Arthritis in Dogs

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Arthritis, or inflammation of the joints, is a common problem in dogs. Large breeds and older dogs are especially prone to this painful condition. Arthritis can be the result of an injury, an infection, developmental defects, immune disorders, or simply chronic wear and tear of the joints.

Osteoarthritis, also known as degenerative joint disease (DJD), is the most common form of arthritis in dogs, and these terms are often used interchangeably.

Arthritis occurs when the cartilage that cushions the ends of bones breaks down over time. Normally, cartilage allows smooth, frictionless motion in the joint. With arthritis, the cartilage gets rough and ultimately wears away, exposing the sensitive bone underneath. Pain, inflammation, and stiffness are the results. The joint loses its stability, and bone spurs develop. This yields more pain and stiffness.

Arthritis can happen in any joint in the dog's body including the shoulders, elbows, hips, knees, and spine. It is a progressive disease, in that it gets worse over time. It is often associated with older age but occurs in younger dogs as well.

Causes of Arthritis in Dogs

There are many causes of arthritis in dogs. The most common is DJD (degenerative joint disease), the result of chronic wear and tear. DJD is more common in medium- to large-breed dogs that put more stress on their joints because of their size. Other causes of arthritis include:

• Injury (e.g., ruptured cruciate ligament, fractures involving the joint). Injured joints may become chronically unstable, causing wear and tear to cartilage and other joint structures, resulting in arthritis.
• Congenital joint problems (e.g., hip dysplasia, luxating patella, Wobbler's syndrome). These are problems in which joints develop abnormally in the young dog, only to cause joint instability and arthritis later on.
• Infection (e.g., Lyme disease, septic arthritis). Bacteria or other organisms invade the joint, causing destructive inflammation.
• Inflammatory joint disease (e.g., rheumatoid arthritis, immune-mediated arthritis). Common in people, but less often seen in dogs, this set of disorders occurs when the animal's own immune system attacks the joint, leading to arthritis.

Signs of Arthritis in Dogs

Signs of arthritis depend on the dog's age and the joints that are involved. A typical sign is a stiff or altered gait as the dog avoids bearing down on the affected limb. A dog with shoulder trouble may balk at going downstairs. A dog with arthritic hips may no longer be able to jump into the car. Symptoms are often worse when a dog first gets up from a rest.

Because the pain is dull and chronic, a dog with arthritis is not likely to cry out in pain. In fact, an arthritic dog may just seem to be "slowing down," a sign often dismissed as normal aging.

Chronic disuse due to arthritis can lead to noticeable muscle atrophy of the affected limb. Joint swelling may be visible when lower limb joints are affected with arthritis. Cold and damp conditions make arthritis signs worse. An arthritic dog may seek warm, soft places for comfort or may endlessly lick at the painful area.

Diagnosis of Arthritis in Dogs

Your veterinarian will start with a good history and complete physical exam, including gait analysis and careful palpation (feeling) of the joints. X-rays can help confirm the diagnosis. Additional testing such as blood work, urinalysis, joint taps for bacterial culture and cell analysis, or even biopsy may be needed if infection or inflammatory joint disease are suspected. CT scans and MRI's, the gold standards for diagnosing joint problems in people, are becoming increasingly available for pets at specialty animal clinics.

Treatment of Arthritis in Dogs

Treatment for arthritis depends on the cause. Infectious and inflammatory joint disease are usually treated with medication. Surgery can be indicated for joint injury (e.g., cruciate ligament rupture) or congenital joint disease (such as a luxating patella). Hip replacement is becoming increasingly available for dogs with hip dysplasia and DJD of the hips. But for the majority of cases, treatment is first aimed at alleviating pain and slowing the progression of disease.

A few simple lifestyle changes are crucial for any arthritic dog:

1. Weight management

   Weight management is the first step to managing DJD. Getting your dog to slim down decreases the strain on damaged joints. Consult your veterinarian for an appropriate weight control program for your dog. These articles provide great tips once you've talked with your veterinarian.

2. Keep your dog moving

   Regular amounts of low-impact exercise actually improve arthritis symptoms by decreasing stiffness and strengthening the muscles that support the joints. Leash walks on soft surfaces, swimming, and treadmill walking can be beneficial. "Warm up" and "cool down" periods before and after exercise are essential. Your veterinarian can recommend an appropriate exercise program for your dog.

3. Make life easier

   Arthritic dogs can benefit from ramps to avoid the need to use stairs. Elevated feeders are more comfortable for dogs with neck or back problems. Placing throw rugs on bare floors can help a rickety old dog gain traction and prevent painful falls. A warm, padded dog bed is a must.

Medications for Arthritis in Dogs

There are several types of medication currently used in the treatment of canine arthritis. Your veterinarian will develop a treatment plan best tailored to your dog's needs. Many of these drugs are variants of what humans with arthritis might take. Note: Arthritis drugs can be toxic to dogs. Never administer any prescription or non-prescription medication to your dog unless specifically instructed by your veterinarian.

1. Disease Modifying Agents (DMAs)

   This class of drugs works to slow the progression of disease. These may also provide mild pain relief. DMAs do a variety of things including strengthening collagen, enriching joint fluid, or decreasing toxic chemicals in the joint. Examples include Glucosamine HCL and Chondroitin Sulfate, Polysulfated Glucosaminoglycan (Adequan®), Hyaluronic Acid and Methylsulfonylmethane (MSM). DMAs are usually well-tolerated and cause few side effects. Thus they are often prescribed early on, when arthritis symptoms are still mild.

2. Non-Steroidal Anti-inflammatory Drugs (NSAIDS)

   NSAIDS are the cornerstone of treatment for many dogs with painful arthritis. Rimadyl®, Deramaxx® and Meloxicam®, among others, are strong and effective anti-inflammatories made especially for dogs. However, they are not risk-free. Severe liver and stomach problems can occur, so your veterinarian will monitor your dog with regular exams and bloodwork. Please note that over-the-counter NSAIDS such as Aspirin, Ibuprofen, and Naproxen can be dangerous in dogs. These and other painkillers should never be given to a dog without specific orders from your veterinarian.

3. Corticosteroids

   Prednisone, triamcinolone, and related drugs are very effective for arthritis pain but can cause undesirable side effects as well. Increased thirst, urination, hunger, and agitation are some short-term side effects. Long-term use can cause unwanted weight gain and actually destabilize joints by weakening the muscles, tendons, and ligaments associated with those joints. Corticosteroids are only used for occasional flare-ups or when other treatments fail.

4. Newer Pain Medications

   Several new painkillers, such as Tramadol and Gabapentin, have emerged in recent years. These can be used alone but are especially effective when combined with an NSAID. Your veterinarian is best qualified to determine which "cocktail" of anti-arthritis drugs is best for your dog.

Physical and Alternative Therapies for Arthritis in Dogs

Some regions of the country now have specialized clinics for dogs that offer therapeutic massage, aqua-therapy, chiropractic, or even acupuncture. Your veterinarian may be able to provide a referral. Physical therapy is something you can do at home. It might be as simple as performing gentle massage or flexion/extension exercises. Warm compresses can soothe aching joints. Consult your veterinarian for specific instructions.

Prognosis for Arthritis in Dogs

Arthritis isn't curable, but with proper care, most arthritic dogs can enjoy a good quality of life for many years to come.

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