Osteoarthritis / Chronic Degenerative Joint Disease / Arthritis
Osteoarthritis is a degenerative and inflammatory joint disease. It is the most common type of arthritis to effect animals (and humans). Approximately 1 in 3 cats and 1 in 5 dogs are effected. Osteoarthritis can effect any joint in the body, although some joints are effected more often than others, usually because they bear more load. Chronic wear and tear is the most common cause, but previous trauma or your pet's genetic make-up may predispose them to this crippling disease. Arthritis can occur at ANY age and ANY weight - it is not just the old and overweight who are affected. Currently there is no cure, but treatment can slow the progression of the disease and increase your pet's comfort.
Osteoarthritis starts with destruction of the cartilage lining of the joints, exposing the underlying bone. When the bones rub together, pain is the result. Eventually the body creates new bone - osteophytes and thickens the joint capsule in an attempt to stabilise the joint, but these actions usually limit joint movement further and make signs appear worse even if the pain is actually less. Abnormal gait then causes abnormal muscle use, causing muscle pain and myofascial trigger points, further exacerbating pain. Animals are very stoic. Signs of arthritic pain are often missed by owners who think their pet is just "getting old".
Common clinical signs of arthritis are:
-
reluctance to walk or play
-
difficulty rising
-
trouble jumping
-
difficulty getting into or out of the car
-
limping/lameness
-
decreased grooming (mainly cats)
-
changed behaviour, even aggression
-
muscle wasting
-
licking certain joints
Treatment
Treatment is aimed at reducing pain and inflammation, slowing disease progression, facilitating the repair of damaged tissues and maintaining or improving joint function. As yet we are unable to cure arthritis. Treatment is most effective if multiple modalities are used together. As osteoarthritis is a continuous degenerative process, ongoing treatment can help prevent relapses and allow your pet to benefit from more sustained improvement.
Weight control is essential
Maintaining a lean body mass or weight loss (commonly needed) is essential to minimise the load on effected joints. We can help design a diet or suggest a good commercial diet food to help. Hills J/D for example, has been specifically formulated for animals with joint disease. It will promote weight loss while adding in omega 3 fatty acids, glucosamine etc - all the things healthy joints need.
Modified Exercise / Physiotherapy
Arthritic joints must move or the problem gets worse. Exercise is essential to maintain joint mobility, but now needs to be modified and controlled. Shorter duration more often and limiting (or preferably stopping) jumping and twisting is recommended. Swimming is great exercise for animals with arthritis - it builds muscle bulk and strength which helps support the joints, it is non-weight bearing so the exercise does not exacerbate the disease process and it is very good exercise for weight loss. For those without a pool or in cold weather, there is a heated pool for dogs at the ACE boarding kennels near the Edinburgh Airforce base or at the Glenside Veterinary Clinic (please ask staff for details/requirements). Environmental modification such as warm padded beds, no draughts and decreasing the number of stairs or steepness of slopes will also ease strain and thus pain.
Neutriceuticals
You can provide some joint components and beneficial compounds through the diet, for example, glucosamine, chondroitin sulphate, omega 3 fatty acids. The omega 3 fatty acids, particularly EPA, have been shown to be more effective in canine arthritis than human. Omega 3s block the genes that produce cartilage destroying enzymes and help control inflammation deep within the joints. Omega 3s should be included in all arthritis plans. Some sources include, deep sea fish oil, flaxseed/linseed oil, "joint Guard", "Sasha's blend", joint support diets (various manufacturers eg Hills J/D). Antioxidents such as vitamins E and C, Selenium and beta-carotene help support a healthy immune system in general, which can help slow arthritis progression.
Medications
These fall into 2 groups.
1. Cartrophen Vet (pentosan polysulphate), is the only disease modifying osteoarthritis drug available. An injection is given weekly for 4 treatments. The course can be repeated as often as every 6 months, but more generally is repeated when clinical signs start to worsen. This medicine will improve the health of all joints in 6 ways, including pain relief.
2. Non-steroidal Anti-inflammatory drugs (NSAIDs). These drugs will reduce the inflammatory component of the disease and are particularly useful during acute pain episodes ("flare ups"). NSAIDs do not modify the disease. They provide comfort but do not slow progression. Modern NSAIDs have been modified for increased safety with long term use. It is NOT recommended to use human NSAIDs - animals often react differently to humans and dangerous side effects can occur. Some modern examples include Previcox, Rimadyl, Norocarp and Metacam. Metacam is the only one registered for use in cats.
Complementary options
Acupuncture is an effective treatment measure for many pets - both for the arthritis itself and any trigger points in muscles. Acupuncture is a holistic approach, our practitioner will usually therefore be assessing all problems in your pet, not just the arthritis. Being drug free it is a good option for those whose bodies do not fair well with drugs (provided they are not needle phobic!). Chiropractic treatment can also be useful to correct secondary problems associated with abnormal gait. Please speak to our friendly vets or nurses if you feel your pet may be suffering from this crippling disease. We are waiting to help.
|
