Arthritis in your Aging Pet

by: Dr. Jo-Ann Liebe

dog_exercise_stairsArthritis, put simply, means “joint inflammation”.  Inflammation which we see after injury such as a cut in your skin or a broken bone is important for recovery and repair of tissue, but chronic, ongoing inflammation in and around joints can lead to degenerative changes that are harmful and permanent.  It is believed that 90% of cats over the age of 12 have some degree of arthritis and at least 20% of dogs over age 7 (that number increases depending on breed and history).

Why do these changes occur at all?  Sometimes the joint is just abnormal from birth.  This type is “congenital” which means “born with”.  An example of this is hip or elbow dysplasia.  If the cartilage, bones, ligaments and muscles do not fit together properly if will result in uneven wear and tear on the cartilage surface.  Cartilage decreases joint stress by reducing impact on the ends of the bones in the joints, like a gelantinous shock absorber.  When cartilage is damaged, a cascade of inflammatory changes occurs, eventually leading to destruction of cartilage and subsequent damage to underlying bone.  Cartilage contains no nerves – if your pet is showing any signs of pain the damage and changes in underlying bone have already begun.  Arthritis can also occur secondary to trauma – this can mean physical injury like torn ligaments, broken bones that are close to or involving the joint or some preventable kinds like increased wear and tear in athletic animals (including the flexibility of cats and their jumping ability) or secondary excessive weight bearing in obese animals.

cat stairs

What can you do about it?  Realize that arthritis can be prevented in some animals and reduced and slowed in others that are predisposed.  The final development of the joints in an adult animal are partially genetic and partially environmental.  You control the environment if you obtain your pet as a puppy/kitten.  The two main areas to control are nutrition and exercise.  Use a good-quality development food, in dogs be sure it is appropriate for your size of dog.  A puppy that will be over 25kg as an adult should be fed a large breed formulation.  Using a home prepared diet, incorrect diet or supplementing with incorrect amounts of calcium and phosphorous can lead to abnormal development.  Besides the right food you also need to feed the correct amount.  Excessive weight can be very damaging to growth plates so it is important to maintain a lean body weight.  The first few months of rapid growth are usually not a problem, but once growth slows at about 5 months of age, food should be reduced/adjusted to match requirements.  Learning body condition scoring and/or getting help from trained individuals at your veterinary hospital can help you keep your developing pet on the right track!

Exercise is the second important environmental factor you should control.  Hard surfaces like concrete and forced excessive running (jogging or running with a bike for example) can result in trauma to the cartilage and growth plates resulting in abnormal joints as an adult.  Growth plates can also be damaged when a puppy or kitten jumps down from high levels (like inside truck down to the ground (puppies) or off a high counter to the floor (kittens)).  This can result in a limb growing “crooked” because part of the growth plate is damaged and part keeps growing.  The best exercise for puppies is leash walking if on concrete and free running on soft ground.

Once your pet is full grown maintaining a lean body weight will help keep joints in good shape.  Use an appropriate diet as recommended by your veterinarian.  If your adult dog was born with conformational abnormalities that predispose him to arthritic changes then use supplements to support cartilage structure, suppress inflammation, and reduce the free-radical damage.  Supplements containing glucosamine, chondroitin, antioxidants, omega fatty acids are all known to be helpful.

The x-rays above show the progression of arthritis in a dog.  The good hip has only minor changes throughout the dog’s life.  The dysplastic hip has a small progression of arthritis until the dog turned 10.  A year and a half later the dog was having further issues with that hip, the x-rays showed a large change in the amount of arthritis in the hip.  With a specialized joint diet, supplements and an NSAID, this dog went on to live comfortably for 2 more years.

What are the signs of arthritis?

  • reluctance to take walks of usual length, decreased activity
  • stiffness (that may disappear once the pet has “warmed up”)
  • difficulty climbing stairs, climbing in the car
  • difficulty rising from rest
  • difficulty jumping up to surfaces that previously were not a problem, hesitancy in jumping
  • limping
  • abnormal gait (movement while walking or running)
  • licking of a single joint
  • acting withdrawn, spending less time playing with family (which is often misunderstood as a sign of aging)
  • soreness when touched
  • rarely, aggression when touched or approached
  • lapsed litterbox habits in cats (due to difficulty in getting in and out of the litter box)

If my dog has arthritis what can I do to help?

dc-arthritis

Taken from an Article by M.K. Shaw, DVM 11/10

Weight Loss

Weight management in older arthritic dogs is very important.  Joints that are already sore and stressed are made worse when they have to support extra weight.  And let’s face it – our pet population is battling obesity just like the human population.  The difference is, it is the HUMANS who are making the dogs obese.  Numerous studies have been done that show reducing weight leads to significant improvement in quality of life.  Ease of activities such as climbing stairs, jumping into a car or truck, and even getting up from a sitting position can improve dramatically with weight loss.

