Arthritis

It can be as uncomfortable for our dogs as it is in humans - but there are ways of managing the disease to ease your pet's pain.

Arthritis simply means 'inflammation of the joints' and is a common problem for many dogs. Most of you will no doubt know of a dog suffering from arthritis that has shown the textbook signs of pain, discomfort and stiffness.

Inside a dog's joints, bone surfaces are normally covered with a thin layer of very smooth cartilage, lubricated with a small amount of joint fluid that allows the two surfaces to glide freely over one another with minimum friction. In dogs with arthritis, cartilage within the joint undergoes change or damage, becoming less smooth and resulting in the bone surfaces rubbing together. This causes discomfort to your dog, as well as further damage to cartilage. 

As a direct result of this increased friction, new bone starts to form around the joint making the joint stiffer, which limits its movement even more - a condition known as degenerative joint disease.

Typically arthritis is a problem seen in older dogs, but the condition can develop from an early age following problems with bone and joint development. Depending on the cause, arthritis may affect one or any number of your dog's joints. Most cases develop as a result of abnormal rubbing within the joint caused by joint instability (e.g. after ligament damage), damage to or abnormal cartilage development, or damage caused by trauma (e.g. fractures). Like humans, signs of arthritis can often vary throughout the animal's life and result in the early onset of joint problems in older age.

As the disease nearly always causes pain and stiffness, dogs may not be as keen to exercise as they were in the past and may show lameness or obvious stiffness (especially after long periods of rest). Commonly this stiffness improves with commencement of exercise, with cold and/or damp conditions usually worsening symptoms. Some dogs may even lick continually at an underlying painful joint - occasionally causing unwanted patches of saliva staining - but rarely do joints appear hot or swollen; more commonly changes are subtle and undetectable to the naked eye. Some patients will show obvious signs of pain, whereas others may just become slower or grumpier.

If your vet suspects your dog is suffering, they can sometimes tell which joints are affected by any pain and/or discomfort by examination, including joint flexion and extension. But to investigate properly they usually suggest further tests (e.g. x-rays), which help confirm and locate arthritic change, and sometimes identify any underlying causes too.

With so many therapy options available nowadays, it's paramount to match any treatment with their underlying cause and joint(s) involved. Arthritis is commonly worse in overweight and unfit dogs, so the most important therapy is the combination of weight control and exercise management: minimising load on the joints, and maximising the range of movement and fitness of the muscles around those joints.

There are three main families of drugs used to successfully treat canine arthritis. The first are cartilage protectors designed to reduce cartilage damage. Pentosan injections are usually the best form of arthritic management, especially in the early stages of joint disease, and are the number one choice if picking just one option. Pentosan stimulates healthy cartilage production and has a long-term effect of preventing the amount of arthritis development. It can also improve pain levels and mobility in the short term and essentially improves joint lubrication. 

Pentosan should be initially started as oneinjection a week for four weeks, then reduced in frequency to oneinjection 1-3 monthly, depending on effect and maintained at this interval long term. 

 Nutraceuticals are not medicinal products, but feed supplements that are designed to support the healthy function of dogs. Commonly used “nutraceuticals” are joint supplements as they tend to contain chondroitin and glucosamine, which occur naturally in joint cartilage alongside natural ingredients like curcuminoid (component of turmeric) a potent antioxidant.

Joint supplements can often be given as a treat alongside any prescription medicines prescribed by your vet. Jointguard, Pernease Powder, Turmerix, Technyflex Canine or 4Cyte are different types of powder supplement that can be added daily to their food. They contain glucosamines, minerals and natural products such as Green-Lipped Mussel. They have a long term effect of reducing the amount of arthritis development and usually maintain excellent cartilage health. 

All these brands work well, however we’ve had a great level of success with dogs on Technyflex and 4Cyte, this can be purchased at the clinic. 

The third set is anti-inflammatory drugs (NSAIDs). These seem ideal for managing inflammation associated with arthritis, but potential problems are their significant side effects, resulting in some warning against long-term use. In the short term, drugs with the highest impact on analgesia and inflammation are often the first choice, but using them in the medium or long term may prove detrimental to the patient so alternatives must be sought.

Various medications can be used to control inflammation and pain in the joints. These can be used long term or intermittently when required. Products available include Previcox (tablets) or Meloxicam (syrup) – both a non-steroidal anti-inflammatory. 

Anti-inflammatories like Meloxicam are very effective at controlling joint inflammation and pain and have been proven to slow the rate of joint degeneration as a result of this effect. They are ok to use in short courses or long term. If pain spikes or episodes occur regularly, it is better to use them daily, on a long-term basis. This keeps the base level of chronic background pain to a minimum rather than allowing it to slowly increase.

In this situation, the main thing to monitor is kidney function – via blood and urine tests, best done on a 6-monthly basis once anti-inflammatories are used consistently. 

The liquid Meloxicam brand we stock at the clinic is usually Meloximav – the same active ingredient, just a different brand. 

Dosage of this drug can start at the recommended level, but can be tapered down until the minimum amount required is reached to maintain good pain relief.  

Tramadol, Neurontin and other pain relief medications can often be used on their own or with Meloxicam. This would be discussed at a review of pain management. With time, supplements and strategies listed in this report, dependence on pain relief requirements may lessen.

If your pet is showing signs or Arthritis, it is best to book a consultation with your vet to have your animal assessed to help maintain and manage their Arthritis best suited to their needs.