Arthritis

This is a disease that strikes fear into a lot of pet owners, believing “arthritis” to be a severe and debilitating problem once diagnosed. Although this can certainly be the case in some individuals, arthritis is often only a mild to moderate ongoing problem. The reality is that all of us suffer from arthritis as we age, humans and cats and dogs. That's a large part of the reason we all “slow down”. In any individual, the developing arthritis may be more or less severe, more or less rapidly progressing.

There are some breeds, and some types of arthritis that are more likely to cause greater problems. For instance, hip dysplasia in many types of animals is a genetic pre-disposition that leads to a more severe type of arthritis at an earlier age.

The take home message on arthritis is to look for early signs, initiate preventative regimes as early as possible and tailor an individual treatment regime to each particular individual.

There are 2 main ways to treat arthritis when signs develop.

1)Anti-inflammatories: These are pain killers, similar to us taking aspirin. These are fantastic at reducing pain and making the pets life much happier. However, they merely “mask” the signs of arthritis, ie: pain, but don't actually treat the disease. The progressive nature of the developing arthritis continues. Also, the effects of continual use of anti-inflammatories can be detrimental to the liver and kidneys and intestines long term.

2)Chondro-protective agents: By chondroprotective agents we mean treatments that actually lubricate the affected joint, smooth the cartilage surface and decrease the progression of arthritis.

Of the above 2 treatment options, obviously the second is far greater than the first. Certainly, some pets are in significant discomfort, despite the use of various chondro-protective agents, and are good candidates to use anti-inflammatories long term if this makes their life much happier. However the real trick to preventing arthritis actually getting to this stage is to use the various chondro-protective agents available to us early in the course of disease so as to hopefully never have to resort to needing long term anti-inflammatories.

SIGNS OF ARTHRITIS

The first signs of arthritis are usually very subtle. This is in fact the best time to start using protective agents. The biggest mistake people make is delaying protective treatment because the signs their pet are showing are subtle and just put down to “old age” and natural “slowing”. If your pet shows the following signs then consideration to diagnosis and treatment is warranted:

• Taking just a little longer to get up after resting
• Not “lasting” quite as long on their walks
• Not jumping onto the couch or into the car as easily as they used to
• A little “proppy” for just a few steps after getting up.

These are the sort of subtle signs to look out for. Obviously, as the disease progresses, these signs become more obvious and worsen in severity.

TREATMENT OF THESE FIRST SIGNS OF ARTHRITIS

Ideally we sedate and xray the patient to get a better idea on the state of the joints. It's amazing how often we have only very subtle clinical signs, yet xrays reveal quite significant damage already. If xrays don't reveal significant damage then we tailor more conservative preventative regime than if we see more severe signs. Hence the great advantage of radiology is that if arthritis is more severe than the clinical signs are suggesting, tailoring a more aggressive preventative regime at this stage, rather than when the patient is struggling more, will give us a greater chance of a longer life without the need for anti-inflammatories.

The mainstay of the chondroprotective agents at our disposal are the following, in order of what is most likely to help to what is least likely to help:

• Cartrophen course. This is a series of 4 injections given 1 week apart. In our experience about 80% of dogs respond well. About 10% have a subtle response and about 10% don't seem to have much response at all. This treatment has by far the greatest chance giving a good response and protecting the joints.
  
  
• Glucosamine and chondroiten preparations for animals: There are a huge number of preparations in this field. You may be familiar with products such as “sasha's blend” which advertises very well. In our opinion some are more likely to help than others, but all may or may not help to some extent.
  
  
• Glucosamine and chondroiten prepartions for humans: Again, there are a large number of products out there, many from the chemist. I'm certainly not against “trialling” them with our pets. Some patients do seem to improve on them and they're worth trying if there hasn't been great success with the above.
  
  
• Hills joint formula food. Although sceptical when Hills first bought out their “joint formula”, I have been pleasantly surprised at how many dogs have had a good response when switching to this food and is certainly worth considering for pet owners preferring commercial foods over natural diets. Ironically, our theory is that a lifetime of commercial foods may have exaccerbated the condition in the first place!
  
  
• Fish oils: Again a large number of preparations all of which may or may not help a little.

HOW DO I KNOW WHAT TO USE?

A great question. Here is our advice. Firstly get some x-rays done so we know exactly what we are dealing with. Then we will tailor a program specific for your pet:

• Start with the top of the list and work down
• Never use 2 products at the same time, as we won't know which one is working and which isn't
• Trial each different product for at least 6 weeks before deciding how effective or otherwise it is. Then consider either changing to a different product if there was no effect, or adding another if there was a moderate effect.
• If a product gives a great effect, there's probably no reason to try other things, stick to that until such time as the condition may be worsening.
• Depending on xray results, decide on frequency and types of future treatments.

ANTI-INFLAMMATORIES

As stated previously, these give great pain relief and clients often come rushing in wanting more of these because the dog was getting around so well. Our preference is to hold off these unless needed if the above options are not giving a great result. If we do recommend them, the following are our guide lines:

• For older patients, a blood test first to monitor liver and kidney health is warranted as these can be potentially damaged if on long term anti-inflammatories.
• After an initial 3-4 week course we would recommend reducing the dose down to the minimum that gives us continued good results. We recommend this for 2 reasons. Firstly because it is a lot healthier to use the minimum dose that is effective (liver and kidney damage). Secondly, it's a lot cheaper for you!
• If a particular anti-inflammatory does not give a great result, there are others worth trying.