Oh Them Bones!

Is your dog having trouble walking or jumping on the couch? It may be time to go to the vet because more than likely your dog is getting arthritis.

By Dr. Christina Britto

Violet, a ten-year-old Labrador retriever entered my office with the main complaint of difficulty getting into her owner’s sports utility vehicle. She walked in slowly with a shortened, stiff stride in her hind limbs and sat down cautiously. Her guardian reported that in Violet’s younger years, she had a ruptured cranial cruciate ligament on the left knee that was repaired with a successful surgery.

My physical examination revealed crunching (crepitus) in both knees and the left hind limb did not flex and extend completely. It was also obvious that Violet had some muscle degeneration in her back legs. X-rays revealed aging changes in her knee bones and Violet was diagnosed with degenerative arthritis. The rest of the appointment was spent discussing how this is the number one cause of chronic pain in dogs and the treatment options that are available.

Arthritis literally means inflammation of a joint. Degenerative arthritis (or osteoarthritis) is a slow deteriorating disease that can affect any joint, but most commonly the hips, knees, elbows, wrists and spine. Degenerative arthritis occurs from inflammation in a joint when cartilage degrades. Cartilage is the soft, nerveless tissue that lines joints and acts as a cushion by protecting the surrounding bone. When that cartilage breaks down from either normal wear and tear, traumatic injuries or congenital defects, the joint can become painful and swollen.

Small and large dogs are susceptible to arthritis. However, obese dogs and those with prior orthopedic injuries and hereditary issues are more prone to developing the disease. These can be breeds like Great Danes, Rotties, Labs, Goldens, and Yorkies. Any patient who had a ruptured cranial cruciate ligament, broken bone or an inherited bone disease, like hip dysplasia or medial patellar luxation, will get arthritis at an accelerated rate.

Symptoms of arthritis to look for in your canine companion are difficulty rising after rest and trouble getting up stairs or on couches. Other signs are stiffness that resolves with exercise and lack of enthusiasm to go on walks. Occasionally, an arthritic dog will lick the joint, limp or vocalize when the painful area is touched.

Your veterinarian will make a diagnosis of arthritis based upon the symptoms, history and physical examination. X-rays of the joint will visualize wear and tear in the bones from lack of healthy cartilage. In some cases, joint fluid can be sampled to rule out other causes of arthritis, like infection or immune mediated disease.

If your dog is diagnosed with degenerative arthritis, your veterinarian will personalize the treatment regime. Managing arthritis is a multimodal approach that consists of weight reduction, controlled exercise, medications and sometimes surgery.

Degenerative arthritis is a progressive and painful disease that can affect all types of older dogs. The signs can be tricky and easily overlooked by the most meticulous guardian, so it is imperative to pay a visit to your veterinarian. Your veterinarian can personalize a treatment program to help slow the progression of arthritis and ensure your dog’s senior years are comfortable.

TREATMENTS

» WEIGHT REDUCTION AND CONTROLLED EXERCISE:
Extra pounds means extra strain on joints. Your veterinarian can make dietary recommendations and suggest low impact activities, like swimming and timed leash walks, to help lose unwanted pounds and gain necessary muscle mass.

» NUTRACEUTICALS:
These are nutrients with medicinal properties, like glucosamine, chondroitin sulfate, omega-3 fatty acids and MSM. They are slow-acting, natural anti-inflammatories that can help rebuild cartilage over time. They generally work better at slowing the progression of arthritis when used alone, but are complementary when used with other faster acting medications.

» NON-STEROIDAL & ANTI-INFLAMMATORY DRUGS:
These medications provide immediate relief by suppressing the inflammatory system, which decreases pain and cartilage damage. There are several types available (Rimadyl, Deramaxx, Metacam, etc.) and your veterinarian can decide which is the best for your dog. They can have negative long-term effects on the kidney and liver, which is why your veterinarian will suggest screening and monitoring blood work. The only human NSAID that can be used by a dog is aspirin, but always speak with your veterinarian before offering your pet any human medications.

» CORTICOSTEROIDS:
These drugs act as anti-inflammatories by suppressing the immune system. This means they can have serious side effects in the body by predisposing the patient to infections. However, they provide immediate relief and are sometimes necessary for short-term treatment.

» TRAMADOL:
This is a narcotic pain reliever with the same properties of Vicodin. It works by affecting the central nervous system and provides generalized pain relief with
side effects being mild sedation and
constipation.

» ADEQUAN INJECTIONS:
This is a series of injections given in the muscle that consists of polysulfated glycosaminoglycans (PSGAGs). This substance helps with joint lubrication and cartilage repair. It can be given in combination with the above stated treatments.

» SURGERY:
In some extreme cases, a total hip replacement can be recommended. However, this procedure must be done by a specialist, is expensive, and has a high complication rate.

Dr. Christina Britto practices at the Brentwood Pet Clinic in West Los Angeles and has an interest in surgery and pediatrics. She shares her home with a mini Poodle named Sophie.