Blog by Dr. Tim Julien
Is your once peppy puppy slowing down? Does your four-legged buddy, Fuzzybritches McPeppertooth, need a little more time to be up an at’em? Does Colonel Claws von Stauffenberg spend less time jumping and more time hiding? Those may be subtle signs that your pet is quietly enduring painful arthritis. Studies have shown that 20% of dogs over 1 year of age suffer from arthritis, which is the #1 cause of chronic pain in dogs. An even bigger surprise, for most people, is that 90% of cats over 12 years of age have evidence of arthritis. “But Doc,” you say, “I have ten old cats and nine of them don’t seem to be in pain!” Exactly; that’s why I’m writing this blog.
Dogs and (especially) cats are really good at hiding discomfort. We often diagnosis arthritis only after it has become obvious, when Abner Doubledoodle is actively limping or having trouble getting up and around. Arthritis in dogs and cats, however, is a progressive and uncomfortable disease that starts well before our brave and stoic pets make it obvious to us. In fact, arthritis in dogs usually results from a joint that was not the right shape (and therefore didn’t fit together exactly correctly) from birth. This incongruence leads to joint inflammation, destruction of cartilage (the cushion between the ends of bones), and irregular proliferation of bone in the joint. This ends in the painful result of bone hitting bone when the affected joint tries to move.
Arthritis is a progressive disease (meaning it will get worse with time) and while it is often not a disease we can cure; it is absolutely a disease we can manage. Not surprisingly, we can do a much better job for much longer if we start coping with the disease when it is in the early stages (before it becomes excruciating for Captain Jack Barkypants to walk). It is really important to realize that arthritis is not strictly an old dog or senior cat disease. “So what are the signs that Sir Percival B. Savage might have early arthritis?” I am so glad you asked!
For dogs, the signs that would make us suspicious of arthritis include: increased stiffness/needing to stretch after a long rest, decreased willingness to go on walks/exercise, a reluctance to jump in the car or up on the couch, increased panting during or after walks/exercise, sleeping more/general decrease in activity, and an increased reluctance to being petted in certain areas of the body (often near the tail or on the shoulders). With time, these subtle signs progress to more overt signs of pain such as: limping, groaning/long sighs when getting up or down, irritability when petted or during play, decrease in appetite, obsessively licking the skin above an affected joint (often causing sores), and (in some cases) yelping in pain when the affected joint is manipulated.
Cats, being the mysterious mavericks that they are, are masters of hiding signs of discomfort. It can be difficult to appreciate when one of our feline buddies is hurting. I have had clients tell me that they can have meaningful reciprocal conversations with their cats (right down to which treatments their cats would prefer…), but most cats that I know refuse to answer even the most direct of questions; we often have to act on a suspicion of pain in cats. Signs that might guide us in that suspicion include: decreased willingness to jump up (you may catch some cats pulling themselves up onto the couch instead), increased hiding, increased vocalization, increased irritability (especially to being handled), altered grooming habits (especially unkempt hair on the back), and altered litter box habits.
At PAZ Veterinary, our doctors diagnose arthritis based on the presence of these clinical signs and results of a thorough physical examination. It is very often important to use radiographs (x-rays) and blood work to make sure your pet’s discomfort is arthritis (and not a different disease that may cause similar clinical signs) and to establish which medications we can safely give your pet to alleviate pain and slow the progression of the disease.
“Well Doc, all this talk about Angus von Wigglebottoms being in pain has been a huge bummer. How do we go about treating?” Again, glad you asked. That section labeled “treatment” directly below explains.
By far, the most effective treatment for slowing the progression of arthritis is making sure Spartacus Creamsicle is at an ideal weight. Even being moderately overweight can have a big impact on the pain level associated with arthritis (and how quickly clinical signs progress). Subcutaneous fat is the largest endocrine organ in the body and it ain’t pump’n out nothing but pro-inflammatory signals. This means that inflammation and pain is worse and harder to control in overweight dogs and cats. Not sure if Princess Puffington Porkchop is overweight? Come on in and ask us! We’d be happy to show you how to tell and we will work with you to get your pup back to fit and trim.
Arthritis pain is chronic and complicated. It is the result of an inflammatory process (arthritis) that will not resolve (unlike a cut or a broken bone). This means that it is often best to apply a multimodal approach (gotta attack that pain from multiple angles). I generally think about the types of treatments as being in three categories: pharmaceutical vs nutraceutical vs neither drug nor supplement
Pharmaceuticals are manufactured drugs (whose safety and efficacy have been scrutinized by the FDA) that provide the mainstay of traditional treatment for arthritis, especially early on in the course of treatment. Please don’t administer these (or any drugs for that matter) without some guidance from your friendly veterinarian. These include: Adequan (an injectable cartilage protectant), Galliprant (a targeted anti-inflammatory), NSAIDs (non-steroidal anti-inflammatory such as Rimadyl, Onsior, or Metacam. Please don’t use human NSAIDs without asking your friendly veterinarian!), Amantadine (a medication that helps other pain medications work more effectively against chronic pain), Gabapentin (an anticonvulsant which is also used to treat chronic pain), and Tramadol (pain medication).
Nutraceuticals are manufactured/standardized nutrients (whose safety and efficacy are not as scrutinized by the FDA) and can provide relief from symptoms of arthritis in conjunction, or in place of, pharmaceuticals. Examples of these include: Omega 3 fatty acids (fish oil, specifically EPA/DHA; must be given in the correct doses to be effective; often most effective for inflammation when given via a prescription diet), joint supplements (glucosamine/chondroitin sulfate, MSM), Chinese herbs (broad category of medicinal herbs used in traditional Eastern medicine), Microlactin (derived from the milk of hyper immunized cows, used as an anti-inflammatory), CBD extract/oil (hemp derived Cannabidiol, used as a non-psychoactive anti-inflammatory), and nutritional supplements (used to support the body’s general health and ensure the efficient absorption of the nutrients important in keeping joints healthy).
Neither Drug nor Supplement are those things that can be used to help control arthritis that don’t involve a needle or a pill. They include: therapeutic laser (increases blood flow and cellular activity using focused light at specific frequencies), regular and reasonable exercise (a mobile joint is a happy joint!), physical therapy (targeted exercises to increase mobility and maintain muscle mass), acupuncture (pain relief and increase blood flow), massage (soothe those achy muscles), heat/ice (stimulate blood flow), surgery (in limited cases), and most importantly WEIGHT LOSS.
Phew! If you stuck with me to the end, thanks and congratulations. I know this is a lot of information but arthritis is an important and complicated subject. The bottom line is that if Sir Leonidas Scruffle-tush III or Agent Jack Meower are showing any of the signs described above, give PAZ Veterinary a call and let us help you keep your best bud happy and bouncy for as long as possible.