Arthritis is an extremely common problem in dogs, as it is in people. There are many different types, but all cause damage and pain and often develop progressive degenerative joint disease.
Arthritis means "inflamed joint" and in inflamed joints the synovial fluid, which is the joint oil, becomes watery and no longer helps the joint surfaces slide easily over each other. Other changes are that the joint cartilage becomes worn and breaks up and the body lays down new bone around the damaged joint to try and stabilise it.
What Causes Arthritis?
Some animals are born with defective joints which become arthritic, some have a weakness that results in arthritis when they are older, some get arthritis after an injury, some animals get infection in their joints and so become arthritic. Some animals become allergic to their joints and develop what is called rheumatoid arthritis.
Diagnosing the Cause
As you can see there are many different causes, and as many of the treatments are specific to one cause, we often need to find out what has caused the problem. Usually this involves radiography, sometimes blood tests and occasionally biopsies.
Treating Arthritis
There are three different main ways in which we treat arthritis; firstly we can modify the pet's lifestyle so as to reduce the wear and tear on the joint, secondly we can treat specific causes of arthritis, thirdly we can give drugs that will kill the pain.
Pressure on the joints is what increases the wear and tear on the joints and causes the cartilage to break up. It is therefore very important to reduce your pet's weight if necessary and keep it down. Excess weight does more damage than anything else and you will do more for your pet’s quality of life by being very strict with their food than anything else.
Another major cause of wear is severe exercise, especially the twisting and turning involved when playing with balls and going out with horses. Regular controlled exercise, such as half an hour's walk once or twice daily, will keep them fit, help keep the weight down and stop the joints seizing up. However too much is worse than none at all so do avoid the occasional very long walks.
A properly balanced diet is also important. We always recommend that you either feed a proprietary food or give a complete vitamin and mineral supplement.
Specific Treatments
Specific causes of Arthritis, such as bacterial infections or Lyme's Disease require treatment with specific drugs in order to stop the progression of the disease. Just giving them painkillers will make them look better for a time, but will allow the infection to do more permanent damage. Rheumatoid Arthritis needs treating with specific cytotoxic drugs to control it, and often special diets will help as well. Some arthritises will require a surgical operation either to fuse the joint or replace it with an artificial one. In all of these cases we need to know what the cause is, and therefore will advise radiography and possibly other tests.
General Treatments
These can be divided into five different groups:
- Firstly there are food supplements such as Synoquin that contain glucosamine hydrochloride (not sulphate!) and chondritin and injections such as Cartrophen are thought to help by improving the quality of synovial fluid, reducing the pressure inside the joints and protecting the joint cartilage.
- In the second group are drugs which work like aspirin in people. They are anti-inflammatory, reduce the swelling in the joints and also reduce pain, and have been shown to slow down the progression of arthritis. In this group are drugs such as Metacam, Rimadyl, Cimalgex, Trocoxil and Previcox.
- In the third group are drugs that powerfully reduce swelling and pain, but which can have side effects. In this group are drugs such as steroids, cytotoxic drugs and gold injections.
- In the fourth group are drugs that modify how pain is felt, a bit like paracetamol in people. Pardale, tramadol and gabapentane are typical of this group.
- In the fifth group there are physical treatments that are very effective at controlling pain. The two we routinely use are acupuncture and theraputic laser treatments.
Acupuncture is an effective method of reducing arthritic pain but does not slow down the progression of the disease. Your pet would usually need treating weekly for a month then every 2-4 weeks thereafter.
Theraputic lasers are similar. Again very effective at reducing pain and often monthly treatments are enough to keep your pet mobile and out of pain.
Recommendations
We feel that the object of treating arthritis must be to diagnose and cure the cause, if possible; to try to slow down the progression of the arthritis and to treat pain so that our pets can enjoy their life to the full for as long as possible.
We always recommend weight control and regular controlled exercise, a good diet and the use of dietary supplements such as Synoquin or Glycoflex. We will discuss trying to diagnose the cause with you and may prescribe specific treatments. We will usually recommend a non-steroidal drug to slow down the disease and reduce the swelling and pain initially, and the use of other drugs, laser therapy or acupuncture if the drugs cause unwanted side effects or do not control the pain adequately.