Pet Advice
Managing Pet Arthritis
Arthritis in Cats
Arthritis is a common, frequently underdiagnosed condition seen in cats and whilst it predominantly affects older cats, signs may also be seen from a young age.
Signs and Treatments
Commonly the signs of arthritis in cats will be seen as a change in lifestyle such as reduced jumping or playing, increased sleeping, or a change in temperament. Once signs of arthritis are suspected, the condition may be managed by a range of treatments including environmental changes, weight control, anti inflammatory pain relief medications, nutraceutical medications, and complementary therapies such as physiotherapy and acupuncture.
Recently we have been using a monthly monoclonal antibody injection called Solensia with great effect for our cat patients with osteoarthritis. This is both safe and seemingly very effective.
The following handouts from International Cat Care Organisation have give detailed information on:
httpss://icatcare.org/advice/arthritis-and-degenerative-joint-disease-in-cats/
httpss://icatcare.org/advice/non-steroidal-anti-inflammatory-drugs-nsaids-and-your-cat/
Arthritis in Dogs
Arthritis means joint inflammation. There can be many causes for this inflammation which include infection and immune mediated disease, but degenerative joint disease or osteoarthritis is the most common form in dogs and cats.
A joint is a point where 2 or more bones articulate. The ends of bone are covered in a layer of cartilage. Further cushioning and lubrication are provided by fluid within the joint space. Damage to and erosion of the cartilage as well as a loss of or change in character of the joint fluid can lead to friction caused by bone rubbing against bone. This then causes inflammation which causes pain. Joint cartilage itself has no nerve ending and therefore, the early stages of osteoarthritis are not overtly painful but as the disease progresses and changes start to occur in the structures in and around the joint, the symptoms become more apparent.
It used to be thought that dogs suffer commonly from osteoarthritis whereas cats are less affected. This, however, is no longer considered to be the case as we recognise the disease to be very prevalent in the feline population. Other companion small animal species such as rabbits have also been diagnosed with this disease. (For more information on arthritis in cats visit our feline page).
What causes arthritis in dogs?
The condition is most commonly caused in older animals by age-related wear and tear. It can occur in younger animals, although, in these cases an underlying cause is generally identified.
Such causes can be developmental such as hip dysplasia; elbow dysplasia; luxating patella (loose kneecaps) or; they can be due to trauma to the joint or the structures that support it such as fractures and ligament tears.
What are the symptoms of arthritis in dogs?
Pain is the typical sign associated with osteoarthritis. Pain may not be evident in the early stages of the disease. As the disease progresses, pain may be noted when the pet is moving or exercising. As the condition progresses further, pain becomes continuous but is worse when the pet is weight bearing and ultimately pain affects all activities including sleep.
A dull ache is associated with chronic pain related to osteoarthritis. Recent use and damage to the joint structures may exacerbate the problem in the short term and cause sharp shooting pain.
How is arthritis diagnosed in dogs?
In most cases a physical examination can be helpful in diagnosing arthritis. Confirmation of the disease, however, requires radiography. In addition, if an underlying cause is suspected that may benefit from surgical treatment, then radiographs to accurately diagnose the condition are vitally important.
How is arthritis treated in dogs?
The main aim of treatment is alleviation of pain. A multi-modal approach that is tailored to every individual patient is required to manage this complex issue.
Weight management is of paramount importance in the treatment of this condition. The more weight the joints have to bear, the more the discomfort and the quicker the progression of the disease. There is often a catch-22 problem with weight management. Excessive weight bearing exercise (like running) is discouraged for patients with osteoarthritis but less exercise makes maintaining or losing weight more difficult. Non-weight bearing exercises such as swimming are therefore recommended. This should be undertaken in a controlled manner at a certified veterinary hydrotherapy centre of which several are now available. Alternatively calm lead walking is also a suitable exercise for these dogs.
Provision of well-padded bedding for the pet to lie on will also help relieve some discomfort.
Although these factors will help, most pets will require some form of medical therapy to provide greater alleviation of their symptoms.
In mild cases of the disease or as an adjunctive treatment, neutraceuticals that contain substances such as glucosamine and chondroitin are used as they provide nutrients that can help in the repair and maintenance of joints. It should be borne in mind that neutraceuticals are not regulated and there is wide variation in the quality of the products that can be purchased. It is recommended that you seek our advice before purchasing a particular brand.
Non-steroidal anti-inflammatory drugs (NSAIDs) are the main stay of medical management for more advanced cases. Several large studies in human and veterinary medicine have demonstrated unequivocally strong evidence for the efficacy of NSAIDs in treating osteoarthritis. There are various types of these drugs available with similar efficacy and your veterinarian will select the product based on the individual patient and the risk of side effects. A common side effect of this drug is to upset the gastrointestinal tract. The drug should therefore be stopped in the face of any vomiting or diarrhoea and our advice be sought. These medications should never be administered on an empty stomach. Another concern with this drug is the risk of aggravating kidney disease. At the standard doses these drugs will not cause kidney damage, but they are contraindicated in the face of pre-existing kidney disease. This is the reason why it is recommended to perform tests to assess kidney function before and every 6 months during treatment.
There is less strong published evidence for the other medications but, based on the available literature and clinical experience, they have an important role to play in the multi-modal management of osteoarthritis that is often required. These drugs include:
- Monoclonal antibody injections (Beransa) is a new monthly treatment for osteoarthritis in dogs. We have been using this treatment with great success in recent times.
- Pentosan polysulphate (Synovan) has a mild anti-inflammatory effect but its main function is thought to be in maintaining joint health including preserving the joint cartilage.
Gabapentin is a medication that can also be used for pain relief
- Paracetamol, The use of this drug is again extrapolated from that in people. It must not be used in cats due to the high risk of toxicity of paracetamol in this species. The drug can be used safely in dogs but only at the prescribed doses as dogs are more susceptible to paracetamol toxicity than people.
Other drugs are available and may be used on a case by case basis.
In some cases where the pain is very severe and/or cannot be managed with medical therapy, then surgical alternatives may be considered. For example, total hip replacement is now a commonly performed procedure at specialist veterinary centres.