Arthritis In Dogs

When you know the signs of arthritis in dogs, what to expect if your dog develops it and how your veterinarian can help puts you in the best position to help your dog.

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Trauma, such as twisting a leg in a fall, can cause arthritis, but it can also be caused by genetics. AndraP Cerar/Hemera/Thinkstock
Dr. Brian Roberts

Hello, fellow dog lovers. I’ll be discussing arthritis in this article, and I’m afraid that my little Havanese mix named Trixie will develop it in the future. She’s only 2.5 years old and weighs around 17 pounds — way too young for arthritis, right? That’s a problem for old dogs and big dogs. Well, the other day I noticed her holding up her left hind leg after jumping down from the couch (by the way, she’s not allowed on the couch!). Her knee was painful, and I quickly determined that her patella (kneecap) was out of place. This is called luxating patella, which is a common condition in small breeds. After brief manipulation, her knee “popped” back into place and she ran around like nothing had happened. This condition may worsen and lead to damage to the ligaments in her knee, which eventually will lead to arthritis.

Arthritis literally means inflammation of the joint(s). You may hear other terms used, such as “osteoarthritis” and “degenerative joint disease.” Inflammation is caused by the immune system when white blood cells become activated inappropriately and release different compounds that damage tissue. In this case, the cartilage is what is damaged. It eventually erodes and is replaced with scar tissue. Arthritis can be mild or severe regarding damage to the joint, and the pain can be continuous or intermittent. Dogs diagnosed with arthritis fall into two categories: those who have developmental problems and those who sustained some type of injury to the joint.

Causes Of Arthritis In Dogs

Developmental Problems: For those of you with larger breed dogs like Golden Retrievers or Labradors, developmental problems with joints are the most common cause of arthritis. Incongruity of the hip joint, termed hip dysplasia, is a leading cause of inflammation in larger breeds. Approximately 40 percent of Labradors, Golden Retrievers and Rottweilers have some degree of hip dysplasia. There is definitely a genetic basis for this disorder.

Other developmental joint conditions commonly affect the elbow and sometimes the knee. With developmental problems, how the bones align with each other and the forces placed upon the joints result in joint inflammation.

Damage: Injuries to the joint from trauma, infection and the immune system lead to inflammation within the joint. For example, if a dog falls while rotating one of his hind limbs, he may rupture the cruciate ligament. The torn ligament results in the joint being unstable and, in the long run, inflammation will ensue. Having an overweight dog means that more forces are being applied to the joint, creating instability — and then arthritis can develop. Immune-mediated arthritis is a term used to describe arthritis secondary to activation of the immune system. An example of this is rheumatoid arthritis.

Symptoms Of Canine Arthritis

Obvious signs of arthritis are difficulty walking (lameness), inability to jump up or down, and vocalizing when a joint is being used or manipulated. The problem we face as pet owners and veterinarians is that once a dog is so painful from arthritis that he has difficulty getting up, the damage in that joint is severe.

So, watch for more subtle signs of arthritis, such as decreased appetite, not being able to run as quickly or jump as high, and lying in a new, but different position than previously. Please be aware that decreased appetite and activity also can be signs of many diseases besides arthritis, so don’t “give your dog two aspirins and call the vet in the morning” if your dog seems more inactive than usual.

Diagnosing Arthritis In Dogs

Your veterinarian can make a diagnosis of arthritis in a few key ways. The most important being the history you provide and a thorough physical examination. Your veterinarian will want to observe your dog walking and running, and also want to perform an orthopedic exam that manipulates different joints to identify if there is a problem. Radiographs (X-rays) of the joints are performed once a problem area has been identified. Radiographs can assist in determining abnormal joint alignment like hip dysplasia, checking for erosion of bone and identifying fluid within the joint.

For breeds predisposed to developmental joint problems, like hip dysplasia, special radiographs taken while your dog is under anesthesia can be performed (PennHIP and OFA). These X-rays are done in very young dogs and sent to experts for interpretation. Just because a joint is normal on an X-ray doesn’t mean arthritis isn’t present! Additional tests may be necessary, such as joint fluid collection and analysis, CT scanning, and blood tests for infectious and immune-mediated disease.

Treatment For Canine Arthritis

So, let’s say Trixie continues to have issues with her knee to the point that her kneecap luxates continuously. For that problem, surgery would be recommended to correct the bone alignment and the groove the kneecap traverses in. Similarly, young dogs with hip dysplasia who have not yet developed arthritis can undergo corrective surgery. Surgery would also be recommended for fractures and infections within the joint.

