What is arthritis?
Arthritis by definition is simply inflammation of the joint. While many people think of arthritis as a faraway thing, in only the really old pets, it can actually begin as early as a 1 year of age and can progress to being a huge issue by the time your pet is middle-aged! The inflammation within the joint slowly eats away at the cartilage and can lead to long term damage as unfortunately, once the cartilage is gone, it doesn’t grow back.
What causes arthritis?
Many different processes can contribute to the development of arthritis in pets and is often not limited to one singular cause.
- Degenerative changes and age: This is by far the most common cause of arthritis in our pets which occurs as part of the normal ageing process (just like humans!)
- Anatomical issues: Some pets are genetically predisposed to joint conditions that cause inappropriate bone-on-bone contact such as hip dysplasia, elbow dysplasia and luxating patellas.
- Injuries and accidents: Just like a human with a torn ACL or a fractured bone involving a joint, pets who have had any injuries to their joints (e.g. cranial cruciate ligament injury, intra-articular fractures), are predisposed to arthritic changes earlier in the affected joints.
- Overweight/obesity: Extra weight places extra unnecessary stress on the joints and can accelerate the development of arthritis
- Other: There are many other less common causes of arthritis including infections, immune-mediated disease, nutritional deficiencies, repetitive stress from high-impact activities – the list keeps going!
What are the signs of arthritis?
Signs of arthritis can be difficult to detect in the early stages of disease. Some pets can be particularly stoic and don’t show any signs until the joints are severely affected. Arthritis is a progressive disease so it is important to monitor your pet closely so that any arthritic changes can be managed as early as possible. Some common signs of arthritis include:
- Reluctance to get up, jump, run, play, etc.
- Change in behaviour (e.g. increased irritability)
- Stiff gait, lameness or limping
- Pain or discomfort when being touched
- Difficulty posturing when toileting
- Wasting or loss of muscle mass
How is arthritis diagnosed?
- Vet examination
Your vet will often start by collecting a thorough history of your pet (what clinical signs have you noted, when did they start, how frequently, etc.) Videos of your pet at home or exercising in the park are GREAT as some pets are particularly stoic at the vet clinic or their clinical signs may be intermittent. There will often also be a distance exam which means backing up and watching your pet move freely. The vet will often have you walk your pet back and forth to analyse their gait, their posture or stance, and how they sit. The vet will then also perform a thorough physical examination which involves palpation of the muscles and joints. This is often done in a very systematic order (e.g. starting from the toes and up), to identify painful areas, joint swellings (effusions), muscle wastage, reduced range of motion, and any stiffness or grating sensations (crepitus) in the joints! It means checking ALL the normal limbs as well, not just the one we think is sore.
- Diagnostic imaging (e.g x-rays, CT scan)
Some pets are quite stoic, while others can be quite dramatic, so sometimes the severity of disease does not always correlate to the clinical signs. This is where diagnostic imaging (x-rays, CT scan, etc.) is performed to help diagnose and assess the severity of joint disease. This will often inform our management plan and also assess for any other sinister issues (e.g. bony cancers) that can be causing similar clinical signs!
How to manage arthritis?
While there is no cure, arthritis is a condition that can be well-managed as long as there is a multi-faceted approach – there is no singular magical fix! The aim is to help slow down progression of the disease so that your pet is able to move and play with as little pain as possible and can enjoy the quality of life they deserve.
- Weight loss
When it comes to arthritis, we should actually flip a well-known proverb instead to “no gain, no pain”! Your pet’s weight has a huge effect on how much stress is placed on their joints, so staying within a healthy weight range is extremely important. In fact, studies have shown that despite the myriad of interventions we use to manage arthritis (including painkillers or other medications), no other intervention has a greater effect on arthritic pain than weight loss! Weight loss sounds simple (exercise more and eat less) but it can certainly be quite a challenge. Prescription diets designed for weight loss can make the journey easier such as Hill’s Prescription Diet Metabolic + Mobility which combines supplementation of omega-3 fatty acids with weight control.
