Arthritis

What is Arthritis in Dogs and Cats?

Arthritis, also known as osteoarthritis or degenerative joint disease (DJD), is a degenerative, progressive, and irreversible condition of the joints. It is characterised by the progressive loss of joint cartilage, bony spurs/growths, and the thickening and scarring of connective tissue around the joint, usually as a result of injury.

Degenerative joint disorders are probably as common in cats as in dogs but are less likely to be associated with obvious clinical signs, such as lameness.

Arthritis is classified as primary or secondary. Primary arthritis is associated with ageing, due to years of wear and tear on the joints. Secondary arthritis is the result of an external event or force (e.g., trauma, poor joint alignment, etc.) that once damaged the joint cartilage.

Arthritis can affect any age, sex, and breed of dog and cat. Most predispositions to it relate to underlying causes, such as elbow dysplasia, hip dysplasia, osteochondrosis, and so forth.

See images below for visual depiction of Arthritis 

Diagnosis

Diagnosis is based on what is found in the physical examination, diagnostic imaging, joint taps, cytology, force plate gain analysis, therapeutic drug trials, and other tests.

Physical Examination Findings in Dogs

Lameness is the most common sign. It may happen once in a while (episodic) progressive (gets worse over time), or be persistent. Stiffness is common after periods of rest. Stiffness and lameness may decrease when the dog warms up a bit with some activity. Lameness often gets worse after periods of overexertion. Pain, swelling, and decreased range of motion may be seen. Thickened joints, excess fluid in the joint space, and muscle weakening
are likely to occur.

Physical Examination Findings in Cats

As opposed to the visible lameness seen commonly in dogs, many cats simply become less active, may hide, or develop behavioural changes, such as irritability, decreased grooming, or difficulty getting into position in the litter box. Cats also may have joint swelling/thickening, too much fluid in the joint space, and decreased range of motion. There may or may not be pain when the cat’s affected joint is moved by you or your veterinarian.

Diagnostic Imaging

Radiographs and CT scans may show the excess fluid in the joints; the bony spurs; signs of an underlying disorder, such as elbow dysplasia, osteochondritis dissecans, hip dysplasia, or cruciate ligament rupture; and so forth.

Therapeutic Trial

In some cases, a therapeutic trial of nonsteroidal anti-inflammatory drugs (NSAIDs) may help confirm the diagnosis if the lameness is less noticeable after taking them.

Treatment, Management, and Prevention

It is not possible to cure arthritis. The goals are to alleviate your pet's discomfort, to minimise further degenerative changes to the joint, and to restore the joint's functionality. Multiple types of treatment are usually necessary to relieve pain, stiffness, and discomfort.

Weight Management

Managing your pet's weight is important. Excess weight increases stress on the joints and muscles. If your pet is obese, your veterinarian will want your pet to lose weight. Daily, low impact activities, such as walking and swimming, will not only help your pet with losing some kilos but can also improve joint mobility, muscle mass, and exercise tolerance. Special foods are also available to help with weight reduction (e.g. Hills W/D or Eukanuba restricted calorie). And we encourage regular free weight check's on your pet at the clinic - Free cuddles included!

Oral Supplements

Oral joint supplements known as chondroprotective agents will help support the cartilage and will have some anti-inflammatory effects. These agents will slow the breakdown of cartilage and/or provide the building blocks that can help build it. Some agents also increase joint fluid secretion and thus decrease inflammation. Oral supplements are generally the first step in treatment/prevention of arthritis.  We recommend to start any pre-disposed breed (most breeds) at around 5 years of age to help slow down natural progression.  Maraboon Veterinary Surgery recommends the 4cyte product due to its strongly documented success.

Cartrophen (Pentosan)

This is a medication which acts to protect the joint by:

• Limiting cartilage deterioration
• Promoting cartilage formation
• Thickening the joint fluid – thus acting as a better lubricant
• Improving blood supply to the joint which helps with healing

Cartrophen is given as an injection under the skin once per week for 4 weeks and is followed by a booster injection every 2 months or as required. Cost per injection is $68 but owner's notice much more improvement than on oral options.  This is generally started on dogs 6-7 years of age (younger for large or giant breed dogs)

Anti-inflammatories (Metacam) & NSAIDS

These medications act to reduce inflammation in the joint and provide pain relief. Some pets will require them intermittently on their “off” days, other pets may require them every day, depending on the severity of their arthritis. Despite the fact that these medications are extremely safe long term, possible side effects that you should be aware of include stomach upset, elevated liver enzymes, and potential worsening of chronic kidney disease. We recommend blood work once a year to ensure no side effects. Few NSAIDs are licensed for use in cats. Your veterinarian will advise you about what NSAID options are available for your cat. Other medication options include tramadol, gabapentin, and amantadine which may be recommended by your veterinarian. 

Frequent gentle exercise

Short, gentle walks or swimming will maintain muscle tone.

Avoiding the Cold

Provide somewhere warm with soft bedding. Dog coats are also good.

Diet

Some foods contain nutrients that can be helpful for pets with arthritis

• Hills J/d
• Foods that contain omega 3 fatty acids , EPA, glucosamine and/or anti-oxidants for joint health

Other Supplements

• Cod liver oil
• Sasha’s blend
• Fish oils
• Glucosamine
• Green lip mussel

Alternative Therapies

Alternative therapies such as acupuncture, stem cell therapy, platelet-rich or conditioned plasma, physical therapy, rehabilitation therapy (e.g. radial shock wave therapy, pulsed signal therapy), green-lipped mussel supplements, vitamin E, and zoledronic acid may be beneficial in some canine patients. Studies to support their use are still being done.

Surgery

Your veterinarian may consider surgical options if your pet’s response to medical treatment is low. In addition, your veterinarian may suggest surgery for certain underlying causes of arthritis, such as cranial cruciate ligament rupture, elbow dysplasia, osteochondritis, dissecans, joint incongruity, intra-articular fractures, and joint instability. Reconstructive procedures can eliminate joint instability and correct the anatomic defects. If your pet has severe hip dysplasia, your veterinarian may suggest a total hip replacement and femoral head/neck ostectomy. If the arthritis is in the wrist or ankle (then joint fusion may be considered; this surgery is usually well tolerated and can result in reasonable functionality.

Monitoring and Prognosis

Your veterinarian may need to do periodic physical examinations every 3-6 months to monitor your pet's response to therapy and the progression of the disease. In addition, if your pet is on an NSAID's, blood tests including complete blood counts and biochemistry profiles, should be done every 6-12 months to ensure there are no side effects impacting the liver or kidneys. With therapy and careful monitoring, arthritis can be managed in many dogs and cats, resulting in a good quality of life that you and your pet will appreciate.