Management of Osteoarthritis in Pets
Your pet has been diagnosed with osteoarthritis. While this is a progressive condition that currently has no cure, there are a lot of things that owners can do to help their pets. These can make a huge difference to their pain, exercise ability and quality of life.
With the right management, many arthritic pets can live a full and enjoyable life.
Keeping weight within the normal range is the only thing scientifically proven to slow the progression of osteoarthritis in pets and has also been conclusively shown to reduce the severity of lameness. It is the single most important thing that owners can do to help. It has also been shown that compared with overweight dogs, those of appropriate weight, live on average two years longer. Some owners are literally killing their pets with “kindness”. Simple reductions in normal food and avoiding excessive treats is often all that is required, however, prescription diets are available from your vet for pets that struggle with weight control.
Exercise is very important in arthritic dogs. A lack of exercise will lead to increased weight, muscle wastage and reduced joint range of motion. Appropriate movement helps nourish the remaining cartilage. However high-intensity exercise such as ball games, prolonged rough play with other dogs or sudden changes in the amount of running can cause increased pain and potentially speed up the deterioration of the disease. The general recommendation is to allow the maximum level of exercise that is tolerated on a regular basis.
A period of lead walking at the beginning and end can help with warm-up and warm down. Off lead exercise is allowed but do not encourage your dog to over-exercise. Throwing a ball will encourage your dog to continue to please you, even when pain has reached levels that he or she would have chosen to stop themselves.
Try and keep exercise constant from day to day. Sudden long or strenuous walks can cause severe pain in dogs that are not used to it (osteoarthritic flare-ups), but the same walk may be tolerated if the dogs can slowly get used to it. If lameness suddenly worsens (an osteoarthritic flare-up) then exercise should be reduced to short (10-15 minute) lead walks for one to four weeks.
Many osteoarthritic dogs and cats will require intermittent or regular use of drugs. The most commonly used type are non-steroidal anti-inflammatory drugs (NSAIDs) such as meloxicam, carprofen, firocoxib or robenacoxib. These medications work by reducing prostaglandin in and around joints. Prostaglandin is responsible for causing both pain and inflammation. NSAIDs can be used for short courses of days to weeks to treat osteoarthritic flare-ups or daily to control long term pain. If using long term, then after the first four weeks these drugs can often be gradually reduced to the lowest effective dose, sometimes half or even a quarter of the recommended amount. They should never be given above the recommended dose.
Most dogs and cats will tolerate these medications well, even if life-long treatment is required. In fact, we would encourage the use of medications to allow pain-free moderate exercise. Some animals will not tolerate these medications and develop signs such as sickness or diarrhoea. They should be stopped immediately if these develop. These medications should also not be used in dogs with significant liver or kidney disease. Several pure pain killer drugs can be used with or instead of NSAIDs if needed.
Despite claims by manufacturers, there is no conclusive evidence showing that oral supplements can slow the progression of osteoarthritis. These supplements are therefore mainly aimed at relieving symptoms. Two of the most used are glucosamine chondroitin sulphate and essential fatty acids.
- Glucosamine and chondroitin sulphate are building blocks of cartilage. Studies show variable effectiveness, but there are some good human clinical trials that have shown similar benefits to NSAIDs. The onset is much slower. A minimum of six weeks should be given to assess a benefit and, in some cases, up to six months before deciding if it is working or not. As these are not classed as medicines, quality control can be very variable. Analysis of some off-the-shelf products has shown a frequently lower content than on the label. Buying from a reputable source gives a better chance that you are administering the correct dose.
- Essential fatty acids are most commonly fish oil derived, with Omega-3 fatty acids frequently present. Feeding high doses of Omega -3 fatty acids can reduce the production of prostaglandin, which is a major cause of pain and inflammation. These are included in some pet foods at increased The Hill’s j/d diet is one such example of this. Two good quality trials in dogs with osteoarthritis showed a reduction in pain and the severity of lameness by following this diet.
Giving a high enough dose of Omega-3 can be difficult. For a 30kg dog, it has been recommended to give 3500mg/day of the two main forms EPA and DHA. A 1000mg fish oil capsule typically contains 300mg of combined EPA and DHA. Therefore 11.6 capsules would be needed per day. In addition to Hill’s, Royal Canin JS for a 30kg dog would provide 1280mg EPA and DHA (4.5 capsules). But j/d also contains other fatty acids which may be beneficial.
- Green-lipped muscle contains high levels of EPA and DHA. Royal Canin JS is a green-lipped mussel-based diet. It has also been shown to reduce lameness in osteoarthritic dogs. Studies show a benefit used high doses 20mg/kg/day. One study which used lower doses of 11mg/kg showed no benefit.
- Antinol is a recent green lipped muscle extract product. Early studies show possible benefits, although based on small trial numbers.
- Rosehip has been used in small human trials and suggests some improvement in pain and stiffness. There are no trials in dogs and cats.
- Turmeric (Curcumin). Human and cow laboratory studies show some anti-inflammatory properties. Dogs absorb this substance poorly, compared to humans, and there are no convincing veterinary trials showing a potential
Pentosan polysulphate (“Cartrophen” / “Synovan”) is commonly given to alleviate the symptoms of osteoarthritis in dogs. It is to reduce inflammation and potentially increase joint lubrication. Many vets feel it is effective in reducing pain and lameness, though the results of limited clinical trials are inconclusive.
There is no one treatment that will cure an osteoarthritic dog or cat. The key to success is understanding the methods in which owners can manage this life-long condition. Many animals have arthritis and are enjoying full and active lives.
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