- Modifying activities at home (e.g. low-impact activities, minimise household obstacles)
Having arthritis doesn’t mean your pet can’t be active, it just means adjusting their exercise routine to what they can tolerate! It is important to keep them moving to maintain muscle mass and mobility. Some great low impact activities include swimming, leisurely leashed walks, and ‘nose work’ mental exercises like a treasure hunt for treats! It is also important to minimise any household obstacles that would otherwise present as a challenge for your pet. This includes providing ramps or steps to get up and down from sofas and beds, avoiding jumping (e.g. help lifting your pet up and down from the car), placing rugs on slippery flooring to help your pet get up more easily and walk around more confidently, or providing your pet with a supportive thick high-density memory foam bed where they can stretch out on.
- Joint supplements or nutraceuticals
Supplements are really popular to help reduce inflammation in the joint and help provide the building blocks for healthy joints. There are many different types available from omega-3 and omega-6 fatty acids, chondroitin sulphate, glucosamin to green lipped mussels, however, not all are equally effective or at an appropriate dose and composition for absorption. Generally speaking, most joint supplements and nutraceuticals given in the right dose do not have negative side effects, but please always consult your veterinarian before commencing. The products we recommend include 4CYTE™ EPIITALIS® FORTE and Blackmore’s PAW Fish Oil 500: Veterinary strength. Remember, joint supplements or nutraceuticals are most effective when used in conjunction with other management methods rather than just sole therapy.
Just as in humans, physiotherapy is very important for overall management! We love physiotherapy so much, we wrote a whole blog on it. The exercises and therapies a physiotherapist assigns can be pivotal in both reducing inflammation in the short term as well as improving your furbaby’s ability to bear weight evenly and maintain mobility. In the long term, the goal is to also strengthen the musculature surrounding the affected joints to improve their function and reduce pain. The important thing here is ensuring your physiotherapist is properly trained! Have a chat with your veterinarian to make sure the physiotherapist you’ve chosen is suitable for you and your furbaby. Better yet, ask your veterinarian for a recommendation! We wholeheartedly recommend the wonderful team at Whole Family Health led by Dr Helen Nicholson.
- Disease modifying osteoarthritis drugs (DMOADs) (e.g. pentosan polysulphate injections (ZYDAX®))
Disease modifying osteoarthritis drugs (DMOADs) are aimed at slowing degeneration and preserving cartilage (chondroprotective). The most commonly used veterinary DMOAD is pentosan polysulphate. This is an injectable agent which relieves inflammation in joints by improving circulation to the cartilage, stimulating cartilage regrowth and breaking the inflammatory cycle. The initial course of injections involves four weekly injections, with the entire course repeated every 3, 6 or 12 months (depending on your pet’s individual needs). Be patient, sometimes the beneficial effects are only obvious towards the end of the course. There are minimal side effects from long or short term use and can be used safely with other drugs. Interestingly enough – despite pentosan polysulphate being used to manage arthritis in pets for many years, studies are currently being completed to evaluate its use for human arthritis!
- Medications (e.g. non-steroidal anti-inflammatory drugs (NSAIDs))
In tougher times, like the colder winter season, medications can be a tremendously useful tool. We can use medications to actively break the inflammatory cycle at the site of tissue damage – think of how we take non-steroidal anti-inflammatory drugs (NSAIDs) when we have a really bad ankle sprain. However, take care, human NSAIDs can be toxic to dogs and lethal to cats! Please always consult with your veterinarian first to get their expertise on prescribing the appropriate NSAID for your pet’s needs. Ideally, we don’t want to use medications all the time, as long-term NSAIDs use can be quite taxing on the liver and kidneys. Regular blood testing to monitor liver and kidney markers is required for any pets on long-term medications, and is recommended for any middle-aged pets (>7 years of age) prior to commencing NSAIDs. We often use medications together with the other therapies we’ve listed above.