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Arthritis In Pets | ||||||||
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What is Arthritis? Symptoms and Diagnosis | Treatment | Dictionary of Terms Arthritis is a progressive, permanent change to the articular surface of synovial joints. It occurs for a number of reasons, but regardless of the originating cause, it becomes a self-sustaining progressive change. A number of things can start arthritis and range from joint injury, hereditary malformations, immune mediated diseases, and the wear and tear of age and obesity.
What causes Arthritis? Arthritis or DJD (degenerative joint disease) generally starts without inflammation, but the series of events that follow lead to inflammation and subsequent degeneration of the joint surface. A number of mediators (chemical reactions) participate in this cascade.
There are many causes of arthritis which include:
Generally, the signs of arthritis creep up slowly. The pet may sleep later, move slower, walk less far, be cranky, or fail to make it up onto the couch. In the case of cats a decrease in grooming and failure to use the litter box may also be signs. As the disease progresses, lameness, loss of muscle mass, and eventually loss of function can occur. Risk factors for developing DJD include:
How is it diagnosed? Some other issues must be ruled out before a diagnosis of arthritis is complete. Certain cancers, infectious diseases such as Lyme disease and Erhlichia, and immune mediated joint disease (rheumatoid arthritis and lupus) must be checked for. A combination of physical exam findings, blood work and radiographs (x-rays) and possibly joint aspiration are generally used. Other testing could include MRI and CT scans. To prevent DJD one needs to manage the pet's weight. Keeping pets on the thin side can reduce or even eliminate the risk of DJD. Supplements that provide the building blocks for collagen and joint fluid and well as decreasing the inflammatory mediators are also of value. In some cases, interceptive surgery may be needed and can be very helpful. Examples of this are repair of fractured coronoid process in elbow dysplasia and various surgical techniques to manage hip dysplasia. Treatment of arthritis employs many angles. The most important step is weight loss. A loss of 10 percent of weight in obese pets can result in 100 percent improvement. One study found that weight loss alone could improve force plate measurements in pets as much as NSAIDs (pain relievers). A diet plan can be devised for your pet to help facilitate weight loss as just feeding less may not work in every patient. Physical therapy such as low impact walks, swimming and passive range of motion is also helpful. Exercises for each specific arthritic joint can be planned and prescribed after a rehabilitation exam. Just like in human medicine, exercises targeted to the joint can bring relief by strengthening the muscles around the joint lending support to the joint. On days when the pet is sore, heat applied to the joint can bring some relief, although in an acute lameness cold is often more helpful. Supplements such as Omega 3 and 6 fatty acids, glucosamine, chondroitin, and ASU are very beneficial. They increase joint fluid and cartilage health and decrease inflammatory mediators in the joints.. The veterinarian will help you chose an appropriate supplement as not all supplements are manufactured well and differences are common. NSAIDS (non-steroidal anti-inflammatory drugs) such as Rimadyl, Deramaxx, and Meloxicam, help reduce pain and inflammation. Aspirin unfortunately will reduce pain, but studies have shown that increased destruction may occur. . In general, these are pain relievers, but these medications do have side effects and cannot be used in all pets. Blood work is needed before the use of non-steroidal drugs, and should be repeated periodically while they are taking these medications. Chondro-protective drugs such as Adequan may help some patients, but care must be taken not to use them with NSAIDs. This medication is given by injection on a schedule prescribed by the veterinarian. Some dogs will get relief for a long period of time, but not all dogs will respond. These injections are given in the muscle or under the skin. Intra-articular injections can also help many pets. Hyaluronic acid (HA) and steroidal injections can be helpful to control pain and reduce inflammation. HA is similar to joint fluid. Arthritic joints have thin, serous joint fluid that has inflammatory mediators in it. HA replaces the fluid with the thick viscous fluid that a normal joint should have. Steroids are used to reduce inflammation too, but are not used in the same joint as the HA at the same time. Intra-articular injections may require sedation to perform depending on the patient and the joint being injected.
The last resort drug is often steroids. Steroids are not a pain reliever, but do dramatically reduce inflammation and can help dogs and cats feel much better. They however, should not be given with NSAIDs. These drugs can be very effective if given by injection into the joint. Intra-articular use will reduce the negative side effects that steroids often have. Arthritis can be a debilitating disease in pets, but fortunately we have many ways to aid in the comfort of our pets giving them an increased quality of life. If you have any questions, or if we have recommended further testing, please feel free to contact us at:
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The newest treatment available for dogs and cats is Adipose Stem Cell Therapy. (See the Regenerative medicine handout). This treatment involves harvesting some fat from the patient and processing it to remove the stem cells from it. These cells are then injected into the arthritic joints to help restore the joint surface and reduce inflammation. This therapy is very promising and helps man patients with end stage arthritis become more comfortable and less painful. Your veterinarian can council you on whether your pet is a candidate for this innovative and effective treatment.