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Arthritis

Arthritis is one of the most common conditions affecting dogs, with up to 60% of adult medium to large dogs having arthritis! Osteoarthritis is by far the most common type of arthritis in dogs. 

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Most people associate arthritis as an "old age" problem. But most causes of arthritis in dogs are due to abnormal joints in puppies, such as hip dysplasia and elbow dysplasia. Other causes of arthritis are a result of degenerative conditions, such as cranial cruciate ligament rupture, or trauma. Of course, dogs may also have degenerative joint disease as they age, but most causes of arthritis begin in dogs by 4-8 months of age.

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How can you tell if your dog has osteoarthritis?

Young dogs and puppies may seem more "laid back", or not as active as other young dogs.  Why?  It might be because they are painful!

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Other indications of possible arthritis in any dog:

  • Decreased activity

  • Not as playful

  • Lameness or limping while walking or trotting

  • Standing with less weight on the affected leg

  • Difficulty going up or down stairs (may be nonweight-bearing or skip a step)

  • Have difficulty getting up after resting

  • May have difficulty moving after major activity

  • Stiffness or loss of range of motion of joints

  • Licking an affected joint

Arthritis other than Osteoarthritis:

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1) Infectious

  • Penetrating injuries

  • Spread via bloodstream

  • Extension from wounds into the joint

2) Tick-Borne Arthritis​

  • Lyme's disease

  • Rocky Mountain Spotted Fever

  • Ehrlichia

3) Immune-Mediated​

  • Systemic Lupus Eythematosis

  • Rheumatoid Arthritis

  • Heartworm Infestation

  • Any chronic infection

4) Drug Associated​

  • Especially trimethoprim-sulfadiazine

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Things to consider regarding osteoarthritis in your dog:

  • Have puppies screened for conditions leading to arthritis during the puppy's last vaccination (4-6 months)

    • Hip dysplasia (PennHip is best to tell how much laxity is present in the hips)​

    • Elbow dysplasia

    • Osteochondrosis/Osteochondritis dissecans

      • Shoulder​

      • Elbow

      • Stifle

      • Hock​​

    • ​Luxating patella (especially small breeds)​​

    • Legg-Calve Perthes (in small breeds)

  • Middle-aged and geriatric dogs​ should have arthritis screening, gait evaluation, and an orthopedic evaluation during annual visits to their veterinarian. 

What is Osteoarthritis?

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Osteoarthritis is a progressive, degenerative condition of joints.  Joints are not just cartilage; a joint is truly an organ, consisting of articular cartilage, supporting bone, joint capsule, synovial fluid, ligaments, surrounding muscles and tendons, and in some cases (such as the knee) meniscal cartilage. All aspects of the joint organ must be considered when developing a treatment plan.  Contrary to popular opinion, there is presently no cure for osteoarthritis, but there are many treatments.

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The events occurring with osteoarthritis are complex, and involve many different inflammatory substances, biochemical, and biomechanical changes to joints. Therefore, treatment can be complex, and not every treatment will help every dog. But working with your veterinarian to find the right combination of treatments is very important to help your dog become less painful and more mobile. 

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Scientifically speaking, the events involved in arthritis are quite complex and research continues to unravel the puzzle. Certain cell signals and messengers "turn on" the production of inflammatory substances, such as interleukins and tumor necrosis factor.  These in turn help with the production of prostaglandins and leukotrienes. Many of the treatments for arthritis are aiming at reducing prostaglandins, for example. In addition, there are destructive enzymes, or matrix metalloproteinases (MMPs) that break down the cartilage matrix. 

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Eventually, the cartilage becomes softer and more susceptible to trauma, becomes thiner, and eventually may completely be worn away so that there is bone-on-bone contact.  The bone beneath the cartilage becomes thicker, stiffer, and less compliant, resulting in more stress to the remaining joint cartilage. The joint capsule becomes thicker and stiffer, trying to stabilize this now less stable joint.  Partly because of this, joint range of motion is reduced.  The synovial fluid, which has a lubricant function, becomes thinner and less capable of performing its job. Pain and decreased activity result in muscle wasting or atrophy, making stabilization of joints more difficult by these weakened muscles. 

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Ultimately, there is a vicious cycle of continued inflammation, breakdown of tissue, and inability to heal that results in loss of joint function, and pain and decreased mobility.

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If you learn nothing else from this site, realize that the changes in arthritis are irreversible, but are treatable.

The earlier treatment is started, the more likely these changes will be slowed, and the more mobile your pet will be.  

Don't Delay!! 

Medical Treatments for Osteoarthritis

 

Dietary Management

  • Weight loss - #1 most effective and least expensive!

  • Omega 3 fatty acids (fish oils)

  • Nutritional supplements - Glucosamine, Chondroitin, Avocado-Soybean Unsaponifiables, Type II collagen, MSM, Green Tea Extract, Boswellia - use trusted and independently tested products - up to 30% of over-the-counter nutritional supplements have little to no active ingredient - and cost is not always the determining factor regarding quality!

 

Pain Management​

  • Nonsteroidal Anti-inflammatory medications - NSAIDs

    • Carprofen, deracoxib, firocoxib, meloxicam, grapiprant​

  • Other analgesic agents - gabapentin, amantidine

 

Physical Modalities - ​

  • Cold, Heat Therapy - simple to apply

  • Extracorporeal Shockwave Treatment (ESWT)

  • Transcutaneous Electrical Nerve Stimulation (TENS)

  • Therapeutic Laser

  • Pulsed Electromagnetic Field Therapy

 

Physical Rehabilitation​

  • Passive Range of Motion

  • Stretching

  • Joint Mobilization

  • Therapeutic Exercises

  • Aquatic Therapy - very effective to reduce weight-bearing on painful joints

 

Biologic Therapies​

  • Platelet Rich Plasma (PRP)

  • Mesenchymal Stem Cell Therapy

 

Joint Injections​

  • Hyaluronic Acid (HA)

  • Corticosteroids

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Surgical Treatments for Osteoarthritis

Treatment of the underlying condition - such as stabilization of the stifle (knee) of a dog with a cranial cruciate ligament rupture (ACL), removing a cartilage flap from the shoulder of a dog with OCD (osteochondritis dissecans), stabilizing a traumatic joint laxation (such as a hip)

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Joint Replacement - commercially available joint replacements are available for dogs with hip, elbow, and stifle arthritis

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Surgery to allow "False Joint" formation (pseudoarthrosis) - femoral head and neck osteotomy, and ostectomy of the humeral head are available to treat severe arthritis of the hip and shoulder joints

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Arthrodesis - surgical fusion of a highly arthritic or unstable joint may reduce pain and improve function, especially of the carpus (wrist) and hock (tarsus or ankle) joints

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Amputation - sometimes amputation of a highly arthritic toe may reduce pain and increase function.  Amputation of the entire limb for severe arthritis is possible, but should be scrutinized because most dogs have more than one arthritic limb, and amputation can put excessive stress on the other limbs. 

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