Achy Breaky Joints

Feb 12, 2018

I’m sure we can all relate to the saying “It’s tough getting old…” My mom once told me that with each decade of life it feels like a new set of problems arises and now that I’m in my thirties I can totally relate. Even though I look young thanks to my short stature and youthful appearance, I myself deal with a variety of aches and pains – some the result of previous injuries and others just the result of normal aging. 

Cats and dogs are no different… they age and develop aches and pains as well. By far the most common complaint we get from owners regarding their pets’ quality of life as they age is mobility and pain due to osteoarthritis. The most commonly reported symptom in dogs is lameness which can be daily or sporadic. Most people report they notice the lameness early in the morning and the patient “works itself out” as the day goes on or will notice the lameness worsen after intense periods of exercise. Symptoms of OA in cats can be less noticeable, therefore it’s very important to watch for signs of OA such as hesitance to perform tasks or activities such as jumping or climbing, spending less time playing, or a change in preferred postures or resting positions. Although it may be moderately uncomfortable to your pet during their examination, we can tell a lot about joint health by manipulating the joints and assessing their range of motion.

Thankfully we have a lot of options for helping manage the symptoms of osteoarthritis (OA) in our furry friends. Some cases may require surgical intervention to help alleviate pain and improve mobility. For the vast majority, however, symptoms can be managed with a combination of weight control, controlled exercise, supplements and medication. Below I’ve outlined many of the steps you can take to help keep your pet as mobile and pain free as possible.

WEIGHT MANAGEMENT AND EXERCISE

You will absolutely want to make sure your pet is at a healthy body condition score (BCS). Based on physical exam findings, we will give your pet a BCS to start with and decide what needs done to achieve an ideal BCS. It’s much easier to keep your pet lean from the beginning rather than trying to get the weight off after they have already become overweight or obese. After a spay or neuter, expect to decrease your pet’s caloric intake by about 30% to help prevent weight gain. Feeding a high-quality pet food at the correct amount and limiting additional treats is key. Keep in mind that something as healthy as a banana can easily account for 10% or more of a small to medium size dog’s daily caloric needs! Most cases of being overweight involve overfeeding, although in some animals there are underlying medical problems contributing to the obesity. Below is a link to one of the common body condition scoring systems we use in dogs:
http://www.pvahosp.com/sites/site-1526/images/Purina_body_condtion_score.jpg

In addition to weight management, daily, low impact exercise can also help keep joints healthy. It is best to develop an exercise routine when your pet is young and healthy, and allow them to continue this routine (such as daily walking, or swimming) as much as they will tolerate. It is important not to force your pet to do more than they are willing or able, but to simply offer the opportunity as they get older to help maintain their muscle strength and joint mobility.

OMEGA FATTY ACIDS AND JOINT SUPPLEMENTS/CARTILAGE PROTECTIVE AGENTS

Omega fatty acids and joint supplements are something that can be started safely in almost any animal, although you should always check with your veterinarian first as there can be certain instances where they may be contraindicated. These supplements can decrease inflammation and support whole body health, not just the musculoskeletal system. They should be started in any animal with a known hereditary condition that will lead to development of OA (for example breeds with hip dysplasia, limb deformities, etc.), injuries (such as dogs with a history of ACL tears), or early evidence of osteoarthritis. The most common components of joint supplements are glucosamine, MSM and chondroitin which are compounds that stimulate synthesis of joint fluid, inhibit degradation of joint cartilage and improve healing of cartilage. An injectable product, Adequan, can provide a faster and longer-lasting improvement in cartilage health and clinical symptoms than the oral formulations. Omega fatty acids work by reducing inflammation and use of OFAs may help reduce the necessary dosages of stronger drugs. There are a lot of joint supplement and OFA options out there for cats and dogs, and we would be happy to help you choose the best one for your pet.

NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs)

NSAIDs have historically been the cornerstone of OA management in dogs (and humans!). Examples include carprofen and meloxicam. Because they can have an increase incidence of side effects with long term use in companion animals compared to humans, it is important that pets receiving NSAIDs chronically be monitored closely by their veterinarian and have labwork checked periodically. Historically NSAIDs would need to be used with great caution with certain pre-existing health conditions (such as renal failure), but a newer NSAID called galliprant is now available and can be used safely for these patients. Galliprant is approved for use in dogs only.

ALTERNATIVE THERAPIES

Acupuncture, non-invasive laser therapy, intra-articular stem cell therapy, platelet rich plasma and physical therapy and rehabilitation are additional therapies that can help patients with osteoarthritis. Hillcrest Animal Hospital is proud to be able to offer non-invasive laser therapy sessions which will often result in noticeable improvement in symptoms within a month. For more information on laser therapy, see my previous blog entry: http://www.hillcrestah.com/blog/laser-force-awakens

OTHER ANALGESICS

Occasionally patients cannot be managed with the above options alone, or it is difficult for the owner to be able to travel with the pet for things like physical therapy, laser therapy, or adequan and so they must rely on medical management alone. For cases where OFAs, joint supplements and NSAIDs are not enough, or for patients that cannot tolerate NSAID use, there are alternative pain medications that can be used. They generally are not as effective as NSAIDs but can help improve symptoms to some extent. Gabapentin and amantadine are two drugs that may be the best alternative options. Historically veterinarians have prescribed a synthetic codeine analogue called tramadol, however newer studies are proving what was already suspected – that unfortunately this drug does not appear to provide any clinical benefit for dogs with osteoarthritis.

As you can see there are so many options for managing OA in cats and dogs. As with most things in life, there is not a “one size fits all” package. We would love to help you help your aging pet and formulate a plan that works best for you. Maybe aging doesn’t have to be quite so tough…

-Megan Vessalo, DVM