Arthritis in Dogs and Cats

Arthritis is one of the most common complaints for which dogs and cats are brought in to the vet. Arthritis (osteoarthritis) is more likely to affect animals the older they get, and there are several additional risk factors which may make it more likely. These include the breed (dogs), weight, and history of previous joint injuries. Arthritis causes discomfort, and reduces an animal’s mobility, impacting on the quality of life and overall lifespan.

Signs that your pet may have arthritis:

• Reluctance to go about normal activities i.e. playing, running, jumping, using stairs.
• Stiffness on rising
• Limping
• Reduced appetite
• Quieter behaviour
• Panting excessively
• Restlessness
• Yelping, usually associated with a particular movement.
• Reduced grooming
• Cats in particular are often very subtle in the signs that they display: they may simply spend more time sleeping, and use different pieces of furniture to move around i.e. jumping via a chair to a table, rather than straight up in one movement.

Diagnosis

Several pieces of information can be put together to reach a diagnosis of osteoarthritis. Firstly a lot can be obtained from the history that you provide us. Observing the animal moving around is very important, and feeling for abnormalities in the joints such as swelling, clicking, or a reduction in normal movement. X-rays are a very useful tool to allow us to visualise exactly what is going on in a joint. They may show thickening of the joint fluid, or extra bone deposition around an affected joint.

Treatment

Happily there are a number of options available to delay the onset and progression of arthritis, and to relieve the pain and other symptoms.

1. Nutraceuticals: supplements which can be added to the food. These include fatty acids (EPA and DHA,) glucosamine, chondroitin. These provide the microscopic “building blocks” for the joints. They are found in many different commercial products including Fish Oil capsules, Pernaease powder, Hill’s j/d diet (dry and wet food).
2. Pentosan polysulphate injections: Also known as cartrophen or zydax, these are given weekly for 4 weeks, and last for several months. The injections contain a synthetic medication which draws more water into the joints, effectively thickening the joint fluid to provide a cushioning effect. If we can stop as much rubbing between the cartilage surfaces, the cycle of inflammation is interrupted which can delay the progression of the disease. Most owners notice a small improvement, particularly as the level of the medication in the body builds up, typically after injection number 2 or 3.
3. Non-steroidal anti-inflammatory drugs, or NSAIDs: these drugs are very effective as pain killers and the improvement in mobility helps to maintain muscle condition. Some side effects can occur, approximately 1 in 25 dogs may experience gastro-intestinal upsets, such as vomiting or diarrhoea, however this is usually temporary and resolves in a few days. If a dog has pre-existing kidney or liver disease, the metabolic pathways used to break down and excrete the drug may not be fully functional, and therefore the pre-existing disease could be exacerbated. For this reason if we are contemplating long term use of NSAIDs we recommend a blood test first to assess general health. Some of the more modern medications such as firocoxib and robenacoxib will be the safest options if we are concerned about side effects.
4. Opiate like medications: Tramadol hydrochloride works on the same site in the body as opioid drugs, and may be a good option for pain relief. This would usually be used in combination with an NSAID.
5. Gabapentin: An anti-seizure medication which works on a receptor in the brain, and is used to treat pain originating from the nervous system. Usually would be used in combination with an NSAID.
6. Other anti-inflammatories: corticosteroids used to be a mainstay of treatment for arthritis, prior to the development of NSAIDs. If a pet needs to be on this type of medication for another condition (such as allergic skin disease), it will also have an anti-inflammatory effect on the joints, and we may adjust the dose accordingly. Under no circumstance are corticosteroids to be used in conjunction with NSAIDs.
7. Stem cell treatment: we have been using ‘Ovine placental extract’ for a few years with good results. Some of the substances, “activating factors”, found in the placenta of the sheep can be isolated, and used to treat patients of any species. We administer the drug intra-venously (usually the dog is happy to sit in the consult room for this, with a nurse holding the leg). The drug circulates around the body and settles at the site of inflammation i.e. joint cartilage. The activating factors stimulate production of the dogs own stem cells, which are now known to be found throughout the body in an adult dog. We do a course of 3 or 4 injections (depending on response) one month apart each time. The cost is $170 per injection. It is best to have the pet off any anti-inflammatory medication from 48 hours before the treatment, due to the localisation at the site of inflammation. If an animal had been diagnosed with cancer, this treatment is NOT recommended, as it promotes growth of any cell.  We have found the majority of dogs (approximately 75%) to have responded well to treatment, particularly when the arthritis is widespread or advanced, but some individuals have a less obvious response. The effects of the treatment last between 1 – 3 years. The drug may need to be ordered in, so please give us a couple of weeks’ notice if possible.
8. Joint injections: sometimes cortisone injected into a joint can make the joint concerned a lot more comfortable. This procedure would typically require a pet to be sedated.
9. Physiotherapy: we can show you a few simple exercises to perform with your pet at home, and discuss exercise modification. Swimming is always an excellent option as it has low impact on the joints, but builds up muscle effectively.
10. Weight management: it is so important to maintain a healthy weight to minimise any unnecessary load on the joints. There are several diets available designed to help reach or maintain a healthy weight; either one of the vets or vet nurses can recommend the best option for your animal.

Prognosis

We are here to help guide you through the options above. With arthritis, it is important to be proactive, and animals can maintain comfort and an excellent quality of life for a number of years.

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