Just like in people, exercise is vital for weight loss.  Feeding less food alone simply decreases the resting metabolic rate.  Exercise increases the rate and thus burns more calories.  One of our goals is also to increase muscle mass.  Providing 20-60 mins a day of activity along with reduced calorie intake will help patients with osteoarthritis.

Veterinary Diets

Several veterinary diets have been introduced to the market specifically for dogs with osteoarthritis and more of these specialty veterinary diets are soon to follow.  These diets contain EPA (eicosapentaenoic acid) and/or DHA (dicisagexaebiuc acid) which result in less inflammation in the joints.  They also include glucosamine and chondroitin.  Some dogs show improvement being these diets in as little as three weeks!

Therapeutic Exercise

Controlled exercise is invaluable in treatment for patients with osteoarthritis.  This helps improve function, reduced pain, and the need for medication.

Initially, an exercise program should avoid overloading the joints.  Walking and swimming are excellent for starters.  Exercise programs must be tailored for each dog and your dog should not be forced to exercise during times of pain, as this will increase inflammation.

Controlled leash walking walking in water, jogging, swimming, and going up and down ramp inclines are excellent low impact exercises.  Exercise should be monitored so there is is no increased pain after the activity.  In the early phases, it is better to do three 10 minute sessions rather than one 30-minute session.  The exercise can be daily or every other day.  Walks should be brisk and purposeful, with minimal stopping.  Swimming and walking in water are some of the best activities for dogs.  The buoyancy of the water is significant and limits the impact on the joints while promoting muscle strength, tone, and joint motion.  Controlled exercise should not increase pain after activity.  If there is pain after an activity, the length of the activity should be decreased by half.  A 10-minute warm down period allows muscles to cool down.  A slower pace walk for 5 minutes will do.  Cold packs can be applied to painful joints for 15 minutes to control post-exercise inflammation.

Medications

Many inflammatory mediators and degradive enzymes are present in osteoarthritis and lead to the deterioration of articular cartilage.

Nonsteroidal anti-inflammatory drugs (NSAIDS) are important in the treatment of osteoarthritis.  They decrease inflammation and pain.  NSAIDS used in veterinary medicine include aspirin, carprofen (Rimadyl), deracoxib (Deramaxx), etodolac (Etogesic), meloxicam (Metacam), and firocoxib.  Your veterinarian will discuss the NSAID options with you and decide which is best for your dog.

Aging dogs often have medical conditions that affect the management of osteoarthritis and the use of these drugs.  Kidney, gastrointestinal, or liver conditions much be assessed to make sure your dog is able to metabolize and excrete the medications.  A complete history, physical exam, and blood work are thus necessary prior to initiating NSAIDS along with periodic follow-up blood work as determined by your veterinarian.

Slow-acting Disease Modifying Osteoarthritis agents

Neutraceuticals are nutritional supplements believed to have a positive influence on cartilage health by alternating cartilage repair and maintenance.

Glucosamine and chondritin sulfate are often used (Glycoflex, Cosequin, Dasequin, and Adequan are a few of these).  They are purported to help improve cartilage metabolism.  They may be more helpful in early osteoarthritis than in chronic, long-term osteoarthritis.  Some people report great success by using them, others do not.

Essential fatty acids (DHA and EPA), the omega 3 and omega 6 fatty acids, have been shown to have marked anti-inflammatory effect when added to the diet at proper levels.  As mentioned above, veterinary joint aid diets contain both of these supplements or they can be added to your pet’s current diet separately.

Acupuncture

Many animals benefit from the ancient Chinese practice of acupuncture.  Acupuncture points (acupoints) are specific spots on the body surface where a practitioner applies stimulation for the diagnosis and treatment of disease.  Thousands of years of clinical practice along with modern research have shown that each acupoint possesses special therapeutic effects.  Each acupoint has a unique location and physiological effect.  Some dogs experience less pain following treatment, allowing a decrease in the use of NSAIDS.  This is particularly helpful in dogs with decreased kidney or liver function.

Environment

There are many things you can do at home to help your dog with osteoarthritis.  Keep your dog in a warm dry environment, away from cold and dampness.  Use a soft, well-padded bed.  Provide good footing to avoid slipping and falling.  Carpet runners work well on hardwood floors.  Minimize stair climbing by using ramps.  You can purchase these from pet stores or make them yourself.  Portable ramps are available to assist dogs getting in and out of cars.  Avoid overdoing activities on weekends and excessive play with other pets.

Together with your dog’s veterinarian you can come up with a plan involving some or all of the above treatments to help with your pet’s osteoarthritis.”

 

If my cat has arthritis what can I do to help?

arthritic catAlthough there aren’t as many NSAIDS available for use in cats, there are some options.  There are neutraceuticals that can be used as well.  Reducing weight in cats is important as the added strain of extra weight especially when jumping is extremely difficult on the joints.  The hips, knees and especially the shoulders and elbows are affected.  Purchasing a shallow litter box can help if your cat has been having difficulty getting in and out of your current litter box.  Helping your cat up and down from surfaces can help reduce the strain from jumping.

