EXCLUSIVE FEATURESManaging arthritis in dogs

Managing arthritis in dogs

Most dog owners have had an elderly dog that suffers from arthritis. The classic signs of ‘slowing down’ or ‘just getting old’ slyly creep in, catching the caregiver off guard. Many owners seek the support of their vet in the later stages to ensure their beloved dog remains comfortable. However, the disease eventually ‘wins’, with the dog struggling through pain to stand, walk, run and do so many of the activities that were part of its daily routine as a younger dog.

By Hannah Capon MA Vet MB MRCVS CCRP and Vera Szito CAMbassador and editor, Canine Arthritis Management

There are a number of common myths associated with arthritis in dogs. By tackling the myths associated with managing this disease, Canine Arthritis Management hopes to give readers the chance to identify and challenge this disease earlier to ensure their dog leads a long and happy life.

Sadly, this is not true. A recent study found that 40% of dogs aged between 8 months and 4 years had radiographic signs of osteoarthritis in at least one joint and 24% were also experiencing some degree of pain.

Dogs can develop osteoarthritis as young as a few months of age. One of the biggest causes of arthritis is developmental joint abnormalities – poorly formed joints such as hip or elbow dysplasia, which are already present in affected dogs at a very young age. Unfortunately, we usually don’t identify arthritis until it is advanced, when the clinical signs become more obvious and easier for us to associate with pain. Sadly, by this time, management options are likely to be more complex and potentially less effective.

It’s important to be aware of the risk of arthritis in our pet dog population at all ages, especially in young dogs. Significant advances in veterinary medicine mean a wider range of treatment options exist, including more simple measures such as strict weight control, lifestyle adaptations, pain management through medication, joint supplements and complementary therapies, which are suitable introductions at any stage of the disease to help control pain and slow its progression. Innovative surgical intervention may also be applicable. Timely identification and intervention allow us to reduce suffering in our dogs and avoid early euthanasia for many dogs, as arthritis is a leading cause of premature euthanasia.

MYTH 2: Arthritis is inevitable
Although a large number of dogs will indeed develop arthritis, fortunately, there are many things we can do to reduce the likelihood, and slow down the progression of arthritis in affected dogs. Some breeds are more prone to arthritis than others due to genetics, excess body weight and, we suspect, challenging lifestyles which involve repetitive impact forces through their joints.

Dog in bedMYTH 3: Nothing needs to be done to help your arthritic dog until they are in pain
One of the most important interventions with a positive influence on osteoarthritis is keeping your dog lean – 4½ to 5 out of 9 on the Body Condition Score chart (https://wsava.org/wp-content/uploads/2020/01/Body-Condition-Score-Dog.pdf). Minimal body fat will not only reduce the weight being transferred through the joints, but also reduce a significant driver of inflammation resulting in discomfort within the joint. Ideal body weight throughout a dog’s lifespan has been shown to delay onset, progression and clinical signs of arthritis and can also extend their life by potentially years. This is one of the most effective interventions, and what’s great is it is free!

Your dog’s daily activities are another logical intervention. Highimpact activities such as fetch, or anything involving sudden stops, starts, turning and jumping, put significant stress on joints and may contribute to injuries. Dogs will willingly participate in these activities, not realising that pain and discomfort may come later!

Keeping an arthritic dog moving is important, and gentle, frequent movement is best. This includes walks at your dog’s pace, scent work, tracking (mantrailing) and trick training. Several short, slower walks a day are better than one long walk. Make sure distances and activities are similar each day, rather than challenging your dog beyond their capabilities with huge walks on weekends.

As arthritis progresses, so does our dogs’ vulnerability and possibility of slips and trips, causing further injuries. Simple modifications at home can reduce the chances of this. Ensuring all flooring is non-slip by using rugs will give your dog better traction, and minimise the chances of slips, trips and falls that will flare up pain and potentially progress the condition. Stairs are another possible source of injury and are best avoided through blocking with a baby gate or similar. Using a ramp to get into and out of the car will minimise the impact on joints – your dog can be trained to do this from a very young age.

Good quality sleep plays an important role in pain management, hence the quality and size of your dog’s bed is really important. It needs to be in a safe, quiet and dry place, be reasonably firm and supportive, with clear and well-defined edges, large enough for them to lie fully stretched lengthwise and not cluttered with trip hazards like blankets and toys.
Complementary therapies, such as hydrotherapy and physiotherapy, can help to minimise the impact of arthritis or even reduce the chances of your dog developing the condition. Other therapies such as acupuncture, massage and laser can also be helpful (please make sure you check the qualifications of any therapist you use).

