Arthritis is a degenerative disease of the joints. It can be caused by genetic malformation of the joints, from previous traumatic injuries, and/or it may develop as your pet ages. Specifically, it is the erosion of the cartilage that lines the ends of the bones in the joints. This cartilage cushions the joints and produces proteins that lubricate the joints. With arthritis, this cartilage is damaged and unable to provide the cushion or shock absorption that is needed and is unable to produce the lubricating proteins. This causes pain and further inflammation in the joint when the affected joints are asked to move in a normal manner. As time goes on, the bones rub against each other in an abnormal fashion and bone chips (called joint mice) can occur.
Arthritis is suspected when your pet begins to have difficult rising, walking or moving. Your pet may appear stiff, or be reluctant to go up and/or down stairs. Cold weather may make these signs more apparent and your pet may be painful during manipulation of the arthritic joints. Arthritis is diagnosed with a physical examination by your veterinarian and with radiographs (x-rays).
The goals of treatment for arthritis include reducing pain, improving the joint environment, protecting the cartilage and reducing the progression of the arthritis. You should see that your pet is more comfortable and moves easier. The following are recommendations for therapy:
Weight management - Excessive weight results in more stress on painful joints. More stress means less activity and less activity may mean more weight gain. This can become a vicious circle. For some pets, losing those extra pounds may be the only therapy needed. In addition, weight loss is also beneficial to your pet’s long-term health in many other ways. Your veterinarian may recommend you feed less of the current diet or may prescribe a reducing diet that is high in fiber and low in calories for the weight loss period.
Activity - Mild to moderate daily exercise is suggested. It is important for joints to move. This may mean a trip to the end of the block and back. Exercise is also helpful in managing weight. Heavy to extreme exercise is to be avoided - no vigorous ball playing, no once a week walks or runs, no full day of swimming. We want your pet to enjoy the things that they love doing, but exercise that results in pain means that the joints are inflamed. Inflammation of joints results in progression of your dog’s arthritis. You may need to stop the ball playing after a few throws or call the dog in before they overdo the activity.
Proteins - We can supplement your pet with the proteins that lubricate the joints. These proteins are called glycosaminoglycans (or GAGs) and they can stimulate the joints to produce proteins and help to prevent further degradation of the joint tissue. These are nutritional supplements so there are little to no side effects, and for some pets this is the only ‘medication’ needed to manage their arthritis. There are two ways to give GAGS, either daily by mouth or through a series of injections.
The oral products are readily available without a prescription and may contain a single ingredient or combination of Glucosamine and Chondroitin. In addition, they may also contain beneficial ingredients such as vitamins C and/or E, shark cartilage or MSM (methylsulfonylmethane), omega-3 fatty acids, creatine monohydrate, grape seed extract, citrus bioflavonoids, selenium, calcium phosphate, and alpha-lipoic acid. Ask your veterinarian which is the right product for your pet. They may advise you to pick something up at your local health food store or they may prefer you purchase veterinary products such as Cosequin or a newer product called Dasuquin. Even though the veterinary products are more expensive, they are usually preferred because of the quality and diversity of the ingredients.
Adequan ™ is the name of the injectable product and these proteins are a purified pig cartilage that is injected into your pet’s muscle by the veterinarian twice a week for four weeks. This loading period is needed to achieve a high level of proteins for a longer period of time. After the series of eight injections, your pet returns for a single injection as needed. This may be once a month, every two to three months, or every six months. Some advanced stages of arthritis require that both the injectable and oral forms of proteins be given.
Non-Steroidal Anti-Inflammatory Drugs - Historically, pets were put on aspirin for arthritis. This is no longer the recommendation because of intestinal bleeding, other gastrointestinal issues and destruction to the very joint cells and proteins we are trying to maintain in good health. Some of our patients have been using Rimadyl™ for a few years to manage arthritis, but we have new products such as Previcox ™, Deramaxx ™ and Metacam™ that we are now recommending as our first choice for pain management. They are in the same class of drugs as aspirin but cause less of the gastrointestinal issues, intestinal bleeding or damage to the joint cells as does aspirin. In addition, there may be less of the reported liver effects that Rimadyl may cause in some patients. However, some individual dogs may not tolerate these medications well and you should report any vomiting, diarrhea or appetite changes to your veterinarian. Metacam™ is the first NSAID approved for use in cats. Whichever drug is selected, your veterinarian may also choose to periodically monitor your pet’s bloodwork to ensure your pet is tolerating the medication. Your veterinarian may also recommend you keep your pet on the above-mentioned oral or injectable GAGs as they may help reduce the NSAID dose needed.
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