For non-developmental osteoarthritis typically noted in older dogs, surgery is usually a last resort. Believe it or not, knee replacement, hip replacement and even elbow replacement surgery can be performed! However, the mainstay of arthritis treatment involves diet, supplements, exercise, anti-inflammatory drugs and pain control.

1. Diets And Supplements. If you search the Internet for diet recommendations for dogs with arthritis, you’ll find thousands of articles. I will focus on evidence-based diets and supplements for arthritis, meaning scientific studies were performed and found significant benefit to treat arthritis in dogs.

  • Omega-3-based diets: These diets have additional omega-3 fatty acids, which decrease inflammation. At least six different studies concluded that these diets are effective to help treat osteoarthritis.
  • Chondroitin sulfate and glucosamine hydrochloride: Glucosamine and chondroitin are proteins and sugars naturally found in joint cartilage. The idea is that supplementation will assist in cartilage repair, maintain health of the joint, improve function and decrease joint pain. Unfortunately, the evidence had mixed results and, most importantly, only certain products were tested versus the hundreds of these supplements that can be purchased. Your veterinarian will advise you best, but I would say they may help and are worth a try.
  • Green-lipped mussel: A number of supplements have this ingredient and, similar to glucosamine-chondroitin, studies showed “moderate” benefit of using this compound.

There are quite a few other supplements that were found to have some benefit, including elk velvet preparation and S-adenosyl l-methionine (SAMe).

2. Exercise: Moderate, low-impact exercise is commonly recommended for most dogs with osteoarthritis. The degrees of arthritis and joint range of motion and level of pain must all be considered when creating an exercise program. Walking on sand, swimming, underwater treadmill workouts and use of inclines are just some of the things that help build muscle, increase joint mobility and reduce weight. A specific regimen for your dog should be prescribed by your veterinarian. For example, I would not recommend you make your 10-year-old dog with severe hip dysplasia run a mile in 90-degree heat!

3. Anti-Inflammatory Drugs: Two groups of drugs fall into this category: NSAIDs (non-steroidal anti-inflammatories) and anti-inflammatory steroids (glucocorticoids). NSAIDs are used routinely in dogs with osteoarthritis. You may have heard the term COX-1 and COX-2 inhibitors. COX stands for cyclooxygenase, which is the enzyme that leads to inflammatory compounds. Basically these medications are similar to aspirin. Studies have found that long-term use will be of benefit to treat osteoarthritis. There are some side effects to be wary of when using NSAIDs, including gastrointestinal ulcers and damage to the kidneys, so never give medication to your dog unless your veterinarian tells you to do so!

Steroids like prednisone and dexamethasone are potent anti-inflammatories. Similar to joint replacement, they are used as a “last resort.” Most of us will not recommend their use at all in treating arthritis unless injected directly into the affected joint. Long-term systemic use via pills has many side effects, such as ulcers (like aspirin but worse!), liver damage, Cushing’s disease and weakened immune systems. Again, the cause of arthritis comes into play: Immune-mediated arthritis is treated with steroids.

4. Pain Control: Several options are available to control pain, and your veterinarian will know which will work best for your dog.

  • NSAIDs: By reducing inflammation, NSAIDs help ease pain.
  • Tramadol: This is an opiod (morphine-derivative) that blocks pain receptors. It’s relatively safe and can be used with or instead of NSAIDs, especially in patients with kidney or GI problems. The main side effects are drowsiness and liver problems.
  • Pregabalin: This gabapentin-like analogue helps prevent the “wind-up” phenomenon of chronic pain.
  • Acupuncture: Stimulation of certain meridians along nerve and pain pathways cause release of endorphins, which decrease pain.
  • Cold laser: Class IV laser therapy leads to dilation of veins and capillaries, which helps reduce pain and promote tissue healing.

What To Remember About Dog Arthritis

This is a lot of information, so here’s a quick summary.

  • Arthritis is defined as joint inflammation and is also called osteoarthritis and DJD (degenerative joint disease).
  • There are two main types of arthritis: developmental and degenerative.
  • Signs of arthritis include lameness, joint swelling, decreased appetite, difficulty getting up and down, and vocalization.
  • Diagnosis involves a physical exam, orthopedic exam and imaging using X-rays.
  • Treatment is a program of diet, weight reduction, supplementation using Omega-3 and glucosamine-chondroitin, exercise, anti-inflammatory drugs and pain control.

Your veterinarian will create a tailored plan for your dog. I hope you are now well-informed about arthritis in dogs!

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Dogs · Health and Care