Osteoarthritis management

Osteoarthritis (OA) is a common painful condition in pets, causing changes in their behavior, capabilities and how they move. It is prevalent in dogs and cats of all ages but is more readily identified as they get older as the clinical signs become more obvious. If not managed appropriately, pets may be left in constant pain, lose their independent mobility and are at risk of premature euthanasia for welfare reasons. However, there are numerous readily available and affordable management options which reduce the pain, slow the progression of the disease and leave the pet with a good quality of life. “Osteoarthritis is not the end of the road, it is just the start of a new direction!”

Osteoarthritis is a disease that affects the whole joint. The cartilage in the joint degenerates, becoming damaged and thinned. The underlying bone becomes thickened and loses its concussion absorbing properties. The joint capsule that surrounds, stabilizes, nourishes and protects the rest of the joint becomes thickened and new bone may form around the joint. All these changes contribute to a joint that is initially painful when used, but over time that pain can become continuous as well as radiate. Other regions of the dog’s body will become further sources of discomfort over time as the dog attempts to shift body weight and function away from the arthritic joint, highlighting the importance of identifying arthritis early.

Arthritis in dogs is commonly secondary to developmental joint diseases, such as hip dysplasia, elbow developmental disease and patellar luxation, and because large dog breeds are more prone to these conditions, they are more likely to develop osteoarthritis. However, in reality small and medium breeds also regularly succumb to arthritis due to development related conditions, joint trauma and excess body weight. Knowing that osteoarthritis is a long-term, non-curable, progressive condition that actually begins when a dog is in its prime should encourage all dog owners to maintain their dog at an appropriate weight, encourage regular appropriate exercise, be vigilant for early signs, as well as getting their dog routinely checked by a veterinary professional.

So if you’ve noticed that your faithful friend is not as keen to go out for their regular walks, and you had put it down to them ‘growing up’ or old age – don’t! Many pets will not advertise their pain and instead simply appear quieter and more subdued. These subtle changes in behavior presentation can lead to the early signs of joint pain going unnoticed, but by being vigilant and investigating any concerns, the disease can be identified earlier and more management options exist.

Acute flares are common and are often the cause of an owner taking their dog to the veterinarian for the first time. They assume the sudden onset of obvious clinical signs, such as struggling to walk, not willing to stand has only just developed when in fact it has been smoldering away for months. An acute flare is when your dog experiences a sudden increase in joint related pain which commonly occurs when your dog has overdone an activity, such as playing fetch or jumping into the car. This sudden deterioration should always be investigated because an apparent flare may actually be due to another condition such as a joint infection, trauma, or even an unrelated concurrent condition which will need appropriate management.

Acute flares will subside with appropriate management and your veterinarian may recommend a plan encompassing a period of rest or controlled exercise, an increase in pain relief medication, and lots of mental distraction. In addition they may suggest other interventions like laser therapy, acupuncture, and physiotherapy to support the medication being prescribed.

Fortunately, there are many ways to help your dog with osteoarthritis. Your veterinarian will likely recommend multimodal management – this means that several strategies/treatments may be introduced at the same time, such as medications, supplements, physical therapies, weight control, lifestyle adaptations, and surgery. The recommended management plan will depend on which joints are affected, and the severity of your dog’s condition, as well as your circumstances. The treatments are unlikely to stop or slow the progression of OA but should improve your dog’s symptoms, allowing your pet to have a good quality of life for an extended period of time.

Drug therapy

Non-steroidal anti-inflammatory drugs (NSAIDs) and monoclonal antibodies are commonly the first medications prescribed to alleviate the pain and inflammation associated with OA. There are many further medications available to treat OA and your veterinarian may suggest another medication if there is no improvement or your dog doesn’t tolerate the original prescription, so don’t feel you don’t have plenty of options.

In recent years huge strides have been made in managing arthritis in a more targeted fashion such as through surgeries and intra-articular injections. Please ask your veterinarian what additional services they offer in addition to the baseline treatment described above.

Weight loss

Being obese or overweight is hugely counterproductive in managing osteoarthritis. Not only does it mean that there is more pressure on the compromised and painful joints, the extra fat is a source of inflammatory mediators that drive the inflammation within the joint. This ramps up the pain and progression of the disease. Maintaining an appropriate body weight has the most profound influence on OA, so asking your veterinary team their opinion on your dog’s body weight and how to maintain it is essential, and may even lead to a reduction in the medications they have become reliant on.

Your veterinarian will recommend that your dog loses weight and reaches a body condition score of 4-5/9 or 3/5. They can plot you a timeline to hit your target weight, calculate your dog’s calorie needs and advise you on appropriate diets.

Modifying exercise routines

Inappropriate exercise can be a real driver of the pain of osteoarthritis and potentially its progression. Make sure you get advice from your veterinary team about your dog’s capabilities and needs and follow sensible advice such as avoiding long periods of inactivity, and encouraging them to gently move about throughout the day. Regular moderate exercise will improve your dog’s overall fitness and increase strength, flexibility and stamina of the supportive tissues of the joint – ultimately improving the comfortable use of the joint.

Changes to home environment

Arthritis leads to pain, weakness, and vulnerability to trips, slips and falls, so making simple modifications to your home to help them and prevent accidents will ultimately help your dog. Easy to implement additions like non-slip rugs, non-skid floor surfaces, raising food and water bowls, introducing orthopedic dog beds, steps or ramp to allow them to get into the car and other hard to access areas more easily, as well as preventing access to treacherous areas such as stairs, can minimize the chances of acute flares. 

Complementary therapies

Therapies such as physiotherapy, hydrotherapy, laser therapy, and acupuncture are often helpful. Seek advice from your veterinarian as to which would be most appropriate for your dog and their condition, as well as who they recommend.

Nutraceuticals / supplements

A nutraceutical product (a food or naturally occurring food supplement marketed as having a beneficial effect on health) may be considered. Omega-3 fatty acids have the most evidence of offering benefit, whereas glucosamine and chondroitin sulfate are falling out of favor after trials have shown them to offer little benefit. The quality of supplements can vary dramatically as it is an unregulated market (meaning clinical evidence of benefit and safety are not required). Be careful not to fall foul to well marketed but useless products. Ask your veterinarian for their advice.

Finally, please ensure that your dog is regularly assessed by your veterinarian as osteoarthritis is a progressive condition that is likely to require routine changes to your management plan to keep your dog comfortable and independently mobile.