Orchard Vets
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Arthritis pain – is your pet keeping a ‘stiff’ upper lip?

8th December 2017

What is arthritis?

Arthritis means inflammation of a joint.  There are several different types of arthritis;  the most common form in older dogs is osteoarthritis.  Over 20% of dogs will be diagnosed with osteoarthritis in their lifetime, which makes it the most significant painful condition our pets have to deal with.  The changes occurring in the joint include loss of the smooth cartilage lining the joint surfaces, and the formation of new bone.  This leads to pain and loss of mobility of the joint.  

Arthritis in older cats is also very common; it is also under-diagnosed due to the tendency of cats to hide their pain.  Cats with arthritis will often just modify their lifestyle so they no longer climb, jump or sharpen their claws…all the things cats love to do!

Cats suffer with arthritis too – and will often spend less time climbing if so

 

 

What are the signs of osteoarthritis?

Generally, arthritis is a condition that develops slowly.  The changes seen are often just dismissed as ‘getting old’ or ‘slowing down’.  Animals in pain with chronic arthritis will almost never cry out or whine from the pain.  Often more than one limb is affected so they may not show an obvious limp.  Early signs of arthritis may include: 

  • Stiffness when walking, especially when first getting up in the morning or after a nap. 
  • Slower on a walk, or not able to walk as far. 
  • Less keen to play 
  • Difficulty jumping on to furniture, or in or out of the car 
  • Difficulty climbing the stairs 
  • Cats will stop sharpening their claws, so they become very thickened and may even curl around and grow into the pad. 

Pets that are more severely affected may also show the following signs: 

  • A limp may develop on the worst affected limb 
  • Licking over the joints, especially the carpus (wrist) or hock (ankle). 
  • Panting, or other signs of restlessness or anxiety 
  • Difficulty ‘settling’ when going to sleep at night.

 

How is arthritis treated?

Osteoarthritis is not a condition that can be cured; it must be managed throughout the pet’s life.  The main focus of treatment is provision of pain relief (analgesia).  However, it is also important to make lifestyle changes to maximise your pet’s quality of life and mobility.

 

Non steroidal anti-inflammatory drugs (NSAIDs)

Most patients with arthritis will be prescribed a non-steroidal anti-inflammatory drug such as Metacam, Previcox or Onsior.  During your consultation, the veterinarian will discuss with you if this is a suitable type of drug for your pet.  There are some patients that may have an upset stomach when taking these types of medication.  If this occurs for your pet, stop giving the medication and contact the surgery to speak to the vet about how to manage this or what other medications may be suitable.  

 

Other painkilling drugs

For patients whose discomfort is not controlled by NSAIDs alone, or who are unable to take NSAIDs, other painkillers may be prescribed on their own or in combination.  Drugs that may be used include Pardale (paracetamol/codeine), opioid medications such as tramadol, or ‘neuromodulators’ such as gabapentin or amantidine.   

Many of these are human medications prescribed under strict conditions (known as the ‘Cascade’) – you must NEVER give a human medication to your pet without specific instructions from your vet.  This particularly applies to ibuprofen, which is quite dangerous in dogs and is not prescribed, although it is well-tolerated in humans, and the use of paracetamol in cats.  Cats are unable to process paracetamol and will develop a fatal liver toxicity – NEVER give any paracetamol to a cat.

 

Joint supplements

There is a wide range of joint supplements on the market to maintain joint health in pets.  The most common ingredients are glucosamine and chondroitin.  Many also contain an omega 3 and 6 supplement, often green lipped mussel extract, fish oils or something similar.  Omega oil supplements are thought to provide a mild anti-inflammatory effect in arthritis. 

A joint supplement can be useful in the early stages or in addition to NSAIDs.  We recommend YuMove and YuMove Advance, as we feel it is a good quality product, in which a degree of natural anti-inflammatory effect has been demonstrated.

 

 

What else can I do?

Managing arthritis is most successful if a ‘multi-modal approach’ is adopted; that is, addressing all the aspects of a pet’s lifestyle that may impact on the condition and their quality of life.  Changes at home can be just as important as medication prescribed by your vet.

