Arthritis/Joint Disease

Arthritis is a degenerative joint disease in which pain and stiffness develop as a result of wear and tear to the joints involved.In the normal joint, the bone surfaces, which meet and rub together, are covered by a thin layer of cartilage - an elastic substance acting as a self-reparing, shock absorbing layer. The moving parts of the joint are encased within a capsule filled with synovial fluid, which acts as lubricant. Wear and tear, which occurs throughout life, may reach a stage where areas of the cartilage become worn, exposing the underlying bone and leading to pain and/or impaired movement.

Arthritis is a condition that results in painful joints. It is extremely common in older pets, especially the larger breeds of dogs. Any joint can be affected with arthritis. The most commonly affected joints include the hips, knees, shoulders, elbows, and vertebral column (back). It is estimated that arthritis affects 1 in 5 adult dogs—or more than 8 million in the U.S.

Arthritis may be a result of an injury or may develop for unknown reasons. Frequently it is progressive (worsens with time). It may develop slowly or quickly. Often it begins with occasional sore days, often associated with weather changes or strenuous exercise. Clinical signs in most pets are often worse when they first get up and start to move. Overweight pets are most susceptible.

Many clinical signs may be a result of arthritis and the related pain it causes. Signs may include lack of appetite, reluctance to walk, climb stairs, or play, limping, lagging behind on walks, difficulty in rising from a resting position, personality changes, or even crying aloud when the pain is severe.

Other diseases must be ruled out before a diagnosis of osteoarthritis can be made. Potential rule-outs include disc disease, ligament tears, bone infections, and nerve damage. X-rays are often necessary to obtain the correct diagnosis.

Signs of Osteoarthritis include:

• Lameness
• Hot, swollen joints
• Pain, especially with exercise
• Decreased "range of motion" (shorter steps)
• Decrease in muscle size

Treatment of Osteoarthritis attempts to:

• Reduce pain
• Prevent or slow down degeneration of the bone
• Restore function as much as possible

Diagnosis of Osteoarthritis includes:

• History
• Physical examination
• Radiographs (x-rays)
• Joint fluid analysis

Treatment for Osteoarthritis may include the following:

• Rest; keep warm and dry; use soft bedding, such as "egg crate mattress"
• Weight loss to decrease overall pressure on joints
• Anti-inflammatory drugs
• Drugs to increase joint fluid
• Non-weight bearing exercise (such as swimming) to maintain muscle strength and range of motion.
• Surgical correction (knee replacement, joint removal, joint replacement)

It is important to re-evaluate regularly to determine the effectiveness of treatment and progression of disease.

Degenerative joint disease is the number one cause of chronic pain in the dog and cat. The condition itself is the result of long term stresses and instability of a joint either as a result of old injury or of natural development of the joint in that individual. While surgery may be able to help in some situations, most of the time the degeneration of the joint cannot be reversed and treatment focuses on preventing progression of damage.

Arthritis can affect dogs and cats of any age, although we frequently think of it as a disease of the geriatric animal. There is no cure for arthritis, but veterinarians are able to offer a variety of treatment choices to help pets live active and comfortable lives. Early diagnosis is extremely important in finding effective medical treatment, and pet owners are the best equipped to notice day to day changes and first subtle signs of this disease.

Taking longer to get to its feet, and inability to jump or climb are signs that arthritis could be affecting your pet. Keep a record of the arthritic signs you've noticed, the conditions under which they occur (before or after exercise, for example), and the approximate time you first noticed the symptoms. Because most cases of arthritis are degenerative and arise from joint imperfections, make a note of any developmental joint defects (such as hip dysplasia) or accidents your pet has had. Sometimes, other types of arthritis (inflammatory) can be caused by a systemic ailment such as Lyme Disease or rheumatoid arthritis so it's also important to remember whether your pet has shown any signs of illness.

At your pet's appointment, your veterinarian will give it a general physical and an orthopedic exam. The vet will look for swelling, heat, or asymmetry between the animal's limbs. He or she will flex and extend each joint to check for decreased range of motion, pain, or abnormal joint sounds. X-rays may be recommended. The animal will be examined for bone changes, such as mild dislocation or bony outgrowths known as osteophytes, which are early signs of degenerative joint disease. Sometimes the only way to check for early onset is by checking the fluid that lubricates the joint (synovial fluid). This is done by removing and analyzing some of the fluid from a suspicious joint and is called a "joint tap".

Veterinarians usually advise a three-way approach to the medical management of arthritis; exercise moderation, weight control, and anti-inflammatory medication. Too little exercise can cause an arthritic animal to become stiff and sore, but too much can cause pain. Weight control is important because excess weight places undue stress upon the joints, accelerating joint degeneration.

Pets do not tolerate human painkillers such as aspirin, ibuprofen, and Tylenol™ as well as people. It is important to work closely with your veterinarian to minimize side effects of any arthritis medications. Periodic comprehensive physical examinations and laboratory screening is necessary to monitor the body’s response to any long-term medication.

Sometimes medical treatments fail to adequately relieve arthritis pain and surgery may be the next option. For example, if bone or cartilage fragments are in the joint, the surgeon can remove them to decrease inflammation. This may not stop the deterioration since damage has already been done, but it may slow it down.

Food supplements, known as oral nutraceuticals, may have medical benefit. The products we recommend include glucosamines, chrondroitin sulfates, MSM (methylsulfonylmethane) , and omega 3 fatty acids. Glucosamines and chrondoitin sulfates act to increase the production of of joint fluid. MSM is a natural anti-inflammatory, and omega fatty acids are useful in aiding the immune system.

Catching arthritis early is key to help your pet live comfortably if diagnosed with this disease. So pay close attention to your pet’s activities and movements.

ASPIRIN
Aspirin is a non-steroidal anti-inflammatory drug or NSAID. It is effective in relieving pain due to inflammation. It is readily available and inexpensive, and has a relatively fast onset of action. However, it may not be strong enough or may cause serious side effects such as upset stomach or even intestinal bleeding. Aspirin also deactivates platelets and thus can promote bleeding during surgery or trauma. The enteric coating of aspirin can create unpredictable absorption, collecting in the stomach until a toxic dose is reached. Cats can be easily overdosed with aspirin. Do not use aspirin or any other medication for your pet without veterinary consultation.

RIMADYL AND ETOGESIC
These medications are also NSAIDs. They were developed as an improvement upon aspirin and other NSAIDs with less side effects in animals. Rimadyl and Etogesic are both designed for indefinite use in dogs with minimal side effect potential. Rimadyl is given twice daily and Etogesic is given once daily.

Typically a short trial of one of these is prescribed to see if the effect is worth continuing; as with people, some individuals respond better to different NSAIDs. If the effect is good, then the medication can be continued. Some blood testing is recommended prior to long term use and every 6 months thereafter.Approximately 1 dog in 5000 will have a serious liver reaction to Rimadyl. Animals with histories of elevated liver enzymes, pre-existing liver disease, Cushing’s Disease, or phenobarbital use should not take Rimadyl. Neither of these medications should be used in cats.

DERAMAXX
As research progresses to make safer arthritis medications for both humans and animals, the coxib class of NSAIDs was developed. Inflammation is in part medicated by biochemicals called “prostaglandins.” While some prostaglandins mediate inflammation, other prostaglandins are needed for normal healthy cell function. Deramaxx is available as a chewable tablet and is for once a day use. It is a very safe NSAID and provides strong pain relief.










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