Pet Health
Non-surgical Management of Arthritis in Dogs
Holly Frisby, DVM, MS
Veterinary Services Department, Drs. Foster & Smith, Inc.

It is never easy to see a beloved pet and friend in pain. Medical treatment of degenerative
joint disease (osteoarthritis)
has greatly improved in the last several years thanks to the
introduction and approval of several new drugs and supplements. And while there is not
yet a cure for this debilitating disease, there is much you can do to control the pain, make
your pet comfortable, and perhaps slow down the progression
of the symptoms.

Weight management

Weight management is the first thing that
must be addressed. All surgical and medical
procedureswill work much better if the animal
s not overweight. Considering that up to half
of the pets in the U.S.are overweight, there is
a fair chance that many ofthe dogs with degenerative joint disease are also overweight.
Getting the dog  down to his recommended weight and keeping it there may be the most
important thing an owner can do for their dog. This may be the hardest part of the
treatment, but it is well worth it. Very few dogs can drive to McDonalds, work a can
opener, or open the refrigerator, so you, the owner, are controlling what your dog eats. If
you feed your dog less, it will lose weight.

Exercise

Exercise is the next important step. What we are trying to accomplish here is to restrict
the amount of exercising, yet still maintain adequate movement to increase or maintain
muscle strength. Young, active dogs are going to need to be restricted to walks on the
leash. Swimming is an excellent way for dogs to maintain muscle mass, but place minimal
stress on the joints. Older dogs should also participate in these activities to a lesser extent.
Jumping in all forms is bad for dogs with arthritis. While watching a dog play Frisbee is very
enjoyable and fun for the dog, remember that it is very hard on a dog's joints. Remember,
it is important to exercise daily; only exercising on weekends, for instance, may cause more
harm than good if the animal is sore for the rest of the week and becomes reluctant to
move at all.

Provide warmth and good sleeping areas

Slip a sweater on your dog. Arthritis tends to worsen in cold, damp weather. A pet
sweater will help keep joints warmer. You may want to consider keeping the temperature
in your home a little warmer, too.

Provide a firm, orthopedic foam bed. Beds with dome-shaped, orthopedic foam distribute
weight evenly and reduce pressure on joints. They are also much easier to get out of. The
orthopedic beds we offer are very good choices. Place the bed in a warm spot away from
drafts. Next to a heat register is best.

Massage and physical therapy

Your veterinarian or the veterinary staff can show you how to perform physical therapy on
your dog to help relax stiff muscles and promote a good range of motion in the joints.

Your dog may benefit from massage. A soothing massage of the affected area helps relieve
stiffness and soreness. Remember, your dog is in pain, so start slow and build trust. Start
by petting the area and work up to gently kneading the muscles around the joint with
your fingertips using a small, circular motion. Gradually work your way out to the
surrounding muscles. Moist heat is also beneficial. A water bottle or soaked towel works
best.

Make daily activities less painful

Going up and down stairs is often difficult for arthritic pets,
and for dogs, it can make going outside to urinate and
defecate very difficult. Many people build ramps, especially
on stairs leading to the outside, to make it easier for the
dogs to go outside.

Larger breed dogs can especially benefit from elevating their food and water bowls.
Elevated feeders make eating and drinking more comfortable for arthritic pets, particularly if
there is stiffness in the neck or back.

Agents to promote healthy cartilage

Glucosamine and Chondroitin: Glucosamine and Chondroitin are two of the supplements
that have recently become widely used in treating both animals and humans for
osteoarthritis. These products have been around for a while, but due to the lack of
scientific studies supporting them and the medical profession's resistance to endorse a
nutraceutical, they had failed to gain popularity. Now due to the overwhelming success in
treating patients with osteoarthritis, these products have come to the forefront of therapy
and are becoming one of the most popular products for treating arthritis today. Examples
include Drs. Foster & Smith Joint Care, Cosequin, and Glyco-Flex.

Glucosamine is a major component of cartilage. Chondroitin enhances the formation of
cartilage and inhibits
enzymes in the joint, which tend to break down cartilage.

