OSTEOARTHRITIS
(by Dr Jason Smith 2006)
What is arthritis (osteoarthritis/degenerative joint disease)?
Arthritis is a progressive, degenerative joint disease which can cause pain, reduce mobility, and reduced quality of life for pets. 1 in 5 adult dogs suffer arthritis.
In a normal joint, bone surfaces are covered with a smooth, cushioning layer of cartilage, which is bathed in a thick lubrication fluid. The joint is encased in a capsule and supported by surrounding soft tissues. Early arthritic changes involve the joint fluid becoming less lubricant and the cartilage surfaces becoming eroded and roughened. As disease progresses, the bone underneath the cartilage starts to react, and the soft tissues surrounding the joint become thickened and painful. In a nutshell, arthritis is a disease affecting the joints. The cartilage lining of the joint is worn down causing pain.
What causes arthritis?
In some cases specific disease progresses (e.g. autoimmune disease, infection) need to be ruled out or treated. Most cases however are considered to be a result of “wear and tear” on joints.
Factors that can predispose to “wear and tear” effects include: genetics; conformation (e.g. hip dysplasia); poor nutrition; injury; and, obesity.
Arthritis is common in older pets, however any animal of any age may become afflicted.
What are the signs of arthritis?
Signs depend on the location and severity of the arthritis. Some pets are more stoic than others, and do not readily complain, but arthritis is painful, even though the outward signs may be subtle.
Signs include:
- Reduced activity (reluctance to walk or play)
- Change in character (reduced interaction with people; aggression; anxiety)
- Stiffness/lameness (difficulty getting up after resting; difficulty jumping or climbing stairs; limping)
- Licking or chewing joints
- Changes in toilet behavior (e.g. incontinence; toileting inside)
How is arthritis diagnosed?
Usually a combination of the following is required to definitively diagnose arthritis as the cause for the above signs:
- Physical examination by your Vet
- Radiograph
- Arthroscopy (“key-hole” examination with a scope), or arthrotomy (surgically opening the joint for examination)
- Blood tests
- Joint fluid analysis
- Gamma-scintigraphy, CT and MRI are regularly used in human medicine for orthopedic assessment, but unfortunately are not readily accessible for pets in Perth (currently available only via referral to a veterinary specialist at Murdoch University).
How is arthritis treated?
Unfortunately an arthritic joint can not be “fixed”, however most pets can be given considerable relief, and greatly improved quality of life with a combination of the following:
ENVIRONMENT:
Warm, comfortable, well-padded bedding is essential. Avoid draughts and dampness. Sometimes applying local warmth (e.g. wheat bag) to the affected joints may help.
DIET:
“Senior” diets have added nutrients for joint support, and can help with weight control.
WEIGHT CONTROL:
Joint problems are aggravated by excess weight.
EXERCISE:
Regular, low-impact exercise is important to keep the joints mobile, and nourished, and to strengthen muscle. Daily walking or swimming is ideal. Avoid over-exercise or high-impact activities that involve running or jumping.
NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS):
These are the most common class of prescription anti-inflammatory used for arthritis treatment. They provide symptomatic relief. Commonly used veterinary NSAIDs include carprofen (trade name Rimadyl), meloxicam (trade name Metacam) and ketoprofen (trade name Ketofen).
*Avoid human anti-inflammotories (unless under advice from your vet). Animals and humans metabolise some drugs very differently. Some medications which are safe for human use can have serious and life-threatening side effects on pets (e.g. naproxen, ibuprofen, paracetamol, indomethacin).
CORTICOSTEROIDS (e.g. Prednisolone):
These prescription drugs are also good anti-inflammatories, but not often used for arthritis due to a higher risk of side effects after long-term use.
Both groups of drugs can relieve the pain of arthritis in some cases. However they have little effect on cartilage degradation – the cause of pain in arthritic joints.
CARTROPHEN is a medication which possess anti-inflammatory,
anti-arthritic and chondroprotective properties. It acts to protect the joint cartilage by:
limiting cartilage degradation;
promoting cartilage formation;
improving the quality of joint fluid
improving blood supply to the joint -> this helps it heal.
By virtue of these actions, cartrophen may provide a degree of pain relief. A course of 4 weekly injections is required then followed by either a repeated course every 6mths or one injection monthly in chronic cases. Cartrophen generally provides long term relief (usually 3-12 months) to approximately 80% of pets with arthritis.
ORAL CHONDROPROTECTIVE AGENTS/ NUTRACEUTICALS:
Alternative medications may include Arthrocart (glucosamine combined other with essential joint nutrients), Sasha’s Blend (shark cartilage and green-lipped mussel - predominantly containing chondroitin) and Omega-3/fish oil (all these products are available at our vet centres). These nutraceuticals are non-prescription products that have been shown to assist in relieving the symptoms of arthritis. They are generally derived from natural products.
SURGERY:
May be considered/indicated in some cases.
COMPLIMENTARY THERAPIES:
Treatment modalities such as acupuncture and herbal remedies are used in some cases.
