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| Pet Information |
| Pet Information |
Arthritis
By Dr. Karen Thomas
A moveable joint at the intersection of two or more bones is held together by a joint capsule and ligaments. It
is cushioned by cartilage on the bone ends and lubricated by joint fluids. Arthritis occurs when any of these
components break down. Although old age wear and tear is probably the most common cause, there are
many others. Infectious causes include bacteria which reach the joints by way of bite wounds or other
punctures and those that arrive by way of the blood such as Borrelia (Lymes Disease) and “joint ill” from the
umbilicus in new born puppies, kittens and foals. Fungal infections may also be seen in joints. Immune
mediated joint disease such as rhematoid arthritis is uncommon but is the first diagnosis considered when
multiple joints are suddenly affected by swelling and pain.
Some veterinarians consider Lymes arthritis to be an immune mediated after effect of Borrelia infection as
opposed to being caused by the infection itself. Ruptured cruciate ligament of the knee is a common injury in
middle aged overweight dogs. Because it occurs with minimal trauma in dogs, investigations are underway
to determine if there may be an immune component to this ailment. Infectious and immune mediated joint
disorders are suggested by the presence of fever, swelling in one or more joints, and severe lameness or
reluctance to move. The diagnosis is based on blood tests, xrays, and laboratory examination of joint fluid. In
rare cases a biopsy may be necessary. Appropriate treatment—antibiotics or steroids--may cure or control
these conditions but unless diagnosis and treatment happen early there may be permanent joint damage and
arthritis later in life. Any moveable joint can be affected by traumatic dislocation, but the hip is the most
frequently involved. Sometimes dislocations can be replaced under anesthesia by simple manipulation, but
often surgery is needed to reduce luxations, and pins or screws may have to be used to hold the joint
together.
Surgery is also a treatment option for some joints which develop improperly during growth. Once again the
hip is the joint most likely to be affected. But besides hip dysplasia, there are a number of other congenital or
developmental joint disorders. Lack of fusion of growth centers in elbows causes an ununited anconeal
process or fragmented coronoid processes called “elbow dysplasia”. Uneven bone growth called
osteochondritis dessicans (OCD) occurs most often in the shoulders but may be seen in many other joints. It
can lead to broken off pieces of cartilage which calcify in the joint. These joint “mice” feel to the dog like a
rock in your shoe. A circulatory disorder in the hip of toy dogs causes severe hip deformation called Legge-
Perthes syndrome. The knee joint is very complex with three major bones—the femur, tibia, and fibula; and
three minor bones—two fabellae and the patella. Growth deformities, especially related to displaced or
dislocating patellas, are common.
Since early detection and treatment of joint disorders delays progression of arthritis and prevents a great
deal of discomfort it is important to ask your veterinarian about the appropriate time to evaluate your puppy
for joint disease. Palpation and/or xrays can detect problems before lameness begins. Persistent or
recurrent limping, an unusual gait or poor muscle development in young growing dogs should be
investigated. If early arthritis or its predisposition can be detected there are several things that can be done.
Whenever possible, surgical correction of the defect should be performed.
Cost on these operations ranges from several hundred to a few thousand dollars depending on the type of
operation. There are several different types of operations available for hip dysplasia and knee deformities.
Most should be performed by a specialist or at a university but some may be performed by a general
practice veterinarian. Such surgery on a 4-8 month old dog can buy years of pain free existence.
If surgery is not an option, keeping the dog thin and providing daily exercise are very helpful. Exercise
should be walking or swimming daily, not chasing a frisbee on weekends and being a couch potato all
week. (Does this sound like advice our doctors give us?)
Chondroprotective agents (chondro=cartilage) can be used lifelong. These include adequan, an injectable
drug given once a month, and glucosamine with or without chondroitin. Glucosamines are oral
“neutraceuticals” sold as food supplements, not FDA approved drugs. Their usefulness has been shown by
years of experience as opposed to controlled drug trials. Because there are many brands and their
production is not regulated, it is important to check with a veterinarian to make sure you get one with the
proper strength, dose and purity.
