Non-surgical Management of Arthritis

It is never easy to see a beloved pet and friend in pain. Medical treatment of degenerative joint disease (osteoarthritis) has greatly improved in the last several years thanks to the introduction and approval of several new drugs and supplements. And while there is not yet a cure for this debilitating disease, there is much you can do to control the pain, make your pet comfortable, and perhaps slow down the progression of the symptoms.

Weight management

Weight management is the first thing that must be addressed. All surgical and medical procedures will work much better if the animal is not overweight. Considering that up to half of the pets in the U.S. are overweight, there is a fair chance that many of the dogs with degenerative joint disease are also overweight. Getting the dog down to his recommended weight and keeping it there may be the most important thing an owner can do for their dog. This may be the hardest part of the treatment, but it is well worth it. Very few dogs can drive to McDonalds, work a can opener, or open the refrigerator, so you, the owner, are controlling what your dog eats. If you feed your dog less, it will lose weight.

Exercise

Exercise is the next important step. What we are trying to accomplish here is to restrict the amount of exercising, yet still maintain adequate movement to increase or maintain muscle strength. Young, active dogs are going to need to be restricted to walks on the leash. Swimming is an excellent way for dogs to maintain muscle mass, but place minimal stress on the joints. Older dogs should also participate in these activities to a lesser extent. Jumping in all forms is bad for dogs with arthritis. While watching a dog play Frisbee is very enjoyable and fun for the dog, remember that it is very hard on a dog’s joints. Remember, it is important to exercise daily; only exercising on weekends, for instance, may cause more harm than good if the animal is sore for the rest of the week and becomes reluctant to move at all.

Provide warmth and good sleeping areas

Slip a sweater on your dog. Arthritis tends to worsen in cold, damp weather. A pet sweater will help keep joints warmer. You may want to consider keeping the temperature in your home a little warmer, too.

Provide a firm, orthopedic foam bed. Beds with dome-shaped, orthopedic foam distribute weight evenly and reduce pressure on joints. They are also much easier to get out of. The orthopedic beds we offer are very good choices. Place the bed in a warm spot away from drafts. Next to a heat register is best.

Massage and physical therapy

Your veterinarian or the veterinary staff can show you how to perform physical therapy on your dog to help relax stiff muscles and promote a good range of motion in the joints.

Your dog may benefit from massage. A soothing massage of the affected area helps relieve stiffness and soreness. Remember, your dog is in pain, so start slow and build trust. Start by petting the area and work up to gently kneading the muscles around the joint with your fingertips using a small, circular motion. Gradually work your way out to the surrounding muscles. Moist heat is also beneficial. A water bottle or soaked towel works best.

Make daily activities less painful

Going up and down stairs is often difficult for arthritic pets, and for dogs, it can make going outside to urinate and defecate very difficult. Many people build ramps, especially on stairs leading to the outside, to make it easier for the dogs to go outside.

Larger breed dogs can especially benefit from elevating their food and water bowls. Elevated feeders make eating and drinking more comfortable for arthritic pets, particularly if there is stiffness in the neck or back.

Agents to promote healthy cartilage

Glucosamine and Chondroitin: Glucosamine and chondroitin are two of the supplements that have recently become widely used in treating both animals and humans for osteoarthritis. These products have been around for a while, but due to the lack of scientific studies supporting them and the medical profession’s resistance to endorse a nutraceutical, they had failed to gain popularity. Now due to the overwhelming success in treating patients with osteoarthritis, these products have come to the forefront of therapy and are becoming one of the most popular products for treating arthritis today. Examples include Drs. Foster & Smith’s Joint Care, Cosequin, and Glyco-Flex.

Glucosamine is a major component of cartilage. Chondroitin enhances the formation of cartilage and inhibits enzymes in the joint, which tend to break down cartilage.