 

Diet and nutrition

One of the most important things you can do if your pet is suffering from arthritis is keep them in a lean, healthy body condition.  If they are carrying extra weight, that is extra weight on joints that are already sore, and can promote ongoing damage.  Fat is also an active tissue, and promotes inflammation.  Reduction in the percentage of body fat can reduce pro-inflammatory chemicals in the body. 

Reduction in weight of a dog requires a dramatic restriction in their calorie intake, of around 30-50%.  This often means they will feel hungry if no change to the type of diet they are fed is made.  It can sometimes be difficult to meet all their vitamin and mineral requirements on a restricted diet, and to ensure loss of body fat and maintenance of lean muscle mass.  We provide weight management clinics with our trained veterinary nurses who will discuss how to manage your pet’s diet, provide a personalised target weight and weight loss plan, and regularly check your pet’s weight to make sure they are on target.

 

Managing exercise

It is important to be realistic about the exercise your pet can manage.  If they are suffering from arthritis, it is unlikely they will be able to continue at the same level of exercise that they did before, especially if dogs performed high-impact activities such as agility or fly-ball.  However, exercise is still very important both for physical health – it keeps heart and lungs healthy, and maintaining a good healthy muscle mass helps to support joints such as the hips and stifles (knees) – weight loss, and also for mental health and quality of life – there aren’t many dogs that don’t enjoy a walk! 

Most owners of dogs showing signs of arthritis find that they manage better with shorter walks, more frequently, than a long walk less frequently.  Keeping the level of exercise similar each day is also helpful – but don’t worry too much if they miss a day.

Arthritic dogs may not be able to cope with high impact exercise like agility

 

Keeping warm

Cold joints and muscles are much more painful and inflexible than warm ones.  Even dogs that have always managed fine with cold weather may benefit from a coat as they get older and creakier.  Be particularly aware of your pet getting wet on walks – either from rain or mud, or swimming in cold water.  Ensure that they are dried off quickly when they get home, or consider getting a fleece ‘drying coat’ for them.

 

Changing their environment

Owners coming in with arthritic dogs will often comment that they struggle more on slippery flooring – finding it more difficult to rise and sometimes slipping over.  Wooden, laminate or tile floorings can be very difficult and frightening for pets that have mobility problems.  Using mats or rugs to create ‘safe routes’ around the house can make a real difference to their quality of life at home.  Don’t forget about areas where they might need to stand on a slippery floor, such as by a food or water bowl. 

Speaking of food or water bowls, some dogs with arthritis in their forelimbs, neck or back will find a raised bowl easier to eat and drink from.   

Dogs that are struggling to get in or out of cars – or on to furniture or the owners’ bed if they are allowed! – can benefit from using a ramp or a step to allow them to get up more easily. 

You may also find that as they are getting older, your pet benefits from different bedding.  Some will prefer a warmer bed, with thicker blankets to cushion aching joints, while others may choose to lie stretched out on the floor.  They may benefit from a thicker mattress (memory foam ones are particularly good!) or pad, or a raised platform bed that means they do not have to bend as much to get comfortably into or out of their bed.

 

Hydrotherapy and physiotherapy

Consulting with a trained physiotherapist, to get a detailed assessment of your pet can be very helpful.  Often as joints become stiff and painful and dogs avoid moving them, they will develop aches and pains and tight muscles elsewhere.  A physiotherapist can provide massage and exercises to help to ease this and maintain mobility.  They will also provide exercises and techniques that can be done at home to keep pets comfortable and mobile. 

Hydrotherapy can also be useful, especially as being in the pool or underwater treadmill helps to take the dog’s weight off their joints, meaning that it is a useful low impact form of exercise. 

Both physio- and hydrotherapy are often under-used in the treatment of dogs with osteoarthritis.  Speak to us about the benefits your pet could get, and hydro- and physiotherapists we recommend locally.

Hydrotherapy can be helpful for arthritic dogs

 

Mobility and treatment reviews

We recommend regular physical examinations and reviews for patients suffering from arthritis.  This allows us to monitor them for any potential side effects from medication, but also to identify what other changes can be made, or other medications introduced to improve the pet’s quality of life as the condition progresses.  It gives you the chance to raise any concerns with the vet about how your pet is doing, and work together as a team to keep your companion fit and well for as long as possible.