Chondroprotectives strengthen and heal cartilage and improve the lubricating ability of the joint fluid. They
can be used even in cases where arthritis is quite advanced but for improvement to occur they should be
given in high doses for a short induction period followed by a lower maintenance dose.
Another option for more advanced cases is non steroidal anti inflammatory drugs (NSAIDS). This family
includes aspirin, phenylbutazone (a horse medication), and ibuprophen. The two NSAIDS which are
approved for dogs at this time are Rimadyla and Etogesica. Unlike human drugs, they have been shown to
be generally safe when given over a long period of time, and their direct pain relieving effects make them
especially useful for more immediate relief. Your veterinarian may advise periodic monitoring for signs of
stomach ulcers or liver disease as these may occur in very rare cases with these drugs.
Accupuncture has been used to relieve chronic arthritic pain, but it should be performed only by someone
trained and experienced in its use. There are other supplements such as super oxide dismutase, a free
radical scavenger, which may be of use in selected cases.
A special note to cat owners. Although cats are less likely to develop arthritis than dogs, bite wounds and
other traumatic joint injuries do occur. Both hip dysplasia and knee cap luxations have also been seen in
cats. In addition, cats are now living longer, and are more inclined to be overweight, so we can expect to
see an increase in arthritis in senior cats.
There are currently no NSAIDS which are safe for use in cats. Neither tylenol (acetaminophen), nor aspirin
nor either of the new dog NSAIDS should be used for arthritis in cats. The chondroprotectives are safe in
cats but there is less data to demonstrate effectiveness. The simple application of heat by way of heating
pads or hot compresses can temporarily relieve discomfort.
If you know your pet is arthritic, do not assume that it doesn’t hurt if it is not limping. The gradual onset of
arthritis pain accustoms the pet to higher and higher levels of discomfort. If two or more legs are equally bad
it is impossible to limp on one leg without making another leg hurt worse. Look for general stiffness,
reluctance to use stairs, lameness that improves as the animal moves around, and muscle atrophy. Many
owners of older pets are pleasantly surprised at how much more active the pet becomes when arthritis
treatment is begun.
By Dr. Karen Thomas
A moveable joint at the intersection of two or more bones is held together by a joint capsule and ligaments. It
is cushioned by cartilage on the bone ends and lubricated by joint fluids. Arthritis occurs when any of these
components break down. Although old age wear and tear is probably the most common cause, there are
many others. Infectious causes include bacteria which reach the joints by way of bite wounds or other
punctures and those that arrive by way of the blood such as Borrelia (Lymes Disease) and “joint ill” from the
umbilicus in new born puppies, kittens and foals. Fungal infections may also be seen in joints. Immune
mediated joint disease such as rhematoid arthritis is uncommon but is the first diagnosis considered when
multiple joints are suddenly affected by swelling and pain.
Some veterinarians consider Lymes arthritis to be an immune mediated after effect of Borrelia infection as
opposed to being caused by the infection itself. Ruptured cruciate ligament of the knee is a common injury in
middle aged overweight dogs. Because it occurs with minimal trauma in dogs, investigations are underway
to determine if there may be an immune component to this ailment. Infectious and immune mediated joint
disorders are suggested by the presence of fever, swelling in one or more joints, and severe lameness or
reluctance to move. The diagnosis is based on blood tests, xrays, and laboratory examination of joint fluid. In
rare cases a biopsy may be necessary. Appropriate treatment—antibiotics or steroids--may cure or control
these conditions but unless diagnosis and treatment happen early there may be permanent joint damage and
arthritis later in life. Any moveable joint can be affected by traumatic dislocation, but the hip is the most
frequently involved. Sometimes dislocations can be replaced under anesthesia by simple manipulation, but
often surgery is needed to reduce luxations, and pins or screws may have to be used to hold the joint
together.