When a pet has degenerative joint disease, the joint wears abnormally and the protective
cartilage on the surface of the joint gets worn away, and the resultant bone-to-bone
contact creates pain. Glucosamine and chondroitin give the cartilage-forming cells
(chondrocytes), the building blocks they need to synthesize new cartilage and to repair
the existing damaged cartilage. These products are not painkillers; they work by actually
healing the damage that has been done. These products generally take at least six weeks
to begin to heal the cartilage and most animals will need to be maintained on these
products the rest of their lives to prevent further cartilage breakdown. Because these
products are naturally-occurring compounds, they are very safe to use and show very few
side effects. There are many different glucosamine/chondroitin products on the market,
but they are not all created equal. We have seen the best results and fewest side effects
from products that are formulated especially for dogs and which contain pure ingredients
that are human grade in quality. Products such as Drs. Foster and Smith Joint Care and
Gluco-C, or the veterinary-sold product Cosequin are several that fit this category.

Polysulfated Glycosaminoglycan (Adequan):

Adequan is a product that is administered in an injection. A series of shots are given over
weeks and very often have favorable results. The cost and the inconvenience of weekly
injections are a deterrent to some owners, especially since the oral glucosamine products
are so effective. This product helps prevent the breakdown of cartilage and may help with
the synthesis of new cartilage. The complete mechanism of action of this product is not
completely understood, but appears to work on several different areas in cartilage
protection and synthesis.

Anti-inflammatories and pain relievers

Buffered Aspirin: Buffered aspirin is an excellent anti-inflammatory and painkiller for dogs.
(
Do NOT give your cat aspirin unless prescribed by your veterinarian.) It can be
used along with glucosamine/chondroitin products and is safe for long-term use. With all
aspirin products used in dogs, there is a risk of intestinal upset or in rare cases,
gastric
ulceration. Because of these problems,
it is recommended that if a dog develops signs of GI upset, the product be discontinued
until a veterinary exam can be performed. (By giving aspirin with a meal, you may be able
to reduce the possibility of side effects.) Using buffered aspirin formulated just for dogs
makes dosage and administration much easier. Regular aspirin, Tylenol, and ibuprofen have
many more potential side effects and are not recommended without veterinary guidance.

Carprofen (Rimadyl): Carprofen is a non-steroidal anti-inflammatory developed for use in
dogs with osteoarthritis. Carprofen is a very strong and effective painkiller and
anti-inflammatory agent. It is a prescription product and because of potential side effects,
careful adherence to dosing quantity and frequency must be followed. The manufacturer
recommends that periodic blood work to be done on animals that are on this product to
monitor any developing
liver problems resulting from its use. This product is often used
initially with glucosamine therapy and then as the glucosamine product begins to work, the
carprofen dose is reduced or eliminated.

Corticosteroids: Corticosteroids have been used for many years to treat the pain and
inflammation associated with osteoarthritis, although their use now is controversial.
Corticosteroids act as a potent anti-inflammatory, but unfortunately, have many undesirable
short- and long-term side effects. Because of these side effects and the advent of newer,
more specific drugs, corticosteroids are generally only used in older animals where all other
pain control products have failed, or in acute flare-ups. Corticosteroids are a prescription
product and come in both a pill and injectable form.

Vitamin C

Vitamin C has received a lot of press lately, primarily because of studies done in humans
that have linked it to preventing and controlling a variety of diseases. Much of the use in
animals has been extrapolated from human medicine. Humans are one of only a handful of
species that have a requirement for Vitamin C. Dogs and cats synthesize their own Vitamin
C, so this is one area where we probably should not be using human studies as guidelines
for treating dogs and cats. We know that Vitamin C acts as an antioxidant and is an
important nutrient in the synthesis of collagen and cartilage. We also know that Vitamin C
is water-soluble and it is very difficult to create a toxicity. Vitamin C does lower the pH of
urine and some researchers question the possible long-term side effects of over-acidified
urine. The benefits of Vitamin C in preventing or treating degenerative joint disease are
purely speculative. Using reasonable doses of Vitamin C does not appear to be harmful and
some day research may show that it is beneficial in animals.

Surgery

Some forms of degenerative joint disease can be treated with surgery. For example, hip
replacements in dogs with
hip dysplasia are becoming more common. Other procedures can
also be performed, but their success rests upon how many bony changes have occurred in
and around the joint. Please see the article on the specific joint disease for extended
discussion on the surgical treatment options for that disease.

Summary

Each dog with arthritis will need to have a management program specifically designed for
his needs. What helps one dog with arthritis may not help another. Work with your
veterinarian and watch your dog carefully so that between you, your dog, and your
veterinarian you can determine what is best for your dog. Realize, too, the program may
need to be changed as your pet ages, or if symptoms improve.


Copyright © 1997-2004, Drs. Foster & Smith, Inc. All Rights Reserved.
Reprinted from
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