Arthritis

As summer draws to an end and the days and nights get cooler we start to see an increase in the cases of arthritis presenting to the clinic. Arthritis is very common, affecting one in five adult dogs. It is more prevalent in older dogs of medium-large breeds, but pets of any age and any size can be affected by this painful degenerative disease.  Arthritis usually develops slowly and causes chronic pain.  There are signs to look for which are indicators that your dog could have arthritis... does your dog have trouble getting up in the morning and seem a bit stiff? Arthritic cats are good at hiding their discomfort and the signs may be subtle and difficult to spot.Because the disease develops slowly, it is often assumed that it's just old age, and nothing can be done. Fortunately, this is not true. There are a variety of treatments available.

Cause

Arthritis refers to a disorder of the joint. It can have many causes, including infection, immune system disorders, cancer and trauma, but commonly refers to the degenerative changes occurring in joints due simply to the wearand-tear of normal daily activity. A more correct name is Degenerative Joint Disease (DJD).  Any joint can be affected, but the most common joints are the hip, knee, shoulder and elbow, as well as the spine.

It is caused when the cartilage within the joints is worn away, and the synovial fluid, which lubricates the joint, becomes thin and watery. This creates friction and pain when your dog moves. The joints may also become swollen, which adds to the discomfort. At its worst - and especially if left untreated - arthritis can cause chronic pain, difficulty in movement and a decline in quality of life.

Symptoms

Symptoms include reduced activity, difficulty getting up or stiffness in the legs (especially early in the morning or after a sleep) and perhaps lameness. Other symptoms may be:

  • reluctance to walk or play
  • difficulty climbing stairs or jumping into the car
  • lagging behind on walks
  • licking or chewing at the joints o yelping in pain when touched
  • personality change (possibly aggression)
  • reduced appetite

If your pet is showing any of these signs, it may be time for a check-up

Diagnosis

A history of the problem is combined with a physical examination to determine the range of movement in a joint, any joint thickening or crepitus (a crunching/crackling feeling while manipulating the joint) and the degree of pain.

X-rays show the amount of new bone production, bone remodelling and other changes adjacent to the joint, narrowing of the joint space, and sometimes increased amounts of joint fluid.

It may be advised to sample the joint fluid to rule out other causes of joint pain such as infection, and immunemediated problems, as these have specific treatments.

Treatment

If arthritis is treated effectively, a dog's life will be both more comfortable and longer. There are three main ways to minimise the aches and pains:

1)  Weight control. If a dog is carrying too much weight, this puts added stresses on the joints. These stresses cause a higher level of joint damage, and consequently more severe arthritis. The first line of management of arthritis may be to use special diets to help a dog lose weight and so to minimise further joint damage.

2)  Exercise program. Moderate exercise helps to keep stiff joints supple and mobile. The exact exercise requirements depend on the individual dog, but in general, the motto is 'little and often'. This means 15  - 20 minutes twice a day rather than one long 40 minute hike every morning. Other physical therapies, such as hydrotherapy and physiotherapy are also now used to help affected dogs.

3)  Medication. Modern veterinary science has a number of different drugs which help to ease arthritis by relieving pain and improving the function of the joints. There are three different groups of drugs in common use:

a)  Non Steroidal Anti-Inflammatory Drugs (NSAIDs). This long-winded name describes a very broad group of drugs which minimise the inflammation of damaged joints, and also provide pain relief. Aspirin is the simplest and best known drug in this group, but nowadays there are many other, more modern and more effective  NSAIDs designed to treat arthritic dogs. NSAIDs may be in the form of tablets, or liquids, and often a daily dose is all that is needed to transform an old dog's quality of life. Many human anti-arthritis drugs can cause serious or even fatal results in dogs, so owners must always follow the guidance given by their vet.

b) Glucocorticoids (commonly known as 'steroids' or 'cortisone'). These drugs can provide a higher level of antiinflammatory effect than NSAIDs, but with more obvious and serious side effects in the long term. They can be given as tablets, or in exceptional cases, an injection directly into affected joints may be suggested.

c) Cartilage sparing and stimulating drugs. This new group of drugs is thought to work by directly protecting the cartilage of the joints, and by promoting healing of damaged cartilage. They do not seem to be effective in every case, but are often worth trying. They can be given by a once-weekly injection for four weeks, repeated every 6 months. Dietary supplements such as glucosamine and chondroitin sulphate can also provide help with the health of the joints.

There are other ways that arthritis can be helped, including special diets and acupuncture. The correct arthritis management program is different for each individual pet. It's best to work closely with your vet to devise a strategy which is custom-made for a pet's particular situation.