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Arthritis in Dogs and Cats
Martin James


Arthritis literally means inflammation of a joint, although we often use it to describe OSTEOARTHRITIS or DEGENERATIVE JOINT DISEASE - an extremely common problem in dogs and cats (as in their owners!). In most cases arthritis occurs secondary to a lifetime of wear and tear although we also see it in younger animals following damage to a joint (e.g. a ruptured cruciate ligament) or due to mal-formation of a joint such as that seen with hip dysplasia.
In an arthritic joint the normally super-smooth cartilage lining the bones of the joint becomes scarred and thinned- the resulting increased friction leads to inflammation. In addition the movement of the joint becomes limited due to thickening of the fibrous capsule surrounding the joint and due to the formation of rough new bone (osteophytes) around the edge of this capsule. Nerves in the capsule and bone become inflamed leading to pain for the animal.

Diagnosis

Unfortunately osteoarthritis is not always easy to spot. By its nature it creeps on slowly, so animals tend to learn to cope with the soreness without showing any obvious pain. Indeed as the problem is often bilateral it can be very difficult to limp when either your hips or elbows hurt! As a result some dogs and cats can appear to be very stoical about the pain from arthritis- often it is only once the pain has been treated that owners realise how much their pet was suffering.

The classical signs are lameness, stiffness and difficulty getting up. Typically this will be most severe after resting, especially first thing in the morning or following a long walk- cold or damp days are often worst. You may also notice them to be less willing to charge around on a walk, looking to come home or sit down sooner than usual. Occasionally an animal will cry in pain- particularly if they have over-exercised or slipped awkwardly.

Spotting the problem can be even more difficult in cats, although we are diagnosing it more and more. A reluctance to exercise and play, while losing their ability to jump up to, or down from heights can sometimes be the only signs. Occasionally cats can become quite miserable and grumpy with the condition.

So we can often be suspicious of arthritis from changes you have noticed. A veterinary examination may reveal changes such as joint swelling, crepitus (a grating sensation) on movement of the joint and pain, although x-rays under sedation or general anaesthetic tend to be the best way to diagnose the condition. They are also useful to stage the progression of the disease and will also rule out other problems such as fractures and tumours.

What Can be Done?

Weight Control

Fortunately there are now many medications, food supplements and other treatments, which can help arthritis. However probably the most important thing you can do for your pet is to DIET him. In most cases arthritis is due to wear and tear so it is no surprise that arthritis is most common in heavy dogs and cats (and people!). It is rare to see the problem in Yorkies and Miniature Poodles (unless they have been overweight through their life) while German Shepherds, Labradors and Rottweilers are pretty much guaranteed to get problems. Equally large or fat cats are very prone- think of all that leaping down from heights, jarring their elbows and shoulders, that they do, day in, day out. We can give the best, most expensive, medication in the world to a fat cat or dog and it will only do so much. In fact for an overweight pet carrying a few extra kilos can mean literally the difference between life and death - between a few extra years of good quality life and the necessity for euthanasia! The point cannot be overstressed!

As these animals are older and less active reducing their normal food by a quarter or a third often won’t help much- you just end up with a very hungry pet! Changing their diet to a veterinary low calorie food is usually the only way to get anywhere. There are now several available in dry and tinned forms so there is bound to be one that your cat or dog will like. With any diet the most important thing is regular weight checks to monitor progress. We have free nurse clinics available, where your pet can be weighed and the different diet foods discussed- please take advantage of this service. After the right diet, regular weight checks are the most important factor in achieving successful weight loss.

Exercise

Initially, if the joints are very sore rest is important to prevent further damage and reduce inflammation. However it is important to maintain joint mobility, so for dogs regular controlled exercise should be used as soon as possible- short lead walks to start with, then building slowly to more normal levels. The aim is to find a level that the dog can cope with on a regular basis, without causing stiffness afterwards - 2-3 short walks through the day are usually better than one long one. What must be avoided is inactivity during the week then a long run at the weekend. A lot of pain and stiffness on Monday will be the inevitable result. A dog on a walk is full of excitement and adrenaline - he doesn't stop to consider what he will feel like the next day, so don't keep throwing the ball for him because he seems to be having a good time.

Non-weight bearing exercise - i.e. swimming - is a good way to build up muscle. Ponds and rivers are ok in warm weather and there are indoor heated pools now available for dogs.

Cats will also benefit from regular exercise. Get some good toys to initiate play sessions every day.

Medication

As with people, the most effective medications for arthritis are non-steroidal anti-inflammatory drugs (fortunately NSAIDs for short). Ibuprofen and aspirin are the most well known human tablets of this class - but don’t give then to your pet. They are very toxic - especially ibuprofen. As their name suggests, NSAIDs reduce inflammation, though they also have a very strong pain killing effect.

The three commonest NSAIDS we prescribe to animals are Metacam, Norocarp and Zubrin. Metacam is a liquid, which is given on the food making it easy to administer, the other 2 are tablets - Zubrin dissolves instantly once it is put in the animal’s mouth. Like Ibuprofen and Aspirin stomach upsets can occur with these medications- normally within 3-7 days of starting treatment. Administering them with food makes this less likely to occur and Zubrin seems to be the safest in this respect. If your animal is having problems with it’s kidney or liver function NSAIDS can make matters worse, so in older animals we normally recommend a blood test before starting treatment. NSAIDS get to work very quickly to make your pet more comfortable and after a few days the dose can often be reduced and can be adjusted up and down according to how the animal is feeling- ask your vet for advice. At the correct dose NSAIDS can be used on a long-term basis, with many animals receiving them effectively for years.

Another treatment we often use is an injection called Cartrophen. This contains a polymer, which binds to cartilage improving its function as well as having an anti-inflammatory effect in the joints. The treatment is started with a course of four weekly injections into the scruff of the neck and can be repeated as often as necessary - normally every 6-24 months.

Glucosamine is a large protein found in the cartilage and fluid of joints. It has been proven to improve arthritis in people and has been used successfully for many years in animals. It is a so-called neutraceutical rather than a drug as it has no effect on metabolism, so is very safe to give. There are several veterinary products available and it seems to be most useful in early or mild cases, or when used in combination with other treatments such as NSAIDS, to help reduce the dose of drug needed.

Bioflow Collars have a magnet on them with a “central reversing polarity” effect, which is said to help with pain relief. Their effectiveness is relatively unproven. However they are free from side effects, easy to put on and we have several animals in the practice who have appeared to benefit from their use.

Prevention

As with all illnesses, prevention is better than cure. Don’t let your pet become fat through it’s life- be aware of what weight it should be from the start and keep it slim- pet’s are luckier than us, they have owners to stop them eating too much and giving in to hunger!

A lot of joint problems such as hip and elbow dysplasia occur while your dog is growing. Factors, which make them more likely to occur, include over-exercising and being overweight before reaching adulthood. Limit your puppy to shorter walks (20-30mins at a time) rather than all day marathons (which I know are very tempting with a 6 month old bundle of energy). Once they have reached maturity (8 months for a small dog, 24 months for the biggest) you can let them run as much as they like! Don’t forget to keep your puppy slim - you should be able to feel his ribs easily. Believe it or not they should not have too much “puppy fat”! If they eat too much the extra weight causes damage to the immature cartilage and bones, and the extra nutrition means a very fast growth rate so the joints don’t a chance to form properly.

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