Osteoarthritis or degenerative joint disease is the most common reason for chronic pain in dogs. It is a progressive, self-perpetuating process that involves degradation of the entire joint. The condition itself is the result of long-term stresses on a joint, either as a result of an old injury or of a poorly conformed joint in that individual.
Lameness and a stiff gait after rest are also signs of the disease, but it may improve with activity. Sometimes symptoms may be vague and mistaken for normal aging. The diagnosis of chronic osteoarthritis is primarily based on radiographic (x-ray) changes.
While it is not possible to cure osteoarthritis there are therapies to alleviate discomfort, minimize further changes, and restore function of the affected joint(s).
The most important treatment in overweight pets with osteoarthritis is weight loss. Excessive weight increases stress on joints and muscles and adipose tissue (fat) can cause the development of osteoarthrosis. Medical therapy will vary depending on the severity and location of the osteoarthritis. A multi-modal treatment (two or more different types) approach is the most effective and best started prior to development of chronic pain. Once chronic pain is established, medical therapy is generally not as effective.
Similarly, pharmaceuticals should be given regularly and not “as needed” after the pain worsens. In most patients, the use of a non-steroid anti-inflammatory drug (NSAID) is indicated. They control pain and inflammation, increasing mobility.
A newer drug called grapiprant (Galliprant®) does not inhibit the COX enzymes but works by blocking the inflammation and pain-producing prostaglandin receptors. Gabapentin, a pain relief drug, is generally very effective combined with an NSAID or sometimes used alone in mild cases. It is generally started at a low dose and the dosage gradually increased. It may not be helpful in patients until a high dosage is reached. The medication is safe for long-term use.
Bedinvetmab (Librela™) is an anti-nerve growth antibody that has been developed specifically for use in dogs with osteoarthritis. Nerve growth factor is a key driver in osteoarthritis pain. The antibody binds to nerve growth factor, making it inactive, and mobility and comfort increase.
Adequan® is an injectable glycosaminoglycan. Implementing the medication at an early stage is most effective. Many clients report significant improvement in mobility. Fish oil (Omega-3 fatty acids) has been found to have anti-inflammatory properties. For those patients that are not responsive to previously reviewed medications, there are regenerative agents that can be injected into the affected joint(s). Platelet rich plasma has growth factors and anti-inflammatory cytokines that are beneficial with osteoarthritis.
Another regenerative therapy is stem cell therapy where the patient’s fat is harvested and processed into a product that is injected into the joint. While both have been shown to have good effectiveness, they are more invasive modes of therapy. Lastly, injecting corticosteroids usually along with hyaluronic acid (a natural component of cartilage) into the joint has been used for many years with variable effectiveness.
Lifestyle changes are also beneficial. Regular moderate exercise including leash walking and swimming reduces inflammation and maintains good muscle strength to stabilize joints. Passive range of motion exercises, massage and hydrotherapy with an underwater treadmill or deep-water therapy are all valuable. A warm, well padded, e.g. orthopedic foam bed area to sleep is also important. Weight loss is most important, but if needed, exercise in moderation and pharmaceuticals with fish oil supplementation can help. Your veterinarian can help with catching early signs of this disease and
guiding you with preventive treatment and therapies to delay progression of arthritis. If needed, medications can relieve the debilitating pain associated with osteoarthritis.
Dr. Kenton Taylor is a veterinarian with Miramonte Veterinary Hospital, 1766 Miramonte Ave., Mountain View. For more information, call (650) 962-8338 or visit miramontevet.com.
