The agony of arthritis

has your pet lost the spring in their step?

Degenerative joint disease (arthritis) is a common cause of severe pain in our pets.  Figures show that approximately 90% of pets over 10 years suffer from arthritis.  This is the result of long term stresses on a joint either from an old injury, abnormal cartilage development or trauma. Arthritis affects both dogs and cats but is particularly prevalent in large breeds of dogs

Arthritis can affect any joint but is most commonly found in a pet’s hip, elbow, shoulder, knee, wrist, ankle or spine. Preventing this degenerative disease from progressing is all about maintaining the normal structures of the joint, so it’s important to understand joint structure first. The articular surfaces of the joint have cartilage caps on the ends of each bone, which are smooth surfaces that glide across each other. Cartilage decreases joint stress by reducing the impact on the ends of the bones, 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 occur, eventually leading to the destruction of the cartilage and damage to the underlying bone. Cartilage contains no nerves so if your pet is showing any signs of pain, changes in the underlying bone have already begun.
There is also a joint capsule that encloses the joint, creating a hinge structure. The capsule has an inner layer that secretes joint fluid, providing both nutrition and lubrication to the enclosed joint. With arthritis, the joint capsule becomes inflamed and thickened, and no longer functions normally. Impurities enter the joint and the lubricating fluid loses its natural properties, leading to a progressively abnormal and painful joint.

Warning signs
Signs of arthritis to watch out for include:
Reluctance to take walks of usual length • Stiffness, which may disappear once your pet has ‘warmed up’ • Difficulty climbing stairs, climbing into the car, or onto the bed or sofa • Difficulty rising from rest • Limping • An abnormal gait •  Licking of a single joint or part of a limb • Acting withdrawn or spending less time playing with family • Soreness, yelping or flinching when touched or moved • Out-of-character grumpiness when touched or approached.

Effective treatment
Arthritis is best addressed by what is called a ‘multi-modal approach’, meaning that multiple treatments yield better results than any single therapy. From seven years of age, all dogs and cats should be fed a senior formula to help support their joints. Arthritic pets can also benefit greatly from joint care supplements, pain medication or physical therapy. Surgery may be able to help in some situations e.g. with bone or cartilage chips floating around in the joint. However, most of the time the degeneration of the joint can’t be reversed and treatment focuses on preventing further damage. As pet owners (in consultation with professionals including vets), 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 and cats with arthritis. Lightening the load on joints will help decrease the associated pain. If your pet is overweight, a proper diet, exercise and weight control are essential. Providing a padded bed, and a warm, dry environment for your cat or dog can also help control discomfort.

Gentle exercise
Warming up and providing passive physiotherapy should become part of your dog’s exercise routine. Warming the muscles decreases stiffness, increases blood flow and reduces pain. A warm washcloth in a plastic bag makes an excellent warm compress for application to stiff joints – test it on yourself first to ensure it’s not too hot. 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 pain leads to disuse and poor muscle conditioning. For this reason, regular exercise is very important. Short walks or swims that do not leave your pet unduly sore the next day should be part of the daily exercise routine. If your 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. Dogs will guide you as to what level of activity their bodies can handle. Ideally, a final five-minute slower pace of exercise is followed by five minutes of massage.

Useful supplements
Medications for arthritic pain can be divided into two groups: slow-acting and fast-acting drugs. Slow-acting drugs ultimately improve joint function and help with pain relief, but they require a time frame of weeks to months for their effect to be felt. These products are typically known as Neutraceuticals – nutritional supplements that have medicinal properties. All arthritis patients can benefit from their use and they’re considered a basic starting level for joint care. These products complement anti-inflammatory medications and, in most studies, allow a 50% reduction in prescription drugs required to adequately manage inflamed joints. Your vet may recommend one or more of the following:
Glucosamine – these products are cartilage components harvested chiefly from sea slugs. Taken orally (pills or powder), they provide the building blocks needed to repair damaged cartilage and may have some anti-inflammatory properties.
Omega 3 fatty acids – these dietary fats, typically cold-water fish oils, have been found to have anti-inflammatory properties. While they have primarily been used to treat itchy skin, many arthritic dogs and cats have also benefited from them.
MSM – another Neutraceutical anti-inflammatory agent.
A natural source of sulphur, MSM provides the framework for glycosaminoglycans that enable cartilage to soak up water, acting as a cushion for articulating bones, which are all sulfates.
Antioxidants and free radical scavengers – those that are readily available include vitamin C, vitamin E, SAMe, MSM, and Superoxide Dismutase. Supplementing our bodies’ naturally occurring scavengers with additional antioxidants can slow down age-related change.

Short-term relief
Most pets suffering from the pain of arthritis need relief now, not in a month or two when the cartilage building blocks and nutritional anti-inflammatories have had a chance to build up. Never give your pet human medication – even a quarter of a Panadol could be fatal for your cat.
NSAIDS (non-steroidal anti-inflammatory drugs) act quickly by suppressing the inflammatory molecules that lead not only to the pain of arthritis but also to cartilage damage. However, these medications cannot 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.
Newer NSAIDs work by curtailing production of harmful inflammatory prostaglandins, while 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 leukotrienes. The result is relief from just about any type of inflammation but in the long run, side effects are problematic. Using these medications long term to control arthritis pain is not desirable.
Another option is Cartrophen injections, which 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.
the big picture
There is a large menu of medications to select from for our arthritic pets, and while proper medication – under the guidance of your vet – is an important part of therapy, weight control and proper exercise should not be forgotten.

Key points to remember
*   Signs of osteoarthritis may be subtle and easy to miss, so regular examinations by your vet are an important tool in diagnosis.
*    Early treatment is critical to effectively slow progression of the disease.
*   Maintaining an ideal body weight is absolutely critical for arthritic pets.
*   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.
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Article provided by Patrick Foley - Vetwise