Dr Debbie Prattley BVSc MOst CVA CCRP PhD
Now that winter is on it’s way, we often notice that our older pets are slower to get going in the mornings. About 80% of dogs over 8 years old have arthritis – but it’s not only a disease of older dogs. About 35% of dogs of any age will be affected, and some from a really young age if their joints didn’t form well as they were growing.
What do you see if your pet has arthritis?
It can be quite different for different animals. In the early stages, you might not see anything. Often the arthritis advances so slowly that you don’t realise things are changing until something happens – like a slip or a fall – and suddenly they’re quite lame. The changes in the joint are often first found in an xray, and can be quite significant. We just didn’t know they were there before.
For other animals, you’ll see the signs of joint problems. The list of things you might see is probably endless! But here are some common ones:
- stiff when getting up after a sleep, especially if they were playing or went for a long walk before their snooze, or if they did a lot the day before
- limping after playing
- slow or needing help to get into or out of the car
- not wanting to jump places they used to jump – vehicles, bed etc
- slow to go up and down stairs
- shaking legs
- sitting with their hind legs out to the side
- going slower on a walk, stopping and refusing to go any further, doing a lot more sniffing, standing and looking around or yawning. They’re not necessarily tired, but are trying to tell us they don’t want to carry on.
What exactly is arthritis?
Mostly we think about arthritis as being wear and tear, and losing cartilage in the joints. That happens, but you also get inflamed joint linings, runnier joint fluid (and less of it), thickened joint capsules, and bony spurs and growths. That all adds up to having a joint that no longer provides the cushioning that it used to, so it can’t absorb the concussion that comes with running and jumping. It also means the joint is stiffer and doesn’t bend or stretch as much as it used to. There is inflammation in the joint, and the nerves send messages of pain to the brain. Often multiple joints are affected, and you end up with chronic pain in more than one place. This can be in the spine as well as in the legs. Arthritis also waxes and wanes, so you have bad patches and better ones. If your pet has a slip or fall, an arthritic joint will be more severely impacted than a healthy one, and it can take several weeks to settle back down again.
What can we do about it?
Firstly, think about the things your dog USED to be able to do more easily than they can now. Have you noticed any of the things in the list above? Even if they’re subtle? Those are the things you can use to monitor how well treatment is working, so write them down somewhere easy to find. You can also take some short videos on your phone.
Secondly, see your vet to get a diagnosis. While arthritis is really common, it’s not the only thing that can cause pain and lameness, and we want to be sure we’re treating the right thing.
Once you have a diagnosis there are lots of options to help manage it, although unfortunately there isn’t a cure. Some of the things that help with arthritis management include:
- Weight control – If your dog is overweight, the amount of extra pressure that puts on a diseased joint is huge. And the faster they move, the more impact it has. Getting to a healthy weight is enormously helpful, and probably the cheapest thing you can do. Unfortunately it’s also really difficult if they are already very overweight and have severe arthritis with lots of pain and weakness. But every little bit they lose will help them to feel better. Call the clinic for help!
- Exercise – Little and often wins the day for arthritic dogs. If they overdo it they might be sore for a few days and not want to do anything at all. Try to avoid the highs and lows if you can! See how long a walk they can do without being worse next time they get up after a sleep – but start with short walks (5-10 minutes) and gradually build up. Bear in mind that you do get those ups and downs with arthritis, so sometimes you might have to temporarily cut back. Also stop doing things that put lots of pressure on the joints, like chasing balls and rabbits, and the ducking and diving play with other dogs.
- Changing the environment – putting down non-slip mats on slippery floors, using toe-grips or paw-grips, using ramps and support harnesses, and lifting up feed bowls are some of the things that can make your house easier to navigate for an arthritic dog.
- Supplements – there are many, many supplements out there that are sold to help with arthritic joints. Some work better than others. We recommend Antinol (capsules of concentrated green-lipped mussel oil), and 4cyte (a plant extract). It usually takes several weeks for oral supplements to take effect.
- Injections for joint care – there is a medication called pentosan that is injected under the skin, but is designed to help support the joints. An initial course is one injection a week for 4 weeks.
- Pain medications – in the earlier stages, if your pet has one of those rough patches or a slip or fall, a short course of anti-inflammatories or pain medications might be all that’s needed to settle things back down again. If their joints are more severely affected, they might need to be on medication long term. We generally try to keep them on the lowest necessary amount of medication, as the drugs can have side effects, especially for their stomach, liver and kidneys. We recommend regular blood tests for this reason.
- Pain injections – there’s a new monthly injection for pain relief, that blocks ONE of the pathways that causes pain by stopping a nerve growth factor from doing its job. That can be really helpful in many dogs. However, it’s not very helpful for animals who already have problems with their nervous system. It’s common for older pets in particular to have some nerve degeneration, which we can see as scuffing their toes and being a bit wobbly in the hind legs. The monthly injection also isn’t an anti-inflammatory, so you might need tablets as well as the injection. Your vet needs to check your pet first to see if this injection might be right for them, but don’t worry if it’s not as there are still many other management options.
What about rehab?
Rehabilitation isn’t only used after an injury or surgery – we also help pets with their day-to-day issues. The first thing we do is an assessment to see how well your dog is coping. We’ll look at how they stand (do they carry their weight evenly on all legs?), how they move (are they lame at walk and/or trot? Which legs are affected?) and how muscly they are (have they lost muscle because they’re in pain or not moving very much?). Next is a thorough hands-on check-over of the musculoskeletal system. We try to check each individual joint on all of the limbs and the spine, and see if those joints can move normally and as much as they should be able to. We take note if there is any pain, swelling or stiffness anywhere. If we see any hints of neurological problems, we’ll assess those too. If you haven’t already had further investigation, such as x-rays, we’ll recommend them if needed, and will discuss medical options if you’re not already aware of them. After that, we’ll have a chat with you about other things we can offer. There are usually a few choices, and we will make recommendations that are appropriate for you and your pet’s individual circumstances. Here are examples of what we can do:
Therapeutic exercise
Your dog can do more than walking! We can tailor exercises to help strengthen weak muscles, improve joint mobility and improve core strength. We can also work on balance and proprioception – the sense of touch that lets us know whereabouts our limbs are. This is a problem often seen in dogs that knuckle their hind paws over. Dogs love their exercise sessions as they get lots of attention and rewards.
Manual therapies
This is where we use hands-on techniques to give relief to tight muscles and to mobilise joints that aren’t working as well as they should.
Laser
When we use a laser it sends infrared light into the tissues, stimulating enzymes in the cells. This sets off various pathways that reduce swelling, inflammation and pain.
Acupuncture
Although acupuncture is an ancient therapy, there are now many research studies that show the effects it has in the body. We use it to help with pain relief, particularly in dogs with joint disease and muscle spasm. Electroacupuncture is also really useful for pain relief and stimulating muscles.
Call us now to book your dog in for a pre-winter WOOF WOF!