When a pet has degenerative joint disease, the joint wears abnormally and the protective cartilage on the surface of the joint gets worn away, and the resultant bone-to-bone contact creates pain. Glucosamine and chondroitin give the cartilage-forming cells (chondrocytes), the building blocks they need to synthesize new cartilage and to repair the existing damaged cartilage. These products are not painkillers; they work by actually healing the damage that has been done. These products generally take at least six weeks to begin to heal the cartilage and most animals will need to be maintained on these products the rest of their lives to prevent further cartilage breakdown. Because these products are naturally-occurring compounds, they are very safe to use and show very few side effects. There are many different glucosamine/chondroitin products on the market, but they are not all created equal. We have seen the best results and fewest side effects from products that are formulated especially for dogs and which contain pure ingredients that are human grade in quality. Products such as Drs. Foster and Smith’s Joint Care and Gluco-C, or the veterinary-sold product Cosequin are several that fit this category.

Polysulfated Glycosaminoglycan (Adequan):Adequan is a product that is administered in an injection. A series of shots are given over weeks and very often have favorable results. The cost and the inconvenience of weekly injections are a deterrent to some owners, especially since the oral glucosamine products are so effective. This product helps prevent the breakdown of cartilage and may help with the synthesis of new cartilage. The complete mechanism of action of this product is not completely understood, but appears to work on several different areas in cartilage protection and synthesis.

Anti-inflammatories and pain relievers

Buffered Aspirin: Buffered aspirin is an excellent anti-inflammatory and painkiller for dogs. (Do NOT give your cat aspirin unless prescribed by your veterinarian.) It can be used along with glucosamine/chondroitin products and is safe for long-term use. With all aspirin products used in dogs, there is a risk of intestinal upset or in rare cases, gastric ulceration. Because of these problems, it is recommended that if a dog develops signs of GI upset, the product be discontinued until a veterinary exam can be performed. (By giving aspirin with a meal, you may be able to reduce the possibility of side effects.) Using buffered aspirin formulated just for dogs makes dosage and administration much easier. Regular aspirin, Tylenol, and ibuprofen have many more potential side effects and are not recommended without veterinary guidance.

Buffered aspirin, or aspirin of any kind, should not be given to cats, unless prescribed by your veterinarian.

Carprofen (Rimadyl): Carprofen is a non-steroidal anti-inflammatory developed for use in dogs with osteoarthritis. Carprofen is a very strong and effective painkiller and anti-inflammatory agent. It is a prescription product and because of potential side effects, careful adherence to dosing quantity and frequency must be followed. The manufacturer recommends that periodic blood work to be done on animals that are on this product to monitor any developing liver problems resulting from its use. This product is often used initially with glucosamine therapy and then as the glucosamine product begins to work, the carprofen dose is reduced or eliminated.

Corticosteroids: Corticosteroids have been used for many years to treat the pain and inflammation associated with osteoarthritis, although their use now is controversial. Corticosteroids act as a potent anti-inflammatory, but unfortunately, have many undesirable short and long-term side effects. Because of these side effects and the advent of newer, more specific drugs, corticosteroids are generally only used in older animals where all other pain control products have failed, or in acute flare-ups. Corticosteroids are a prescription product and come in both a pill and injectable form.

Vitamin C

Vitamin C has received a lot of press lately, primarily because of studies done in humans that have linked it to preventing and controlling a variety of diseases. Much of the use in animals has been extrapolated from human medicine. Humans are one of only a handful of species that have a requirement for Vitamin C. Dogs and cats synthesize their own Vitamin C, so this is one area where we probably should not be using human studies as guidelines for treating dogs and cats. We know that Vitamin C acts as an antioxidant and is an important nutrient in the synthesis of collagen and cartilage. We also know that Vitamin C is water-soluble and it is very difficult to create a toxicity. Vitamin C does lower the pH of urine and some researchers question the possible long-term side effects of over-acidified urine. The benefits of Vitamin C in preventing or treating degenerative joint disease are purely speculative. Using reasonable doses of Vitamin C does not appear to be harmful and some day research may show that it is beneficial in animals.

Surgery

Some forms of degenerative joint disease can be treated with surgery. For example, hip replacements in dogs with hip dysplasia are becoming more common. Other procedures can also be performed, but their success rests upon how many bony changes have occurred in and around the joint. Please see the article on the specific joint disease for extended discussion on the surgical treatment options for that disease.

Summary

Each dog with arthritis will need to have a management program specifically designed for his needs. What helps one dog with arthritis may not help another. Work with your veterinarian and watch your dog carefully so that between you, your dog, and your veterinarian you can determine what is best for your dog. Realize, too, the program may need to be changed as your pet ages, or if symptoms improve.

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