As your dog gets older, you might easily write off a lack of movement or energy to the slowing down that affects us all. Yet it’s often due to arthritis. Vets estimate that four dogs in five will show some signs of arthritis after the age of 8, and a quarter of the population will be affected by the most common kind: osteoarthritis, also known as degenerative joint disease.
Cartilage cushions healthy joints to permit a full range of motion. In osteoarthritis (OA), the cartilage breaks down, inflaming the joint. That can happen because of age, injury, repetitive stress or disease. Because it’s progressive, the dog faces increased pain and inflammation and decreased range of motion. Sometimes bone spurs develop in a condition called osteophytosis. Any joint can get OA, but the spine and limbs have it most often.
OA usually follows developmental orthopedic problems, such as cranial cruciate ligament disease, hip dysplasia, elbow dysplasia, kneecap dislocation, etc. OA without obvious primary causes may be related to genetics, obesity, exercise, diet – and yes, plain old age.
Signs of OA aren’t always specific. They include reluctance to exercise, decrease in activity, stiffness, lameness, inability to jump, changes in gait such as “bunny-hopping,” or pain when you manipulate a limb. You may see behavioral changes, such as aggression.
Vets diagnose OA by studying the animal’s history and performing a physical exam. They’ll palpate limbs and joints to look for pain responses, thickening of the joint capsule, accumulation of joint fluid (effusion) or sometimes osteophytes and muscle wasting.
They’ll also use imaging techniques. Typically, they will start with X-rays which give information about bone structure changes and some soft tissue changes. Other tools less commonly used include magnetic resonance imaging (MRI) and computed tomography (CT). CT assesses one structure and cartilage changes in more detail and MRI can provide information about soft tissues associated with the joint such as ligaments and menisci.
Vets usually recommend multiple approaches. Owners should start with weight control, by far the most critical aspect of OA management. Fat perpetuates inflammation, and increased body weight puts additional force on joints. Ideally, you should be able to feel your dog’s ribs but not see them, see an hourglass figure when viewed from above, and see a tucked-up belly when viewed from the side.
You’ll also want to modify your pet’s activity. Limit high-impact events such as running or jumping, as they can cause more inflammation and pain. Replace those activities with more controlled ones, such as leash walks. Consistent low-impact exercise helps build muscles around joints and eventually promotes joint stability.
You can rehabilitate an animal with range-of-motion exercises, therapeutic exercises and aqua therapy, including an underwater treadmill or swimming. Those improve joint mobility, increase muscle mass and build exercise endurance. Acupuncture, LASER therapy and other rehabilitation treatments may help, though studies don’t conclusively prove their benefits.
Pharmaceuticals for Osteoarthritis
Like humans, dogs can take certain nonsteroidal anti-inflammatory drugs for pain: carprofen, meloxicam, deracoxib, ketoprofen, etc. Patients who can’t tolerate these NSAIDs can use adjunctive analgesics such as amantadine, gabapentin, tramadol, codeine, or corticosteroids.
Vets can’t say exactly how well joint supplements alleviate OA pain. Chondroitin sulfate, glucosamine HCL, omega-3-fatty-acid supplementation are the most commonly recommended ones and don’t have severe adverse effects.
Disease modulating agents have become hot topics in the veterinary world. Some can be given as muscle injections, some as injections within the joint. These include platelet-rich plasma, hyaluronic acid and stem cells – though again, more research is needed to ascertain the benefits of these agents.
Platelet-rich plasma involves extracting a small amount of blood and separating the plasma, whose platelets contain growth factors and proteins that aid in tissue healing and regeneration. Synovetin is a safe, one-time agent that treats inflammation inside a joint; it delivers microscopic particles of radioactive material to inflammatory cells, killing or deactivating them. Monoclonal antibody therapy uses specialized antibodies to target inflammatory molecules. By binding to those molecules, antibodies help suppress inflammation and reduce pain and joint damage.
Surgery for Osteoarthritis
For some joints, this may be the best choice for advanced OA. Surgeries can treat the primary cause, such as suture-based or osteotomy-based techniques for knee cranial cruciate ligament rupture. Surgeries can also be salvage procedures to remove painful joint components, such as a femoral head and neck excision, arthrodesis (fusion of joints) or total joint replacement surgery. That happens most commonly in hips, elbows and knees.
The conservative approach can slow down the progression of the disease, and many dogs can live comfortably for years with OA. But it’s a progressive disease that generally worsens with time. Dogs who get surgery usually recover extremely well, especially if a diseased joint is completely removed or replaced.
Charlotte Animal Referral and Emergency operates as the pet version of a human medical center. CARE offers all types of treatments, from emergency care 24 hours a day, 365 days a year, to board-certified specialty attention when you get a referral from your primary veterinarian. Please take a visual tour of the practice at carecharlotte.com/tour.