Surgery is also a treatment option for some joints which develop improperly during growth. Once again the
hip is the joint most likely to be affected. But besides hip dysplasia, there are a number of other congenital or
developmental joint disorders. Lack of fusion of growth centers in elbows causes an ununited anconeal
process or fragmented coronoid processes called “elbow dysplasia”. Uneven bone growth called
osteochondritis dessicans (OCD) occurs most often in the shoulders but may be seen in many other joints. It
can lead to broken off pieces of cartilage which calcify in the joint. These joint “mice” feel to the dog like a
rock in your shoe. A circulatory disorder in the hip of toy dogs causes severe hip deformation called Legge-
Perthes syndrome. The knee joint is very complex with three major bones—the femur, tibia, and fibula; and
three minor bones—two fabellae and the patella. Growth deformities, especially related to displaced or
dislocating patellas, are common.
Since early detection and treatment of joint disorders delays progression of arthritis and prevents a great
deal of discomfort it is important to ask your veterinarian about the appropriate time to evaluate your puppy
for joint disease. Palpation and/or xrays can detect problems before lameness begins. Persistent or
recurrent limping, an unusual gait or poor muscle development in young growing dogs should be
investigated. If early arthritis or its predisposition can be detected there are several things that can be done.
Whenever possible, surgical correction of the defect should be performed.
Cost on these operations ranges from several hundred to a few thousand dollars depending on the type of
operation. There are several different types of operations available for hip dysplasia and knee deformities.
Most should be performed by a specialist or at a university but some may be performed by a general
practice veterinarian. Such surgery on a 4-8 month old dog can buy years of pain free existence.
If surgery is not an option, keeping the dog thin and providing daily exercise are very helpful. Exercise
should be walking or swimming daily, not chasing a frisbee on weekends and being a couch potato all
week. (Does this sound like advice our doctors give us?)
Chondroprotective agents (chondro=cartilage) can be used lifelong. These include adequan, an injectable
drug given once a month, and glucosamine with or without chondroitin. Glucosamines are oral
“neutraceuticals” sold as food supplements, not FDA approved drugs. Their usefulness has been shown by
years of experience as opposed to controlled drug trials. Because there are many brands and their
production is not regulated, it is important to check with a veterinarian to make sure you get one with the
proper strength, dose and purity.
Chondroprotectives strengthen and heal cartilage and improve the lubricating ability of the joint fluid. They
can be used even in cases where arthritis is quite advanced but for improvement to occur they should be
given in high doses for a short induction period followed by a lower maintenance dose.
Another option for more advanced cases is non steroidal anti inflammatory drugs (NSAIDS). This family
includes aspirin, phenylbutazone (a horse medication), and ibuprophen. The two NSAIDS which are
approved for dogs at this time are Rimadyla and Etogesica. Unlike human drugs, they have been shown to
be generally safe when given over a long period of time, and their direct pain relieving effects make them
especially useful for more immediate relief. Your veterinarian may advise periodic monitoring for signs of
stomach ulcers or liver disease as these may occur in very rare cases with these drugs.
Accupuncture has been used to relieve chronic arthritic pain, but it should be performed only by someone
trained and experienced in its use. There are other supplements such as super oxide dismutase, a free
radical scavenger, which may be of use in selected cases.
A special note to cat owners. Although cats are less likely to develop arthritis than dogs, bite wounds and
other traumatic joint injuries do occur. Both hip dysplasia and knee cap luxations have also been seen in
cats. In addition, cats are now living longer, and are more inclined to be overweight, so we can expect to
see an increase in arthritis in senior cats.
There are currently no NSAIDS which are safe for use in cats. Neither tylenol (acetaminophen), nor aspirin
nor either of the new dog NSAIDS should be used for arthritis in cats. The chondroprotectives are safe in
cats but there is less data to demonstrate effectiveness. The simple application of heat by way of heating
pads or hot compresses can temporarily relieve discomfort.
If you know your pet is arthritic, do not assume that it doesn’t hurt if it is not limping. The gradual onset of
arthritis pain accustoms the pet to higher and higher levels of discomfort. If two or more legs are equally bad
it is impossible to limp on one leg without making another leg hurt worse. Look for general stiffness,
reluctance to use stairs, lameness that improves as the animal moves around, and muscle atrophy. Many
owners of older pets are pleasantly surprised at how much more active the pet becomes when arthritis
treatment is begun.
| -ARTHRITIS- PROBLEMS |
 | |  | |  |
