treatment of itchy skin, many arthritic dogs and cats have also benefited from supplementation. 

MSM:

MSM is another Neutraceutical anti-inflammatory agent.  MSM occurs naturally in most plant and animal tissues and is a natural source of sulphur. For commercial sale MSM is derived from DMSO (dimethyl sulfoxide). MSM provides the framework for glycosaminoglycans that enable cartilage to soak up water and thus act as a cushion for articulating bones, which are all sulfates. MSM also has anti-inflammatory and anti-oxidant properties.

Anti-oxidants and Free Radical Scavengers;

Free radicals are harmful biochemicals that can attack us from external sources (such as pollution, sunlight, etc.) or when we make them ourselves as by-products of oxygen use. These little molecules are highly reactive and attack our structural proteins as well as cause production of a number of inflammatory proteins. Supplementing or bodies naturally occurring scavengers with additional anti-oxidants can retard age-related change. Anti-oxidants that are readily available include Vitamin C, Vitamin E, SAMe, MSM, and Superoxide Dismutase.

Most pets with arthritis pain need relief now, not in 1 to 2 months when the cartilage building blocks and nutritional anti-inflammatories have had a chance to build up.

NSAIDS

act quickly by suppressing the inflammatory molecules that ultimately lead not only to the pain of arthritis but also to cartilage damage. None of these medications can safely be combined with one another. Furthermore, human NSAIDs tend to be toxic to pets, especially cats, and safer medications developed specifically for pet use have become the standard for joint pain management. Never use a human medication of any kind in your pet. One quarter of a Panadol is enough to horribly kill your friendly neighbourhood cat.

Newer NSAIDS work by distinguishing between two cyclooxygenase enzymes curtailing production of harmful inflammatory prostaglandins, wihile leaving intact “good” prostaglandins that help promote kidney circulation and intestinal health. Pre-treatment screening blood tests are still important before long term use of an NSAID as a dangerous pre-existing kidney or liver condition may preclude their use. Monitoring blood tests are recommended every six months for pets on NSAIDs.

Corticosteroids

inhibit production of all prostaglandins and of leukotrienes as well. The result is relief from just about any type of inflammation but in the long run side effects are problematic. Using these medications to control arthritis pain is not desirable in the long term.

Cartrophen Injections

contain an injectable cartilage component, mostly chondroitin sulfate, derived from cattle cartilage.  They inhibit harmful enzymes, stimulate cartilage repair, and increase joint lubrication. They are best given as an initial series of injections, then as a single booster every one to two months and can be safely combined with any of the other medications.

Our arthritic pets have a large menu of medications to select from and while proper medication (guided by your vet) is an important part of therapy, weight control and proper exercise should not be forgotten. 

Key points

• Signs of osteoarthritis may be subtle and easy to miss, so use regular examinations by your vet as an important tool in diagnosis

• Early treatment is critical to effectively slowing progression of the disease

• Maintaining ideal body weight is absolutely critical for arthritic patients

• Newer concepts of arthritis management include controlled moderate regular exercise to maintain muscle mass and decrease pain

• Neutraceutical agents are most effective when started early and then maintained for life

• Non-steroidal anti-inflammatory and analgesic drugs, and physical therapy are of great benefit in controlling later stages of the disease