Arthritis

 

It can be an all too familiar sight that as our pets get old, they get a bit stiff and slow down and we often put this down to ‘arthritis’ – but what do we actually mean by this?

There are many different types of ‘arthritis’, but the most common is osteoarthritis (OA), also known as degenerative joint disease (DJD). The cartilage, which covers the bones at the joint, degenerates and allows cracks to form, and new irregular bone can form. This prevents smooth motion of the joint and causes a lot of pain during movement.

The typical signs include:

  • Stiffness, slowing down
  • Reluctant to climb stairs, jump onto chairs, into the car etc.
  • Not as keen on going for walks as previously
  • Limping for a few days after vigorous/lengthy activity

These signs are often worst after strenuous exercise or first thing in the morning, but may improve after mild exercise.

 

WHAT CAUSES IT?

OA can be caused by various factors, e.g.

  • Old age/wear and tear
  • Previous injury e.g. fracture repair, cruciate ligament injury, joint surgery

 

HOW CAN WE DIAGNOSE IT?

The history is very important and can give clues. Physical examination can also show signs such as swollen joints, limited range of movement, extra fluid accumulation on the joint, ‘crepitus’ (grating noise or clicking on movement).We may also need to take radiographs (x-rays) to confirm OA. Typical changes include new bone formation, irregular bone, swollen joint etc. Radiographs need sedation or general anaesthesia to be taken safely and accurately. Occasionally, we may need to take a sample of joint fluid, using a needle, and send this off to a laboratory to check for any signs of OA.

 

HOW CAN IT BE TREATED?

There are varying ways in which OA can be treated and no two animals will respond the same. We may, therefore, need to try several treatments until we find the most suitable one for your pet. We may also need to use two or more treatments concurrently.

  • DIET – it is important that your pet is not overweight, as this will overload and cause more pain in the joints.
  • EXERCISE – the rule is little and often. 10 minutes of gentle exercise 3 or 4 times a day is much better than one longer period of exercise.
  • HEAT – a hot compress over the joints often helps reduce pain and swelling in acute flare ups of OA
  • SWIMMING is an excellent form of exercise, as it encourages muscle use and joint movement without weight bearing. Alternatively, walking on soft surfaces e.g. sand, grass is better than on hard surfaces.
  • PAINKILLERS – We normally prescribe Non-Steroidal Anti-inflammatory Drugs (NSAIDs), to reduce joint pain and any inflammation. These are often very effective and may appear to give a new lease of life. However, it is important to understand that they are only relieving the signs and not curing the underlying problems. They may be given on a permanent, temporary or as needed basis.

WE DO NOT RECOMMEND THE USE OF HUMAN PAINKILLERS AS THEY CAN BE FATAL TO PETS  

  • INJECTIONS – There is an injection (only available for dogs) which helps to produce glycosaminoglycans, the building blocks of cartilage. It also destroys enzymes involved in breaking down cartilage. It is given as a course of injections 7 days apart from each other. It should not be given at the same time as NSAIDs. A course of injections may last for several months before it needs repeating.
  • NEUTRACEUTICALS – Cartilage requires the presence of various compounds to enable it to grow and maintain its shape; by supplementing the diet with these, we can help to restore normal cartilage and actually repair the damage (as long as the damage is not too severe). The main compounds are Chondroitin Sulphate and Glucosamine. Pets may need to be on these for life, although it can take 4-6 weeks of treatment before seeing any improvement.
  • SURGERY – This is normally only carried out as a last resort and tends to be used only where a specific joint is affected.

Options include:

  • ARTHODESIS – this involves fusing two or more bones together with bone plates and screws or pins and screws so that there is no longer a joint present. This reduces pain and although quite a complex operation, is often very successful. Most commonly, the hock (ankle) or carpus (wrist) joints are done, but other joints can be treated.
  • JOINT REMOVAL – A simpler option, used in the shoulder or hip joint where part of the bone is removed and a false joint allowed to form.
  • JOINT REPLACEMENT – Total hip replacement can be done in certain cases, although this is a specialist procedure needing referral to an orthopaedic specialist.

 

WHAT ELSE COULD IT BE?

Not all cases of stiffness/lameness are caused by OA, other possibilities include:

  • Septic arthritis, where infection gets into the joint. This needs antibiotics and surgery to flush out the joint
  • Rheumatoid arthritis, where the body starts attacking its own joints. This fortunately is not a common diagnosis in dogs and cats.
  • Sprains, strains, muscle tears etc.
  • Fractures of the bone at the joint

WHAT ABOUT LONG TERM?

Although OA can be a progressive disease getting worse with age, in most cases we can help them to live a long and happy life. They may not always run around like a puppy but they are often much happier after starting treatment.

  • A final warning – long-term tablets and injections can be costly – so we advise you to consider pet insurance BEFORE your pet develops osteoarthritis!
  • Factors such as exercise and weight control are very important in controlling the problem.

If you have any questions about whether your pet may be affected by OA or you want to discuss treatment/management options, please contact the clinic for a consultation with one of our vets.