MYTH 4: If my dog is not limping, it is not in pain; it would yelp and limp if it was in pain
The truth is, by the time a dog limps with arthritis, they are likely in significant pain. Chronic pain caused by arthritis is different from acute pain, such as that caused by touching a hot stove. Arthritic dogs will not yelp or cry; they will simply get on with their daily lives, and cope as best they can. We do the same; if your back hurts you will still do your chores and pick the kids up from school!

Dogs show pain through changes in their behaviour, movement, posture and body shape. Constant pain can be tiring and signs include being reluctant to go for or slowing down during walks, hesitating when jumping onto or off furniture or the car, reluctance to walk on tiled or slippery floors, sleeping more, licking their joints, panting, becoming less tolerant of handling, becoming reactive to dogs or people, developing noise sensitivities, or altered gait or posture. A change in coat pattern or muscle tone can also indicate physical changes that relate to an underlying painful condition. Often the disappearance or reduction of previously normal behaviours, such as greeting you at the door or jumping onto the sofa, can indicate pain.

Dog at the vetsMYTH 5: Pain relief should only be used as a last option, due to the potential risk of adverse events
Experiencing pain when using a joint leads to the limb being used less. This will change the way the dog moves, which will cause physical changes, reduced function and more pain over time.

If pain is not sufficiently managed in a timely manner, your dog’s long term capabilities will decrease, pain will amplify and they will become more sensitive to pain – a phenomenon called central sensitisation. The longer an animal has been living with pain, the harder it is to control, requiring higher doses, complicated dosing regimes and multiple medications. It is therefore advisable to start pain relief as soon as you notice signs of discomfort in your dog, in order to prevent deterioration and potentially reduce your reliance on medication later. Monitoring your dog’s signs of pain is the best way to give them the amount of medication they need.

MYTH 6: Anti-inflammatories are the only medication used to treat arthritis, and once they are no longer effective there is nothing else that can be done for your dog
Anti-inflammatories are well evidenced and are generally safe and effective in controlling arthritic pain. However, many other medications are also available to help manage pain and using several medications together is often required. Bear in mind that arthritis is a progressive disease that can wax and wane. It’s not that medications ‘stop working’, but more likely the condition has worsened or a flare up is occurring, which best responds to additional medications or interventions. The ‘arthritis tool box’ for dogs is ever expanding. Exciting new medications are available, as are intra-articular injections, laser and shockwave therapy and surgeries. Please do not be down-hearted – your vet will be able to discuss a variety of options and can also refer you to a specialist if needed.

Dog getting into carMYTH 7: Natural remedies or supplements are the safest and best option for a dog with arthritis
Many people wish to use supplements or ‘natural’ products instead of prescription medications to manage pain, believing that ‘natural’ is safer. Whilst supplements have their place in a management plan, especially early in the course of the disease when we aim to support joint health, the supplements industry is huge and unregulated, with few clinical trials. Most supplements lack evidence of effectiveness, so if choosing to use a supplement, ensure that you know what evidence supports their use and that they are produced by a reputable manufacturer.

In contrast, medications must go through rigorous trials and tests to prove their safety and benefit, whereas supplements can go straight to market. Please don’t rely on supplements to replace pain relieving medications. If your dog is in pain, please talk to your vet about using evidence-based prescription medications.

Remember… Arthritis is a significant welfare concern in pets. Identifying the signs earlier, actioning effective plans tailored to the individual dog, and adapting them as required is our best advice. It is not the end of the road, it’s just the start of a new direction! Keep your pet happy and healthy.

For more information on identification and evidence-based management of arthritis, visit www.caninearthritis.co.uk and seek guidance from the International Veterinary Association of Pain Management – Advocating for Best Practices in the Prevention, Detection and Management of Pain in Animals: www.ivapm.org.

This article was commissioned by the British Small Animal Veterinary Association (BSAVA). BSAVA PetSavers have produced the Ageing Canine Toolkit, a useful guide for owners of ageing dogs, which includes a check list that you can complete and take to your vet for discussion on managing your dog’s needs: tinyURL.com/BSAVAPetSaversACT The purpose of the British Small Animal Veterinary Association is to drive excellence in veterinary practice to improve the health and welfare of small animals. www.bsava.com

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