Arthritis

Arthritis is a chronic, painful condition that has a number of negative consequences. Arthritic pets tend to be less active, and tend to gain weight. Lack of exercise leads to loss of muscle. Sometimes the pain of arthritis can be debilitating to the point where euthanasia is the humane option.

We need to try to slow down the progression of the changes and keep arthritic pets comfortable and mobile.

Initial recommendations for arthritic dogs

Weight loss

Excess weight is probably the number one risk factor in the development of arthritis for most pets. Any pet that is not slim is experiencing unnecessary impact on the joints, which causes further damage and accelerates the progression of the disease. Dogs with weight problems may need a medically managed diet in order to lose weight. Please talk to a member of the AMH staff if you have questions regarding weight loss for your dog.

Glucosamine/chondroitin/MSM

This is a nutraceutical that also may slow the progression of arthritic disease. You can find it in almost any health food store or pharmacy. Your dog should take this daily for the rest of her life. You can open the capsules and sprinkle the powder on his food if he doesn't like taking capsules. There is also a chewable tablet for pets that is available here at the hospital. Glucosamine has been shown to work better in conjunction with chondroitin and MSM. There are many commercially available products with these combinations. They are usually dosed based on the glucosamine content, at roughly 500 mg on glucosamine per 10 kg body weight per day. A 30 kg (65 lb) dog would get 3 capsules a day.

Salmon Oil

Salmon oil contains docosahexaenoic acids (DHA) and eicosapentanoic acid (EPA), two anti-inflammatory omega-3 fatty acids that have been shown to be of benefit in arthritis. Salmon oil should be given daily.

Royal Canin / Medi-Cal Mobility Support

This is an excellent diet that contains several supplements (including glucosamine and chondroitin). Its real claim to fame is that it is one of a very few diets that contain Perna canaliculus, or green-lipped mussels. These little critters contain high levels of some potent anti-inflammatories, including EPA and DHA (just like fish oils) and another fatty acid called eicosatetraenoic acid (ETA). A 1997 study concluded that the lipid (fat) fraction of Perna mussels might be a stronger anti-inflammatory than fish oils, evening primrose oil, or flax oil. [M. Whitehouse, T. Macrides, et al. Antiinflammatory activity of a lipid fraction (Lyprinol) from the N Z green lipped mussel. Inflam. Pharmacol. 5: 237 -248; 1997]

Perna canaliculus is not available in Canada as a regular supplement. Thankfully, it is available in this food. If this diet is fed, there is no need to give other supplements. It is not cheap food (no prescription diets are) but if you add up the monthly expense of a regular dog food, glucosamine/chondroitin/MSM supplements, and salmon oil capsules, the food generally comes in lower. You have the added advantage that you don't have to remember to give your dog pills or powders with each meal. Just remember to feed him!

Exercise

Arthritic dogs should exercise as much as they can tolerate without becoming lamer. Avoid repetitive, pounding exercise like jogging. Swimming is excellent low-impact exercise that helps to strengthen muscle and also aids in cardiovascular fitness.

Heat

Arthritic joints often respond well to heat. BE CAREFUL to apply only dry heat, and be extremely careful not to burn your pet. Never use electric heating pads. If grain-filled warming bags are used, do not overheat them. The right temperature is that which you can tolerate on your skin for 5 minutes without being uncomfortable. Some dogs do really well with a couple of towels warm from the dryer applied to their aching areas. The heat source can be applied for 15-20 minutes at a stretch.

More advanced arthritis with chronic pain

Anti-inflammatories and pain medication (meloxicam, deracoxib)

Meloxicam and deracoxib are COX-2 specific non-steroidal anti-inflammatory drugs (NSAIDs). They act on the inflammatory pathways, and are also very good analgesics (pain killers). Inflammation is the body's response to injury. It can be a good thing in some cases, and can aid in healing. But in arthritis it can actually cause more damage to the joints. Inflammation causes heat, swelling, and pain in the joints. Controlling inflammation may decrease the rate at which arthritis progresses by decreasing further damage to the joint components.

Meloxicam comes as a liquid (for dogs under 35 kg) or a tablet for larger dogs. Deracoxib is a chewable tablet. Either drug should be given with food, or can be given by mouth directly after a meal. They are given once a day. To minimize the risks of side effects, DO NOT go over the maximum dose stated on the bottle.

NEVER give any medications to your dog at home without consulting your veterinarian.  Over the counter arthritis drugs such as ASA, acetaminophen (Tylenol) and ibuprofen (Advil) can have serious (even fatal) adverse effects when given in conjunction with meloxicam or deracoxib. Ask your veterinarian first! Don't risk your dog's life!

WARNING! DERACOXIB FLAVOR CHEWS ARE EXTREMELY PALATABLE, MEANING THAT YOUR DOG WILL ENJOY EATING THEM. Normally this is a good thing in regard to medication, but these flavor chews can be so tasty that the dog will want to eat the whole bottle at a time. This can have disastrous consequences. Store your prescriptions carefully, in a locked cabinet or a place that the dog cannot reach.

Adequan/Cartrophen injections

These are drugs that help sustain the remaining cartilage in the joints and may decrease the rate at which the arthritis progresses. Some pets respond very well to weekly or monthly injections.

Additional analgesics, medical treatments

The goal in pets with advancing arthritis is to keep them comfortable and as pain-free as possible. To that end we will often prescribe ancillary drugs, such as tramadol, amantadine, gabapentin and s-adenosyl methionine (SAMe).