“Pain is not just about how it feels but how it makes you feel” (Source: J Reid)
Did you know that 80% of dogs over 8 years old have arthritis? (Source: Canine Arthritis Management)
I decided to write this as I have heard from two friends this week whose dogs (Labradors one aged 6 and one aged 7) have received a diagnosis of arthritis which has been so upsetting for them both but there is so much we can do to help our dogs continue to live a good life. This is just an overview and in no way meant to replace veterinary advice but I hope you find it helpful.
Arthritis is often hard to diagnose or slow to be diagnosed. This is no criticism of vets or owners. There are several reasons for this including:
It is an insidious disease
Dogs are stoical
Arthritis waxes and wanes
Symptoms can be very mild to begin with as well as intermittent or indicative of something else. Symptoms can include: -
Slowing down a little
Less keen to go on walks
Less tolerant of other dogs
Sleeping more
Lameness
Not settling at night
Struggling to lie down or sit
Hesitant jumping into or off something
Spending more time alone
Changes in muscle mass
Unable to stretch fully
Unable to shake fully
Not wagging their tail fully
Licking paws
Sensitive when touched
Arthritis (sometimes referred to as osteoarthritis or degenerative joint disease) is often considered an older dog disease however 80% of dogs over eight years old and 20% of dogs over the age of one suffer from arthritis. It is estimated that 35% of all dogs in the UK have arthritis and it is one of the commonest causes of elective euthanasia. 24.5% of Labradors are euthanised due to musculoskeletal disorders.
Arthritis can be classified as normal forces on abnormal joints or abnormal forces on normal joints.
The cause can be primary – wear and tear – or secondary to diseases such as hip dysplasia; as a result of a trauma/surgery or from inappropriate use.
There is no cure but progression can be slowed with therapies and lifestyle/environment adaptations and pain can be effectively managed so a diagnosis of arthritis does not have to mean the end of your dog’s working life or a life led in pain, there are many ways to help your dog and a multi-modal approach delivers the best results.
A multimodal approach is the gold standard for the treatment of arthritis and this requires the veterinary team, the owner and therapists working together. As arthritis is a disease that waxes and wanes the effectiveness of treatments and medications may change as the disease goes through its natural cycle.
MEDICATION
Pharmaceutical treatment options include analgesics and injections to provide pain relief and reduce inflammation.
NSAIDs (non-steroidal anti-inflammatory) are commonly prescribed analgesics and whilst not suitable for dogs with kidney, liver or gastrointestinal issues are very effective in managing pain and inflammation for many dogs.
NSAIDs block the effects of special enzymes -- specifically Cox-1 and Cox-2 enzymes. Pain signals are electrical messages sent from the nerves to the brain telling the body that something hurts. Pain levels are increased by prostaglandins. Prostaglandins are released by damaged tissue and cox enzymes play key role in the production of prostaglandins. By blocking the cox enzymes, NSAIDs stop the body making as many prostaglandins resulting in less inflammation and less pain.
Librela is the new injectable for relief of pain caused by arthritis having been on the market since March 2021. Librela works by blocking the pain signals and it is an antibody rather than a drug. Librela is administered monthly and this is also a great opportunity for the vet to monitor and assess the dog on a regular basis.
Dogs with severe arthritis may well receive injectables and NSAIDs and other forms of pain relief such as paracetamol (or the veterinary version Pardale V). Paracetamol offers pain relief but does not reduce inflammation.
There is some evidence that supplements such as Yu Move improve mobility and joint health however not many studies have been done and the market is unregulated unlike the pharmaceutical market.
I am not a vet so this is just an overview of some of the medications available – your vet will advise on the best treatment options for your dog.
WEIGHT LOSS
One thing everyone agrees upon is that weight loss is one of the best things we can do for our arthritic dogs. Overweight dogs will be putting extra stress on already painful joints and, in addition, fat is known to increase inflammation in joints. In some cases, dogs that have lost weight have been able to stop pain relief medication (only stop medication on the advice of your vet).
It is harder to manage weight when the dog is less mobile but there are lower calorie foods available, reducing snacks (however sad those eyes are!) and shorter but more frequent walks can all help. Hydrotherapy is a great way to exercise a dog whilst reducing impact on painful joints.
THERAPIES
How can a physical therapist help?
They use the tools available to them to help slow the progression of the disease by maintaining or improving the dog’s mobility and retaining/rebuilding as much muscle mass as possible; restore movement and function or maintain and improve mobility (dependent on the stage of the disease); they can help prevent compensatory issues building / treat compensatory issues; reduce pain levels
Tools they may use include:
Hydrotherapy, if this is an option as not everyone has a centre nearby, to maintain mobility and muscle mass. Hydrotherapy also allows the dog to move with reduced pressure on their limbs encouraging placement of all four limbs and improved range of motion. Hydrotherapy is a great way to aid weight loss.
Massage and myofascial release to treat compensatory issues which are a major cause of pain and mobility issues in an arthritic dog.
Exercises to build core and postural supportive muscles and aid proprioception. Proprioception is the body’s ability to sense movement, action and location. Proprioception is one of the first things lost with diseases such as arthritis and loss of proprioception will mean the dog does not have as much awareness of the location of their limbs leading to stumbling, loss of traction, paw knuckling all of which will aggravate already painful joints, strain muscles and disrupt fascia so good proprioception is important.
Functional exercises including passive range of motion exercises which aid proprioception; aid mobility by “reminding” the joint of its capabilities and gently encourage the dog to use it (as arthritis waxes and wanes there will be times when the dog has good mobility but the joint maybe locked down by the body’s protective mechanisms); replication of joint movement is thought to encourage the formation of synovial fluid which can help prevent cartilage erosion caused by arthritis.
ANYTHING ELSE?
There are several small and low-cost changes that will positively impact your dog’s quality of life such as using a ramp for the car, reducing stair usage, putting non-slip mats on hard flooring.
Pain scores charts- we often don’t notice changes in our own dog but completing a pain scale will help identify changes in behaviour, coat, posture, mood, sleep patterns etc.
A Good Day / Bad Day Diary (link here) are useful to take to your vet consult as it’s easy to forget when they’ve had good or bad days.
Monthly photographs will highlight any postural changes and coat changes both good and bad and are a very useful aid for your therapist.
Videos – this allows your vet and to see the dog moving which they can’t always do in the clinic and also the dog may be having a good day that day so this allows the vet to see them on a bad day.
As well as your vet, vet nurse and therapist, Canine Arthritis Management is an excellent resource: -
If you would like to learn more about how I can help then please do book a Discovery Call here.
If you have any concerns regarding your dog’s health, please contact your vet.
References
CAM Advocate Course
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