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Treating Osteoarthritis Arthritis in pets

There are many treatment options and suggestions for treating Osteoarthritis (OA) in pets and in this short article we will focus on what OA is and the basics of treating it.

What is Osteoarthritis?

Osteoarthritis is a chronic, painful, degenerative, and inflammatory disease that affects joints and ultimately leads to loss of mobility and limb dysfunction. It is generally most common in large breed dogs and geriatric cats. But remember that pets of all ages and of any breed can develop OA and unfortunately these younger pets are often overlooked.

Prevalence in dogs

Osteoarthritis is by far the most common form of arthritis in dogs and it is estimated that 20 % of all dogs develop OA regardless of their age. It mainly affects the limbs and lower spine. In most cases it is a secondary disease associated with developmental orthopedic diseases such as elbow and hip dysplasia, cranial cruciate ligament ruptures and patella luxations.

Prevalence in cats

OA is common in cat’s of any age but is often underdiagnosed as cats seem to endure severe orthopedic ailments without showing major clinical signs. In contrast to dogs, cat’s seem to develop OA as a primary disease (not as a result of something else) which has also been referred to as age related cartilage degeneration, as there is no apparent originating factor. This means the older a cat gets, the higher the chance that it will suffer from osteoarthritis. It has been shown that 90% of cats older than 12 years will suffer from OA. And this is why we associate OA mainly with geriatric cats.

What are the treatment options?

It is extremely important to realise that there is no single perfect treatment for this disease. Treatment always needs to be multimodal. This means that many different treatments and techniques need to be used at the same time to achieve the best results for your pet.

Weight loss and management- This is by far the most important factor in long term management of this disease. If nothing else is done besides reducing your pet’s weight to an acceptable body condition score, you will achieve more than any drug or supplement or therapy is able to do. Remember body condition score is more important than the actual weight by number. Ideally you need to use a diet that is calorie restricted. This is best achieved by choosing a diet that contains a high protein, low calorie and high omega 3 content.

Exercise- The correct amount of regular exercise is the second most important factor in the management of OA and has shown to decrease lameness. By the correct amount of exercise, I also mean that when your pet is not doing well, it needs to rest! Exercise programmes need to be uniquely created for your pet and slowly implemented. As a general guideline one would be to start with 5-10 minutes per day. If your pet tolerates this level of activity well, then only after a week you can increase it by 5 minutes. If at any stage your pet is not doing well, then rest and start the slow process again. Swimming is an excellent exercise form for pets with OA as it has lower weight bearing effects on the joints. Bear in mind that a 2 minute swim is the same as a 20 min walk. It is also a great way to help with weight loss which leads to decreased lameness.

Rehabilitation- Other important therapies that should always be explored would include specific therapeutic exercises (physiotherapy) and aqua therapy (underwater treadmill and swimming). Acupuncture and laser therapy are also commonly used on pets and seem to benefit many.

Medications- Non-steroidal anti-inflammatories (NSAIDS) are the third most important factor in the management of OA. The aim is to use them as little as possible, as they can cause gastric ulcers, kidney and liver problems, if used incorrectly. This does not, however, mean that they should never be used! They are very effective in treating chronic pain and your veterinarian will advise you on which medication would be most suited to your pet. There are other less frequently used medications for treating OA for pets that cannot tolerate NSAIDS, and when needed, these will be decided upon by your veterinarian.

Surgery-In some cases surgical management may be the best or only treatment choice. The surgeries that are done either treat the cause (such as repairing a cruciate ligament rupture) or are salvage procedures to remove the painful joint (such as fusing a joint, removing a bone forming part of a joint or total joint replacement surgery)

Nutraceuticals-There are many prescribed joint supplements on the market to treat OA and in many cases they should be considered add on treatments. By this I mean that you cannot just supplement with nutraceuticals and ignore other important aspects such as weight management and the correct exercise plan and expect a great improvement. Remember that treatment needs to be multimodal. The most common examples of joint supplements would include Chondroitin sulfate, glucosamine sulfate, omega-3-fatty-acid, green lipped mussel extract, MSM and collagen type 2, which can be found in the GCS Joint Care Advanced products. The biggest advantage of joint supplements is that they seem to benefit many animals even though most evidence is anecdotal and have minimal, if any, adverse effects. This is especially useful in older animals or animals with liver or kidney disease.

Another way to think about treating this very common painful disease is to realise that you can treat it both proactively and reactively. Proactive treatment is aimed to protect the joints from degradation and slows the progression of the disease. Whereas reactive treatment alleviates pain and minimizes clinical signs but won’t necessarily impact the course of the disease.

Proactive measures include

- Optimising or slowing bone growth by limiting food during development phases for puppies and kittens. And never supplementing with calcium. This is especially crucial for large breed dogs as they need to grow slowly and therefore the correct diet is essential.
- Keeping pets slim and trim. Maintaining a healthy body weight and condition score dramatically decreases the rate of OA progression and increases longevity.

Reactive measures include

- pain management (anti-inflammatories (NSAIDS), nutraceuticals such as omega 3 and collagen type 2, chondroitin sulphate and glucosamine)
- weight loss
- the appropriate amount of exercise and rehabilitation
surgery

Osteoarthritis is an extremely common disease affecting many pets and there is no single method to effectively treat it, but rather one should employ a multimodal approach. It is a disease that affects animals both young and old. The earlier treatment is implemented the better the outcome for your pet. This is generally done by combining proactive and reactive strategies.

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