 

If you have any questions about your pet, arthritis and what you an do, please contact your veterinarian.

Albert North Veterinary Clinic 306-545-7211

 

 

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Diabetic Pets

The pancreas is made up of exocrine (a gland that secretes through ducts to the epithelium, rather than directly to the bloodstream) and endocrine (a gland that secrets directly into the bloodstream) portions.  The exocrine pancreas is responsible for producing the digestive enzymes.  The endocrine pancreas is responsible for secreting hormones.  It contains Islets of Langerhans, which contain beta cells; these cells are responsible for the secretion of insulin.

Diabetes Mellitus is a disease caused by lack of insulin and/or resistance to insulin.  It occurs mainly in middle aged or older dogs and cats.  The cause is not fully known yet but heredity is likely a large factor in many cases.  Female dogs and male cats appear to be at increased risk.  Certain breeds such as Poodles, Dachshunds, Samoyeds, Bichons, and Cairn Terriers also  appear to be at increased risk.  Obesity increases the likelihood that your pet will develop diabetes.

drinking cat Clinical signs include

  • increased thirst and urination
  • weight loss
  • increased appetite
  • cataracts may occur
  • rarely we may see rear limb weakness.

If the diabetes has gone untreated for some time or if a diabetic animal gets stressed (e.g. from an untreated infection) the animal may become depressed, may not want to eat and may develop vomiting and/or diarrhea; this is called diabetic ketoacidosis.

A diagnosis relies upon blood and urine tests.  Extensive blood tests are necessary to help rule out other disorders that may affect prognosis or cause insulin resistance.

 

 Treatment

Treatment depends on whether the animal is sick or not.  If the animal has diabetic ketoacidosis they should be hospitalized.  Fluids are given, usually intravenously, and the animal will be started on insulin.  Once the animal is eating, not vomiting, and brighter, it can be sent home on insulin.  If the animal does not have diabetic ketoacidosis, it will be started on insulin at home after  the owner is shown how to give injections under the skin and how to handle insulin.

insulin injThe blood sugar should be checked 2-4 hours after the insulin injection at the clinic for the first day or two to ensure that it is not getting too low.  A week after starting insulin, a blood glucose curve will be done; the patient must be hospitalized for the day after getting insulin and being fed at home.  The blood glucose curve involves taking a blood sugar sample every 1-2 hours throughout the day in order to see how effective the insulin dose is, how long it is lasting and when it reaches its lowest point.  If the blood sugar is not getting to the desired range, the insulin dose will be adjusted and the blood glucose curve will be repeated in another week or two.  This continues until the blood glucose gets down to the desired level.  After the curves reach the desired level, the blood glucose will be checked at the time it reaches its lowest level, once every 1-2 weeks to start, then gradually less frequently.  It usually takes about one month of blood glucose curves to the find the desired dose, although some animals will be regulated after only 1 or 2 curves and some will require several curves.

 

Owners should be aware of the signs of low blood sugar, as one of the main complications of insulin treatment is low blood sugar.  These signs include:

  • weakness
  • lethargy
  • wobbliness
  • seizures.

You can give food, syrup or sugar water unless the animal is seizuring, in which case it is necessary to phone the clinic immediately.  If the patient is vomiting or not eating, please phone your veterinarian; usually the full insulin dose will not be given and an exam will be recommended.

diabetic foods

Feeding is important with diabetes.  For dogs preferably a high fiber diet should be used; this can decrease insulin requirements by causing weight loss and decreased post-eating fluctuations of blood glucose.  Half the days calories should be fed within ½ an hour of the morning injection and the rest 12 hours later at the time of the second insulin injection. * For cats higher protein, lower carbohydrate diets are usually recommended.

 

Oral medications don’t work on most diabetic animals and so are not commonly used or recommended.  Occasionally cats will respond to these drugs.  These drugs can only be tried if the cat is otherwise healthy and not in diabetic ketoacidosis.  Secondary side effects to the oral medications include vomiting and liver disease, blood glucose dropping too low or progression of the diabetes, potentially to ketoacidosis, if the oral medications don’t work.  If there is no improvement after one to two months, the cat should be switched to insulin.  Occasionally, a cat will have transient diabetes, where eventually it can be weaned off insulin, especially if they are on a low carb diet and reach a healthy weight.

 

The prognosis is generally good for most diabetics, unless they have other complicating diseases.  However, it should be remembered that diabetes is a potentially life threatening disease and can be expensive to treat, especially if complications occur, so the decision of whether to treat or not to treat should not be taken lightly.  If the owner elects not to treat, the patient should be euthanized once it loses its appetite, starts vomiting and becomes depressed.

If you suspect your pet may have diabetes please contact your veterinarian.  The sooner your pet is placed on a proper diet and started on medication, the better for your pet.

eating dog